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Tanioka N, Kuwahara M, Edo N, Nokubo Y, Shimizu S, Akimori T. Small bowel volvulus associated with percutaneous endoscopic gastrojejunostomy tube: A case report. Int J Surg Case Rep 2024; 115:109270. [PMID: 38266368 PMCID: PMC10818069 DOI: 10.1016/j.ijscr.2024.109270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Percutaneous endoscopic gastrojejunostomy (PEG-J) is a convenient and safe enteral feeding tool for patients with oropharyngeal dysfunction accompanied by gastroesophageal reflux. However, serious complications have not been fully characterized. PRESENTATION OF CASE A 22-year-old man with cerebral palsy was referred to our department with complaints of vomiting and massive bloody stools for 10 h. On imaging examination, strangulated bowel obstruction due to the PEG-J tube was suspected because the tube was located on the right side of the body, and the small intestine was diffusely dilated with a reduced wall contrast effect. Urgent laparoscopy revealed a small bowel volvulus (SBV) twisted 180° clockwise around the superior mesenteric artery, which was repaired manually without intestinal resection. The patient was treated in the intensive care unit postoperatively but required partial ileal resection and colostomy owing to the difficulty in managing watery diarrhea and intestinal infection. The patient was discharged after stoma closure 121 days after initial surgery. DISCUSSION Although SBV rotated at the site of PEG insertion has been reported as a rare complication, there are no reports of rotation of the PEG-J tube itself associated with SBV. In the present case, abnormal positioning of the PEG-J tube on imaging was helpful for diagnosis. CONCLUSION SBV should be recognized as a potential complication of PEG-J, since delayed diagnosis can lead to irreversible ischemia of the extensive small intestine.
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Affiliation(s)
- Nobuhisa Tanioka
- Department of Surgery, Hata Kenmin Hospital, 3-1 Yoshina, Yamanacho, Sukumo-city, Kochi 788-0785, Japan.
| | - Michio Kuwahara
- Department of Surgery, Hata Kenmin Hospital, 3-1 Yoshina, Yamanacho, Sukumo-city, Kochi 788-0785, Japan.
| | - Naoki Edo
- Department of Surgery, Hata Kenmin Hospital, 3-1 Yoshina, Yamanacho, Sukumo-city, Kochi 788-0785, Japan.
| | - Yuzuko Nokubo
- Department of Surgery, Hata Kenmin Hospital, 3-1 Yoshina, Yamanacho, Sukumo-city, Kochi 788-0785, Japan
| | - Shigeto Shimizu
- Department of Surgery, Hata Kenmin Hospital, 3-1 Yoshina, Yamanacho, Sukumo-city, Kochi 788-0785, Japan
| | - Toyokazu Akimori
- Department of Surgery, Hata Kenmin Hospital, 3-1 Yoshina, Yamanacho, Sukumo-city, Kochi 788-0785, Japan
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2
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Kawanishi Y, Kuwahara M, Utsunomiya M, Ishida N, Ishikawa Y, Hiroi M, Akimori T. Pneumothorax during lenvatinib treatment for hepatocellular carcinoma with lung metastasis. Clin J Gastroenterol 2020; 14:288-292. [PMID: 33108567 DOI: 10.1007/s12328-020-01273-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/13/2020] [Indexed: 11/27/2022]
Abstract
Lenvatinib is an inhibitor of tyrosine kinases, such as vascular endothelial growth factor receptor and fibroblast growth factor receptor, and was first approved for use in thyroid cancer in 2015 in Japan. Additional approval was given in March 2018 for its use as a first-line treatment for advanced or unresectable hepatocellular carcinoma. Herein, we report a case of pneumothorax during lenvatinib treatment for multiple lung metastases of hepatocellular carcinoma in a 71-year-old man. Although the development of pneumothorax during treatment with anticancer agents for lung metastases is well-known, this is the first report of pneumothorax induced by lenvatinib during treatment for lung metastases of hepatocellular carcinoma.
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Affiliation(s)
- Yasuhiro Kawanishi
- Department of Surgery, Kochi Prefectural Hata Kenmin Hospital, 3-1Yoshina, Yamanachou, Sukumo, 788-0785, Japan.
| | - Michio Kuwahara
- Department of Surgery, Kochi Prefectural Hata Kenmin Hospital, 3-1Yoshina, Yamanachou, Sukumo, 788-0785, Japan
| | - Masato Utsunomiya
- Department of Surgery, Kochi Prefectural Hata Kenmin Hospital, 3-1Yoshina, Yamanachou, Sukumo, 788-0785, Japan
| | - Nobuko Ishida
- Department of Surgery, Kochi Prefectural Hata Kenmin Hospital, 3-1Yoshina, Yamanachou, Sukumo, 788-0785, Japan
| | - Yoichi Ishikawa
- Department of Surgery, Kochi Prefectural Hata Kenmin Hospital, 3-1Yoshina, Yamanachou, Sukumo, 788-0785, Japan
| | - Makoto Hiroi
- Department of Surgery, Kochi Prefectural Hata Kenmin Hospital, 3-1Yoshina, Yamanachou, Sukumo, 788-0785, Japan
| | - Toyokazu Akimori
- Department of Surgery, Kochi Prefectural Hata Kenmin Hospital, 3-1Yoshina, Yamanachou, Sukumo, 788-0785, Japan
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3
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Fujieda Y, Maeda H, Oba K, Okamoto K, Fukudome I, Shiga M, Kawanishi Y, Akimori T, Kuroiwa H, Nishimoto H, Namikawa T, Murakami I, Kobayashi M, Hanazaki K. Lymph node retrieval after colorectal cancer surgery: a comparative study of the efficacy between the conventional manual method and a new fat dissolution method. Surg Today 2020; 50:726-733. [PMID: 31912338 DOI: 10.1007/s00595-019-01944-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 12/05/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE This study compared the efficacy of two different methods for lymph node (LN) searching after colorectal cancer surgery: the fat dissolution and the conventional manual method. METHODS For the fat dissolution method, we used a commercially available solution of collagenase and lipase (FD group). The primary endpoint was the number of identified LNs in the FD group compared to an historical control (control group) after adjusting by propensity score matching. RESULTS Using 37 matched patients from each group, we identified 20.6 ± 7.2 LNs using the fat dissolution method compared to 13.5 ± 5.9 using the conventional method (t test, P < 0.01). Three patients in the FD group received an inappropriate LN examination in terms of number, while the number of the retrieved LNs was < 12 in 12 patients in the control group. The mean diameter of LNs without metastasis was 3.2 ± 1.9 mm in the FD group, and 40% of metastasis cases were found in LNs < 5 mm in diameter. A pathological examination confirmed that using the fat resolution method did not change the morphological or immunochemical staining findings. CONCLUSION We demonstrated that fat dissolution had a positive impact on the number of retrieved LNs after colorectal cancer surgery without disturbing the microscopic observation.
