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Takada T, Isaji S, Yoshida M, Horiguchi A, Ando H, Miyakawa S, Kiriyama S, Gomi H, Mukai S, Higuchi R, Abe Y, Okamoto K, Suzuki K, Toyota N, Hori S, Homma Y, Kato H, Umezawa A, Hata J, Inoue D, Kobayashi M, Tsuyuguchi T, Maruo H, Kumamoto Y, Asano Y, Kondo Y, Arakawa S, Asai K, Mori Y, Nagamachi Y, Mizuno S, Yagi S, Ohyama T, Misawa T, Sano K, Itoi T, Taniai N, Unno M, Yamamoto M, Mayumi T. Modified Socratic Method (planned and executed by Takada) for medical education: Grade II Acute Cholecystitis of Tokyo Guidelines 2018 as an example case. J Hepatobiliary Pancreat Sci 2021; 29:505-520. [PMID: 34758180 DOI: 10.1002/jhbp.1076] [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] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/01/2021] [Accepted: 10/26/2021] [Indexed: 12/07/2022]
Abstract
BACKGROUND Socratic method, which is an educational method to promote critical thinking through a dialogue, has never been practiced in a large number of people at the academic societies. METHODS Modified Socratic method was performed for the first time as an educational seminar using an example case of moderate acute cholecystitis based on the evidence described in Tokyo Guidelines 2018. We adopted a method that Takada had been modifying for many years: the instructor first knows the degree of recognition of the audience, then the instructor gives a lecture in an easy-to-understand manner and receives questions from the audience, followed by repeated questions and answers toward a common recognition. RESULTS Using slides, video, and an answer pad, 281 participants including the audience, instructors and moderators came together to repeatedly ask and answer questions in the five sessions related to the case scenario. The recognition rate of the topic of Critical View of Safety increased significantly before vs after this method (53.0% vs 90.3%). The seminar had been successfully performed by receiving a lot of praise from the participants. CONCLUSION This educational method is considered to be adopted by many academic societies in the future as an effective educational method.
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Affiliation(s)
- Tadahiro Takada
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Shuji Isaji
- Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Masahiro Yoshida
- Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health & Welfare, Ichikawa, Japan
| | - Akihiko Horiguchi
- Department of Gastroenterological Surgery, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Hisami Ando
- Aichi Developmental Disability Center, Kasugai, Japan
| | | | - Seiki Kiriyama
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Harumi Gomi
- Office of Medical Education and Center of Infection Diseases, International University of Health and Welfare, Narita, Japan
| | - Shuntaro Mukai
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Ryota Higuchi
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuta Abe
- Department of Surgery, Keio University, Tokyo, Japan
| | - Kohji Okamoto
- Department of Surgery, Center for Gastroenterology and Liver Surgery, Kitakyushu City Yahata Hospital, Kitakyushu, Japan
| | - Kenji Suzuki
- Department of Surgery, Fujinomiya City General Hospital, Fujinomiya, Japan
| | - Naoyuki Toyota
- Department of Surgery, Tsudanuma Central General Hospital, Narashino, Japan
| | - Shutaro Hori
- Department of Surgery, Keio University, Tokyo, Japan
| | - Yuki Homma
- Department of Gastroenterological Surgery, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Hiroyuki Kato
- Department of Gastroenterological Surgery, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Akiko Umezawa
- Department of Surgery, Minimally Invasive Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Jiro Hata
- Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki City, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University Hospital, Kanazawa, Japan
| | - Motoyuki Kobayashi
- Department of Surgery, Matsusaka Chuo General Hospital, Matsusaka, Japan
| | - Toshio Tsuyuguchi
- Department of Gastroenterology, Chiba Prefectural Sawara Hospital, Katori, Japan
| | - Hirotoshi Maruo
- Department of Surgery, Shizuoka City Shimizu Hospital, Shizuoka, Japan
| | - Yusuke Kumamoto
- Department of General, Pediatric and Hepato-Biliary-Pancreatic Surgery, Kitasato University, Sagamihara, Japan
| | - Yukio Asano
- Department of Gastroenterological Surgery, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Yuka Kondo
- Department of Gastroenterological Surgery, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Satoshi Arakawa
- Department of Gastroenterological Surgery, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Koji Asai
- Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Yasuhisa Mori
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukiko Nagamachi
- Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan
| | - Shugo Mizuno
- Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Shintaro Yagi
- Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, Kanazawa, Japan
| | | | - Takeyuki Misawa
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Keiji Sano
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Takao Itoi
- Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan
| | - Nobuhiko Taniai
- Department of Digestive Surgery, Nippon Medical School, Musashikosugi Hospital, Kawasaki, Japan
| | - Michiaki Unno
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Toshihiko Mayumi
- Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
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Tanaka S, Uchida S, Hakamata A, Miyakawa S, Odagiri K, Inui N, Watanabe H, Namiki N. Simultaneous LC-MS analysis of plasma concentrations of sildenafil, tadalafil, bosentan, ambrisentan, and macitentan in patients with pulmonary arterial hypertension. Pharmazie 2021; 75:236-239. [PMID: 32539916 DOI: 10.1691/ph.2020.0021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Phosphodiesterase-5 (PDE-5) inhibitors and endothelin receptor antagonists (ERAs) are standard therapies for pulmonary arterial hypertension (PAH). The inter-individual variability of these pharmacokinetics is reported remarkably large, and therapeutic drug monitoring (TDM) can be useful to improve the likelihood of the desired therapeutic and safety outcomes. This study aimed to develop a LC-MS method to determine the concentrations of five PAH drugs (PDE-5 inhibitors: sildenafil and tadalafil, ERAs: bosentan, macitentan, and ambrisentan) from plasma samples using a simple process followed by a single mass spectrometric run, and to validate this approach through pharmacokinetic analyses in patients. A solid extraction method was used for sample preparation of the drugs from human plasma. The total run time for a single injection was within 10 min. The calibration curves for all drugs were linear, and the lower limits of quantitation were 1 (sildenafil), 2 (tadalafil), 5 (ambrisentan), and 10 ng/mL (bosentan, macitentan). The accuracy and precision values suggested that the assay had high accuracy and reliability. To prove the utility of this method, the plasma concentrations of the five PAH drugs were determined after their oral administration to nine PAH patients.
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Affiliation(s)
- S Tanaka
- Department of Pharmacy Practice & Science, Hamamatsu University School of Medicine, Japan
| | - S Uchida
- Department of Pharmacy Practice & Science, Hamamatsu University School of Medicine, Japan;,
| | - A Hakamata
- School of Pharmaceutical Sciences, University of Shizuoka, Department of Clinical Pharmacology & Therapeutics, Hamamatsu University School of Medicine, Japan
| | - S Miyakawa
- School of Pharmaceutical Sciences, University of Shizuoka, Department of Clinical Pharmacology & Therapeutics, Hamamatsu University School of Medicine, Japan
| | - K Odagiri
- School of Pharmaceutical Sciences, University of Shizuoka, Department of Clinical Pharmacology & Therapeutics, Hamamatsu University School of Medicine, Japan
| | - N Inui
- School of Pharmaceutical Sciences, University of Shizuoka, Department of Clinical Pharmacology & Therapeutics, Hamamatsu University School of Medicine, Japan
| | - H Watanabe
- School of Pharmaceutical Sciences, University of Shizuoka, Department of Clinical Pharmacology & Therapeutics, Hamamatsu University School of Medicine, Japan
| | - N Namiki
- Department of Pharmacy Practice & Science, Hamamatsu University School of Medicine, Japan
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3
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Iwai K, Yaguchi M, Nishimura K, Yamamoto Y, Tamura T, Nakata D, Dairiki R, Kawakita Y, Mizojiri R, Ito Y, Asano M, Maezaki H, Nakayama Y, Kaishima M, Hayashi K, Teratani M, Miyakawa S, Iwatani M, Miyamoto M, Klein MG, Lane W, Snell G, Tjhen R, He X, Pulukuri S, Nomura T. Anti-tumor efficacy of a novel CLK inhibitor via targeting RNA splicing and MYC-dependent vulnerability. EMBO Mol Med 2019; 10:emmm.201708289. [PMID: 29769258 PMCID: PMC5991599 DOI: 10.15252/emmm.201708289] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The modulation of pre-mRNA splicing is proposed as an attractive anti-neoplastic strategy, especially for the cancers that exhibit aberrant pre-mRNA splicing. Here, we discovered that T-025 functions as an orally available and potent inhibitor of Cdc2-like kinases (CLKs), evolutionally conserved kinases that facilitate exon recognition in the splicing machinery. Treatment with T-025 reduced CLK-dependent phosphorylation, resulting in the induction of skipped exons, cell death, and growth suppression in vitro and in vivo Further, through growth inhibitory characterization, we identified high CLK2 expression or MYC amplification as a sensitive-associated biomarker of T-025. Mechanistically, the level of CLK2 expression correlated with the magnitude of global skipped exons in response to T-025 treatment. MYC activation, which altered pre-mRNA splicing without the transcriptional regulation of CLKs, rendered cancer cells vulnerable to CLK inhibitors with synergistic cell death. Finally, we demonstrated in vivo anti-tumor efficacy of T-025 in an allograft model of spontaneous, MYC-driven breast cancer, at well-tolerated dosage. Collectively, our results suggest that the novel CLK inhibitor could have therapeutic benefits, especially for MYC-driven cancer patients.
