記述言語：日本語   出版者・発行元：(一社)日本肥満学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本肥満学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本糖尿病学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Laparoscopic and robotic surgery for transverse colon cancer are difficult due to complex fusion of the foregut and midgut and variation of the vessels of the transverse colon. Although the vessels of the right colon have been investigated, middle colic artery (MCA) variation and the relationship with vessels around the transvers colon are unknown. We investigated variation of the MCA using computed tomography angiography (CTA) and cadaver specimen and the relationship between the superior mesenteric vein (SMV) and MCA using CTA. The classification of vessels around the transverse colon may lead to safer and reliable surgery. METHODS: This study included 505 consecutive patients who underwent CTA in our institution from 2014 to 2020 and 44 cadaver specimens. Vascular anatomical classifications and relationships were analyzed using CT images. RESULTS: The MCA was defined as the arteries arising from the superior mesenteric artery (SMA) that flowed into the transverse colon at the distal ends. The classifications were as follows: type I, branching right and left from common trunk; type II, the right and left branches bifurcated separately from the SMA; and type III, the MCA branched from a vessel other than the SMA. Type II was subclassified into two subtypes, type IIa with one left branch and type IIb with two or more left branches from SMA. In the CTA and cadaver studies, respectively, the classifications were as follows: type I, n = 290 and n = 31; type IIa, n = 211 and n = 13; type IIb, n = 3 and n = 0; and type III, n = 1 and n = 0. We classified the relationship between the MCA and left side of the SMV into three types: type A, a common trunk runs along the left edge of the SMV (n = 173; 59.7%); type B, a right branch of the MCA runs along the left edge of the SMV (n = 116; 40.0%); and type C, the MCA runs dorsal of the SMV (n = 1; 0.3%). CONCLUSIONS: This study revealed that The MCA branching classifications and relationship between the SMV and MCA. Preoperative CT angiography may be able to reliably identify vessel variation, which may be useful in clinical practice.

DOI： 10.1186/s12957-023-02919-9

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The diagnosis of patients with chronic constipation is very complicated. This study aimed to develop a simple imaging classification for the diagnosis of chronic constipation by abdominal computed tomography (CT). METHODS: Sixty-two patients who underwent abdominal CT in our hospital between January and June 2022 were enrolled. The CT values of the stool in the rectum and cecum were measured in patients with chronic constipation (C group) and in those without (non-C group). RESULTS: A strong correlation was observed between the Bristol Stool Form Scale (BSFS) and the CT value of rectal stool. Furthermore, the rectal stool CT value was significantly higher in patients with chronic constipation than in those without. The CT value of cecal stool did not differ between the two groups. The cecal stool CT value was significantly higher in patients with severe constipation (BSFS 1) than in those with BSFS 2-6. A cutoff CT value of 100 was selected as the optimal value for indicating chronic constipation. CONCLUSIONS: Abdominal CT was useful in the diagnosis of chronic constipation. If the patient had constipation, the optimal cutoff CT value was 100.

DOI： 10.23922/jarc.2022-039

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: A low rate of the incidence of venous thromboembolism (VTE) after surgeries that are preoperatively classified as having high risk of VTE has been reported in recent years. We seek to identify the optimal cases to receive perioperative pharmacologic thromboprophylaxis. In this study, we evaluated the incidence rate of VTE among patients undergoing colorectal surgery who did not receive perioperative pharmacologic thromboprophylaxis, and the ability of coagulofibrinolytic markers to predict the postoperative development of VTE. METHODS: We retrospectively analyzed the rate of postoperative development of VTE in 70 patients undergoing elective colorectal surgery without perioperative pharmacologic thromboprophylaxis and the ability of coagulofibrinolytic markers to predict the development of VTE. RESULTS: The incidence of VTE was observed in 11 patients (15.7%); all cases were asymptomatic and distal-type deep vein thrombosis (DVT). Comparisons of time course changes in perioperative coagulofibrinolytic markers between patients with and without DVT revealed significant differences in soluble fibrin (SF), thrombin-antithrombin complex (TAT), fibrin/fibrinogen degradation product (FDP) and D-dimer. Dynamic postoperative physiological coagulofibrinolytic responses were shown, but all four markers at each postoperative point demonstrated moderate accuracy (median area under the curve [AUC]: 0.788, median sensitivity: 0.865, median specificity: 0.644) for predicting the development of DVT. CONCLUSIONS: The incidence of postoperative VTE was low in patients with colorectal surgery even in those who did not receive perioperative pharmacologic thromboprophylaxis. SF, TAT, FDP and D-dimer were useful for predicting the development of DVT when we set cut-off values taking the physiological perioperative coagulofibrinolytic responses into consideration.