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Affiliation(s)
- Yuki Fujieda
- Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.,Department of Surgery, Hata-Kenmin Hospital, Sukumo, Kochi, Japan
| | - Hiromichi Maeda
- Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
| | - Koji Oba
- Department of Biostatistics, Graduated School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ken Okamoto
- Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.,Cancer Treatment Center, Kochi Medical School Hospital, Nankoku, Kochi, Japan
| | - Ian Fukudome
- Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Mai Shiga
- Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | | | - Toyokazu Akimori
- Department of Surgery, Hata-Kenmin Hospital, Sukumo, Kochi, Japan
| | - Hajime Kuroiwa
- Integrated Center for Advanced Medical Technologies (ICAM-Tech), Kochi Medical School, Nankoku, Kochi, Japan
| | - Hiroyuki Nishimoto
- Integrated Center for Advanced Medical Technologies (ICAM-Tech), Kochi Medical School, Nankoku, Kochi, Japan
| | - Tsutomu Namikawa
- Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Ichiro Murakami
- Department of Diagnostic Pathology, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan
| | - Michiya Kobayashi
- Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.,Cancer Treatment Center, Kochi Medical School Hospital, Nankoku, Kochi, Japan
| | - Kazuhiro Hanazaki
- Department of Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
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Fujieda Y, Maeda H, Akimori T, Kamioka N, Namikawa T, Kobayashi M, Hanazaki K. R0 resection of Stage IV HER2-positive gastric cancer after the first-line chemotherapy: a case of successful conversion therapy. ACRT 2017. [DOI: 10.4993/acrt.25.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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5
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Kanagawa T, Maeda H, Okamoto K, Ishikawa Y, Akimori T, Kamioka N, Usui T, Namikawa T, Hanazaki K, Kobayashi M. Lessons learnt from a case of enterolithotomy for gallstone ileus of the jejunum. ACRT 2017. [DOI: 10.4993/acrt.25.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
| | | | - Ken Okamoto
- Cancer Treatment Center, Kochi Medical School Hospital
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Tsuda S, Maeda H, Uemura S, Kanagawa T, Tsuda S, Akimori T, Fujieda Y, Kamioka N, Kobayashi M, Hanazaki K. Sarcomatoid combined hepatocellular carcinoma and cholangiocarcinoma of liver with spontaneous intra-tumor bleeding: a case report. ACTA ACUST UNITED AC 2017. [DOI: 10.4993/acrt.25.77] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | | | - Sunao Uemura
- Department of Surgery, Kochi Medical School, Kochi University
| | | | - Sachi Tsuda
- Department of Surgery, Kochi Medical School, Kochi University
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7
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Kitagawa H, Namikawa T, Munekage M, Akimori T, Kobayashi M, Hanazaki K. Visualization of the Stomach's Arterial Networks During Esophageal Surgery Using the HyperEye Medical System. Anticancer Res 2015; 35:6201-5. [PMID: 26504051 DOI: pmid/26504051] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM The present study investigated the visualization of the arterial networks in the stomach (ANS) during gastric tube (GT) creation using indocyanine green fluorescence and the HyperEye Medical System (HEMS), and the feasibility of the HEMS-line-marking method (LMM). PATIENTS AND METHODS We reviewed 51 consecutive patients who had undergone esophageal surgery with GT reconstruction. Patients for whom the HEMS was deployed after GT creation to confirm the anastomosed area's blood supply formed the control group (n=28). Patients for whom the HEMS was deployed before GT creation to confirm and mark the ANS border comprised the HEMS-LMM group (n=23). RESULTS The HEMS-LMM visualized the ANS border, and the leakage rate decreased from 17.9% to 4.4% (p=0.204). CONCLUSION The HEMS-LMM is safe and feasible for visualizing the blood supply border of the right gastroepiploic artery and the ANS before GT creation during esophageal surgery, and it might reduce leakage in esophageal surgery.
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Affiliation(s)
| | - Tsutomu Namikawa
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan
| | - Masaya Munekage
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan
| | - Toyokazu Akimori
- Department of Surgery, Kochi Hata Prefectural Hospital, Yamanacho, Sukumo, Kochi, Japan
| | - Michiya Kobayashi
- Department of Human Health and Medical Sciences, Kochi Medical School, Nankoku, Kochi, Japan
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Maeda H, Okamoto K, Namikawa T, Akimori T, Kamioka N, Shiga M, Dabanaka K, Hanazaki K, Kobayashi M. Rarity of late anastomotic leakage after low anterior resection of the rectum. Int J Colorectal Dis 2015; 30:831-4. [PMID: 25862318 DOI: 10.1007/s00384-015-2207-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Late anastomotic leakage is reported to account for half of all anastomotic leakages after low anterior resection of the rectum. An important clinical question is whether late and early anastomotic leakages are different entities. METHODS We retrospectively reviewed the medical records of patients who experienced anastomotic leakage after low anterior resection in two Japanese hospitals. The clinical characteristics were extracted and analyzed. RESULTS During the study period, 179 patients underwent low anterior resection. A pelvic drainage tube was routinely utilized in all cases and was generally removed 4 to 6 days after the operation. Twenty-six patients had anastomotic leakage; the diagnosis was based on fecal contamination of the drainage in 24 cases. The median interval between operation and detection of anastomotic leakage was 3.5 days. Anastomotic leakage was diagnosed within 7 days of the operation in 25 cases and on postoperative day 20 (after hospital discharge) in one case. There was no instance of anastomotic leakage diagnosed more than 30 days after the operation. There was no relationship between clinical variables and days of leakage diagnosis. CONCLUSION The rarity of late anastomotic leakage in our study, compared with previous studies, may relate to the relatively extended period of pelvic drainage tube usage in our institutes, which likely shortens the interval before leakage diagnosis. Our results suggest that late anastomotic leakage is a delayed symptom of subtle early anastomotic leakage rather than a separate entity.