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Affiliation(s)
- Kenichi Iwai
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Masahiro Yaguchi
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Kazuho Nishimura
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Yukiko Yamamoto
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Toshiya Tamura
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Daisuke Nakata
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Ryo Dairiki
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Yoichi Kawakita
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Ryo Mizojiri
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Yoshiteru Ito
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Moriteru Asano
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Hironobu Maezaki
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Yusuke Nakayama
- Integrated Technology Research Laboratories, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Misato Kaishima
- Integrated Technology Research Laboratories, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Kozo Hayashi
- Integrated Technology Research Laboratories, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Mika Teratani
- Integrated Technology Research Laboratories, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Shuichi Miyakawa
- Biomolecular Research Laboratories, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Misa Iwatani
- Biomolecular Research Laboratories, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Maki Miyamoto
- Drug Metabolism & Pharmacokinetics Research Laboratories, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
| | - Michael G Klein
- Department of Structural Biology, Takeda California Inc., San Diego, CA, USA
| | - Wes Lane
- Department of Structural Biology, Takeda California Inc., San Diego, CA, USA
| | - Gyorgy Snell
- Department of Structural Biology, Takeda California Inc., San Diego, CA, USA
| | - Richard Tjhen
- Department of Structural Biology, Takeda California Inc., San Diego, CA, USA
| | - Xingyue He
- Oncology Drug Discovery Unit, Takeda Pharmaceuticals International Co., Cambridge, MA, USA
| | - Sai Pulukuri
- Oncology Drug Discovery Unit, Takeda Pharmaceuticals International Co., Cambridge, MA, USA
| | - Toshiyuki Nomura
- Oncology Drug Discovery Unit, Takeda Pharmaceutical Company, Limited, Fujisawa, Japan
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Soutar MPM, Kempthorne L, Miyakawa S, Annuario E, Melandri D, Harley J, O'Sullivan GA, Wray S, Hancock DC, Cookson MR, Downward J, Carlton M, Plun-Favreau H. AKT signalling selectively regulates PINK1 mitophagy in SHSY5Y cells and human iPSC-derived neurons. Sci Rep 2018; 8:8855. [PMID: 29891871 PMCID: PMC5995958 DOI: 10.1038/s41598-018-26949-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 05/23/2018] [Indexed: 01/06/2023] Open
Abstract
The discovery of mutations within genes associated with autosomal recessive Parkinson's disease allowed for the identification of PINK1/Parkin regulated mitophagy as an important pathway for the removal of damaged mitochondria. While recent studies suggest that AKT-dependent signalling regulates Parkin recruitment to depolarised mitochondria, little is known as to whether this can also regulate PINK1 mitochondrial accumulation and downstream mitophagy. Here, we demonstrate that inhibition of AKT signalling decreases endogenous PINK1 accumulation in response to mitochondria depolarisation, subsequent Parkin recruitment, phosphorylation of ubiquitin, and ultimately mitophagy. Conversely, we show that upon stimulation of AKT signalling via insulin, the mitophagy pathway is increased in SHSY5Y cells. These data suggest that AKT signalling is an upstream regulator of PINK1 accumulation on damaged mitochondria. Importantly, we show that the AKT pathway also regulates endogenous PINK1-dependent mitophagy in human iPSC-derived neurons.
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Affiliation(s)
- Marc P M Soutar
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
| | - Liam Kempthorne
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Shuichi Miyakawa
- Biomolecular Research Laboratories, Pharmaceutical Research Division, Takeda Pharmaceutical Company Limited, Fujisawa, Japan
| | - Emily Annuario
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Daniela Melandri
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Jasmine Harley
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | | | - Selina Wray
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - David C Hancock
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Mark R Cookson
- Laboratory of Neurogenetics, NIH, Building 35, Room 1A116, 35 Convent Drive, Bethesda, MD, 20814, USA
| | - Julian Downward
- The Francis Crick Institute, 1 Midland Road, London, NW1 1AT, UK
| | - Mark Carlton
- CereVance Ltd. 418 Science Park, Milton Rd, Cambridge, CB4 0PZ, UK
| | - Hélène Plun-Favreau
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
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5
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Miura K, Miyakawa S, Narayama S, Hirano H, Kanai K, Miwa T. Athletes as Health Testing Examinees. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634913] [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: 10/17/2022]
Abstract
Abstract:Health-testing examination data of 91 male and 54 female athletes were studied, together with age-matched controls, on serum biochemistry, ECG findings, hematology, and some data on gynecological physiology. Analysis of serum biochemical values revealed statistically significant differences in 14 of 18 routine test items as compared with the age-matched controls. In ECG findings, the combination of bradycardia and left ventricular hypertrophy was most frequently found in male athletes, whereas that of bradycardia and sinus arrythmia was observed predominantly in female athletes. The incidence of anemia and menstrual dysfunction was higher in female athletes than in controls, especially in the basketball team. In the same team, a high rate of deviant ECG records and a different distribution of the age at menarche were also observed.
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Nishimura K, Yaguchi M, Yamamoto Y, Ebara S, Yoichi K, Mizojiri R, Nakayama Y, Hayashi K, Miyakawa S, Iwai K, Nomura T. Abstract B060: Small molecule inhibitor of pre-mRNA splicing evokes antitumor activity via MDM4-p53 pathway. Mol Cancer Ther 2018. [DOI: 10.1158/1535-7163.targ-17-b060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Proper control of gene expression at the level of transcription and RNA processing is a fundamental process of tumor cell growth. Here we showed that a novel pre-mRNA splicing modulator, Cdc2-like kinase (CLK) inhibitor T-025, suppressed tumor cell growth in vitro and in vivo. To reveal the mechanisms linking aberrant splicing and tumor growth suppression by T-025, we combined transcriptomic RNA-seq and proteomic p-SILAC data. We identified MDM4 as a mediator for triggering p53-dependent apoptosis in response to T-025. CLK inhibition led to exon 6 skipping of MDM4 mRNA, a potential target for nonsense-mediated decay, decreasing MDM4 protein. Consistent with these results, overexpression of MDM4 or knockdown of p53 attenuated growth-suppressive effects of T-025. We then investigated the relationship between genomic features and sensitivity to T-025 by evaluating the antiproliferative effect of T-025 against 240 cancer cell lines. Strikingly, expression of MDM4 was correlated with that of CLK2 and cell sensitivity to T-025. In addition, we found that copy number variation and mRNA expression of MYC were correlated with cell sensitivity to T-025. T-025 exhibited greater sensitivity in MYC-expressing cells and MYC-driven spontaneous breast cancer models. Together, we demonstrated that MDM4-p53 signaling and MYC-activation have key roles in antitumor activity of CLK inhibitor.
Citation Format: Kazuho Nishimura, Masahiro Yaguchi, Yukiko Yamamoto, Shunsuke Ebara, Kawakita Yoichi, Ryo Mizojiri, Yusuke Nakayama, Kozo Hayashi, Shuichi Miyakawa, Kenichi Iwai, Toshiyuki Nomura. Small molecule inhibitor of pre-mRNA splicing evokes antitumor activity via MDM4-p53 pathway [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr B060.
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Affiliation(s)
| | | | | | | | | | - Ryo Mizojiri
- Takeda Pharmaceutical Company Limited, Cambridge, MA
| | | | - Kozo Hayashi
- Takeda Pharmaceutical Company Limited, Cambridge, MA
| | | | - Kenichi Iwai
- Takeda Pharmaceutical Company Limited, Cambridge, MA
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Ito M, Nagata H, Yamamoto T, Yoshihara D, Fox IJ, Miyakawa S. Intrasplenic Hepatocyte Transplantation Prolonged the Survival in Nagase Analbuminemic Rats with Liver Failure Induced by Common Bile Duct Ligation. Cell Transplant 2017; 16:547-53. [PMID: 17708344 DOI: 10.3727/000000007783464894] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 12/21/2022] Open
Abstract
It has already been established that hepatocyte transplantation (HTx) in animal models, such as both chemically and surgically induced acute liver failure, liver-based metabolic disease, and cirrhosis, resulted in significant improvement of liver function and survival. However, the efficacy of hepatocyte transplantation in secondary cholestatic liver disease is not well known. In this study, we transplanted hepatocytes into the spleen of Nagase analbuminemic rats (NARs) with common bile duct ligation (CBDL) to evaluate the function of transplanted hepatocytes by both of serum albumin levels and total bilirubin levels. CBDL was carried out on NARs to induce liver failure. Lewis rat hepatocytes were transplanted in NARs 7 days after CBDL. Animals, in groups of four, underwent the following interventions: group 1—intrasplenic transplantation of 30 × 106 primary Lewis rat hepatocytes in NARs with CBDL (n = 4), group 2—intrasplenic injection of 0.5 ml DMEM in NARs with CBDL (n = 4); group 3—CBDL only (n = 4); group 4—intrasplenic transplantation of 30 × 106 primary Lewis rat hepatocytes in NARs (n = 4). Both bilirubin levels and albumin levels in NARs with CBDL were significantly improved post-HTx. Animals receiving hepatocyte transplantation survived longer than animals in nontransplant control groups. This study indicates that hepatocytes can be transplanted to temporarily provide life-supporting liver-specific metabolic function and prolong the survival in recipient rats with liver failure induced by CBDL.
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Affiliation(s)
- Masahiro Ito
- Department of Surgery, Fujita-Health University, Toyoake, Aichi, Japan.
