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Yoshida R, Yamana H, Hayashi M, Yasuda E, Shibayama Y, Hirose Y, Tanigawa N, Uchiyama K, Kubota T. Transplantation of Graft Anti-Host Cytotoxic T Lymphocytes Along with Allogeneic Bone Marrow Skips Macrophage-Induced Graft-Versus-Host Disease. J Interferon Cytokine Res 2021; 41:310-318. [PMID: 34543129 DOI: 10.1089/jir.2021.0032] [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] [Indexed: 11/12/2022] Open
Abstract
Graft-versus-host disease (GVHD) is a physiological response of the graft to allogeneic hosts. However, the effector cells, affected organ(s), and cytokines in the GVHD remain controversially discussed, without having determined a particular cytotoxic activity of the graft against the host. After i.v. injection of C57BL/6 (H-2b) spleen cells into irradiated BDF1 (H-2b/d) mice, the hosts developed interferon-gamma (IFN-γ)-dependent bone marrow (BM) GVHD on days 5-17. When H-2DdKd transgenic H-2b lymphoma cells were i.p. inoculated into irradiated, H-2b splenocyte-transplanted H-2b/d mice, the infiltration of macrophages cytotoxic against H-2DdKd transgenic H-2b mouse skin epithelia (a GVHD activity) into the peritoneal cavity preceded several days the infiltration of interleukin (IL)-2-dependent cytotoxic T lymphocytes (CTLs) to achieve a graft-versus-leukemia (GVL) effect. In contrast, allogeneic BM transplanted alone into the irradiated mice did not induce GVHD for 44 days, whereas i.v. injection of graft anti-host macrophages or graft anti-host CTLs along with allogeneic BM, respectively, induced GVHD or promoted the GVL effect in the absence of GVHD. These results revealed that macrophage-induced GVHD and the CTL-mediated GVL effect were a set (Th1: IFN-γ/IL-2) response of the graft to allogeneic hosts and leukemia cells, respectively, and that graft T cell activation rather than inhibition skipped GVHD after BM transplantation.
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Affiliation(s)
- Ryotaro Yoshida
- Department of Physiology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.,Research Laboratory, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
| | - Hidenori Yamana
- Department of Physiology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan.,Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
| | - Michihiro Hayashi
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
| | - Emi Yasuda
- Department of Pathology, Osaka Medical College, Takatsuki, Japan
| | - Yuro Shibayama
- Department of Pathology, Osaka Medical College, Takatsuki, Japan
| | - Yoshinobu Hirose
- Department of Pathology, Osaka Medical College, Takatsuki, Japan
| | - Nobuhiko Tanigawa
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
| | - Kazuhisa Uchiyama
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
| | - Takahiro Kubota
- Department of Physiology, Osaka Medical and Pharmaceutical University, Takatsuki, Japan
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Sollmann N, Tanigawa N, Bulubas L, Ringel F, Meyer B, Krieg S. Clinical factors affecting the resting motor threshold in preoperative navigated TMS motor mapping. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.015] [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: 10/20/2022] Open
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Abstract
The diagnosis of liver tumors should be utilized for determination of not only the number of lesions, but also their size, segmental location and extent, and the relationship of the mass or masses to the hepatic vasculature. CT during arterial portography (CTAP) is the most sensitive imaging modality for precise diagnosis of hepatocellular carcinoma (1–3, 5). CTAP is thus widely used as a diagnostic imaging technique, particularly for the detection of small hepatocellular carcinomas (4, 6, 8). Conventional splenic portography has been carried out for many years using a wide diameter needle, a large amount of contrast medium and a film-screen system (7). Since the development of arterial portography, fewer splenoportograms have been performed due to the high incidence of bleeding and other complications (7). In this study a 0.6-mm (23 gauge) thin needle was used for splenic puncture and CT was used as a detector instead of a film-screen system. With this technique CT during percutaneous transsplenic portography may be performed on an outpatient basis.
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Affiliation(s)
- S. Sawada
- Department of Radiology, Tottori University Hospital, Yonago, Japan
| | - K. Nakamura
- Department of Radiology, Tottori University Hospital, Yonago, Japan
| | - N. Tanigawa
- Department of Radiology, Tottori University Hospital, Yonago, Japan
| | - M. Kobayashi
- Department of Radiology, Tottori University Hospital, Yonago, Japan
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Sawada S, Fujiwara Y, Koyama T, Kobayashi M, Tanigawa N, Iwamiya T, Katsube Y, Nakamura H, Furui S. Application of Expandable Metallic Stents to the Venous System. Acta Radiol 2016. [DOI: 10.1177/028418519203300216] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Expandable metallic stents were successfully introduced in 12 patients; 6 with superior vena cava (SVC) obstruction due to tumor invasion or lymph node metastases, 3 with inferior vena cava (IVC) obstruction or stenosis due to lymph node metastases or hepatic tumor, one with common iliac vein (CIV) obstruction due to lymph node metastases, one with idiopathic obstruction of the hepatic IVC and Budd-Chiari syndrome, and one with CIV obstruction following a dialysis shunt. The length of the lesions was between 2 and 15 cm. Multiple (2–7) stents in tandem were inserted percutaneously from a femoral venous approach through a 12 to 16 F (4.0–5.3 mm) Teflon sheath. Postoperatively, all 12 patients became free from symptoms such as SVC syndrome or IVC syndrome. In 11 patients, the symptoms did not recur during the follow-up periods of 1 to 21 months.
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Abstract
Various types of Gianturco zig-zag wire stent were implanted into the tracheas of 4 dogs to define the suitable characteristics of the endotracheal wire stent in these animals. The stents were constructed of 0.45, 0.40, and 0.33 mm stainless steel wire. The diameter of the fully expanded stents was 3 cm and their lengths were 2, 3, and 4 cm. The 2 cm stent constructed of 0.33 mm wire showed minimum pathologic changes of the trachea of the dog compared to the other stents, and at the same time had a complete covering of ciliated columnar epithelium over the stent surface.
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Affiliation(s)
- S. Sawada
- Departments of Radiology, Tottori University School of Medicine, Yonago, and Research Institute for Microbial Diseases, Osaka University, Japan
| | - Y. Tanabe
- Departments of Radiology, Tottori University School of Medicine, Yonago, and Research Institute for Microbial Diseases, Osaka University, Japan
| | - Y. Fujiwara
- Departments of Radiology, Tottori University School of Medicine, Yonago, and Research Institute for Microbial Diseases, Osaka University, Japan
| | - T. Koyama
- Departments of Radiology, Tottori University School of Medicine, Yonago, and Research Institute for Microbial Diseases, Osaka University, Japan
| | - N. Tanigawa
- Departments of Radiology, Tottori University School of Medicine, Yonago, and Research Institute for Microbial Diseases, Osaka University, Japan
| | - M. Kobayashi
- Departments of Radiology, Tottori University School of Medicine, Yonago, and Research Institute for Microbial Diseases, Osaka University, Japan
| | - Y. Katsube
- Departments of Radiology, Tottori University School of Medicine, Yonago, and Research Institute for Microbial Diseases, Osaka University, Japan
| | - H. Nakamura
- Departments of Radiology, Tottori University School of Medicine, Yonago, and Research Institute for Microbial Diseases, Osaka University, Japan
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Suto Y, Iwamiya T, Tanigawa N, Shabana M, Ohta Y. Clinical Experience of 123I-IMP Scintigraphy in Detecting Vertebral Bone Metastases of Hepatocellular Carcinoma. Acta Radiol 2016. [DOI: 10.1177/028418519403500212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although bone scintigraphy with 99mTc-MDP is a sensitive diagnostic method to detect bone metastasis, it is not specific for malignancy. A radioactive substance which accumulates specifically into metastatic lesions should be of value. 123I-IMP and bone scintigraphy with 99mTc-MDP were consecutively performed in patients with vertebral bone metastases from hepatocellular carcinoma and lumbar spondylosis deformans in a 7-day interval or shorter. The intensity of uptake was compared. Eighteen of the 20 metastatic lesions (90%) were classified as increased uptake areas in 123I-IMP scintigraphy. MDP-scintigraphy disclosed 16 metastatic lesions (80%), 9 as “hot” lesions (56%) and 7 as “cold” lesions (44%). 123I-IMP scintigraphy was negative in all 12 lesions of lumbar spondylosis deformans. Compared to MDP-scintigraphy, 123I-IMP scintigraphy was more sensitive in detecting vertebral bone metastases of hepatocellular carcinoma with smaller rates of false-positive and false-negative findings.
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Abstract
Arterial occlusion using radiofrequency energy was performed. The length of the noninsulated part of the guidewire was 10 mm and the duration of radiofrequency supply was 20 s. Animal experiments were carried out in 17 canine arteries; 4 out of 6 arteries less than 2.3 mm in diameter were completely occluded during the 20 s radiofrequency supply. A clinical application was also successfully performed without any complications. Arterial occlusion with radiofrequency can be applied to vessels less than about 2 mm in diameter.