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Affiliation(s)
- Hiromichi Maeda
- Cancer Treatment Center, Kochi Medical School Hospital, Kohasu, Oko-cho, Nankoku-city, Kochi, 783-8505, Japan,
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9
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Akimori T, Maeda H, Okamoto K, Namikawa T, Usui T, Hanazaki K, Kobayashi M. A case of Peliosis and epithelial cyst of intrapancreatic heterotopic spleen: a differential diagnosis of pancreatic mucinous cystic neoplasm. ACRT 2015. [DOI: 10.4993/acrt.23.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
| | | | - Ken Okamoto
- Cancer Treatment Center, Kochi Medical School
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10
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Maeda H, Okamoto K, Uemura S, Okabayashi T, Osaki S, Akimori T, Kamioka N, Hanazaki K, Kobayashi M. Staged surgery after colonic decompression may be safer for the treatment of obstructive left-sided colorectal cancer in a non-specialized hospital. Hepatogastroenterology 2014; 61:1938-1941. [PMID: 25713891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIMS The management for the obstructive left sided colorectal cancer is still controversial. METHODOLOGY A retrospective study was performed on 249 consecutive patients who underwent surgical intervention for left sided colorectal cancer in our hospital. Among 36 patients who had colonic obstruction, 25 patients received tumor resection while the rest of the patients received palliative stoma creation. Clinical characteristics and outcome following tumor resection was compared between patients with and without colonic obstruction. RESULTS Prior to tumor resection, all patients received colonic decompression. Flowingly, 20 patients received staged surgeries and five patients underwent one stage surgery, with three of the latter requiring reoperation due to anastomotic leakage. The five-year overall survival rate for patients following tumor resection was 75.5 % and 69.1 % for those with and without colonic obstruction respectively. Log-rank test showed no significant difference in overall survival between the two groups (p = 0.91). CONCLUSIONS Onestage surgery for patients with obstructive colorectal cancer in our hospital was associated with frequent anastomotic leakage. Colonic obstruction itself may not be a poor prognostic factor when decompression preceded surgical resection.
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Kitagawa H, Namikawa T, Iwabu J, Akimori T, Okabayashi T, Sugimoto T, Mimura T, Kobayashi M, Hanazaki K. Efficacy of Laparoscopic Gastric Mobilization for Esophagectomy: Comparison with Open Thoraco-abdominal Approach. J Laparoendosc Adv Surg Tech A 2013; 23:452-5. [DOI: 10.1089/lap.2012.0377] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Tsutomu Namikawa
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan
| | - Jun Iwabu
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan
| | - Toyokazu Akimori
- Department of Surgery, Kochi Prefectural Hospital, Sukumo, Kochi, Japan
| | | | - Takeki Sugimoto
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan
| | - Toshiki Mimura
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, Japan
| | - Michiya Kobayashi
- Department of Human Health and Medical Sciences, Kochi Medical School, Nankoku, Kochi, Japan
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12
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Oya R, Hirashima S, Akimori T, Okuri T, Yahara K, Kakeda S, Onari N, Korogi Y. 8569 POSTER Radiotherapy After Hyperbaric Oxygen Concurrent With Superselective Intra-arterial Carboplatin Chemotherapy Enhances Survival of Patients With Oral Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)72211-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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13
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Akimori T, Hanazaki K, Okabayashi T, Okamoto K, Kobayashi M, Ogata T. Quantitative distribution of brush cells in the rat gastrointestinal tract: brush cell population coincides with NaHCO3 secretion. Med Mol Morphol 2011; 44:7-14. [PMID: 21424931 DOI: 10.1007/s00795-009-0488-1] [Citation(s) in RCA: 13] [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] [Received: 10/22/2009] [Accepted: 12/18/2009] [Indexed: 11/30/2022]
Abstract
The function of brush cells is obscure, but recent cytochemical studies indicate that rat bile duct brush cells secrete NaHCO(3). The aim of this study was to determine the quantitative distribution of brush cells at 16 sites of the rat gastrointestinal tract and to investigate the role of NaHCO(3) secretion at these sites. Specimens of 16 sites of the gastrointestinal tracts of three female Long-Evans rats were fixed in a periodate-lysine-paraformaldehyde solution. Frozen sections were stained with the anti-cytokeratin 18 antibody, a selective marker for brush cells. The numbers of brush cells were counted from photographs. The percentages of brush cells in the epithelium at the 16 sites were gastric groove, 32.3%; corpus adjacent to the gastric groove, 2.5%; corpus, 0.4%; antrum, 0.4%; duodenum adjacent to the pyloric ring, 2.3%; proximal duodenum, 0%; duodenum facing the bile duct orifice, 0%; distal duodenum, 0.2%; proximal jejunum, 0.1%; transitional site between the jejunum and the ileum, 0.1%; distal ileum, Peyer's patch dome, 1.5%; and the villi, 0.4%; caecum, 2.1%; proximal colon, 0.2%; middle colon, 0.1%; distal colon, 0.1%; and rectum, 0.1%. We concluded that the population of brush cells is high in the gastric groove, the duodenum adjacent to the pyloric ring, and the caecum, where NaHCO(3) is postulated to neutralize gastric HCL or organic acids produced by enteric bacteria. The brush cell population is low in the duodenum and jejunum, which receive bile and pancreatic juice.
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Affiliation(s)
- Toyokazu Akimori
- Department of Surgery, Kochi Medical School, Nankoku, Kochi, 783-8505, Japan
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14
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Nakatani H, Akimori T, Takezaki Y, Hanazaki K. Vascular endothelial growth factors and their receptors in the novel human cell line, HN-Eso-1, established from esophageal spindle cell carcinoma. J Med Invest 2011; 57:232-6. [PMID: 20847522 DOI: 10.2152/jmi.57.232] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Human carcinosarcomas of esophagus are uncommon malignant neoplasms that are composed both carcinomatous and sarcomatous components. We established a novel cell line, HN-Eso-1, from the metastatic esophageal spindle cell carcinoma (so-called carcinosarcoma). In this study, we estimated the vascular endothelial growth factors (VEGFs) and VEGF receptors (VEGFRs). Reverse transcription polymerase chain reaction (RT-PCR) studies revealed that VEGF-A, -C, -D and VEGFR-1, -2 were upregulated. Cisplatin reduced the cell viability of HN-Eso-1 cells and VEGF attenuated its effect. These results suggest that expression of VEGF-A, VEGF-C, VEGF-D, VEGFR-1, and VEGFR-2 are involved in the cell's autocrine system and that VEGF protected these cells from the anti-tumor agent.