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Goto R, Miyakawa S, Inomata E, Takami T, Yamaura J, Nakamura Y. De novo sequencing of highly modified therapeutic oligonucleotides by hydrophobic tag sequencing coupled with LC-MS. J Mass Spectrom 2017; 52:78-93. [PMID: 27935159 DOI: 10.1002/jms.3902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 11/23/2016] [Accepted: 11/24/2016] [Indexed: 06/06/2023]
Abstract
Correct sequences are prerequisite for quality control of therapeutic oligonucleotides. However, there is no definitive method available for determining sequences of highly modified therapeutic RNAs, and thereby, most of the oligonucleotides have been used clinically without direct sequence determination. In this study, we developed a novel sequencing method called 'hydrophobic tag sequencing'. Highly modified oligonucleotides are sequenced by partially digesting oligonucleotides conjugated with a 5'-hydrophobic tag, followed by liquid chromatography-mass spectrometry analysis. 5'-Hydrophobic tag-printed fragments (5'-tag degradates) can be separated in order of their molecular masses from tag-free oligonucleotides by reversed-phase liquid chromatography. As models for the sequencing, the anti-VEGF aptamer (Macugen) and the highly modified 38-mer RNA sequences were analyzed under blind conditions. Most nucleotides were identified from the molecular weight of hydrophobic 5'-tag degradates calculated from monoisotopic mass in simple full mass data. When monoisotopic mass could not be assigned, the nucleotide was estimated using the molecular weight of the most abundant mass. The sequences of Macugen and 38-mer RNA perfectly matched the theoretical sequences. The hydrophobic tag sequencing worked well to obtain simple full mass data, resulting in accurate and clear sequencing. The present study provides for the first time a de novo sequencing technology for highly modified RNAs and contributes to quality control of therapeutic oligonucleotides. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- R Goto
- Bioanalysis Business Department, CMIC Pharma Science Co., Ltd., 17-18, Nakahata-cho, Nishiwaki-shi, Hyogo, 677-0032, Japan
| | - S Miyakawa
- Exploratory Research Laboratory, RIBOMIC Inc., 3-16-13, Shirokanedai, Minato-ku, Tokyo, 108-0071, Japan
| | - E Inomata
- Exploratory Research Laboratory, RIBOMIC Inc., 3-16-13, Shirokanedai, Minato-ku, Tokyo, 108-0071, Japan
| | - T Takami
- Bioanalysis Department, CMIC, Inc., Hoffman Estates, Illinois, 60192-3702, USA
| | - J Yamaura
- Exploratory Research Laboratory, RIBOMIC Inc., 3-16-13, Shirokanedai, Minato-ku, Tokyo, 108-0071, Japan
| | - Y Nakamura
- Exploratory Research Laboratory, RIBOMIC Inc., 3-16-13, Shirokanedai, Minato-ku, Tokyo, 108-0071, Japan
- Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
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Kurosawa T, Tachibana H, Moriya S, Miyakawa S, Sato M. SU-F-T-479: Estimation of the Accuracy in Respiratory-Gated Radiotherapy. Med Phys 2016. [DOI: 10.1118/1.4956664] [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: 11/07/2022] Open
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Moriya S, Tachibana H, Hotta K, Nakamura N, Baba H, Kohno R, Miyakawa S, Kurosawa T, Akimoto T. SU-F-J-57: Effectiveness of Daily CT-Based Three-Dimensional Image Guided and Adaptive Proton Therapy. Med Phys 2016. [DOI: 10.1118/1.4955965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Miyakawa S, Tachibana H, Moriya S, Kurosawa T, Sato M. SU-C-202-06: Design and Development of a Non-Rigid Phantom Ventilating Air Quantitatively Evaluating CT-Based Pulmonary Ventilation Imaging. Med Phys 2016. [DOI: 10.1118/1.4955574] [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: 11/07/2022] Open
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Ishihara S, Horiguchi A, Miyakawa S, Endo I, Miyazaki M, Takada T. Biliary tract cancer registry in Japan from 2008 to 2013. J Hepatobiliary Pancreat Sci 2016; 23:149-57. [DOI: 10.1002/jhbp.314] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/20/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Shin Ishihara
- Department of General Surgery and Pancreatic Surgery; Fujita Health University; 1-98 Dengakygakubo, Kutsukake-cho, Toyoake, Aichi 470-1192 Japan
| | - Akihiko Horiguchi
- Department of General Surgery and Pancreatic Surgery; Fujita Health University; 1-98 Dengakygakubo, Kutsukake-cho, Toyoake, Aichi 470-1192 Japan
| | | | - Itaru Endo
- Department of Gastroenterological Surgery; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Masaru Miyazaki
- Department of General Surgery, Graduate School of Medicine; Chiba University; Chiba Japan
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Hakamata A, Odagiri K, Miyakawa S, Irisawa H, Takeuchi K, Inui N, Tanaka S, Uchida S, Watanabe H. Pharmacokinetic and Pharmacodynamic Comparison of Sildenafil-Bosentan and Sildenafil-Ambrisentan Combination Therapies for Pulmonary Hypertension. Clin Transl Sci 2016; 9:29-35. [PMID: 26756977 PMCID: PMC5351320 DOI: 10.1111/cts.12382] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 10/28/2015] [Accepted: 11/20/2015] [Indexed: 11/30/2022] Open
Abstract
To elucidate whether the pharmacokinetics (PK) and pharmacodynamics (PD) of sildenafil are influenced differently when it is coadministered with bosentan (S+B) or with ambrisentan (S+A), we evaluated the PK and PD profiles of sildenafil before and after 4–5 weeks of S+A or S+B treatment in patients with pulmonary arterial hypertension. The area under the plasma concentration–time curve of sildenafil was significantly higher in S+A treatment than in S+B treatment (165.8 ng•h/mL vs. 396.8 ng•h/mL, P = 0.018) and the oral clearance of sildenafil was significantly lower after S+A treatment than after S+B treatment (120.6 L/h/kg vs. 50.4 L/h/kg, P = 0.018). In the PD study, incremental shuttle walking distance was superior during treatment with S+A than during treatment with S+B (S+B; 280 m vs. S+A; 340 m, P = 0.042). There were no concerns about safety with either combination therapy regime.
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Affiliation(s)
- A Hakamata
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - K Odagiri
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - S Miyakawa
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - H Irisawa
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - K Takeuchi
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - N Inui
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - S Tanaka
- Department of Pharmacy Practice and Science, School of Pharmaceutical Science, University of Shizuoka, Shizuoka, Japan
| | - S Uchida
- Department of Pharmacy Practice and Science, School of Pharmaceutical Science, University of Shizuoka, Shizuoka, Japan
| | - H Watanabe
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Gotoh M, Miyata H, Hashimoto H, Wakabayashi G, Konno H, Miyakawa S, Sugihara K, Mori M, Satomi S, Kokudo N, Iwanaka T. National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency. Surg Today 2016; 46:38-47. [PMID: 25797948 PMCID: PMC4674525 DOI: 10.1007/s00595-015-1146-y] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 01/26/2015] [Indexed: 01/13/2023]
Abstract
The National Clinical Database (NCD) of Japan was established in April, 2010 with ten surgical subspecialty societies on the platform of the Japan Surgical Society. Registrations began in 2011 and over 4,000,000 cases from more than 4100 facilities were registered over a 3-year period. The gastroenterological section of the NCD collaborates with the American College of Surgeons' National Surgical Quality Improvement Program, which shares a similar goal of developing a standardized surgical database for surgical quality improvement, with similar variables for risk adjustment. Risk models of mortality for eight procedures; namely, esophagectomy, partial/total gastrectomy, right hemicolectomy, low anterior resection, hepatectomy, pancreaticoduodenectomy, and surgery for acute diffuse peritonitis, have been established, and feedback reports to participants will be implemented. The outcome measures of this study were 30-day mortality and operative mortality. In this review, we examine the eight risk models, compare the procedural outcomes, outline the feedback reporting, and discuss the future evolution of the NCD.
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Affiliation(s)
- Mitsukazu Gotoh
- National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan ,The Japanese Society of Gastroenterological Surgery (JSGS), Database Committee, 1-14-1-501 Shintomi, Chuo-ku, Tokyo, 104-0041 Japan
| | - Hiroaki Miyata
- National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan ,The Japanese Society of Gastroenterological Surgery (JSGS), Database Committee, 1-14-1-501 Shintomi, Chuo-ku, Tokyo, 104-0041 Japan
| | - Hideki Hashimoto
- National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan ,The Japanese Society of Gastroenterological Surgery (JSGS), Database Committee, 1-14-1-501 Shintomi, Chuo-ku, Tokyo, 104-0041 Japan
| | - Go Wakabayashi
- The Japanese Society of Gastroenterological Surgery (JSGS), Database Committee, 1-14-1-501 Shintomi, Chuo-ku, Tokyo, 104-0041 Japan
| | - Hiroyuki Konno
- National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan ,The Japanese Society of Gastroenterological Surgery (JSGS), Database Committee, 1-14-1-501 Shintomi, Chuo-ku, Tokyo, 104-0041 Japan
| | | | - Kenichi Sugihara
- National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan
| | - Masaki Mori
- National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan
| | - Susumu Satomi
- National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan
| | - Norihiro Kokudo
- National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan
| | - Tadashi Iwanaka
- National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan
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15
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Nguyen M, Miyakawa S, Kato J, Mori T, Arai T, Armanini M, Gelmon K, Yerushalmi R, Leung S, Gao D, Landes G, Haak-Frendscho M, Elias K, Simmons AD. Preclinical Efficacy and Safety Assessment of an Antibody-Drug Conjugate Targeting the c-RET Proto-Oncogene for Breast Carcinoma. Clin Cancer Res 2015; 21:5552-62. [PMID: 26240273 DOI: 10.1158/1078-0432.ccr-15-0468] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 07/12/2015] [Indexed: 11/16/2022]
Abstract
PURPOSE The RET proto-oncogene has been implicated in breast cancer, and the studies herein describe the preclinical and safety assessment of an anti-RET antibody-drug conjugate (ADC) being developed for the treatment of breast cancer. EXPERIMENTAL DESIGN RET protein expression was analyzed in breast tumor samples using tissue microarrays. The fully human anti-RET antibody (Y078) was conjugated to the DM1 and DM4 derivatives of the potent cytotoxic agent maytansine using thioether and disulfide linkers, respectively. The resulting compounds, designated Y078-DM1 and Y078-DM4, were evaluated for antitumor activity using human breast cancer cell lines and established tumor xenograft models. A single-dose, 28-day, safety study of Y078-DM1 was performed in cynomolgus monkeys. RESULTS By immunohistochemistry, RET expression was detected in 57% of tumors (1,596 of 2,800 tumor sections) and was most common in HER2-positive and basal breast cancer subtypes. Potent in vitro cytotoxicity was achieved in human breast cancer cell lines that have expression levels comparable with those observed in breast cancer tissue samples. Dose-response studies in xenograft models demonstrated antitumor activity with both weekly and every-3-weeks dosing regimens. In cynomolgus monkeys, a single injection of Y078-DM1 demonstrated dose-dependent, reversible drug-mediated alterations in blood chemistry with evidence of on-target neuropathy. CONCLUSIONS RET is broadly expressed in breast cancer specimens and thus represents a potential therapeutic target; Y078-DM1 and Y078-DM4 demonstrated antitumor activity in preclinical models. Optimization of the dosing schedule or an alternate cytotoxic agent with a different mechanism of action may reduce the potential risk of neuropathy. Clin Cancer Res; 21(24); 5552-62. ©2015 AACR.