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Affiliation(s)
- N. Tanigawa
- From the Department of Radiology, Tottori University Hospital, Tottori, Japan
| | - S. Sawada
- From the Department of Radiology, Tottori University Hospital, Tottori, Japan
| | - N. Morioka
- From the Department of Radiology, Tottori University Hospital, Tottori, Japan
| | - T. Iwamiya
- From the Department of Radiology, Tottori University Hospital, Tottori, Japan
| | - T. Senda
- From the Department of Radiology, Tottori University Hospital, Tottori, Japan
| | - M. Kobayashi
- From the Department of Radiology, Tottori University Hospital, Tottori, Japan
| | - Y. Okuda
- From the Department of Radiology, Tottori University Hospital, Tottori, Japan
| | - Y. Ohta
- From the Department of Radiology, Tottori University Hospital, Tottori, Japan
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Komemushi A, Tanigawa N, Okuda Y, Kojima H, Fujii H, Shomura Y, Sougawa M, Sawada S. A new liquid embolic material for liver tumors: An animal experimental study using Onyx. Acta Radiol 2016; 43:186-91. [PMID: 12010301 DOI: 10.1080/028418502127347736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To evaluate the feasibility of a new liquid embolic material, Onyx, for treating liver tumors. Material and Methods: Onyx is a mixture of 6% (w/v) ethylene-vinyl-alcohol copolymer dissolved in anhydrous dimethyl sulfoxide (DMSO) with 28% (w/v) tantalum powder. In addition to 6% Onyx, we also tried 4%, 2% and 1% solutions, prepared by adjusting the amount of DMSO. We used 15 white rabbits with liver tumors created by percutaneous injection of VX2 tumor cells. In 4 groups with 3 rabbits in each, the liver arteries were embolized with 6%, 4%, 2% and 1% Onyx, respectively, and in 3 rabbits DMSO alone was injected. The injections were performed just proximal to the bifurcation of the proper hepatic artery, followed by celiac arteriography. Post mortem, the livers were examined by soft-tissue radiography, and liver-tissue section microscopy. Results: The maximum number of arterial branching points passed by embolic material in either the right or left hepatic arteries was 11, 15 and 16, for 6%, 4% and 2% Onyx, respectively, but was non-measurable for 1% Onyx. Minimum diameters of arteries reached by 6%, 4%, 2% and 1% Onyx in tumorous areas were 40 μm, 35 μm, 20 μm and 10 μm, respectively, and in non-tumorous areas 35 μm, 5 μm, 5 μm and 5 μm, respectively. Conclusion: This study suggests that Onyx may be feasible for treatment of hepatic tumors.
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Affiliation(s)
- A Komemushi
- Department of Radiology, Kansai Medical University, Osaka, Japan
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Sawada S, Fujiwara Y, Furui S, Tanabe Y, Tanigawa N, Kobayashi M, Iwamiya T, Morioka N, Ohta Y. Treatment of Tuberculous Bronchial Stenosis with Expandable Metallic Stents. Acta Radiol 2016. [DOI: 10.1177/028418519303400312] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Gianturco expandable metallic stents were placed in 5 patients with dyspnea on exercise due to tuberculous bronchial stenosis. The stents were placed after dilatation with a 10-mm diameter high pressure balloon catheter. In all 5 patients, obstructive changes disappeared following the procedure, and dyspnea on exercise improved markedly. No complications related to the procedure were encountered. At follow-up during a period of up to 38 months, 2 patients showed bronchial restenosis at 11 and 17 months, respectively, after stent placement. Restenosis by granulomatous tissue was successfully treated by laser ablation. One patient showed slight one-day hemoptysis 26 months after stent placement.
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Ille S, Sollmann N, Hauck T, Maurer S, Tanigawa N, Obermueller T, Negwer C, Droese D, Boeckh-Behrens T, Meyer B, Ringel F, Krieg S. P72. Impairment of non-invasive language mapping by lesion location a fMRI, rTMS, and DCS study. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2015.04.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kariya S, Nakatani M, Yoshida R, Ueno Y, Komemushi A, Tanigawa N. REPEATED INTRANODAL LYMPHANGIOGRAPHY FOR THE TREATMENT OF LYMPHATIC LEAKAGE. Lymphology 2015; 48:59-63. [PMID: 26714370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Treatment of patients with chylous or non-chylous lymphatic leakage can be difficult. An approach using therapeutic lymphangiography can reduce the lymphatic leakage, but it seldom stops the leakage immediately and subsequent conservative treatment is necessary. We report three cases in which intranodal lymphangiography was performed multiple times to inhibit lymphatic leakage. In each case, the lymph node was punctured under ultrasound guidance using a 23-gauge needle and lipiodol was injected manually at a rate of 1 ml/3 min. The procedure was repeated twice in two cases of gastrointestinal carcinoma and four times in one case of lymphoma. In all three cases, the postoperative lymphatic leakage stopped after the repeated intranodal lymphangiography.
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Yamana H, Tashiro-Yamaji J, Hayashi M, Maeda S, Shimizu T, Tanigawa N, Uchiyama K, Kubota T, Yoshida R. Down-regulated expression of monocyte/macrophage major histocompatibility complex receptors in human and mouse monocytes by expression of their ligands. Clin Exp Immunol 2014; 178:118-28. [PMID: 24842626 DOI: 10.1111/cei.12383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2014] [Indexed: 11/27/2022] Open
Abstract
Mouse monocyte/macrophage major histocompatibility complex (MHC) receptor 1 (MMR1; or MMR2) specific for H-2D(d) (or H-2K(d) ) molecules is expressed on monocytes from non-H-2D(d) (or non-H-2K(d) ), but not those from H-2D(d) (or H-2K(d) ), inbred mice. The MMR1 and/or MMR2 is essential for the rejection of H-2D(d) - and/or H-2K(d) -transgenic mouse skin onto C57BL/6 (H-2D(b) K(b) ) mice. Recently, we found that human leucocyte antigen (HLA)-B44 was the sole ligand of human MMR1 using microbeads that had been conjugated with 80 types of HLA class I molecules covering 94·2% (or 99·4%) and 92·4% (or 96·2%) of HLA-A and B molecules of Native Americans (or Japanese), respectively. In the present study, we also explored the ligand specificity of human MMR2 using microbeads. Microbeads coated with HLA-A32, HLA-B13 or HLA-B62 antigens bound specifically to human embryonic kidney (HEK)293T or EL-4 cells expressing human MMR2 and to the solubilized MMR2-green fluorescent protein (GFP) fusion protein; and MMR2(+) monocytes from a volunteer bound HLA-B62 molecules with a Kd of 8·7 × 10(-9) M, implying a three times down-regulation of MMR2 expression by the ligand expression. H-2K(d) (or H-2D(d) ) transgene into C57BL/6 mice down-regulated not only MMR2 (or MMR1) but also MMR1 (or MMR2) expression, leading to further down-regulation of MMR expression. In fact, monocytes from two (i.e. MMR1(+) /MMR2(+) and MMR1(-) /MMR2(-) ) volunteers bound seven to nine types of microbeads among 80, indicating ≤ 10 types of MMR expression on monocytes. The physiological role of constitutive MMRs on monocytes possibly towards allogeneic (e.g. fetal) cells in the blood appears to be distinct from that of inducible MMRs on macrophages toward allografts in tissue.
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Affiliation(s)
- H Yamana
- Department of Physiology, Osaka Medical College, Takatsuki, Japan; Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Japan
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Hayashi K, Fujiwara Y, Nomura M, Kamata M, Kojima H, Kohzai M, Sumita K, Tanigawa N. Predictive factors for pericardial effusion identified by heart dose-volume histogram analysis in oesophageal cancer patients treated with chemoradiotherapy. Br J Radiol 2014; 88:20140168. [PMID: 25429644 DOI: 10.1259/bjr.20140168] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To identify predictive factors for the development of pericardial effusion (PCE) in patients with oesophageal cancer treated with chemotherapy and radiotherapy (RT). METHODS From March 2006 to November 2012, patients with oesophageal cancer treated with chemoradiotherapy (CRT) using the following criteria were evaluated: radiation dose >50 Gy; heart included in the radiation field; dose-volume histogram (DVH) data available for analysis; no previous thoracic surgery; and no PCE before treatment. The diagnosis of PCE was independently determined by two radiologists. Clinical factors, the percentage of heart volume receiving >5-60 Gy in increments of 5 Gy (V5-60, respectively), maximum heart dose and mean heart dose were analysed. RESULTS A total of 143 patients with oesophageal cancer were reviewed retrospectively. The median follow-up by CT was 15 months (range, 2.1-72.6 months) after RT. PCE developed in 55 patients (38.5%) after RT, and the median time to develop PCE was 3.5 months (range, 0.2-9.9 months). On univariate analysis, DVH parameters except for V60 were significantly associated with the development of PCE (p < 0.001). No clinical factor was significantly related to the development of PCE. Recursive partitioning analysis including all DVH parameters as variables showed a V10 cut-off value of 72.8% to be the most influential factor. CONCLUSION The present results showed that DVH parameters are strong independent predictive factors for the development of PCE in patients with oesophageal cancer treated with CRT. ADVANCES IN KNOWLEDGE A heart dosage was associated with the development of PCE with radiation and without prophylactic nodal irradiation.