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Affiliation(s)
- Hajime Nakatani
- Department of Surgery, Kubokawa Hospital, Shimanto-cho, Kochi, Japan
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15
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Yatabe T, Kitagawa H, Yamashita K, Akimori T, Hanazaki K, Yokoyama M. Better postoperative oxygenation in thoracoscopic esophagectomy in prone positioning. J Anesth 2010; 24:803-6. [DOI: 10.1007/s00540-010-0968-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2010] [Accepted: 04/29/2010] [Indexed: 10/19/2022]
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Kitagawa H, Akimori T, Namikawa T, Okino T, Kobayashi M, Nishioka A, Hanazaki K. [A case of small cell undifferentiated carcinoma of the esophagus successfully treated by chemoradiotherapy]. Gan To Kagaku Ryoho 2009; 36:1737-9. [PMID: 19838038 DOI: pmid/19838038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Small cell carcinoma of the esophagus is rare, with a poor prognosis, and there is currently no standard therapy. Here we report a case of small cell carcinoma of the esophagus with right supraclavicular lymph node metastasis which was successfully treated by chemoradiotherapy. A 55-year-old man was admitted to our hospital with a right-sided neck tumor. The neck tumor was diagnosed as a small cell carcinoma by aspiration cytology. Endoscopy revealed an irregular tumor in the middle thoracic esophagus, 31 cm from the upper incisor teeth, but malignant cells were not detected from an esophageal biopsy. Right supraclavicular lymph node metastasis was detected by computed tomography and positron emission tomography computed tomography, and aspiration cytology revealed small cell undifferentiated carcinoma cells. The patient was diagnosed with a small cell carcinoma of the esophagus with supraclavicular lymph node metastasis, stage III: T2N3M0. Concurrent chemoradiotherapy using 5-fluorouracil and cisplatin was started. Lymph node reduction occurred from day 3, and endoscopy two months after chemoradiotherapy showed only a scar. We diagnosed the patient in complete remission, and he continues to do well with a recurrence-free status of 14 months after initial chemoradiotherapy.
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Okamoto K, Hanazaki K, Akimori T, Okabayashi T, Okada T, Kobayashi M, Ogata T. Immunohistochemical and electron microscopic characterization of brush cells of the rat cecum. Med Mol Morphol 2008; 41:145-50. [PMID: 18807140 DOI: 10.1007/s00795-008-0412-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Accepted: 07/01/2008] [Indexed: 11/30/2022]
Abstract
Brush cells (BCs) are relatively rare cells that are sparsely distributed throughout the mammalian digestive and respiratory systems. BCs have been identified in the rodent large intestine, but these cells have not been characterized by immunocytochemistry or electron microscopy. We previously demonstrated that rat bile duct BCs had strong immunoreactivity for six proteins that function in HCO(3)(-) secretion and thus assumed that BCs secrete NaHCO(3). It is well known that the gastrointestinal (GI) tract secretes NaHCO(3), but it is not known whether BCs of the GI tract also express proteins related to HCO(3)(-) secretion. Thus, in the present study, using double immunostaining for cytokeratin 18, a specific marker for BCs, we investigated protein expression in BCs from the rodent GI tract. We show that BCs from the GI tract express six proteins related to HCO(3)(-) secretion: cystic fibrosis transmembrane conductance regulator (CFTR), Cl(-)/HCO(3)(-) exchanger, Na(+)/HCO(3)(-) cotransporter, carbonic anhydrase II, Na(+)/H(+) exchanger (NHE) 1, and NHE3. These results suggest that BCs from the GI tract secrete NaHCO(3). In addition, we examined BCs from the rat cecum using electron microscopy (EM). Transmission EM (TEM) showed that BCs have long microvilli, a well-developed tubulovesicular system, and an abundant cytoskeleton. Scanning EM revealed that BCs were scattered on the luminal surface of the cecum and had numerous long microvilli.
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Affiliation(s)
- Ken Okamoto
- Department of Surgery, Kochi Medical School, Oko-cho, Nankoku, Kochi 783-8505, Japan
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18
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Kitagawa H, Akimori T, Okabayashi T, Namikawa T, Sugimoto T, Kobayashi M, Hanazaki K. Total laparoscopic gastric mobilization for esophagectomy. Langenbecks Arch Surg 2008; 394:617-21. [PMID: 18542990 DOI: 10.1007/s00423-008-0354-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Accepted: 05/09/2008] [Indexed: 02/05/2023]
Affiliation(s)
- Hiroyuki Kitagawa
- Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi, 783-8505, Japan
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Namikawa T, Kobayashi M, Okabayashi T, Okamoto K, Akimori T, Sugimoto T, Hanazaki K. Clinicopathological analysis of idiopathic perforation of the gallbladder. Surg Today 2007; 37:633-7. [PMID: 17643203 DOI: 10.1007/s00595-006-3476-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2006] [Accepted: 12/25/2006] [Indexed: 02/08/2023]
Abstract
Idiopathic perforation of the gallbladder (IPGB) is a rare event, and the underlying mechanisms are unknown. We investigated the clinicopathological characteristics of this disorder. We reported a case of IPGB, and reviewed 30 other cases reported up to the end of 2005 in a Medline and Japan Centra Revuo Medicina search of the medical literature. We analyzed the clinical findings, laboratory data, and histopathological features. The mean age of the patients was 70.2 +/- 12.8 years, and there were 19 men and 12 women. Underlying diseases such as hypertension, cerebral infarction or hemorrhage, renal failure, respiratory failure, and malignancy were reported in 35.5% of the patients. Perforation was found more often in the fundus (53.3%) than in the body (43.3%) or neck (3.3%) of the gallbladder. Thrombus was found in the intramural vessels of the gallbladder wall in 13 patients (50%), whereas 13 (50%) were free of thrombus. Serum amylase was significantly higher in the intramural vessels in the thrombus-negative group than in the thrombus-positive group. The overall operative mortality was 3.3%. Univariate and multivariate analyses indicated that a delay of more than 24 h from the manifestation of symptoms to operation and a perforation size greater than 2 cm required significantly longer hospitalization. Thrombosis in the intramural vessels seems to be related to the events leading to IPGB; however, it is difficult to consider it the only cause. Early operation and the size of the perforation are important determinants of the outcome of treatment for IPGB.