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Affiliation(s)
- Minh Nguyen
- Takeda California, Inc., San Diego, California
| | | | | | - Toshiyuki Mori
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Ltd., Fujisawa, Kanagawa, Japan
| | - Toshimitsu Arai
- Pharmaceutical Research Division, Takeda Pharmaceutical Company Ltd., Fujisawa, Kanagawa, Japan
| | | | - Karen Gelmon
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Rinat Yerushalmi
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Samuel Leung
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Dongxia Gao
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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Watanabe M, Hayashi T, Miyazaki Y, Miyakawa S. Cross-sectional area and muscle activity of the lumbar multifidus muscles in varying postures during abdominal draw-in exercises. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1622] [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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17
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Yoshitomi H, Miyakawa S, Nagino M, Takada T, Miyazaki M. Updated clinical practice guidelines for the management of biliary tract cancers: revision concepts and major revised points. J Hepatobiliary Pancreat Sci 2015; 22:274-8. [DOI: 10.1002/jhbp.234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 02/03/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Hideyuki Yoshitomi
- Department of General Surgery, Graduate School of Medicine; Chiba University; 1-8-1 Inohana, Chuo-ku Chiba 260-8670 Japan
| | | | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Tadahiro Takada
- Department of Surgery; Teikyo University School of Medicine; Tokyo Japan
| | - Masaru Miyazaki
- Department of General Surgery, Graduate School of Medicine; Chiba University; 1-8-1 Inohana, Chuo-ku Chiba 260-8670 Japan
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18
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Miyazaki M, Yoshitomi H, Miyakawa S, Uesaka K, Unno M, Endo I, Ota T, Ohtsuka M, Kinoshita H, Shimada K, Shimizu H, Tabata M, Chijiiwa K, Nagino M, Hirano S, Wakai T, Wada K, Isayama H, Iasayama H, Okusaka T, Tsuyuguchi T, Fujita N, Furuse J, Yamao K, Murakami K, Yamazaki H, Kijima H, Nakanuma Y, Yoshida M, Takayashiki T, Takada T. Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition. J Hepatobiliary Pancreat Sci 2015; 22:249-73. [PMID: 25787274 DOI: 10.1002/jhbp.233] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract and ampullary carcinomas in 2008. Novel treatment modalities and handling of clinical issues have been proposed after the publication. New approaches for editing clinical guidelines, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, also have been introduced for better and clearer grading of recommendations. METHODS Clinical questions (CQs) were proposed in seven topics. Recommendation, grade of recommendation and statement for each CQ were discussed and finalized by evidence-based approach. Recommendation was graded to grade 1 (strong) and 2 (weak) according to the concept of GRADE system. RESULTS The 29 CQs covered seven topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, (6) radiation therapy, and (7) pathology. In 27 CQs, 19 recommendations were rated strong and 11 recommendations weak. Each CQ included the statement of how the recommendation was graded. CONCLUSIONS This guideline provides recommendation for important clinical aspects based on evidence. Future collaboration with cancer registry will be a key for assessment of the guidelines and establishment of new evidence. Free full-text articles and a mobile application of this guideline are available via http://www.jshbps.jp/en/guideline/biliary-tract2.html.
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Affiliation(s)
- Masaru Miyazaki
- Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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19
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Miyazaki M, Ohtsuka M, Miyakawa S, Nagino M, Yamamoto M, Kokudo N, Sano K, Endo I, Unno M, Chijiiwa K, Horiguchi A, Kinoshita H, Oka M, Kubota K, Sugiyama M, Uemoto S, Shimada M, Suzuki Y, Inui K, Tazuma S, Furuse J, Yanagisawa A, Nakanuma Y, Kijima H, Takada T. Classification of biliary tract cancers established by the Japanese Society of Hepato-Biliary-Pancreatic Surgery: 3(rd) English edition. J Hepatobiliary Pancreat Sci 2015; 22:181-96. [PMID: 25691463 DOI: 10.1002/jhbp.211] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 01/04/2023]
Abstract
The 3(rd) English edition of the Japanese classification of biliary tract cancers was released approximately 10 years after the 5(th) Japanese edition and the 2(nd) English edition. Since the first Japanese edition was published in 1981, the Japanese classification has been in extensive use, particularly among Japanese surgeons and pathologists, because the cancer status and clinical outcomes in surgically resected cases have been the main objects of interest. However, recent advances in the diagnosis, management and research of the disease prompted the revision of the classification that can be used by not only surgeons and pathologists but also by all clinicians and researchers, for the evaluation of current disease status, the determination of current appropriate treatment, and the future development of medical practice for biliary tract cancers. Furthermore, during the past 10 years, globalization has advanced rapidly, and therefore, internationalization of the classification was an important issue to revise the Japanese original staging system, which would facilitate to compare the disease information among institutions worldwide. In order to achieve these objectives, the new Japanese classification of the biliary tract cancers principally adopted the 7(th) edition of staging system developed by the International Union Against Cancer (UICC) and the American Joint Committee on Cancer (AJCC). However, because there are some points pending in these systems, several distinctive points were also included for the purpose of collection of information for the future optimization of the staging system. Free mobile application of the new Japanese classification of the biliary tract cancers is available via http://www.jshbps.jp/en/classification/cbt15.html.
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Affiliation(s)
- Masaru Miyazaki
- Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuoh-ku, Chiba, 260-8670, Japan
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20
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Ohtsuka M, Miyakawa S, Nagino M, Takada T, Miyazaki M. Revision concepts and distinctive points of the new Japanese classification for biliary tract cancers in comparison with the 7thedition of the Union for International Cancer Control and the American Joint Committee on Cancer staging system. J Hepatobiliary Pancreat Sci 2015; 22:197-201. [DOI: 10.1002/jhbp.212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Masayuki Ohtsuka
- Department of General Surgery, Graduate School of Medicine; Chiba University; Chiba Japan
| | - Shuichi Miyakawa
- Department of Biliary-Pancreatic Surgery; Fujita Health University; Aichi Japan
| | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Tadahiro Takada
- Department of Surgery; Teikyo University School of Medicine; Tokyo Japan
| | - Masaru Miyazaki
- Department of General Surgery, Graduate School of Medicine; Chiba University; Chiba Japan
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21
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Morine Y, Shimada M, Takamatsu H, Araida T, Endo I, Kubota M, Toki A, Noda T, Matsumura T, Miyakawa S, Ishibashi H, Kamisawa T, Shimada H. Clinical features of pancreaticobiliary maljunction: update analysis of 2nd Japan-nationwide survey. J Hepatobiliary Pancreat Sci 2014; 20:472-80. [PMID: 23579999 DOI: 10.1007/s00534-013-0606-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Pancreaticobiliary maljunction (PBM) is a congenital anomaly, which can be defined as a union of the pancreatic and biliary ducts located outside off the duodenal wall. We herein investigate clinical features of PBM including as the 2nd report of a Japanese nationwide survey. PATIENTS AND METHODS During a period of 18 years (from 1990 to 2007), 2,561 patients with PBM were registered at 141 medical institutions in Japan. Among them, eligible patients (n = 2,529) were divided into two groups: adult (n = 1,511) and pediatric patients (n = 1,018). Comparisons of clinical features including associated biliary cancers were performed according to the biliary dilatation (BD), age factor, and time era. RESULTS Only one case in pediatric patients with BD combined with a bile duct cancer (0.1 %). In adult patients, the bile duct cancer and the gallbladder cancer was seen in 6.9 and 13.4 % patients with BD and in 3.1 and 37.4 % patients without BD, respectively. In adult patients with BD, the occurrence rates of biliary cancers were increased in latter period (00'-07') compared with former period (90'-99'). The ratio of biliary cancer localization was changed between former and latter period, and the bile duct cancer was increased in latter period (from 5.5 to 9.3 %). CONCLUSIONS The largest series of PBM were evaluated to clarify the clinical features including the associated biliary cancer in this Japan-nationwide survey. This report could be widely used in the future as a reference data for diagnosis and treatment of PBM.