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Affiliation(s)
- K Hayashi
- 1 Department of Radiology, Kansai Medical University, Hirakata, Japan
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Yamaue H, Kubota T, Tanigawa N, Ohyama S, Sakuramoto S, Inada T, Kitagawa Y, Ochiai T, Terashima M, Gotoh M, Yasuda Y, Hara A, Kato H, Matsuyama J, Kodera Y, Nashimoto A, Yamaguchi T, Takeuchi M, Fujii M, Nakajima T. Exploratory Phase Ii Trial Assessing Relevance of in Vitro Chemosensitivity Test As a Predictor of Survival in Gastric Cancer Undergoing Adjuvant Chemotherapy (Jaccro-Gc04). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu334.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Takahari D, Hamaguchi T, Yoshimura K, Katai H, Ito S, Fuse N, Konishi M, Yasui H, Terashima M, Goto M, Tanigawa N, Shirao K, Sano T, Sasako M. Survival analysis of adjuvant chemotherapy with S-1 plus cisplatin for stage III gastric cancer. Gastric Cancer 2014; 17:383-6. [PMID: 23719867 DOI: 10.1007/s10120-013-0264-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [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] [Received: 12/04/2012] [Accepted: 04/21/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND We previously reported that S-1 plus cisplatin was feasible as adjuvant chemotherapy for stage III gastric cancer after D2 gastrectomy. Herein we evaluate the recurrence-free survival and overall survival rates as secondary endpoints based on updated follow-up data. METHODS Patients with stage III gastric cancer who underwent D2 gastrectomy were enrolled. Treatment consisted of 3 cycles of S-1 (40 mg/m(2) PO) twice daily on days 1-21 and cisplatin (60 mg/m(2) IV) on day 8, and S-1 was given on days 1-28 every 6 weeks until 1 year after surgery. RESULTS From August 2007 to September 2009, 63 patients were accrued. Overall, 34 and 25 patients had stage IIIA and IIIB disease, respectively. After a median follow-up of 3.9 years, 16 patients experienced recurrence and 11 patients died. The 3-year recurrence-free survival rate was 74.1 % (95 % CI: 60.8-83.5 %, IIIA 81.8 %, IIIB 64.0 %). The 3-year overall survival rate was 84.5 % (95 % CI: 72.3-91.6 %, IIIA 87.9 %, IIIB 80.0 %). Recurrence sites included the peritoneum (n = 8), hematogenous sites (n = 6), and lymph nodes (n = 4). CONCLUSION The present results indicate that adjuvant therapy with S-1 plus 3 cycles of cisplatin may provide a survival benefit to patients with stage III gastric cancer.
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Affiliation(s)
- Daisuke Takahari
- Department of Clinical Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Aichi, Japan,
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Suzuki S, Komemushi A, Sano A, Kariya S, Kanno S, Nakatani M, Yoshida R, Kono Y, Tanigawa N. Short term efficacy and safety of balloon-occluded retrograde transvenous obliteration of portosystemic shunt in patients with hepatic encephalopathy. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.332] [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: 11/24/2022] Open
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Yoshida R, Kariya S, Nakatani M, Kono Y, Komemushi A, Tanigawa N. Renal volume reduction by transcatheter renal artery embolization with N-butyl cyanoacrylate for symptomatic polycystic kidney disease. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Kariya S, Komemushi A, Nakatani M, Yoshida R, Sawada S, Tanigawa N. Re: CO2 microbubble contrast enhancement in x-ray angiography. A reply. Clin Radiol 2013; 68:1180. [DOI: 10.1016/j.crad.2013.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 11/26/2022]
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Ueda H, Tanaka H, Ichikawa K, Itabashi M, Kameoka S, Fujii S, Saito N, Kimura R, Shida Y, Fujimori Y, Ohtake S, Tomita S, Imura J, Yasuda Y, Tanigawa N, Uchiyama K, Fujimori T. Immunohistochemical analysis of the DNA methyltransferase 3b expression is associated with significant improvements in the discrimination of ulcerative colitis-associated neoplastic lesions. Surg Today 2013; 43:1275-80. [PMID: 23307264 DOI: 10.1007/s00595-012-0456-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 08/19/2012] [Indexed: 12/18/2022]
Abstract
PURPOSE Making a clinicopathological diagnosis of dysplasia is crucial. We herein assess the significance of the DNA methyltransferase 3b (DNMT3b) expression as a diagnostic marker of ulcerative colitis (UC)-associated neoplasia. METHODS Thirty-one patients with long-standing and extensive UC were included in this study. The expression of DNMT3b in non-neoplastic rectal epithelium (non-dysplasia in 31 patients) and colorectal neoplasia (dysplasia in 43 patients and invasive cancer in 34 patients) was determined using immunohistochemistry. The presence of immunoreactive DNMT3b was assessed in the areas with the highest density of cells with positively staining nuclei. DNMT3b was expressed as the percentage of positive cells relative to the total number of cells counted under high power magnification. RESULTS The DNMT3b expression in neoplastic rectal epithelium (0.76, range 0.59-0.84) was increased compared to that observed in non-neoplastic epithelium (0.32, range 0.18-0.67, P < 0.001). A ROC curve analysis confirmed 0.68 to be the best diagnostic cut-off value for the DNMT3b expression in neoplastic epithelium (area under the curve = 0.810). The sensitivity of the diagnostic test was 66.2 %, the specificity was 86.7 %, the positive predictive value was 95.7 % and the negative predictive value was 36.1 %. The positive likelihood ratio was 4.98 and the negative likelihood ratio was 0.20. The accuracy was 69.9 %. CONCLUSIONS An immunohistochemical analysis of the DNMT3b expression was associated with significant improvements in the discrimination of UC-associated neoplastic lesions.
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Affiliation(s)
- Hirofumi Ueda
- Department of Surgical and Molecular Pathology, Dokkyo Medical University School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0292, Japan
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Harima Y, Ikeda K, Utsunomiya K, Komemushi A, Kanno S, Shiga T, Tanigawa N. Prediction of Outcome for the Patients With Advanced Cervical Cancers After Chemoradiation Therapy Using MicroRNA Analysis. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.244] [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: 10/26/2022]
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Lee SW, Tanigawa N, Nomura E, Tokuhara T, Kawai M, Yokoyama K, Hiramatsu M, Okuda J, Uchiyama K. Benefits of intracorporeal gastrointestinal anastomosis following laparoscopic distal gastrectomy. World J Surg Oncol 2012; 10:267. [PMID: 23232031 PMCID: PMC3546847 DOI: 10.1186/1477-7819-10-267] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 11/24/2012] [Indexed: 12/13/2022] Open
Abstract
Background Laparoscopic gastrectomy has recently been gaining popularity as a treatment for cancer; however, little is known about the benefits of intracorporeal (IC) gastrointestinal anastomosis with pure laparoscopic distal gastrectomy (LDG) compared with extracorporeal (EC) anastomosis with laparoscopy-assisted distal gastrectomy (LADG). Methods Between June 2000 and December 2011, we assessed 449 consecutive patients with early-stage gastric cancer who underwent LDG. The patients were classified into three groups according to the method of reconstruction LADG followed by EC hand-sewn anastomosis (LADG + EC) (n = 73), using any of three anastomosis methods (Billroth-I (B-I), Billroth-II (B-II) or Roux-en-Y (R-Y); LDG followed by IC B-I anastomosis (LDG + B-I) (n = 248); or LDG followed by IC R-Y anastomosis (LDG + R-Y) (n = 128)). The analyzed parameters included patient and tumor characteristics, operation details, and post-operative outcomes. Results The tumor location was significantly more proximal in the LDG + R-Y group than in the LDG + B-I group (P < 0.01). Mean operation time, intra-operative blood loss, and the length of post-operative hospital stay were all shortest in the LDG + B-I group (P < 0.05). Regarding post-operative morbidities, anastomosis-related complications occurred significantly less frequently in with the LDG + B-I group than in the LADG + EC group (P < 0.01), whereas there were no differences in the other parameters of patients’ characteristics. Conclusions Intracorporeal mechanical anastomosis by either the B-I or R-Y method following LDG has several advantages over at the LADG + EC, including small wound size, reduced invasiveness, and safe anastomosis. Although additional randomized control studies are warranted to confirm these findings, we consider that pure LDG is a useful technique for patients with early gastric cancer.
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Affiliation(s)
- Sang-Woong Lee
- Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7, Daigaku-Machi, Takatsuki City Osaka 569-8686, Japan.