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Affiliation(s)
- Tsutomu Namikawa
- Department of Tumor Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku 783-8505, Japan
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Kobayashi M, Okamoto K, Okabyashi T, Akimori T, Namikawa T, Sakamoto J, Hanazaki K. Anti-reflux pouch-esophagostomy after total gastrectomy. Surg Technol Int 2007; 16:89-92. [PMID: 17429774 DOI: pmid/17429774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The most prominent and severe complication after a total gastrectomy is severe reflux esophagitis. We have developed a procedure involving jejunal pouch-esophagostomy to avoid such postoperative reflux. The novel procedure reported here initially involves folding a jejunal segment of approximately 35 cm in length. A side-to-side jejuno-jejunostomy at the anti-mesenteric side was then affected using a 100-mm linear stapler. This resulted in a jejunal pouch, 10 cm in length, and a 7-cm apical section of unstapled jejunal loop. Finally, an esophago-jejuno end-to-side anastomosis (pouch-esophagostomy) was formed at the right anterior wall of the apical bridge using a circular stapler. We have therefore introduced a "partial posterior fundoplication"-like wrapping technique to the standard gastrectomy using the apical bridge of the jejunal pouch. Only a little postoperative reflux was revealed by barium meal testing - even in the Trendelenburg's position - in patients treated with the described anti-reflux anastomosis procedure. Jejunal pouch reconstruction with partial posterior wrapping is a useful procedural addition for minimizing reflux esophagitis following a total gastrectomy.
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Affiliation(s)
- Michiya Kobayashi
- Department of Human Health and Medical Science, Kochi Medical School, Nankoku, Japan
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Kobayashi M, Araki K, Okamoto K, Okabayashi T, Akimori T, Sugimoto T. Anti-reflux pouch-esophagostomy after proximal gastrectomy with jejunal pouch interposition reconstruction. Hepatogastroenterology 2007; 54:116-8. [PMID: 17419243] [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: 05/14/2023]
Abstract
Reflux esophagitis is a serious postoperative complication for patients undergoing gastrectomy. We designed a new jejunal pouch-esophagostomy to prevent reflux after proximal gastrectomy. After proximal gastrectomy, ajejunal segment about 17 cm long was folded. Side-to-side jejuno-jejunostomy was made using a linear stapler with 100-mm staples along the length at the anti-mesenteric side. A 10-cm-longjejunal pouch with a 7-cm-long apical bridge was made. Esophago-jejuno end-to-side anastomosis (pouch-esophagostomy) was made with circular stapler at the right anterior wall the apical bridge. We add "partial posterior fundoplication" like wrapping using the apical bridge of the jejunal pouch. Patients with this new anti-reflux anastomosis showed no reflux on barium meal study even in the right anterior oblique deep Trendelenburg's position. Jejunal pouch reconstruction with partial posterior wrapping provides a satisfactory result with regard to preventing reflux esophagitis.
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Maeda H, Okabayashi T, Kobayashi M, Morishita S, Nishimori I, Ito S, Sugimoto T, Akimori T, Onishi S, Araki K. Usefulness of multi-detector row computed tomography for accurate preoperative assessment of pancreatic adenocarcinoma: report of a case. West Afr J Med 2006; 25:242-5. [PMID: 17191428 DOI: 10.4314/wajm.v25i3.28287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 74-year-old female underwent surgical treatment for adenocarcinoma of the pancreatic head. Preoperative multi-detector row computed tomography (MD-CT) demonstrated tumor invasion into the accessory right colic vein and the branch of the middle colic artery (MCA), which was not detected by digital subtraction angiography. MD-CT showed anatomical variants in the left hepatic artery arising from the left gastric artery, and the right posterior hepatic artery arising from the superior mesenteric artery. Three-dimensional reconstruction CT generated a clear picture of the anatomy of the region concerned, which is essential for a safe operation. The MD-CT findings were highly consistent with the intraoperative findings. We have demonstrated that MD-CT is an important and highly accurate modality for pancreatic surgery.
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Affiliation(s)
- H Maeda
- Department of Tumor Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi 783-8505, Japan
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23
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Mizobuchi S, Nakatani H, Akimori T, Kuge K, Okazaki Y, Sasaguri S. Novel use of Weerda laryngoscope to remove early cervical esophageal cancer. Ann Thorac Surg 2006; 79:e34-5. [PMID: 15919263 DOI: 10.1016/j.athoracsur.2005.01.067] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2004] [Revised: 01/17/2005] [Accepted: 01/20/2005] [Indexed: 10/25/2022]
Abstract
A 65-year-old man was followed up after endoscopic mucosal resection for esophageal cancer in February 2000. Thereafter, he received endoscopic mucosal resection, radiation therapy, and argon plasma coagulation for recurrent and multiple primary esophageal cancers. On follow-up examination, two additional esophageal cancers were detected by endoscopy in September 2003. One lesion was located 16 cm from the incisor close to the entrance to the esophagus. To preserve the larynx, this lesion was removed by mucosal resection using a Weerda distending operating laryngoscope. This report describes this novel use of a Weerda distending operating laryngoscope to remove superficial cervical esophageal cancer.
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Affiliation(s)
- Shunji Mizobuchi
- Department of Surgery II, Faculty of Medicine, Kochi University, Kochi, Japan.
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Nakatani H, Araki K, Jin T, Kobayashi M, Sugimoto T, Akimori T, Namikawa T, Okamoto K, Nakano T, Okabayashi T, Hokimoto N, Kitagawa H, Taguchi T. STI571 (Glivec) induces cell death in the gastrointestinal stromal tumor cell line, GIST-T1, via endoplasmic reticulum stress response. Int J Mol Med 2006; 17:893-7. [PMID: 16596277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
STI571 is a specific inhibitor of tyrosine kinases, such as BCR-ABL, platelet-derived growth factor receptor, and c-KIT, and has recently been approved for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors (GISTs). This study demonstrated that STI571 induces cell death in the gastrointestinal stromal tumor cell line, GIST-T1. In these cells, STI571 induced pro-caspase-12 or pro-caspase-7 cleavage and it affected caspase-3 activity and induced the endoplasmic reticulum (ER)-resident chaperone, glucose-regulated protein 78. The STI571-induced cell death was blocked by the protein synthesis inhibitor, cycloheximide. Together, these results suggest that STI571 induces cell death in GIST-T1 cells, at least in part, via the ER stress response.