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Affiliation(s)
- Yuji Morine
- Japanese Study Group on Pancreaticobiliary Maljunction, Tokushima, Japan.
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22
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Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H, Sano K, Miura F, Ohta T, Kayahara M, Nagino M, Igami T, Hirano S, Yamaue H, Tani M, Yamamoto M, Ota T, Shimada M, Morine Y, Kinoshita H, Yasunaga M, Takada T. Gallbladder bed resection or hepatectomy of segments 4a and 5 for pT2 gallbladder carcinoma: analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci 2014; 20:518-24. [PMID: 23430053 DOI: 10.1007/s00534-012-0584-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Hepatectomy of segments 4a and 5 (S4a+5) is the recommended treatment for pT2 gallbladder cancer. However, gallbladder bed resection is also occasionally used. Using nationwide data from the Japanese Biliary Tract Cancer Registry and a questionnaire survey, we retrospectively compared these 2 methods of treatment. METHOD The study involved 85 patients with pT2, pN0 gallbladder cancer (55 treated with gallbladder bed resection, and 30, with S4a+5 hepatectomy). The prognosis and mode of tumor recurrence following treatment were analyzed retrospectively, with overall survival as the endpoint. RESULTS The 5-year survival rate did not differ significantly between the 2 groups. Univariate analysis showed that bile duct resection and perineural tumor invasion were significant prognostic factors, but the extent of hepatectomy, location of the major intramural tumor, regional lymph node excision, and histological type were not. Multivariate analysis identified perineural tumor invasion as a significant prognostic factor. Recurrence occurred most frequently in both lobes than S4a+5 of the liver following gallbladder bed resection. CONCLUSION In the present study of cases of Japanese Biliary Tract Cancer Registry, it was not possible to conclude that S4a+5 hepatectomy was superior to gallbladder bed resection.
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Affiliation(s)
- Akihiko Horiguchi
- Department of Biliary-Pancreatic Surgery, Fujita Health University, Toyoake, Aichi, Japan.
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Yanagi T, Hattori Y, Takenaka R, Iwabuchi M, Miyakawa S, Sugie C, Baba F, Ogino H, Mori Y, Shibamoto Y. Usefulness of Induction Chemotherapy Followed by Chemoradiation in the Treatment of Oropharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tanaka S, Uchida S, Miyakawa S, Inui N, Takeuchi K, Watanabe H, Namiki N. PP176—Comparison of Inhibitory Duration of Grapefruit Juice on Organic Anion-Transporting Polypeptide and CYP3A4. Clin Ther 2013. [DOI: 10.1016/j.clinthera.2013.07.212] [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: 11/27/2022]
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Shimura M, Ito M, Horiguchi A, Miyakawa S. Distal pancreatectomy with en bloc celiac axis resection performed while monitoring hepatic arterial flow by using a transonic flowmeter during operation. ACTA ACUST UNITED AC 2012; 59:1498-500. [PMID: 22107748 DOI: 10.5754/hge11661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIMS Pancreatic body cancer often involves the common hepatic artery and/or the celiac axis, and is regarded as an unresectable disease. Hepatic blood flow must be monitored while performing distal pancreatectomy with en bloc celiac axis resection (DP-CAR) for managing the progression of pancreatic body cancer. We first confirmed a safe level of blood flow by monitoring hepatic venous oxygen saturation (ShvO2) to prevent hepatic ischemia caused by occlusion of the common hepatic artery. However, this method is technically difficult and a long period of time is required to insert the catheter. Thus, we monitored hepatic arterial flow by using a transonic flowmeter in the hepatic artery during operation. METHODOLOGY Between April 1992 and January 2011, 14 patients underwent DP-CAR. In 6 of these 14 patients we measured ShvO2. In 2 of the 14 patients, a transonic flowmeter was used for determining the hepatic arterial flow during operation. RESULTS There were no complications during this operation. Operation time when the blood flow was monitored using a transonic flowmeter was less than that when ShvO2 was measured. CONCLUSIONS Monitoring the transonic flowmeter hepatic artery is a useful and quick method for real-time evaluation of hepatic circulation during operation.
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Horiguchi A, Uyama I, Ito M, Ishihara S, Asano Y, Yamamoto T, Ishida Y, Miyakawa S. Robot-assisted laparoscopic pancreatic surgery. J Hepatobiliary Pancreat Sci 2011; 18:488-92. [PMID: 21491102 DOI: 10.1007/s00534-011-0383-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND In the field of gastroenterological surgery, laparoscopic surgery has advanced remarkably, and now accounts for most gastrointestinal operations. This paper outlines the current status of and future perspectives on robot-assisted laparoscopic pancreatectomy. METHODS A review of the literature and authors' experience was undertaken. RESULTS The da Vinci Surgical System is a robot for assisting laparoscopy and is safer than conventional endoscopes, thanks to the 3-dimensional hi-vision images it yields, high articular function with the ability to perform 7 types of gripping, scaling function enabling 2:1, 3:1, and 5:1 adjustment of surgeon hand motion and forceps motions, a filtering function removing shaking of the surgeon's hand, and visual magnification. By virtue of these functions, this system is expected to be particularly useful for patients requiring delicate operative manipulation. CONCLUSIONS Issues of importance remaining in robot-assisted laparoscopic pancreatectomy include its time of operation, which is longer than that of open surgery, and the extra time needed for application of the da Vinci compared with ordinary laparoscopic surgery. These issues may be resolved through accumulation of experience and modifications of the procedure. Robot-assisted laparoscopic pancreatectomy appears likely to become a standard procedure in the near future.
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Affiliation(s)
- Akihiko Horiguchi
- Department of Gastroenterological Surgery, Fujita Health University, 1-98 Dengakugakubo Kutsukakecho, Toyoake, Aichi, Japan.
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Kawai M, Kondo S, Yamaue H, Wada K, Sano K, Motoi F, Unno M, Satoi S, Kwon AH, Hatori T, Yamamoto M, Matsumoto J, Murakami Y, Doi R, Ito M, Miyakawa S, Shinchi H, Natsugoe S, Nakagawara H, Ohta T, Takada T. Predictive risk factors for clinically relevant pancreatic fistula analyzed in 1,239 patients with pancreaticoduodenectomy: multicenter data collection as a project study of pancreatic surgery by the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci 2011; 18:601-8. [PMID: 21491103 DOI: 10.1007/s00534-011-0373-x] [Citation(s) in RCA: 173] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND/PURPOSE It is important to predict the development of clinically relevant pancreatic fistula (grade B/C) in the early period after pancreaticoduodenectomy (PD). This study has been carried out as a project study of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHPBS) to evaluate the predictive factors associated with clinically relevant pancreatic fistula (grade B/C). METHOD The data of 1,239 patients from 11 medical institutions who had undergone PD between July 2005 and June 2009 were retrospectively analyzed to review patient characteristics and perioperative and postoperative parameters. RESULTS A drain amylase level >4,000 IU/L on postoperative day (POD) 1 was proposed as the cut-off level to predict clinical relevant pancreatic fistula by the receiver operating characteristic (ROC) curve. The sensitivity, specificity, and accuracy of this cut-off level were 62.2, 89.0, and 84.8%, respectively. A multivariate logistic regression analysis revealed that male [odds ratio (OR) 1.7, P = 0.039], intraoperative bleeding >1,000 ml (OR 2.5, P = 0.001), soft pancreas (OR 2.7, P = 0.001), and drain amylase level on POD 1 >4,000 IU/L (OR 8.6, P < 0.001) were the significant predictive factors for clinical pancreatic fistula. CONCLUSION The four predictive risk factors identified here can provide useful information useful for tailoring postoperative management of clinically relevant pancreatic fistula (grade B/C).
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Affiliation(s)
- Manabu Kawai
- Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan
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Abstract
BACKGROUND Robotic surgery is the most advanced development in minimally invasive surgery. However, the number of reports on robot-assisted endoscopic gastrointestinal surgery is still very small. In this article, we describe total laparoscopic pancreaticoduodenectomy (PD) undertaken using the da Vinci Surgical System® (Intutive Surgical). METHODS Three patients underwent robotic PD between November 2009 and February 2010. Following resection of the pancreatic head, duodenum, and the distal stomach, intracorporeal anastomosis was accomplished by Child's method of reconstruction, which includes a two-layered end-to-side pancreaticojejunostomy, an end-to-side choledochojejunostomy, and a side-to-side gastrojejunostomy. RESULTS The time required for surgery was 703 ± 141 min, and blood loss was 118 ± 72 mL. The average hospital stay period was 26 ± 12 days. As a postoperative complication, pancreatic juice leak occurred in one case, but it was managed with conservative treatment. Of the three patients, one had cancer of the papilla of Vater, one had cancer of the pancreatic head, and one had a solid pseudopapillary neoplasm. In all cases, the surgical margin was negative for tumor. CONCLUSIONS Robot-assisted PD required a long time, but organ removal with less bleeding was able to be safely performed owing to the high degree of freedom associated with the forceps manipulation and the magnified view. Similarly, pancreatojejunostomy could certainly be conducted. No major postoperative complications were found. Accumulation of da Vinci PD experience in the future will lead to safer and faster PD.
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Affiliation(s)
- A Horiguchi
- Department of Gastroenterological Surgery, Fujita Health University, Toyoake, Aichi, Japan.