DOI： 10.23922/jarc.2022-077

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本肥満学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Few studies have reported on the interactions between gastrectomy and antithrombotic therapy, especially the long-term prognosis. We aimed to clarify the short- and long-term prognosis of gastrectomy for patients on antithrombotic therapy. METHODS: We reviewed the perioperative data and survival rate of patients who underwent laparoscopic distal gastrectomy (LDG) at our institute between 2010 and 2013. RESULTS: There were 119 patients enrolled in this retrospective study: 31 who were taking antithrombotic drugs (antithrombotic therapy (ATT) group), and 88 who were not (non-ATT group). The mean age was significantly higher in the ATT group than in the non-ATT group. No significant differences were observed in the amount of intraoperative bleeding or blood hemoglobin level after surgery between the groups. Bleeding complications occurred in only one patient from the ATT group, and the postoperative complication rate was comparable between the groups. During follow-up, cerebrovascular or cardiovascular events developed in 19.4% of the ATT group patients and 4.5% of the non-ATT group patients; however, there were no significant differences in the 5-year overall survival rates between the groups (ATT group, 76.9%; non-ATT group, 82.9%). CONCLUSIONS: Antithrombotic therapy did not affect the short-term or long-term prognosis of patients after LDG.

DOI： 10.1007/s00595-022-02479-7

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: During the perioperative period, coagulofibrinolytic activation occurs, which occasionally results in thromboembolic complications. However, natural perioperative coagulofibrinolytic responses have not been well investigated. The present study examined perioperative coagulofibrinolytic changes and their association with the development of venous thromboembolism (VTE). METHODS: We retrospectively analyzed the changes in coagulofibrinolytic markers for 7 days in 70 patients undergoing elective colorectal surgery. To explore the natural coagulofibrinolytic response, we investigated patients not undergoing perioperative chemical thromboprophylaxis. RESULTS: Coagulation activation occurred from just after surgery to postoperative day (POD) 1, followed by a gradual decrease, but persisted to even POD 7. Fibrinolytic activity showed a tri-phasic response: activation, shutdown and reactivation. Consequently, fibrin/fibrinogen degradation product (FDP) and D-dimer levels continued to increase until POD 7. The development of deep vein thrombosis (DVT) was observed in 11 patients (15.7%). Postoperative sustained hyper-coagulation [soluble fibrin (SF) or thrombin-antithrombin complex (TAT) values on POD 7 > their normal limits] was significantly associated with the development of DVT (SF, p < 0.001; TAT, p = 0.001). CONCLUSION: We found initial coagulation activation and a tri-phasic response of fibrinolytic activity after colorectal surgery. Thus, physicians need to pay attention to these responses when attempting to prevent or treat VTE.

DOI： 10.1007/s00595-021-02393-4

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The increasing age of patients with severe motor and intellectual disabilities (SMID) has become a serious concern. Few studies have investigated tumor treatment in this population. METHODS: Tumor treatments for 12 SMID patients were examined. RESULTS: Blood tests and ultrasonography were useful for screening. With regard to treatment, surgery for SMID patients was performed in the same manner as for patients without SMID, and the results were generally satisfactory, without major complications. Typically, cancer was diagnosed at an advanced stage, and many metachronous double cancers were observed. CONCLUSIONS: Treatment yielded satisfactory results for patients with SMID and their families. Future studies should examine the clinical significance of screening and tumor operative method for patients with SMID.

DOI： 10.1272/jnms.JNMS.2022_89-217

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Indocyanine green (ICG) fluorescence angiography has recently been reported useful as a method for predicting intestinal blood flow and may reduce anastomotic leakage. However, the quantification method for ICG fluorescence angiography has not been established. We usually measure the tissue oxygen saturation (StO2 ) in the intestinal tract via near-infrared spectroscopy, as it is able to measure the oxygen concentration accurately and immediately shows objective data. In this study, we propose that the time to reach the anastomotic site after intravenous ICG injection is an effective parameter for quantifying ICG fluorescence angiography from the comparison to the data of StO2 in the intestinal tract.