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Affiliation(s)
- Hajime Nakatani
- Department of Tumor Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.
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Nakatani H, Araki K, Jin T, Kobayashi M, Sugimoto T, Akimori T, Namikawa T, Okamoto K, Nakano T, Okabayashi T, Hokimoto N, Kitagawa H, Taguchi T. STI571 (Glivec) induces cell death in the gastrointestinal stromal tumor cell line, GIST-T1, via endoplasmic reticulum stress response. Int J Mol Med 2006. [PMID: 16596277 DOI: 10.3892/ijmm.17.5.893] [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: 02/05/2023] Open
Abstract
STI571 is a specific inhibitor of tyrosine kinases, such as BCR-ABL, platelet-derived growth factor receptor, and c-KIT, and has recently been approved for the treatment of chronic myeloid leukemia and gastrointestinal stromal tumors (GISTs). This study demonstrated that STI571 induces cell death in the gastrointestinal stromal tumor cell line, GIST-T1. In these cells, STI571 induced pro-caspase-12 or pro-caspase-7 cleavage and it affected caspase-3 activity and induced the endoplasmic reticulum (ER)-resident chaperone, glucose-regulated protein 78. The STI571-induced cell death was blocked by the protein synthesis inhibitor, cycloheximide. Together, these results suggest that STI571 induces cell death in GIST-T1 cells, at least in part, via the ER stress response.
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Affiliation(s)
- Hajime Nakatani
- Department of Tumor Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.
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Okabayashi T, Kobayashi M, Sugimoto T, Akimori T, Namikawa T, Okamoto K, Maeda H, Araki K. Clinicopathological features of type 1 gastric carcinoma: the need to be cautious of superficial lesion surrounding type 1 gastric carcinoma. Hepatogastroenterology 2006; 53:313-6. [PMID: 16608047 DOI: pmid/16608047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND/AIMS Gastric carcinoma (GC) is one of the most common malignant tumors of the digestive tract and the incidence of adenocarcinoma of the upper one-third of the stomach has increased recently worldwide. The objective of this study was to analyze the clinicopathological variables in patients with GC and examine preoperative diagnosis and the medical treatment strategy of Type 1 GC. METHODOLOGY Nine hundred and eighty-one patients with GC who underwent surgical resection between 1981 and 2002 at Kochi Medical School were studied. Thirty-five patients with Type 1 GC were compared with non-Type 1 GC patients on postoperative surgicopathological parameters, and changing trends were evaluated. RESULTS The characteristics of patients with Type 1 GC were different from those of patients with non-Type 1 GC: Their tumors were more often in the upper one-third of the stomach (37% vs. 15%), lesions were histologically differentiated in 80% (vs. 56%), and there were more superficial lesions surrounding Type 1 GC (80% vs. 8%). The absolute value and the rate of Type 1 GC increased significantly from the first half to the second half of the study. CONCLUSIONS Our findings showed that when Type 1 GC is discovered, physicians should investigate the mucosa around the main neoplasm carefully. The current series suggested that Type 1 GC are associated frequently with superficial lesions, making local resections more difficult, and that Type 1 GC was similar clinicopathologically to carcinoma of the gastric cardia and had different etiologies contributed to its tumorgenesis, compared with non-Type 1 GC, and Type 1 GC may become the key which solves the problem of carcinoma at the gastric cardia.
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Okabayashi T, Kobayashi M, Morishita S, Sugimoto T, Akimori T, Namikawa T, Okamoto K, Hokimoto N, Araki K. Confirmation of the posterior gastric artery using multi-detector row computed tomography. Gastric Cancer 2006; 8:209-13. [PMID: 16328594 DOI: 10.1007/s10120-005-0336-5] [Citation(s) in RCA: 8] [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] [Received: 12/20/2004] [Accepted: 04/28/2005] [Indexed: 02/07/2023]
Abstract
BACKGROUND The blood supply of the stomach is well characterized. Although the posterior gastric artery (PGA) is the second most important artery supplying the upper third of the stomach, the main features and clinical importance of the PGA have not been established. The aim of this study was to use multi-detector row computed tomography (MD-CT) to investigate the features of the PGA with respect to its incidence, location and size, and to correlate the findings with clinical practice. METHODS In August 2004, 50 preoperative patients (33 men and 17 women) were evaluated prospectively by MD-CT. Informed consent for the present study was accepted at Kochi Medical School. The length of the PGA, from the root of the splenic artery, and the internal diameter of the PGA were examined. Correlations between body mass index (BMI) and the observed features of the PGA were investigated. RESULTS The PGA was recognized in all patients. In 49 (98%) patients, the PGA branched from the splenic artery. In 1 (2%) patient, the PGA originated from the root of the celiac trunk. The PGA was discernible for a length of 4.2-14.3 cm (mean, 9.1 cm) from the root of the splenic artery, and the internal diameter of the PGA was 0.5-2.1 mm (mean, 1.0 mm). BMI did not correlate with PGA length or internal diameter. CONCLUSION Our current study suggested that the anatomical and clinical features of the PGA can be shown by clinical methods, and that these features are useful in planning surgical treatment.
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Affiliation(s)
- Takehiro Okabayashi
- Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi 783-8505, Japan
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Okabayashi T, Kobayashi M, Nishimori I, Sugimoto T, Akimori T, Namikawa T, Okamoto K, Onishi S, Araki K. Benefits of early postoperative jejunal feeding in patients undergoing duodenohemipancreatectomy. World J Gastroenterol 2006; 12:89-93. [PMID: 16440423 PMCID: PMC4077486 DOI: 10.3748/wjg.v12.i1.89] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To study whether early postoperative enteral nutrition reduces the incidence of complications and/or improves nutritional status following duodenohemipancreatectomy (DHP).