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Horiguchi A, Ishihara S, Ito M, Asano Y, Yamamoto T, Miyakawa S. [Pancreatoduodenectomy for invasive carcinoma of the head of the pancreas with ligation of the inferior pancreaticoduodenal artery performed first]. Nihon Geka Gakkai Zasshi 2011; 112:159-163. [PMID: 21688458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The ideal surgical procedure for treating pancreatic cancer achieves radical excision in a minimally invasive manner and allows rapid transition to adjuvant chemotherapy. If the afferent artery to the pancreatic head is not ligated until the latter half of the surgery, congestion of the pancreaticoduodenal vein may occur, leading to phleborrhagia and increased intraoperative hemorrhage. Ligation of the afferent artery, i.e., the inferior pancreaticoduodenal artery (IPDA), in the first half of the surgery may prevent the occurrence of hemorrhage due to congestion. Early ligation of the IPDA is also useful in ensuring the success of radical dissection of the plexus around the superior mesenteric artery or the no. 14 lymph node. We have been performing pancreaticoduodenectomies with antecedent IPDA ligation since 2005 and have found that the percentage of R0 versus R1 and R2 has increased compared with that when standard pancreaticoduodenectomies were performed. Preemptive ligation of the IPDA early in pancreaticoduodenectomy for invasive pancreatic cancer is a useful method for reducing blood loss and achieving R0 resection in a thorough yet efficient manner.
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Affiliation(s)
- Akihiko Horiguchi
- Department of Biliary-Pancreatic Surgery, Fujita Health University School of Medicine, Toyoake, Japan
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Horiguchi A, Ishihara S, Ito M, Asano Y, Furusawa K, Yamamoto T, Miyakawa S. Middle-segment-preserving pancreatectomy for biliary-pancreatic tumors. Hepatogastroenterology 2011; 58:1018-1021. [PMID: 21830434] [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: 05/31/2023]
Abstract
BACKGROUND/AIMS Intraductal papillary mucinous neoplasm (IPMN) and pancreatic endocrine tumors can develop at multiple sites of the pancreas at the same time, sometimes necessitating total pancreatectomy. When low-grade pancreatic malignancy is treated surgically, preservation of function to improve long-term QOL is emphasized. For low grade malignancy tumor of the pancreatic head and tail, we performed middle- segment-preserving pancreatectomy (MSPP), with resection of the pancreatic head and tail alone, resulting in favorable QOL. METHODOLOGY MSPP was performed for 4 patients. Intraoperative blood loss, hospital stay, postoperative complications, histopathological findings and prognosis were examined. RESULTS Mean intraoperative blood loss was 1255 +/- 365g, mean hospital stay 61 +/- 53 days, and mortality 0%. Postoperatively, pancreatic fistula was observed in 3 patients, but subsided with conservative treatment. In one patient with diabetes preoperatively, diabetes was exacerbated postoperatively, necessitating insulin treatment. No postoperative onset of diabetes was observed. Percent change in body weight during the postoperative 6 month period from preoperative weight was 93 +/- 6.3%. One patient died of malignant lymphoma 1 year and 4 months after surgery. The other patients are alive and socially active. CONCLUSION MSPP enables maintenance of good QOL long after surgery for malignancy affecting the head and tail of the pancreas.
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Affiliation(s)
- Akihiko Horiguchi
- Department of Gastroenterological Surgery, Fujita Health University, Kutsukake-cho, Toyoake, Japan.
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Kurosawa G, Sumitomo M, Ukai Y, Subere J, Muramatsu C, Eguchi K, Tanaka-Hashiba M, Sugiura M, Ando M, Sato N, Morita M, Inaba K, Morigaki S, Takasaki A, Akahori Y, Miyakawa S, Uyama I, Maeda K, Shiroki R, Hoshinaga K, Mizoguchi Y, Hattori Y, Sugioka A, Sugiura M, Kurosawa Y. Selection and analysis of anti-cancer antibodies for cancer therapy obtained from antibody phage library. Cancer Sci 2010; 102:175-81. [PMID: 21040215 DOI: 10.1111/j.1349-7006.2010.01739.x] [Citation(s) in RCA: 15] [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: 12/31/2022] Open
Abstract
The search for effective antibodies (Ab) for curable cancer immunotherapy has been a quest of many research groups in order to find an effective target that exists on the cancer cell surface. So far there have been no conclusive answers to shed light on the search. This study therefore aimed to bridge the gap of cancer therapy. Screening against 49 kinds of cell lines belonging to 11 kinds of solids cancers was performed. Isolation and characterization for approximately 4200 monoclonal antibodies (mAb) was also performed thereafter. Of those mAb 488 clones that turned out to bind to 29 tumor-associated antigens (TAA) were subjected to immunohistochemical (IHC) analyses. Selection of target antigens (Ag) and a potential antibody for cancer therapy was conducted prior to clinical examinations. In order to find predictably effective targets for therapeutic Ab against solid cancers, expression of the Ag on the surface of cancer and normal cells was extensively examined by IHC analyses using fresh cancer specimens resected from patients. In this study, the tendencies of all staining patterns and distribution of the Ab are reported. While all of the TAA appeared to be involved in tumorigenesis, their expression was not restricted to some specific tumor types but rather randomly distributed among various cancers. Some kinds of Ab including anti-epidermal growth factor receptor (EGFR) and anti-human epidermal growth factor receptor 2 (HER2) indicated the frequency of expression in normal cells was generally low. We concluded that identification of 488 mAb and the accumulated results of IHC analyses in this study could be the key for further therapeutic Ab against cancers. The targets that showed cancer-specific expression are expected to be better for therapeutic Ab than the other Ab. Moreover, further investigation into the growth of cancer cell lines using full human IgG form of Ab shows available efficacy in specific cases.
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Affiliation(s)
- Gene Kurosawa
- Division of Antibody Project, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Aichi, Japan.
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Imai T, Shindo Y, Utugi K, Iida K, Watanabe K, Mukai N, Kono I, Miyakawa S, Maeda A, Kitagawa Y, Kiso Y. Effects Of Rehydration On The Markers For Muscle Damage Enhanced By Endurance Exercise. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000384689.88942.c6] [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: 11/21/2022]
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Horiguchi A, Ishihara S, Ito M, Asano Y, Yamamoto T, Miyakawa S. Three-dimensional models of arteries constructed using multidetector-row CT images to perform pancreatoduodenectomy safely following dissection of the inferior pancreaticoduodenal artery. J Hepatobiliary Pancreat Sci 2010; 17:523-6. [PMID: 20714842 DOI: 10.1007/s00534-009-0261-9] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Accepted: 12/28/2009] [Indexed: 11/25/2022]
Abstract
BACKGROUND/PURPOSE During a pancreatoduodenectomy (PD) it is important that the anatomy of the arcade of blood vessels in the head of the pancreas is fully understood before the surgery in order to reduce intraoperative bleeding. In most of the patients our group has treated, the inferior pancreaticoduodenal artery (IPDA), one of the efferent arteries of the head of the pancreas, has formed a short common trunk with the first jejunal artery (FJA). Thus, by first locating the origin of the FJA, it was easier to locate the IPDA. There are two ways to locate the IPDA: (1) by measuring the distance between the origin of the superior mesenteric artery (SMA) and that of the FJA; (2) by measuring the distance between the origin of the middle colic artery (MCA) and that of the FJA. Here, we report our measurements of both distances using three-dimensional (3D) models of arteries constructed with multidetector-row computed tomography (MD-CT) images and discuss which is the better measurement to determine the location of the IPDA during PD. METHODS A total of 140 patients underwent 64-MD-CT imaging to acquire early and late arterial phase scans. The distance between the origin of the SMA and that of the FJA and the distance between the origin of the MCA and that of the FJA origin were measured. RESULTS In patients whose IPDA formed either a common trunk with the FJA or arose directly from the SMA, the IPDA or the common truck was located in parallel with the SMA at a very short distance of approximately 18 mm from the MCA origin towards the center. The distance between the SMA origin and the IPDA was significantly longer (approximately 36 mm). Therefore, locating the MCA origin during PD helped determine the location of the IPDA. However, in patients whose anterior inferior pancreaticoduodenal artery (AIPDA) and posterior inferior pancreaticoduodenal artery (PIPDA) arose separately, the distance between the AIPDA origin and the MCA origin was approximately 18 mm, the distance between the AIPDA origin and the PIPDA origin was approximately 19 mm, and the distance between the PIPDA origin and the SMA origin was 19 mm. Thus, locating the SMA helped determine the location of the IPDA during PD in these patients. CONCLUSION Based on our findings that the distance between the IPDA origin and the MCA origin was short, we have shown that it is effective to locate the MCA origin in order to determine the location of the IPDA.
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Affiliation(s)
- Akihiko Horiguchi
- Department of Bilio-Pancreatic Surgery, Fujita Health University, Toyoake, Aichi, Japan.
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Hyodo K, Xu C, Mishima H, Miyakawa S. Optical Stress Imaging for Orthopedic Biomechanics – Comparison of Thermoelastic Stress Analysis and Developed Mechanoluminescent Method. IFMBE Proceedings 2010. [DOI: 10.1007/978-3-642-14515-5_139] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Ito M, Horiguchi A, Asano Y, Yamamoto T, Tuda K, Morigaki S, Shimura M, Uyama I, Miyakawa S. Spleen-preserving distal pancreatectomy performed laparoscopically. Hepatogastroenterology 2010; 57:162-164. [PMID: 20422894] [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: 05/29/2023]
Abstract
The current literature contains little information about laparoscopic surgery for pancreatic disease. We performed spleen-preserving distal pancreatectomy on 7 cases during the period from 2005 to 2008 at our university hospital, including 2 laparoscopic operations. Case 2: A 54-year-old woman was found to have a hypoechoic 4 x 4 cm lesion in the tail of the pancreas, adjacent to and impinging on the spleen. On careful assessment we suspected a mucoid cystic tumor (MCT), and performed a laparoscopic spleen-preserving distal pancreatectomy. Blood loss was 380 g, and operating time was 310 min. Case 1: A 27-year-old woman was found to have a hypoechoic 2 x 2 cm mass on ultrasound examination of the body of the pancreas. We performed laparoscopic spleen-preserving distal pancreatectomy for solid pseudopapillary tumour (SPT) of the pancreas. Blood loss was minimal, and operating time was 182 min. The other 5 cases were operated upon using the open method. All were female, with an average age of 54.8 years. The average blood loss was 387 g. Operating time was 321 min. Laparoscopic pancreatic surgery is generally thought to be difficult owing to the need for lymph node resection, and because nerve plexus invasion occurs with malignant tumors such as pancreatic cancer. The present case series was reported to demonstrate the techniques that have evolved the safety of the operation and its future potential related to the minimally invasive nature of the surgery.