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Inoue Y, Hayashi M, Hirokawa F, Egashira Y, Tanigawa N. Clinicopathological and operative factors for prognosis of carcinoma of the ampulla of vater. Hepatogastroenterology 2012; 59:1573-6. [PMID: 22683975 DOI: 10.5754/hge10742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND/AIMS The prognostic factor(s) of carcinoma of the ampulla of Vater were analyzed retrospectively and the significance of lymphadenectomy around the superior mesenteric artery and para-aortic region on the clinical outcome was evaluated. METHODOLOGY From 1985 to 2008, 34 carcinomas of the ampulla of Vater patients who underwent pancreaticoduodenectomy with curative intent were analyzed with respect to tumor extent, operation method and prognosis. RESULTS Overall 5-year survival was 52.6%. On multivariate analysis, lymph node metastasis, pancreatic invasion, venous invasion, perineural invasion and lymphadenectomy around the superior mesenteric artery were the significant prognostic factors. However, the dissection of para-aortic lymph nodes had no substantial survival benefit. Compared with the duodenal cancer, the prognosis for carcinoma of the ampulla of Vater was significantly worse although no differences in clinicopathological characteristics of patients were observed. CONCLUSIONS Lymph node metastasis, pancreatic invasion, venous invasion, perineural invasion, and lymphadenectomy around the superior mesenteric artery are important prognostic factors. Pylorus-preserving pancreaticoduodenectomy, with lymphadenectomy around the superior mesenteric artery without dissection of para-aortic lymph nodes is recommended as optimal surgery. Though the treatment results were worse than that of duodenal cancer, curative operation should be performed, regardless of site of origin.
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Affiliation(s)
- Yoshihiro Inoue
- Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan.
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Kariya S, Komemushi A, Nakatani M, Yoshida R, Sawada S, Tanigawa N. CO2 microbubble contrast enhancement in x-ray angiography. Clin Radiol 2012; 68:346-51. [PMID: 22981730 DOI: 10.1016/j.crad.2012.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 07/26/2012] [Accepted: 08/06/2012] [Indexed: 12/23/2022]
Abstract
AIM To demonstrate that carbon dioxide (CO2) microbubble contrast enhancement depicts blood vessels when used for x-ray examinations. MATERIALS AND METHODS Microbubbles were generated by cavitation of physiological saline to which CO2 gas had been added using an ejector-type microbubble generator. The input pressure values for CO2 gas and physiological saline that produced a large quantity of CO2 microbubbles were obtained in a phantom. In an animal study, angiography was performed in three swine using three types of contrast: CO2 microbubbles, conventional CO2 gas, and iodinated contrast medium. For CO2 microbubble contrast enhancement, physiological saline, and CO2 gas were supplied at the input pressures calculated in the phantom experiment. Regions of interest were set in the abdominal aorta, external iliac arteries, and background. The difference in digital values between each artery and the background was calculated. RESULTS The input pressures obtained in the phantom experiment were 0.16 MPa for physiological saline and 0.5 MPa for CO2 gas, with physiological saline input volume being 8.1 ml/s. Three interventional radiologists all evaluated the depictions of all arteries as "present" in the CO2 microbubble contrast enhancement, conventional CO2 contrast enhancement, and iodinated contrast enhancement performed in three swine. Digital values for all vessels with microbubble CO2 contrast enhancement were higher than background values. CONCLUSIONS In x-ray angiography, blood vessels can be depicted by CO2 microbubble contrast enhancement, in which a large quantity of CO2 microbubbles is generated within blood vessels.
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Affiliation(s)
- S Kariya
- Department of Radiology, Kansai Medical University, Hirakata, Osaka, Japan.
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Affiliation(s)
- T Sakuma
- Department of Diagnostic Pathology, Osaka Rosai Hospital, Sakai, Osaka, Japan
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Sakuma T, Iseki R, Mimura A, Tanigawa N, Takamizu R. Rapid cytologic diagnosis of choroidal malignant melanoma by vitreous smear. J Fr Ophtalmol 2012; 35:535.e1-4. [PMID: 22658841 DOI: 10.1016/j.jfo.2011.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 07/28/2011] [Accepted: 08/02/2011] [Indexed: 10/28/2022]
Abstract
The eye is an uncommon subject of cytopathological examination. However, cytopathologic examination may be required for definitive diagnosis in some cases, as malignant tumors of the eye may sometimes be difficult to distinguish clinically from benign disorders. We report a case of malignant melanoma (MM) of the choroid, in which vitrectomy was performed for the initial clinical diagnosis of vitreous hemorrhage. As the dense vitreous hemorrhage was gradually cleared during the vitrectomy, a choroidal mass was discovered and the vitreous fluid was procured for rapid cytologic diagnosis. We used a modified Shorr's stain that can be completed within several minutes. With this method, highly atypical, pleomorphic cancer cells, occasionally associated with melanin pigment granules, were demonstrated. These cytologic findings indicated a diagnosis of MM arising from the choroid. Histologic examination of the enucleated eye confirmed MM of epithelioid type. The advantage and indication of the rapid cytologic diagnosis is discussed.
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Affiliation(s)
- T Sakuma
- Departement of Diagnostic Pathology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
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Tashiro-Yamaji J, Shimizu T, Hayashi M, Yamana H, Tanigawa N, Uchiyama K, Kubota T, Yoshida R. Specific binding of HLA-B44 to human macrophage MHC receptor 1 on monocytes. Gene 2012; 501:127-34. [DOI: 10.1016/j.gene.2012.04.020] [Citation(s) in RCA: 6] [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: 02/03/2012] [Accepted: 04/09/2012] [Indexed: 11/25/2022]
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Lopergolo A, Tavecchio M, Lisanti S, Ghosh JC, Dohi T, Faversani A, Vaira V, Bosari S, Tanigawa N, Delia D, Kossenkov AV, Showe LC, Altieri DC. Chk2 phosphorylation of survivin-DeltaEx3 contributes to a DNA damage-sensing checkpoint in cancer. Cancer Res 2012; 72:3251-9. [PMID: 22586065 DOI: 10.1158/0008-5472.can-11-4035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Survivin is an oncogene that functions in cancer cell cytoprotection and mitosis. Here we report that differential expression in cancer cells of a C-terminal splice variant of survivin, termed survivin-ΔEx3, is tightly associated with aggressive disease and markers of unfavorable prognosis. In contrast to other survivin variants, survivin-ΔEx3 localized exclusively to nuclei in tumor cells and was phosphorylated at multiple residues by the checkpoint kinase Chk2 during DNA damage. Mutagenesis of the Chk2 phosphorylation sites enhanced the stability of survivin-ΔEx3 in tumor cells, inhibited the expression of phosphorylated H2AX (γH2AX) in response to double-strand DNA breaks, and impaired growth after DNA damage. DNA damage induced Chk2 phosphorylation, stabilization of p53, induction of the cyclin-dependent kinase inhibitor p21, and homologous recombination-induced repair were not affected. In vivo, active Chk2 was detected at the earliest stages of the colorectal adenoma-to-carcinoma transition, persisted in advanced tumors, and correlated with increased survivin expression. Together, our findings suggest that Chk2-mediated phosphorylation of survivin-ΔEx3 contributes to a DNA damage-sensing checkpoint that may affect cancer cell sensitivity to genotoxic therapies.
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Affiliation(s)
- Alessia Lopergolo
- Prostate Cancer Discovery and Development Program, Center for Systems and Computational Biology, The Wistar Institute, Philadelphia, Pennsylvania 19104, USA
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Abstract
Schwannoma is predominantly a benign neoplasm of the Schwann cells in the neural sheath of the peripheral nerves. Occurrence of schwannoma in parenchymatous organs, such as liver, is extremely rare. A 64-year-old man without neurofibromatosis was observed to have a space-occupying lesion of 23mm diameter in the liver during follow-up examination for a previously resected gastrointestinal stromal tumor (GIST) in the small intestine. He underwent lateral segmentectomy of the liver under a provisional diagnosis of hepatic metastatic recurrence of the GIST. Histological examination confirmed the diagnosis of a benign schwannoma, confirmed by characteristic pathological findings and positive immunoreactions with the neurogenic marker S-100 protein, but negative for c-kit, or CD34. The tumor was the smallest among the reported cases. When the primary hepatic schwannoma is small in size, preoperative clinical diagnosis is difficult. Therefore, this disease should be listed as differential diagnosis for liver tumor with clinically benign characteristics.