METHODS: We studied 39 patients who underwent DHP for a peri-ampullary mass. Twenty-three patients received total parental nutrition and then started to have an oral intake of nutrition between postoperative day (POD) 7 and 14 [late postoperative enteral nutrition (LPEN) group]. Sixteen patients started to have enteral feeding through a jejunostomy catheter the day after the operation [early postoperative enteral nutrition (EPEN) group]. The incidence of complications and laboratory data at the early postoperative stage were studied in comparison between LPEN and EPEN groups.
RESULTS: Serum levels of albumin and total protein in the EPEN group were significantly higher than those in the LPEN group. The loss of body mass index was significantly suppressed in the EPEN group as compared to the LPEN group. The lymphocyte count decreased immediately after the operation was restored significantly faster in the EPEN group than in the LPEN group. The EPEN group showed significantly fewer incidences of postoperative pancreatic fistulas, as well as a significantly shorter length of hospitalization than the LPEN group. There were no significant differences in the incidences of other postoperative complications between the two groups, such as delayed gastric emptying, surgical site infection, cholangitis, and small bowel obstruction.
CONCLUSION: EPEN is a safe and beneficial opportunity for patients who have undergone DHP for a peri-ampullary mass.
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Affiliation(s)
- Takehiro Okabayashi
- Department of Tumor Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
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Kitagawa H, Kobayashi M, Okabayashi T, Okamoto K, Namikawa T, Sugimoto T, Akimori T, Hokimoto N, Araki K. A Case of Metastatic Lung Cancer with Cavitation from Sigmoid Colon Cancer. Jpn J Gastroenterol Surg, Nihon Shokaki Geka Gakkai zasshi 2006. [DOI: 10.5833/jjgs.39.724] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Kitagawa H, Okabayashi T, Nishimori I, Kobayashi M, Sugimoto T, Akimori T, Kohsaki T, Miyaji E, Onishi S, Araki K. Rapid Growth of Mucinous Cystic Adenoma of the Pancreas Following Pregnancy. ACTA ACUST UNITED AC 2006; 37:45-8. [PMID: 17290080 DOI: 10.1385/ijgc:37:1:45] [Citation(s) in RCA: 8] [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] [Subscribe] [Scholar Register] [Received: 11/30/1999] [Revised: 11/30/1999] [Accepted: 11/30/1999] [Indexed: 11/11/2022]
Abstract
A 25-yr-old woman delivered a healthy child by cesarean section. At 8 mo postpartum, she became aware of an upper abdominal tumor. Abdominal computed tomography and upper abdominal ultrasonography revealed a large cystic mass in the body of the pancreas. Endoscopic retrograde pancreatography showed no connection between the main pancreatic duct and the cystic lesion. The patient underwent tumor resection at 11 mo postpartum. Pathological examination of the tumor revealed mucin-producing columnar epithelial cells lining the cystic wall with ovarian-type stromal tissue and no findings indicative of malignancy, giving a diagnosis of mucinous cystic adenoma of the pancreas. Immunohistochemical studies revealed positive staining for progesterone receptor but not for estrogen receptor in the stromal cell nuclei. Postpartum rapid growth of a benign mucinous cystic neoplasm might be linked to the production of female sex hormones during lactation.
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Affiliation(s)
- Hiroyuki Kitagawa
- Department of Tumor Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan
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Jin T, Nakatani H, Taguchi T, Sonobe H, Morimoto N, Sugimoto T, Akimori T, Nakano T, Namikawa T, Okabayashi T, Kobayashi M, Araki K. Thapsigargin Enhances Cell Death in the Gastrointestinal Stromal Tumor Cell Line, GIST-T1, by Treatment with Imatinib (Glivec). ACTA ACUST UNITED AC 2006. [DOI: 10.1248/jhs.52.110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Toufeng Jin
- Doctoral Course, Medical Graduate School of Kochi University
- Department of General Surgery, College of Medical, Yanbian University
| | - Hajime Nakatani
- Department of Tumor Surgery, Kochi Medical School, Kochi University
| | - Takahiro Taguchi
- Department of Human and Medical Science, Graduate School of Kuroshio Science, Kochi University
| | - Hiroshi Sonobe
- Department of Laboratory Medicine and Pathology, National Hospital Organization, Fukuyama Medical Center
| | - Norihito Morimoto
- Department of Clinical Laboratory Medicine, Kochi Medical School, Kochi University
| | - Takeki Sugimoto
- Department of Tumor Surgery, Kochi Medical School, Kochi University
| | - Toyokazu Akimori
- Department of Tumor Surgery, Kochi Medical School, Kochi University
| | - Takumi Nakano
- Department of Tumor Surgery, Kochi Medical School, Kochi University
| | - Tsutomu Namikawa
- Department of Tumor Surgery, Kochi Medical School, Kochi University
| | | | | | - Keijiro Araki
- Department of Tumor Surgery, Kochi Medical School, Kochi University
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Kobayashi M, Okamoto K, Akimori T, Tochika N, Yoshimoto T, Okabayashi T, Sugimoto T, Araki K. Localization of thymidine phosphorylase in advanced gastric and colorectal cancer. J Mol Histol 2005; 35:69-74. [PMID: 15323351 DOI: 10.1023/b:hijo.0000021086.09680.4f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Thymidine phosphorylase (TP) is known to be more concentrated in human cancer tissues than in adjacent normal tissue based on findings using enzyme-linked immunosorbent assay (ELISA) and immunohistochemistry. However, the ultrastructural localization of TP in cancer tissues has not previously been demonstrated. We investigated the localization of TP in gastric cancer and colorectal cancer tissue by ELISA, immunohistochemistry, and immunoelectron microscopy. Between April 1997 and May 2000, we obtained surgically resected specimens from 42, 46, and 36 cases of advanced gastric, colon, and rectal cancer, respectively. ELISA demonstrated that the TP level was higher in cancer tissues than in adjacent normal tissue. Immunohistochemically, cancer cells were positive for the enzyme in some cases. However, in a number of cases immunopositive inflammatory cells were also present in cancerous tissues. At the electron microscope level, TP was diffusely distributed in the cytoplasm of cancer cells and in the mitochondria of the neutrophil in gastric cancer tissue. In rectal cancer tissues, cytoplasmic granules in macrophages in cancer tissues were immunoreactive for the TP. These findings suggest that TP is produced by macrophages and exists in neutrophils and cancer cells.