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Affiliation(s)
- Masahiro Ito
- Department of Surgery, Fujita Health University, Toyoake, Aichi, Japan.
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Horiguchi A, Miyakawa S, Ishihara S, Ito M, Asano Y, Furusawa K, Shimizu T, Yamamoto T. Surgical design and outcome of duodenum-preserving pancreatic head resection for benign or low-grade malignant tumors. J Hepatobiliary Pancreat Sci 2009; 17:792-7. [PMID: 19894017 DOI: 10.1007/s00534-009-0221-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2009] [Accepted: 09/01/2009] [Indexed: 11/27/2022]
Abstract
To apply duodenum-preserving pancreatic head resection (DPPHR) as radical procedure for benign or low-grade malignant tumors, it needs the reconciliation of complete pancreatic head resection and preservation of the bile duct and peripancreatic vessels. Several modifications have been introduced and applied to remove these lesions, however, the techniques have not been made clear in the management of the peripancreatic vessels and the bile duct. The long-term outcomes of the DPPHR have been reported as extremely rare in comparison with pylorus preserving pancreatoduodenectomy (PPPD) in these pancreatic head tumors. The angiograms by multi-detector row CT (MD-CT) can be reconstructed more physiologically than selective angiography. The anterior arcade is predominant in 43% of 64 patients. Therefore, we modified the DPPHR to include a complete resection of the pancreatic head and the preservation of both anterior and posterior arterial arcades. The bile duct is covered by the pancreatic parenchyma in various ways. The techniques of the preservation of the bile duct are also introduced. We performed 21 DPPHRs and 19 PPPDs in the patients with benign or low-grade malignant pancreatic head tumor. There was no significant difference in operative factors. The postoperative death was one patient in PPPD, but none in DPPHR. The postoperative complications of PPPD were more often than that of DPPHR. There is no postoperative recurrence in DPPHR in the follow-up period from 2 to 216 months. Both exocrine and endocrine function and the long-term results following DPPHR were superior to those following PPPD. The DPPHR should be favored over the PPPD in benign or low-grade malignant tumors of the head of the pancreas if there is no compromise with oncologic radicality.
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Affiliation(s)
- Akihiko Horiguchi
- Department of Biliary-Pancreatic Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
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Wakabayashi A, Tanese K, Yamamoto K, Tanomogi H, Miyakawa S. Extraocular sebaceous carcinoma expressing oestrogen receptor alpha and human epidermal growth factor receptor 2. Clin Exp Dermatol 2009; 35:546-8. [PMID: 19874363 DOI: 10.1111/j.1365-2230.2009.03654.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tanese K, Wakabayashi A, Suzuki T, Miyakawa S. Immunoexpression of human epidermal growth factor receptor-2 in apocrine carcinoma arising in naevus sebaceous, case report. J Eur Acad Dermatol Venereol 2009; 24:360-2. [PMID: 19703100 DOI: 10.1111/j.1468-3083.2009.03407.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
MESH Headings
- Aged
- Apocrine Glands
- Biomarkers, Tumor/biosynthesis
- Biomarkers, Tumor/immunology
- Biopsy
- Carcinoma/immunology
- Carcinoma/metabolism
- Carcinoma/pathology
- Humans
- Immunohistochemistry
- Male
- Neoplasms, Multiple Primary/immunology
- Neoplasms, Multiple Primary/metabolism
- Neoplasms, Multiple Primary/pathology
- Nevus, Sebaceous of Jadassohn/immunology
- Nevus, Sebaceous of Jadassohn/metabolism
- Nevus, Sebaceous of Jadassohn/pathology
- Receptor, ErbB-2/biosynthesis
- Receptor, ErbB-2/immunology
- Skin Neoplasms/immunology
- Skin Neoplasms/metabolism
- Skin Neoplasms/pathology
- Sweat Gland Neoplasms/immunology
- Sweat Gland Neoplasms/metabolism
- Sweat Gland Neoplasms/pathology
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Iizuka T, Miyakawa S, Sato M, Suzuki K, Hamada J, Sakai F. Diversity of acute brain damage in mitochondrial disorders. J Neurol Sci 2009. [DOI: 10.1016/j.jns.2009.02.088] [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]
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Miyakawa S. [Postgraduate surgical training and system for board-certified surgeons in gastroenterology]. Nihon Geka Gakkai Zasshi 2009; 110:123-127. [PMID: 19507526] [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: 05/27/2023]
Abstract
The board-certified surgeon in gastroenterology is one of the subspecialties based on the board-certified general surgeon. Certification is given to those who pass the qualifying and certifying examinations administered by the Japanese Society of Gastroenterological Surgery, after achieving specified standards of surgical experience and demonstrating excellence in presentation, publication, and training provided by the curriculum. The level of acquired surgical skill for the initial certification is the ability to perform surgery for the treatment of gastroenterological diseases at the lower-middle degree of difficulty under laparotomy or thoracotomy. As of January 2009, there were 4,554 (about 21.6%) board-certified surgeons in gastroenterology among the 12,087 members of the Japanese Society of Gastroenterological Surgery. Creating a database of gastroenterological surgeries plays an important role in the evaluation of training facilities and gastroenterological specialists, information disclosure to the public, and analysis of the balance between the supply of and demand for surgeons. It is necessary to correct the gap between the tentative plan proposed by the Association of Social Insurance Committees of Societies for Surgery (Gaihoren) and payment for surgical treatment and to establish a system to evaluate specialist surgeries fairly to provide greater incentive for surgeons to become board certified.
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Shinohara T, Uyama I, Kanaya S, Inaba K, Isogaki J, Horiguchi A, Miyakawa S. Totally laparoscopic pancreaticoduodenectomy for locally advanced gastric cancer. Langenbecks Arch Surg 2009; 394:733-7. [PMID: 19404673 DOI: 10.1007/s00423-009-0492-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2009] [Accepted: 04/06/2009] [Indexed: 01/12/2023]
Abstract
BACKGROUND In patients having locally advanced cancer of the stomach with suspected tumor infiltration to the pancreatic head or the duodenum, a concurrent pancreaticoduodenectomy with gastrectomy is occasionally prerequisite to achieve a microscopically tumor-free surgical margin. MATERIALS AND METHODS We present the first series of successful totally laparoscopic pancreaticoduodenectomy (TLPD) for advanced gastric cancer with suspected infiltration to the pancreatic head. RESULTS TLPD was successfully performed without adverse events during surgery and resulted in favorable short-term outcomes of three patients with locally advanced gastric cancer with suspected invasion to the pancreas. CONCLUSIONS Although TLPD for locally advanced gastric cancer is a technically difficult challenging operation that requires careful dissection along the major vessels, intracorporeal tie sutures, and the placement of an external drainage tube into a narrow pancreatic duct, this procedure is technically feasible and safe in the hands of experienced surgeons. Long-term follow-up is mandatory to validate oncological outcome.
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Affiliation(s)
- Toshihiko Shinohara
- Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoake, 470-1192, Aichi, Japan.
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Yamamoto T, Horiguchi A, Ito M, Nagata H, Ichii H, Ricordi C, Miyakawa S. Quality control for clinical islet transplantation: organ procurement and preservation, the islet processing facility, isolation, and potency tests. ACTA ACUST UNITED AC 2009; 16:131-6. [PMID: 19242650 DOI: 10.1007/s00534-009-0064-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2008] [Accepted: 07/15/2008] [Indexed: 11/28/2022]
Abstract
Pancreatic islet transplantation has become one of the ideal treatments for patients with type 1 diabetes mellitus due to improvements in isolation techniques and immunosuppression regimens. In order to ensure the safety and rights of patients, isolated islets need to meet the criteria for regulation as both a biological product and a drug product. For the constant success of transplantation, therefore, all investigators involved in clinical islet transplantation must strive to ensure the safety, purity, and potency of islets in all the phases of clinical islet isolation and transplantation. In this review, we summarize the quality control for clinical islet isolation and transplantation, and the latest topics of pre-transplant islet assessment.
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Affiliation(s)
- Toshiyuki Yamamoto
- Department of Surgery, School of Medicine, Fujita Health University, Aichi, Japan.
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Abstract
BACKGROUND Hepatocyte transplantation is a promising treatment for several liver diseases and can also be used as a "bridge" to liver transplantation in cases of liver failure. Although the first animal experiments with this technique began in 1967, it was first applied in humans only in 1992. Unfortunately, unequivocal evidence of transplanted human hepatocyte function has been obtained in only one patient with Crigler-Najjar syndrome type I and, even then, the amount of bilirubin-UDP-glucuronosyltransferase enzyme activity derived from the transplanted cells was not sufficient to eliminate the patient's eventual need for organ transplantation. METHODS A literature review was carried out using MEDLINE and library searches. RESULTS This review considers the following: (1) alternatives or bridges to orthotopic liver transplantation (OLT); (2) solutions to the shortage of organs-the shortage of organ donors has impeded the development of human hepatocyte transplantation, and immortalized hepatocytes in particular could provide an unlimited supply of transplantable cells in a nearly future; (3) future directions. We review these efforts along with hepatocyte transplantation over the last 13 years.