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Affiliation(s)
- Michihiro Hayashi
- Michihiro Hayashi, Nobuhiko Tanigawa, Department of General and Gastroenterological Surgery, Department of Pathology, Department of Radiology, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan
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Kawai M, Peretta S, Burckhardt O, Dallemagne B, Marescaux J, Tanigawa N. Endoscopic pyloromyotomy: a new concept of minimally invasive surgery for pyloric stenosis. Endoscopy 2012; 44:169-73. [PMID: 22271027 DOI: 10.1055/s-0031-1291475] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [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: 12/13/2022]
Abstract
BACKGROUND AND STUDY AIMS Pyloric stenosis is currently managed using open or laparoscopic pyloromyotomy. However, with recent improvements in flexible endoscopic instrumentation and techniques, totally peroral endoscopic approaches could reduce the invasiveness of myotomic procedures. The aim of the study was to establish the feasibility and efficacy of endoscopic submucosal pyloromyotomy in a porcine model. METHODS Four pigs were included in a preliminary study and a 2-week survival study was performed in another four pigs. An esophagogastroduodenoscope was inserted perorally into the stomach. Saline solution was injected into the submucosal space proximal to the pylorus. The gastric mucosa was incised and a 5-cm submucosal tunnel was created. After exposure of the muscular layer in a submucosal tunnel, myotomy of the circular muscle layer was performed until the longitudinal muscular layer was reached. Once myotomy was completed, endoscopic clips were used to re-approximate the mucosal incision. RESULTS Submucosal dissection, identification of the circular muscular layer, and pyloromyotomy were achieved in all animals. Acute complications such as bleeding and perforation were not observed in any cases. Median pyloric resting pressure was reduced from 16.5 mmHg to 6.1 mmHg immediately after myotomy and 8.4 mmHg at 14 days after myotomy. CONCLUSION Peroral endoscopic submucosal pyloromyotomy appears to be technically feasible and effective. Potential clinical applications, such as for infantile hypertrophic pyloric stenosis or delayed gastric emptying after esophagectomy, could be considered after confirmation of safety in additional survival studies.
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Affiliation(s)
- M Kawai
- Department of Surgery, IRCAD/EITS, Strasbourg, France.
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Yamamoto M, Okuda J, Tanaka K, Kondo K, Tanigawa N, Uchiyama K. Clinical outcomes of laparoscopic surgery for advanced transverse and descending colon cancer: a single-center experience. Surg Endosc 2011; 26:1566-72. [PMID: 22179459 PMCID: PMC3351590 DOI: 10.1007/s00464-011-2071-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 11/09/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND The role of laparoscopic surgery in management of transverse and descending colon cancer remains controversial. The aim of the present study is to investigate the short-term and oncologic long-term outcomes associated with laparoscopic surgery for transverse and descending colon cancer. METHODS This cohort study analyzed 245 patients (stage II disease, n = 70; stage III disease, n = 63) who underwent resection of transverse and descending colon cancers, including 200 laparoscopic surgeries (LAC) and 45 conventional open surgeries (OC) from December 1996 to December 2010. Short-term and oncologic long-term outcomes were recorded. RESULTS The operative time was longer in the LAC group than in the OC group. However, intraoperative blood loss was significantly lower and postoperative recovery time was significantly shorter in the LAC group than in the OC group. The 5-year overall and disease-free survival rates for patients with stage II were 84.9% and 84.9% in the OC group and 93.7% and 90.0% in the LAC group, respectively. The 5-year overall and disease-free survival rates for patients with stage III disease were 63.4% and 54.6% in the OC group and 66.7% and 56.9% in the LAC group, respectively. CONCLUSION Use of laparoscopic surgery resulted in acceptable short-term and oncologic outcomes in patients with advanced transverse and descending colon cancer.
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Affiliation(s)
- Masashi Yamamoto
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan
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Sakai A, Otani M, Miyamoto A, Yoshida H, Furuya E, Tanigawa N. Identification of phosphorylated serine-15 and -82 residues of HSPB1 in 5-fluorouracil-resistant colorectal cancer cells by proteomics. J Proteomics 2011; 75:806-18. [PMID: 21989268 DOI: 10.1016/j.jprot.2011.09.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2011] [Revised: 09/20/2011] [Accepted: 09/26/2011] [Indexed: 01/13/2023]
Abstract
To identify the proteins involved in 5-fluorouracil (5-FU) resistance, a comparison of the total and phosphorylated proteins between the human colorectal cancer (CRC) cell line DLD-1 and its 5-FU-resistant subclone DLD-1/5-FU was performed. Using 2-DE and MALDI-TOF/TOF-based proteomics, 17 up-regulated and 19 down-regulated protein spots were identified in the 5-FU-resistant DLD-1/5-FU cells compared with the parent cell lines. In DLD-1/5-FU cells, 7 anti-apoptotic proteins (HSPB1, proteasome subunit α-5, transitional endoplasmic reticulum ATPase, 14-3-3 β, 14-3-3 γ, 14-3-3 σ, and phosphoglycerate kinase 1) were up-regulated and 4 proapoptotic proteins (cofilin-1, pyruvate kinase M2, glyceraldehyde-3-phosphate dehydrogenase, and nucleophosmin) were down-regulated. The results show that the acquired drug resistance of DLD-1/5-FU cells is caused by the prevention of drug-induced apoptosis, in particular through the enhanced constitutive expression of HSPB1 and its phosphorylated form. Short interfering RNA knockdown of endogenous HSPB1 in DLD-1/5-FU cells restored the sensitivity to 5-FU. Furthermore, MALDI-TOF/TOF and 2-DE Western blot analysis identified the phosphorylated residues of HSPB1 as Ser-15 and Ser-82 in the main (diphosphorylated) form and Ser-15, Ser-78, and Ser-82 in the minor (triphosphorylated) form. The current findings indicate that phosphorylated HSPB1 may play an important role in 5-FU resistance.
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Affiliation(s)
- Akiko Sakai
- Department of Chemistry, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan.
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Tanigawa N, Lee SW, Kimura T, Mori T, Uyama I, Nomura E, Okuda J, Konishi F. The Endoscopic Surgical Skill Qualification System for gastric surgery in Japan. Asian J Endosc Surg 2011; 4:112-5. [PMID: 22776273 DOI: 10.1111/j.1758-5910.2011.00082.x] [Citation(s) in RCA: 52] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Laparoscopic surgery has been increasing in popularity in recent years. In 2004, the Japan Society for Endoscopic Surgery developed its Endoscopic Surgical Skill Qualification System (ESSQS) to assess surgeons. METHODS To earn the ESSQS accreditation, applicants must submit an unedited operative video in which they perform either a distal gastrectomy or pylorus-preserving gastrectomy with lymph node dissection for gastric cancer. The videos are assessed by two separate judges based on detailed criteria for common and procedure-specific technical-grade slips. Common criteria from all fields of gastrointestinal and general surgery are used to evaluate the basic laparoscopic surgical skills and autonomy of the operator. The target organ determines the procedure-specific criteria are set to assess whether or not adequate oncological clearance has been achieved. RESULTS Between 2004 and 2009, 154 (44.6%) out of 345 applicant surgeons assessed under the ESSQS for gastric surgery have been accredited. Interrater agreement was acceptable and ranged between 0.21 and 0.59. CONCLUSION The ESSQS system may facilitate improvement in surgical technique and the standardization of laparoscopic surgery in Japan.
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Affiliation(s)
- N Tanigawa
- Japan Society for Endoscopic Surgery, Tokyo, Japan
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Nomura E, Lee SW, Bouras G, Tokuhara T, Hayashi M, Hiramatsu M, Okuda J, Tanigawa N. Functional outcomes according to the size of the gastric remnant and type of reconstruction following laparoscopic distal gastrectomy for gastric cancer. Gastric Cancer 2011; 14:279-84. [PMID: 21519869 DOI: 10.1007/s10120-011-0046-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [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] [Received: 09/07/2010] [Accepted: 03/07/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND In gastric cancer, various methods of gastric resection and reconstruction have been devised according to the location of the primary tumor and the depth of invasion. The functional outcomes of patients treated by laparoscopy-assisted or totally laparoscopic distal gastrectomy were compared with respect to the approach, size of the remnant stomach, and type of reconstruction. METHODS Patients who required distal gastrectomy to treat early-stage cancer between May 2000 and December 2008 were treated by one of the four following procedures: Billroth Type I (B-1) reconstruction for 1/2 remnant stomach (1/2B1ML) or B-1 for 1/3 remnant stomach (1/3B1ML), through a mini-laparotomy following laparoscopy-assisted surgery; intra-corporeal B-1 for 1/2 remnant stomach (1/2 B1IC); or intra-corporeal Roux-en-Y for 1/3 remnant stomach (1/3RYIC). The primary outcome measure was digestive function, assessed by body weight, food intake, and degree of abdominal symptoms. The secondary outcome was morbidity. RESULTS The 1/2B1ML (n = 27) and 1/2B1IC (n = 56) groups were significantly superior to the 1/3 resection groups in terms of the preservation of body weight. The 1/3B1ML (n = 29) and 1/3RYIC (n = 64) groups were associated with significantly decreased food intake compared with the 1/2B1ML group. Endoscopy revealed a greater incidence of esophagitis and gastritis among the 1/3B1ML patients compared with the 1/3RYIC patients. There were no operative deaths, and no differences in morbidity between the groups. CONCLUSION Patients with early-stage cancer actually benefit from 1/2 gastrectomy rather than the typical 2/3 gastrectomy. B-1 reconstruction is appropriate for patients with large gastric remnants, and intra-corporeal reconstruction in experienced hands is associated with no apparent disadvantages, while offering a favorable cosmetic result.