DOI： 10.1111/ases.13002

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本肥満症治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本糖尿病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本肥満学会  

J-GLOBAL

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Few studies have reported on the interactions between gastrectomy and antithrombotic therapy, especially the long-term prognosis. We aimed to clarify the short- and long-term prognosis of gastrectomy for patients on antithrombotic therapy. METHODS: We reviewed the perioperative data and survival rate of patients who underwent laparoscopic distal gastrectomy (LDG) at our institute between 2010 and 2013. RESULTS: There were 119 patients enrolled in this retrospective study: 31 who were taking antithrombotic drugs (antithrombotic therapy (ATT) group), and 88 who were not (non-ATT group). The mean age was significantly higher in the ATT group than in the non-ATT group. No significant differences were observed in the amount of intraoperative bleeding or blood hemoglobin level after surgery between the groups. Bleeding complications occurred in only one patient from the ATT group, and the postoperative complication rate was comparable between the groups. During follow-up, cerebrovascular or cardiovascular events developed in 19.4% of the ATT group patients and 4.5% of the non-ATT group patients; however, there were no significant differences in the 5-year overall survival rates between the groups (ATT group, 76.9%; non-ATT group, 82.9%). CONCLUSIONS: Antithrombotic therapy did not affect the short-term or long-term prognosis of patients after LDG.

DOI： 10.1007/s00595-022-02479-7

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Wilms tumor (WT) is the most common malignant kidney tumor in children. High blood pressure is seen in up to 55% of children with WT. However, hypertensive cardiomyopathy with congestive heart failure due to WT is remarkably rare, with only several cases reported worldwide. In this report, a pediatric case of WT with hypertension causing hypertensive cardiomyopathy and congestive heart failure is presented. An 8-month-old male child with abdominal distension was seen by his primary physician. He was referred to our hospital for further examination and treatment. Abdominal contrast-enhanced computed tomography demonstrated a weakly enhancing, large abdominal mass, which was larger than 12 cm. Two-dimensional transthoracic echocardiography showed a diffuse hypokinetic left ventricle. The patient was diagnosed with cardiomyopathy caused by hypertension. Open surgical resection of the mass was successfully performed. His postoperative course was uncomplicated, and the patient was successfully discharged. The plasma renin activity was maintained at a high level even after left nephrectomy, suggesting that the right kidney was likely the source of renin secretion. Mechanical compression of the right renal blood vessels by a greatly enlarged left kidney can cause right renal ischemia, which activates renin excretion. Nephrectomy can be an effective treatment for a WT patient with hypertension causing hypertensive cardiomyopathy, and then cardiac function will be improved within several weeks. We recommend routine echocardiography surveillance in patients with WT. This report can help pediatric surgeons become more familiar with cardiomyopathy caused by WT.

DOI： 10.1272/jnms.JNMS.2021_88-513

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: During the perioperative period, coagulofibrinolytic activation occurs, which occasionally results in thromboembolic complications. However, natural perioperative coagulofibrinolytic responses have not been well investigated. The present study examined perioperative coagulofibrinolytic changes and their association with the development of venous thromboembolism (VTE). METHODS: We retrospectively analyzed the changes in coagulofibrinolytic markers for 7 days in 70 patients undergoing elective colorectal surgery. To explore the natural coagulofibrinolytic response, we investigated patients not undergoing perioperative chemical thromboprophylaxis. RESULTS: Coagulation activation occurred from just after surgery to postoperative day (POD) 1, followed by a gradual decrease, but persisted to even POD 7. Fibrinolytic activity showed a tri-phasic response: activation, shutdown and reactivation. Consequently, fibrin/fibrinogen degradation product (FDP) and D-dimer levels continued to increase until POD 7. The development of deep vein thrombosis (DVT) was observed in 11 patients (15.7%). Postoperative sustained hyper-coagulation [soluble fibrin (SF) or thrombin-antithrombin complex (TAT) values on POD 7 > their normal limits] was significantly associated with the development of DVT (SF, p < 0.001; TAT, p = 0.001). CONCLUSION: We found initial coagulation activation and a tri-phasic response of fibrinolytic activity after colorectal surgery. Thus, physicians need to pay attention to these responses when attempting to prevent or treat VTE.