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Affiliation(s)
- Masahiro Ito
- Department of Surgery, Fujita-Health University, Toyoake, Aichi, Japan.
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Miyakawa S, Ishihara S, Horiguchi A, Takada T, Miyazaki M, Nagakawa T. Biliary tract cancer treatment: 5,584 results from the Biliary Tract Cancer Statistics Registry from 1998 to 2004 in Japan. ACTA ACUST UNITED AC 2008; 16:1-7. [PMID: 19110652 DOI: 10.1007/s00534-008-0015-0] [Citation(s) in RCA: 170] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2008] [Accepted: 07/01/2008] [Indexed: 12/12/2022]
Abstract
BACKGROUND/PURPOSE The results from the Japanese Biliary Tract Cancer Statistics Registry from 1988 to 1998 were reported in 2002. In the present study, we report here selectively summarized data as an overview of the 2006 follow-up survey of the registered cases from 1998 to 2004 for information bearing on problems with the treatment of cancer of the biliary tract. METHODS A total of 5,584 patients were registered from 1998 to 2004. The site of cancer was the bile duct in 2,732 patients, the gallbladder in 2,067, and the papilla of Vater in 785. Those cases were analyzed with regard to patient survival according to the extent of tumor invasion (pT), the extent of lymph node metastasis (pN) and the stage. RESULTS The five-year survival rate after surgical resection was 33.1% for bile duct cancer, 41.6% for gallbladder cancer, and 52.8% for cancer of the papilla of Vater. For hilar or superior bile duct cancer, the 5-year survival rate was lower with an increase in the pT, pN and f stage, except pT3 vs. pT4, pN1 vs. pN2 and stage III vs. stage IVa. For middle or distal bile duct cancer, the 5-year survival rate was lower with increase in pT, pN and f stage, except pT2 vs. pT3, pN2 vs. pN3, stage II vs. stage III and stage III vs. stage IVa. For gallbladder cancer, the 5-year survival rate was lower with increase in pT, pN and f stage. For cancer of the papilla of Vater, the 5-year survival rate was lower with increase in pT, pN and f stage, except pT1 vs. pT2, pN1 vs. pN2, and stage III vs. stage IVa. CONCLUSIONS In the present study, the outcomes of surgical treatment were better than that of the previous report from Japan and foreign countries. The pT, pN and stage of gallbladder cancer are well defined. However, there were no significant differences in some groups of those of bile duct cancer and cancer of the papilla of Vater.
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Affiliation(s)
- Shuichi Miyakawa
- Department of Biliary and Pancreatic Surgery, Fujita Health University, Toyoake, Aichi, Japan.
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Liu X, Matsumoto S, Okitsu T, Iwanaga Y, Noguchi H, Yonekawa Y, Nagata H, Kamiya H, Ueda M, Hatanaka N, Miyakawa S, Kobayashi N, Song C. Analysis of donor- and isolation-related variables from non-heart-beating donors (NHBDs) using the Kyoto islet isolation method. Cell Transplant 2008; 17:649-56. [PMID: 18819253 DOI: 10.3727/096368908786092711] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Recently, we demonstrated that islet transplantation from non-heart-beating donors (NHBDs) using the Kyoto islet isolation method (KIIM) successfully reversed patients' diabetes state. In this study, we evaluated the effects of donor- and isolation-related variables on islet isolation results from NHBDs by KIIM. Twenty-one islet preparations from the pancreata of NHBDs were isolated by KIIM. Islet preparations that met transplantation criteria and achieved improved patient diabetes control after transplantation were defined as successful isolations. Potential risk factors deemed to affect islet isolation results, such as age, gender, body mass index, hospital stay, donors' blood biochemical tests, a modified pancreata procurement method, and isolation and purification procedure-related variables, were analyzed. Seventeen out of 21 islet isolations (81%) were successful isolations. Postpurification islet yield was 447,639 +/- 39,902 islet equivalents (IE) in the successful isolation group and 108,007 +/- 31,532 IE in the failure group. Donor age was significantly younger in the success group (41.9 +/- 4.0 years old in the success group vs. 57.5 +/- 2.2 years old in the failure group, p = 0.003). Chronic pancreatitis significantly decreased islet yields (p = 0.006). Phase I time was significantly shorter (p = 0.010) and undigested tissue volume was significantly smaller (p = 0.020) in the success group. Purity was in positive correlation to postpurification islet yield, while donor age was in reverse correlation to postpurification islet yield. KIIM enables us to perform islet transplantation from NHBDs; however, the decision to use pancreata from older donors or those with chronic pancreatitis requires careful consideration.
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Affiliation(s)
- Xiaoling Liu
- General Surgery, First Clinical College of Harbin Medical University, Harbin, PR China
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Sugiyama S, Matsumura H, Kitatani T, Kobayashi A, Miyakawa S, Nomura Y, Sakamoto T, Nakamura Y, Okada S, Yamakami M, Maki S, Yoshikawa H, Adachi H, Takano K, Murakami S, Inoue T. Crystallization and preliminary X-ray analysis of RNA aptamer in complex with human immunoglobulin G. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308092180] [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: 11/10/2022] Open
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47
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Matsumura H, Sugiyama S, Tomoya K, Nomura Y, Sakamoto T, Miyakawa S, Nakamura Y, Maki S, Yoshikawa H, Adachi H, Takano K, Murakami S, Inoue T, Mori Y. Crystal structure of RNA aptamer in complex with human immunoglobulin G. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308090132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Morise Z, Sugioka A, Hoshimoto S, Kato T, Ikeda M, Uyama I, Horiguchi A, Miyakawa S. The role of hepatectomy for patients with liver metastases of gastric cancer. Hepatogastroenterology 2008; 55:1238-1241. [PMID: 18795664] [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: 05/26/2023]
Abstract
BACKGROUND/AIMS Although the role of hepatectomy for patients with colorectal liver metastases is well established, few reports exist of hepatectomy for patients with metastases of gastric cancer origin. This study reviews cases of hepatectomy for metastatic gastric cancer at Fujita Health University Hospital. METHODOLOGY Between 1989 and 2004, 18 patients underwent hepatectomy for liver metastases from gastric cancer. The patients consisted of 16 men and 2 women and their ages ranged from 51-76 (median 64) years. Hepatic resection was indicated for patients with synchronous metastases who did not have peritoneal dissemination or any other distant metastases (11 patients), and patients with metachronous metastases who did not have any other recurrent lesions (7 patients). RESULTS Overall survival rate for 1, 2, 3, and 5 years are 56.3, 36.5, 27.3, and 27.3%, respectively. Although the 5-year survival rate was considerable, an early and rapid decrease of survival rate occurred in the first 1-2 years (compared with the colorectal patients). Univariate analysis showed serosal invasion and lymphatic invasion of the primary tumor as significant prognostic factors for survival. CONCLUSIONS Surgical resection for liver metastases of gastric cancer is thought to be beneficial for small part of the patients. For other patients, the procedure may only provide the limited beneficial effects on survival.
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Affiliation(s)
- Zenichi Morise
- Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukakecho, Toyoake, Aichi 470-1192, Japan.
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Ono Y, Oda N, Ishihara S, Shimomura A, Hayakawa N, Suzuki A, Horiguchi A, Senda T, Miyakawa S, Itoh M. Insulinoma cell calcium-sensing receptor influences insulin secretion in a case with concurrent familial hypocalciuric hypercalcemia and malignant metastatic insulinoma. Eur J Endocrinol 2008; 159:81-6. [PMID: 18430790 DOI: 10.1530/eje-08-0069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
CONTEXT AND OBJECTIVE Arterial stimulation and venous sampling (ASVS) is an important technique for localizing insulinoma. The principle behind ASVS is that insulin secretion is promoted from insulinoma cells by the injection of calcium into the insulinoma-feeding artery. However, the mechanism for ASVS-induced insulin secretion remains unclear. Both insulinoma and familial hypocalciuric hypercalcemia (FHH) are rare diseases. This study reports on a case in which both of these diseases occur concurrently. DESIGN AND PATIENT The patient with FHH also suffered from insulinoma. We reasoned that insulin secretion for ASVS is dependent on the calcium-sensing receptor (CaSR). ASVS was performed on this patient. The expression of the CaSR protein and corresponding mRNA were confirmed. RESULTS No significant changes in the plasma levels of insulin and C-peptide were observed during ASVS. The patient was clinically diagnosed as having FHH. We confirmed that a mutation in the CaSR gene was present in the genomic DNA of this patient and that there were no mutations in the multiple endocrine neoplasia type 1 gene. In addition, expression of both CaSR mRNA and CaSR protein was confirmed in the insulinoma samples. CONCLUSION These results suggest that the CaSR gene is involved in ASVS-induced insulin secretion.
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Affiliation(s)
- Yasunaga Ono
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
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Horiguchi A, Ishihara S, Ito M, Nagata H, Asano Y, Yamamoto T, Kato R, Katada K, Miyakawa S. Multislice CT study of pancreatic head arterial dominance. ACTA ACUST UNITED AC 2008; 15:322-6. [DOI: 10.1007/s00534-007-1261-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Accepted: 08/13/2007] [Indexed: 12/29/2022]
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