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Affiliation(s)
- Eiji Nomura
- Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigaku-Machi, Takatsuki, 569-8686, Japan.
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Inoue Y, Hayashi M, Katsumata T, Shibayama Y, Tanigawa N. Hepatocellular carcinoma with right atrial tumor thrombus: report of a case. Surg Today 2011; 41:1122-9. [PMID: 21773904 DOI: 10.1007/s00595-010-4443-5] [Citation(s) in RCA: 22] [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: 02/11/2010] [Accepted: 05/12/2010] [Indexed: 12/14/2022]
Abstract
Hepatocellular carcinoma (HCC) with a tumor thrombus (TT) extending into the right atrium is generally regarded as a terminal-stage condition. We report a case of long-term survival following treatment of this complication with en bloc hepatectomy and resection of the thrombus under cardiopulmonary bypass. Our review of 19 similar cases reported in the literature found the following: that lung metastasis, the most critical prognostic factor, occurred in only 5 (27.8%) patients; that postoperative survival ranged from 18 days to 56 months, with a median survival of 11 months; and that 7 (38.9%) patients showed no signs of recurrence, with 4 (21.1%) surviving longer than 2 years. Thus, to prevent sudden death and extend the survival of patients with HCC and TT extending into the right atrium, we advocate simultaneous en bloc resection performed under cardiopulmonary bypass, provided distant metastasis and recurrence in the remnant liver are controlled.
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Affiliation(s)
- Yoshihiro Inoue
- Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
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Nakai G, Matsuki M, Harada T, Tanigawa N, Yamada T, Barentsz J, Narumi Y. Evaluation of axillary lymph nodes by diffusion-weighted MRI using ultrasmall superparamagnetic iron oxide in patients with breast cancer: initial clinical experience. J Magn Reson Imaging 2011; 34:557-62. [PMID: 21761468 DOI: 10.1002/jmri.22651] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2010] [Accepted: 04/07/2011] [Indexed: 02/06/2023] Open
Abstract
PURPOSE To investigate the diagnostic performance and clinical feasibility of diffusion-weighted magnetic resonance imaging (MRI) using ultrasmall superparamagnetic iron oxide (USPIO) in the evaluation of axillary lymph nodes (ALNs) in patients with breast cancer. MATERIALS AND METHODS Sixteen patients with known breast cancer underwent 1.5 T MRI. Axial diffusion-weighted images (DWIs) and conventional T1- and T2*-weighted images (CIs) were acquired before and 24-36 hours after intravenous administration of USPIO. Detection of ALNs was evaluated on DWIs in comparison with CIs. The apparent diffusion coefficient values (ADCvs) of the nonmetastatic and metastatic nodes in precontrast DWIs were determined. The diagnostic performance of DWI using USPIO was compared with that of CIs using USPIO with pathological correlation. RESULTS Out of a total of 286 ALNs, 216/286 (76%) nodes were detected on DWIs and 238/286 (83%) on CIs. The differences in the ADCvs between metastatic and nonmetastatic nodes were not significant (P = 0.06). Sensitivity of CIs and DWIs using USPIO were respectively 70% and 83%, specificity 98% and 98%, and overall accuracy 93% and 95%. CONCLUSION Although the detection on DWIs of ALNs in patients with breast cancer was inferior compared to CIs, the sensitivity and accuracy of DWIs using USPIO were superior in the diagnosis of ALNs metastasis.
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Affiliation(s)
- Go Nakai
- Department of Radiology, Osaka Medical College, Takatsuki City, Osaka, Japan.
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Hirokawa F, Hayashi M, Miyamoto Y, Asakuma M, Shimizu T, Komeda K, Inoue Y, Tanigawa N. Appropriate treatment strategy for intrahepatic recurrence after curative hepatectomy for hepatocellular carcinoma. J Gastrointest Surg 2011; 15:1182-7. [PMID: 21557020 DOI: 10.1007/s11605-011-1484-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Accepted: 03/08/2011] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The aim of this study is to evaluate the appropriate treatment for intrahepatic recurrence after hepatectomy for hepatocellular carcinoma (HCC). METHODS Of 151 patients who underwent initial hepatectomy for HCC, 82 had intrahepatic recurrence and were divided into two groups: group A, ≤2 tumors, each 3 cm in size; and group B, beyond the group A. Survival and treatment in each group were analyzed retrospectively to determine the best therapeutic modality for intrahepatic recurrence. RESULTS The 5-year overall survival and recurrence rate were 65% and 58%, respectively. Overall 1-, 3-, and 5-year survival rates after recurrence were better in group A (100%, 76%, and 54%) than in group B (74%, 23%, and 5.8%; p < 0.001). The clinical backgrounds were not different for each modality. Of the 43 patients in group A, 10 underwent hepatectomy, 21 ablation therapy, and 12 transcatheter arterial chemoembolization (TACE). The survival rate of hepatectomy was similar to that of ablation therapy and significantly better than that of TACE (p = 0.0248). Of the 39 patients in group B, the results of TACE were similar to other therapies after recurrence. CONCLUSIONS Repeat hepatectomy and ablation therapy were more effective than TACE in the group with ≤2 tumors up to 3 cm in size at recurrence, while any treatment modality was more effective than best supportive care, but the outcome was poorer in the group with ≥3 tumors or tumor size ≥3 cm at recurrence.
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Affiliation(s)
- Fumitoshi Hirokawa
- Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan.
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Tanaka S, Nohara T, Nakatani S, Iwamoto M, Sumiyoshi K, Kimura K, Takahashi Y, Sato N, Tanigawa N. Esthetic result of rhomboid flap repair after breast-conserving surgery for lower quadrant breast cancer lesion with skin invasion: report of two cases. Surg Today 2011; 41:832-6. [PMID: 21626332 DOI: 10.1007/s00595-010-4355-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2010] [Accepted: 04/30/2010] [Indexed: 11/24/2022]
Abstract
Breast-conserving surgery (BCS) has been increasingly performed as a standard operative strategy for patients with breast cancer. The primary purpose of BCS is to acquire both local control and good cosmetic results. An insignificant difference in cancer treatment results has been shown between BCS and total mastectomy. However, achieving sufficiently cosmetic results can be difficult, particularly in patients with tumors that are large or localized to the lower quadrant. To avoid breast deformities and asymmetries after BCS, immediate reconstruction using autologous tissue has been accepted as the standard option. Rhomboid skin and adipose flap repair is a simple, less invasive procedure than the myocutaneous flap, which has primarily been performed in patients with upper quadrant lesions. We herein report the cases of two patients with lower quadrant breast cancer with skin invasion, who underwent BCS with immediate breast repair using a rhomboid flap. This procedure is therefore worth considering as one of the first options for immediate repair after BCS.
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Affiliation(s)
- Satoru Tanaka
- Section of Breast and Endocrine Surgery, Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
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38
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Inoue Y, Tashiro-Yamaji J, Hayashi M, Kiyonari H, Shimizu T, Ibata M, Yamana H, Kubota T, Tanigawa N, Yoshida R. Transgene number-dependent, gene expression rate-independent rejection of Dd-, Kd-, or DdKd-transgened mouse skin or tumor cells from C57BL/6 (DbKb) mice. Microbiol Immunol 2011; 55:446-53. [DOI: 10.1111/j.1348-0421.2011.00337.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Inoue Y, Hayashi M, Satou N, Miyamoto Y, Hirokawa F, Asakuma M, Shimizu T, Kayano H, Yamamoto M, Yamana H, Okuda J, Egashira Y, Tanigawa N. Prognostic Clinicopathological Factors After Curative Resection of Small Bowel Adenocarcinoma. J Gastrointest Cancer 2011; 43:272-8. [PMID: 21607548 DOI: 10.1007/s12029-011-9290-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Yoshihiro Inoue
- Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
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Abstract
INTRODUCTION In laparoscopic rectal surgery, there are some limitations on a surgeon's ability to maneuver, especially in transection of the lower rectum. To achieve minimally invasive surgery, safe anastomosis, including proper rectal transaction, is necessary. METHODS To overcome the difficulty in lower rectal resection, we followed a series of steps. First, we completely mobilized the rectum to the pelvic bottom, just above the anal canal, making the lower rectum mobile and allowing for an easy rectal transection. To secure the transaction, the mesorectum around the transection must be properly divided. We recommend placing the lower right quadrant port as caudal as possible to properly staple the rectum. We found a 60 mm compression-type stapler most suitable for rectal transection. To wash and flatten the rectum, a detachable intestinal clip is quite useful because of its flexibility. Finally, in addition to conventional abdominal drains around the anastomotic site, we employed transanal tube to actively decompress rectal pressure inside the anastomotic site. RESULTS Between August 2009 and July 2010, 101 patients underwent laparoscopic low anterior resection using this technique. Most patients, 98.0% (99/101), underwent lower rectum transection using a single-fire cartridge. The anastomotic leakage rate was only 1.0% (1/101) in total and 1.3% (1/78), when not including patients with diverting stoma. CONCLUSION We have to follow up with more patients to conclude whether our technique is effective in the long term. However, this step-by-step technique could lead to safe anastomosis in laparoscopic low anterior resection for rectal cancer.