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Affiliation(s)
- Michiya Kobayashi
- Department of Surgery, Kochi Medical School, Oko-cho, Kohasu, Nankoku, 783-8505 Japan
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Okabayashi T, Kobayashi M, Akimori T, Akisawa N, Iwasaki S, Onishi S, Araki K. Usefulness of laparoscopic radiofrequency ablation of hepatocellular carcinoma. Surg Technol Int 2005; 14:177-81. [PMID: 16525971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Our intent was to evaluate whether laparoscopic radiofrequency ablation for patients with unresectable hepatocellular carcinoma and a high degree of liver damage has a role to play in the management of the disease. Laparoscopic and hand-assisted laparoscopic radiofrequency ablations were performed on five patients and the short-range outcome and complications of these patients were evaluated. The evaluation of the primary liver tumor by the radiofrequency ablation was carried out by computed tomography on the seventh day after surgery. Three patients underwent laparoscopic radiofrequency ablation, and the other two patients underwent hand-assisted laparoscopic radiofrequency ablation. The Child-Pugh status of all tumors was B status, and one patient had complications due to postoperative ascites. Laparoscopic and hand-assisted laparoscopic radiofrequency ablation with a cooled-tip electrode needle was found to be a safe and effective local treatment of hepatic focal lesions.
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Affiliation(s)
- Takehiro Okabayashi
- Department of Tumor Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi, Japan
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Kobayashi M, Matsuura K, Araki K, Sugimoto T, Hamada S, Akimori T, Tochika N. Three-dimensional demonstration of cystic duct by helical CT scanning. Hepatogastroenterology 2002; 49:1491-5. [PMID: 12397715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
BACKGROUND/AIMS We evaluated the usefulness of helical CT scanning with drip-infusion cholangiography for the delineation of choleductal anatomy in preparation for laparoscopic cholecystectomy. METHODOLOGY One hundred and five cases underwent laparoscopic cholecystectomy for cholecystolithiasis in our department from March 1993 to July 1998. Endoscopic retrograde cholangiography was carried out in 58 cases and helical CT scanning with drip-infusion cholangiography, including, three-dimensional CT in 31 cases. We, retrospectively, investigated three-dimensional helical CT scanning with drip-infusion cholangiography in the point of three-dimensional demonstration of cystic duct anatomy and try to classify the findings. RESULTS Three-dimensional helical CT scanning with drip-infusion cholangiography visualized three-dimensional anatomy of the cystic duct clearly. For the detection of the biliary disease such as stones and polyps, however, endoscopic retrograde cholangiography is superior (sensitivity; 89.7%) to two-dimensional helical CT scanning with drip-infusion cholangiography (sensitivity; 64.5%) and three-dimensional helical CT scanning with drip-infusion cholangiography (sensitivity; 22.6%) except for large lesions. We have classified the three dimensional helical CT scanning with drip-infusion cholangiography findings in three types. CONCLUSIONS Three-dimensional helical CT scanning with drip-infusion cholangiography is not only less invasive but also more useful for the delineation of three-dimensional anatomy of the bile duct.
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Affiliation(s)
- Michiya Kobayashi
- First Department of Surgery, Kochi Medical School, Nankoku 783-8505, Japan.
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35
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Matsubara T, Ueda M, Abe T, Akimori T, Kokudo N, Takahashi T. Unique distribution patterns of metastatic lymph nodes in patients with superficial carcinoma of the thoracic oesophagus. Br J Surg 1999; 86:669-73. [PMID: 10361192 DOI: 10.1046/j.1365-2168.1999.01067.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Lymph node metastasis is commonly found in carcinoma of the thoracic oesophagus, even when the tumour invades only the submucosa. Although lymph node status greatly influences the outcome, the pattern of early lymphatic spread has not been investigated, and the role of lymph node dissection is still a matter of controversy. METHODS A series of 110 patients with superficial carcinoma who underwent systematic extended lymph node dissection was investigated retrospectively. RESULTS Lymph node involvement was found in 0 per cent (none of nine), 23 per cent (five of 22) and 49 per cent (38 of 78) of tumours that invaded the lamina propria, muscularis mucosa and submucosa respectively. Anatomically distant lymph nodes (recurrent nerve nodes and perigastric nodes) were involved more frequently than other intrathoracic nodes adjacent to the main tumour. Only three patients had involvement limited to the intrathoracic group, and in carcinoma that invaded only the muscularis mucosae, all metastatic nodes were located at the thoracocervical junction or in the abdomen. The 5-year survival rate was 89 per cent in the node-negative group and 54 per cent in the node-positive group (P < 0.0003). CONCLUSION The recurrent nerve nodes and perigastric nodes are the principal proximal regional lymph nodes involved in superficial carcinoma of the thoracic oesophagus. Systematic lymph node dissection, which included these nodes, yielded an acceptable and favourable outcome in patients with node-positive superficial carcinoma.
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Affiliation(s)
- T Matsubara
- Department of Surgery, Cancer Institute Hospital, 1-37-1 Kami-Ikebukuro, Toshima-Ku, Tokyo 170, Japan
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Miyagawa H, Kamioka N, Kohara H, Yuube R, Takahashi T, Nakatoh H, Kawada M, Utsunomiya T, Izumiyama F, Akimori T. [A case of advanced hepatocellular carcinoma, in which the tumor almost disappeared by orally administered UFT]. Gan To Kagaku Ryoho 1993; 20:2211-5. [PMID: 8239687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A 59-year-old male with liver cirrhosis was admitted to our hospital for further examination of general fatigue. A huge tumor was found in the right lobe of his liver with abdominal ultrasonography and computed tomography (CT). The titers of serum AFP (14,055 ng/ml) and PIVKA-II (more than 50.0 AU/ml) were extremely high. A tumor embolus was observed in the portal vein with abdominal angiography. According to these findings, he was diagnosed as having advanced hepatocellular carcinoma (HCC). He was treated by oral administration of UFT (600 mg/day) as an unresectable case of HCC. Three months later, the clinical symptoms were greatly improved and HCC was almost diminished with abdominal ultrasonography and CT, although a small tumor embolus was found by angiography. The titers of AFP and PIVKA-II were reduced to the normal range. This case suggests the clinical effectiveness of UFT for the treatment of HCC.
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Affiliation(s)
- H Miyagawa
- Dept. of Internal Medicine, Kouchi Municipal Hospital of Aki
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