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Affiliation(s)
- J Okuda
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.
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41
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Hayashi M, Shimizu T, Hirokawa F, Inoue Y, Komeda K, Asakuma M, Miyamoto Y, Takeshita A, Shibayama Y, Tanigawa N. Clinicopathological Risk Factors for Recurrence within One Year after Initial Hepatectomy for Hepatocellular Carcinoma. Am Surg 2011. [DOI: 10.1177/000313481107700516] [Citation(s) in RCA: 27] [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: 12/22/2022]
Abstract
Hepatocellular carcinoma (HCC) shows a high rate of recurrence after hepatectomy; predictive factors for early recurrence would help determine optimal therapeutic and management strategies. Among 163 patients with HCC undergoing hepatectomy with curative intent, 46 patients developed recurrence within 1 year. Clinicopathological data were retrospectively analyzed to identify predictive parameters for early recurrence. Survival rates in cases of recurrence within 1 year were worse than those of no recurrence within 1 year or recurrence after 1 year. Protein induced by vitamin K absence/antagonist II (PIVKA-II) greater than 150, positive fucosylated alpha-fetoprotein (L3-AFP), and deviancy from Milan criteria (MC) on preoperative imaging were associated with high risk of early recurrence and total number of these three risk factors predicted the survival. With multivariate analysis, 1) preoperatively, positive factors of two or more among three items of PIVKA-II, L3-AFP, and deviancy from MC; 2) and postoperatively, pathological cancer spread (microscopic vascular invasion and/or intrahepatic metastasis) both represented risks for early recurrence. A combination of three preoperative factors, PIVKA-II, L3-AFP, and MC status, in conjunction with the postoperative factor of cancer spread status represents a significant indicator for recurrence within 1 year. Improving the prognosis of patients with HCC would depend on how to adequately treat those at high risk of early recurrence.
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Affiliation(s)
- Michihiro Hayashi
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan
| | - Tetsunosuke Shimizu
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan
| | - Fumitoshi Hirokawa
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan
| | - Yoshihiro Inoue
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan
| | - Koji Komeda
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan
| | - Mitsuhiro Asakuma
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan
| | - Yoshiharu Miyamoto
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan
| | - Atsushi Takeshita
- Departments of Pathology, Osaka Medical College Hospital, Osaka, Japan
| | - Yuro Shibayama
- Departments of Pathology, Osaka Medical College Hospital, Osaka, Japan
| | - Nobuhiko Tanigawa
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan
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42
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Hirokawa F, Hayashi M, Miyamoto Y, Asakuma M, Shimizu T, Komeda K, Inoue Y, Tanigawa N. Re-evaluation of the Necessity of Prophylactic Drainage after Liver Resection. Am Surg 2011. [DOI: 10.1177/000313481107700510] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abdominal drainage after liver resection is considered unnecessary: however, there still exist a number of cases where drain is effective to prevent serious infectious complications. We reevaluated the necessity of drain placement after liver resection from the retrospective analysis of postoperative complications with special reference to the need for drain insertion of 140 patients undergoing hepatectomy without intraoperative abdominal drainage from 2007 through 2010. Three patients required drain reinsertion in the early postoperative period (before postoperative Day 7); all had undergone extended right hepatectomy for hepatocellular carcinoma with portal vein thrombus followed by postoperative liver failure. Risk factors for postoperative bile leakage included repeated hepatectomy, operative procedure with exposure of the major Glisson's sheath (i.e., central bisegmentectomy and anterior segmentectomy), and intraoperative bile leakage. However, because the onset of this complication was as late as postoperative Day 19.5, prophylactic drainage does not appear useful. Although not required routinely, prophylactic drainage might be useful in patients undergoing extended hepatectomy, a high-risk hepatectomy procedure exposing the major Glisson's sheath, those with positive intraoperative bile leakage, for hepatocellular carcinoma, and especially complicated with portal vein thrombus.
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Affiliation(s)
- Fumitoshi Hirokawa
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - Michihiro Hayashi
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - Yoshiharu Miyamoto
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - Mitsuhiro Asakuma
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - Tetsunosuke Shimizu
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - Koji Komeda
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - Yoshihiro Inoue
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
| | - Nobuhiko Tanigawa
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan
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Hirokawa F, Hayashi M, Miyamoto Y, Asakuma M, Shimizu T, Komeda K, Inoue Y, Tanigawa N. Re-evaluation of the necessity of prophylactic drainage after liver resection. Am Surg 2011; 77:539-544. [PMID: 21679584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Abdominal drainage after liver resection is considered unnecessary: however, there still exist a number of cases where drain is effective to prevent serious infectious complications. We re-evaluated the necessity of drain placement after liver resection from the retrospective analysis of postoperative complications with special reference to the need for drain insertion of 140 patients undergoing hepatectomy without intraoperative abdominal drainage from 2007 through 2010. Three patients required drain reinsertion in the early postoperative period (before postoperative Day 7); all had undergone extended right hepatectomy for hepatocellular carcinoma with portal vein thrombus followed by postoperative liver failure. Risk factors for postoperative bile leakage included repeated hepatectomy, operative procedure with exposure of the major Glisson's sheath (i.e., central bisegmentectomy and anterior segmentectomy), and intraoperative bile leakage. However, because the onset of this complication was as late as postoperative Day 19.5, prophylactic drainage does not appear useful. Although not required routinely, prophylactic drainage might be useful in patients undergoing extended hepatectomy, a high-risk hepatectomy procedure exposing the major Glisson's sheath, those with positive intraoperative bile leakage, for hepatocellular carcinoma, and especially complicated with portal vein thrombus.
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Affiliation(s)
- Fumitoshi Hirokawa
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.
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Hayashi M, Shimizu T, Hirokawa F, Inoue Y, Komeda K, Asakuma M, Miyamoto Y, Takeshita A, Shibayama Y, Tanigawa N. Clinicopathological risk factors for recurrence within one year after initial hepatectomy for hepatocellular carcinoma. Am Surg 2011; 77:572-578. [PMID: 21679590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Hepatocellular carcinoma (HCC) shows a high rate of recurrence after hepatectomy; predictive factors for early recurrence would help determine optimal therapeutic and management strategies. Among 163 patients with HCC undergoing hepatectomy with curative intent, 46 patients developed recurrence within 1 year. Clinicopathological data were retrospectively analyzed to identify predictive parameters for early recurrence. Survival rates in cases of recurrence within 1 year were worse than those of no recurrence within 1 year or recurrence after 1 year. Protein induced by vitamin K absence/antagonist II (PIVKA-II) greater than 150, positive fucosylated alpha-fetoprotein (L3-AFP), and deviancy from Milan criteria (MC) on preoperative imaging were associated with high risk of early recurrence and total number of these three risk factors predicted the survival. With multivariate analysis, (1) preoperatively, positive factors of two or more among three items of PIVKA-II, L3-AFP, and deviancy from MC; (2) and postoperatively, pathological cancer spread (microscopic vascular invasion and/or intrahepatic metastasis) both represented risks for early recurrence. A combination of three preoperative factors, PIVKA-II, L3-AFP, and MC status, in conjunction with the postoperative factor of cancer spread status represents a significant indicator for recurrence within 1 year. Improving the prognosis of patients with HCC would depend on how to adequately treat those at high risk of early recurrence.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers/metabolism
- Biomarkers, Tumor/blood
- Biopsy, Needle
- Carcinoma, Hepatocellular/blood
- Carcinoma, Hepatocellular/mortality
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/surgery
- Cohort Studies
- Disease-Free Survival
- Female
- Hepatectomy/methods
- Hepatectomy/mortality
- Humans
- Immunohistochemistry
- Kaplan-Meier Estimate
- Liver Neoplasms/blood
- Liver Neoplasms/mortality
- Liver Neoplasms/pathology
- Liver Neoplasms/surgery
- Logistic Models
- Male
- Middle Aged
- Multivariate Analysis
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Neoplasm Staging
- Predictive Value of Tests
- Preoperative Care/methods
- Prognosis
- Protein Precursors/metabolism
- Prothrombin/metabolism
- Retrospective Studies
- Risk Assessment
- Survival Analysis
- Time Factors
- alpha-Fetoproteins/metabolism
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Affiliation(s)
- Michihiro Hayashi
- Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Osaka, Japan.
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Asakuma M, Hayashi M, Komeda K, Shimizu T, Hirokawa F, Miyamoto Y, Okuda J, Tanigawa N. Impact of single-port cholecystectomy on postoperative pain. Br J Surg 2011; 98:991-5. [PMID: 21538340 DOI: 10.1002/bjs.7486] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2011] [Indexed: 12/15/2022]
Abstract
BACKGROUND This study compared postoperative pain following four-port laparoscopic cholecystectomy (LC) and single-port cholecystectomy (SPC). METHOD This prospective, quasi-randomized, single-centre trial focusing on postoperative pain included 49 patients undergoing elective surgery with either a conventional LC, or SPC using a surgical glove port. Postoperative pain was evaluated using a visual analogue scale (VAS) and postoperative analgesic use as primary outcome measures. Total duration of operation, length of hospital stay, blood test results on the day after surgery and total port cost were secondary outcome measures. RESULTS Twenty-five LCs and 24 SPCs were undertaken. The VAS score on day 1 after surgery was significantly less in the SPC group than in the LC group: median (range) 24 (12-38) versus 45 (33-57) mm (P = 0·002). Significantly fewer patients in the SPC group required analgesia (9 of 24 versus 19 of 25 in the LC group; P = 0·007). There were no significant differences in total duration of operation, length of hospital stay, and blood test results on the day after surgery. CONCLUSION Single-port surgery using a surgical glove port reduces postoperative pain compared with conventional LC.
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Affiliation(s)
- M Asakuma
- Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka 569-8686, Japan.
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46
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Kayano H, Okuda J, Tanaka K, Kondo K, Tanigawa N. Evaluation of the learning curve in laparoscopic low anterior resection for rectal cancer. Surg Endosc 2011; 25:2972-9. [PMID: 21512883 DOI: 10.1007/s00464-011-1655-8] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Accepted: 02/20/2011] [Indexed: 02/06/2023]
Abstract
BACKGROUND Laparoscopic low anterior resection for rectal cancer is considered to be more technically demanding than laparoscopic colectomy. This study aimed to analyze the learning curve for laparoscopic low anterior resection and to identify the factors that influence this learning curve. METHODS Data from 250 consecutive patients undergoing laparoscopic low anterior resection for rectal cancer, excluding patients with a combined resection such as cholecystectomy, hepatectomy, hysterectomy, or gastrectomy, between December 1996 and April 2010 were analyzed. For operative time, the learning curve was analyzed using the moving average method. The conversion rate and the postoperative complication rate were evaluated in five groups of up to 50 patients each based on the number of cases required for analysis of operative time. In addition, risk factors that influenced conversion to open surgery and postoperative complications were analyzed. RESULTS The learning curve analysis for operative time using the moving average method showed stabilization at 50 cases. The conversion rate decreased significantly by group 4 (151-200 cases). The postoperative complication rate decreased significantly by group 5 (201-250 cases). The significant factors for conversion to open surgery were male sex (odds ratio [OR], 2.6094; 95% confidence interval [CI], 1.1-6.4) and T stage (OR, 2.4793; 95% CI, 1.1-5.8). For postoperative complications, male sex (OR, 3.8590; 95% CI, 1.9-3.8) was significant. In addition, the risk factors for anastomotic leakage were male sex (OR, 15.7659, 95% CI, 3.2-284.8) and multiple firing (2 or more cartridges for rectal transection) (OR, 3.0589; 95% CI, 1.1-9.5). CONCLUSIONS The risk factors affecting the learning curve for laparoscopic low anterior resection were T stage and male sex. In laparoscopic low anterior resection, rectal transection in particular can be technically difficult, and standardization for accurate performance of the same technique for expanded indications is very important.
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Affiliation(s)
- Hajime Kayano
- Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigakumachi, Takatsuki-City, Osaka 569-8686, Japan
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Takahashi Y, Kuwabara H, Yoneda M, Isogai Z, Tanigawa N, Shibayama Y. Versican G1 and G3 domains are upregulated and latent transforming growth factor-β binding protein-4 is downregulated in breast cancer stroma. Breast Cancer 2011; 19:46-53. [DOI: 10.1007/s12282-011-0264-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Accepted: 03/10/2011] [Indexed: 12/18/2022]
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48
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Hayashi M, Shimizu T, Tsunematsu I, Hirokawa F, Asakuma M, Takeshita A, Haga H, Tanigawa N. Hepatitis A virus-related late-onset hepatic failure: a case report. EXP CLIN TRANSPLANT 2011; 9:150-152. [PMID: 21453235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Late-onset hepatic failure, the least of the fulminant hepatic failures, has not occurred in patients with hepatitis A virus-related acute liver failure. We report a rare case of hepatitis A virus-related late-onset hepatic failure treated successfully by an emergent liver transplant. A 58-year-old Japanese woman who presented with fever and general malaise was diagnosed as having jaundice and liver dysfunction by a positive serum test for anti-hepatitis A virus IgM, which ultimately led to a diagnosis of acute hepatitis A virus associated hepatitis. Despite intensive treatment, her general condition was poor, and she developed a hepatic coma 79 days from the onset of the disease. Under a diagnosis of hepatitis A virus-related late onset hepatic failure, she was given a living-donor liver transplant 82 days from the start of the disease. The resected native liver revealed submassive necrosis with marked cholestasis, compatible with late-onset hepatic failure. Today, 5 years after the transplant, she is alive and well with no signs of recurrent hepatitis A virus-hepatitis. This case should alert the physician to the clinical management of a patient with hepatitis A virus-related acute liver failure.
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Affiliation(s)
- Michihiro Hayashi
- Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan.
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Inoue Y, Hayashi M, Hirokawa F, Takeshita A, Tanigawa N. Peritoneovenous shunt for intractable ascites due to hepatic lymphorrhea after hepatectomy. World J Gastrointest Surg 2011; 3:16-20. [PMID: 21286221 PMCID: PMC3030739 DOI: 10.4240/wjgs.v3.i1.16] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2010] [Revised: 09/19/2010] [Accepted: 09/26/2010] [Indexed: 02/06/2023] Open
Abstract
A peritoneovenous shunt has become one of the most efficient procedures for intractable ascites due to liver cirrhosis. A case of intractable ascites due to hepatic lymphorrhea after hepatectomy for hepatocellular carcinoma that was successfully treated by the placement of a peritoneovenous shunt is presented. A 72-year-old Japanese man underwent partial resection of the liver for hepatocellular carcinoma associated with hepatitis C viral infection. After hepatectomy, a considerable amount of ascites ranging from 800-4600 mL per day persisted despite conservative therapy, including numerous infusions of albumin and plasma protein fraction and administration of diuretics. Since the patient’s general condition deteriorated, based on the diagnosis of intractable hepatic lymphorrhea, a subcutaneous peritoneovenous shunt was inserted. The patient’s postoperative course was uneventful and the ascites decreased rapidly, with serum total protein and albumin levels and hepatic function improving accordingly. For intractable ascites due to hepatic lymphorrhea after hepatectomy, we recommend the placement of a peritoneovenous shunt as a procedure that can provide immediate effectiveness without increased surgical risk.
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Affiliation(s)
- Yoshihiro Inoue
- Yoshihiro Inoue, Michihiro Hayashi, Fumitoshi Hirokawa, Nobuhiko Tanigawa, Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686, Japan
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50
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Kimura K, Wada A, Ueta M, Ogata A, Tanaka S, Sakai A, Yoshida H, Fushitani H, Miyamoto A, Fukushima M, Uchiumi T, Tanigawa N. Comparative proteomic analysis of the ribosomes in 5-fluorouracil resistance of a human colon cancer cell line using the radical-free and highly reducing method of two-dimensional polyacrylamide gel electrophoresis. Int J Oncol 2011; 37:1271-8. [PMID: 20878074 DOI: 10.3892/ijo_00000778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Many auxiliary functions of ribosomal proteins (r-proteins) have received considerable attention in recent years. However, human r-proteins have hardly been examined by proteomic analysis. In this study, we isolated ribosomal particles and subsequently compared the proteome of r-proteins between the DLD-1 human colon cancer cell line and its 5-fluorouracil (5-FU)-resistant sub-line, DLD-1/5-FU, using the radical-free and highly reducing method of two-dimensional polyacrylamide gel electrophoresis, which has a superior ability to separate basic proteins, and we discuss the role of r-proteins in 5-FU resistance. Densitometric analysis was performed to quantify modulated proteins, and protein spots showing significant changes were identified by employing matrix-assisted laser desorption/ionization time-of-flight/time-of-flight mass spectrometry. Three basic proteins (L15, L37 and prohibitin) which were significantly modulated between DLD-1 and DLD-1/5-FU were identified. Two proteins, L15 and L37, showed down-regulated expression in DLD-1/5-FU in comparison to DLD-1. Prohibitin, which is not an r-protein and is known to be localized in the mitochondria, showed up-regulated expression in DLD-1/5-FU. These 3 proteins may be related to 5-FU resistance.
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Affiliation(s)
- Kosei Kimura
- Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki City, Osaka 569-8686, Japan
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