DOI： 10.1007/s00595-021-02393-4

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Indocyanine green (ICG) fluorescence angiography has recently been reported useful as a method for predicting intestinal blood flow and may reduce anastomotic leakage. However, the quantification method for ICG fluorescence angiography has not been established. We usually measure the tissue oxygen saturation (StO2 ) in the intestinal tract via near-infrared spectroscopy, as it is able to measure the oxygen concentration accurately and immediately shows objective data. In this study, we propose that the time to reach the anastomotic site after intravenous ICG injection is an effective parameter for quantifying ICG fluorescence angiography from the comparison to the data of StO2 in the intestinal tract.

DOI： 10.1111/ases.13002

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Recently, aging in patients with severe motor and intellectual disabilities (SMID) has been causing serious problems. There have been few reports about treatment for tumors in patients with SMID. METHODS: The treatments performed for tumors of 12 SMID patients were examined. RESULTS: Blood tests and ultrasonography were useful in screening. With regard to treatment, the surgery for SMID patients was performed in the same manner as in healthy cases, and the results were generally satisfactory, without major complications. Typically, the patients were diagnosed in advanced stages; many metachronous double cancers were observed. CONCLUSIONS: We reported a tumor therapy to the patients with SMID. Our therapy provides satisfactory results for patients with SMID and their families. Further studies are required to clarify the clinical significance of the screening test and the tumor operative method for the patients with SMID.

DOI： 10.1272/jnms.JNMS.2022_89-217

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)南江堂  

＜文献概要＞横行結腸進行癌に対する腹腔鏡下手術は,バリエーションが多い静脈系や膵・十二指腸損傷に注意しながら十分なリンパ節郭清を行う必要があり,難易度が高い手術に位置づけられている.横行結腸中央部に存在する進行癌をターゲットとする頭側尾側混合アプローチ(pincer approach)は安全なリンパ節郭清に有用で,発生学に準じた,剥離層を大切にした授動と,丁寧に血管分枝を確認しながら郭清操作を行うことが重要と考えている.

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00393&link_issn=&doc_id=20210824070006&doc_link_id=10.15106%2Fj_geka83_1088&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_geka83_1088&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

J-GLOBAL

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Rubinstein-Taybi syndrome is an extremely rare autosomal dominant genetic disorder that occurs in 1/125,000 and is characterized by distinctive facial appearance, short stature, mild to severe mental retardation, and higher risk for cancer. In addition, variable organ anomalies had been reported. Paraovarian cyst causing torsion of the ipsilateral fallopian tube is less common, with an estimated incidence of 1/1,500,000, but it can adversely affect tubal function. It occurs mainly in women in the reproductive age and is very rare in prepubescent girls. Here, we described the successful treatment of an extremely rare case of paraovarian cyst causing torsion of the ipsilateral fallopian tube in a patient with Rubinstein-Taybi syndrome. A 14-year-old girl with Rubinstein-Taybi syndrome was referred to our hospital for abdominal pain. Her medical history was unremarkable, except for moderate hirsutism and keloid scar. Physical examination revealed tenderness in the lower abdominal midline. The preoperative diagnosis was torsion of a left ovarian cyst. An exploratory laparoscopy was performed because of acute abdominal pain and revealed a left fallopian tube that was twisted twice due to an ipsilateral paraovarian cyst. The huge paraovarian cyst required laparotomy cystectomy, and the left ovary was preserved. Her postoperative course was uncomplicated. Preoperative diagnosis of paraovarian cysts can be difficult. The moderate hirsutism seen in our patient suggested the presence of a large paraovarian cyst due to androgen receptor-mediated effects. Therefore, Rubinstein-Taybi syndrome patients with hirsutism should be screened and assessed by pediatric surgeons for the presence of paraovarian cysts.

DOI： 10.1272/jnms.JNMS.2021_88-311

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：American Society of Mechanical Engineers (ASME)  

Local recurrence of rectal cancer is defined as any evidence of relapse within the small pelvis after surgical resection of the primary tumor. After removal of a rectal tumor, necrotic cellular debris and viable exfoliated cancer cells are present in the rectal lumen
using saline or povidone-iodine solution, many surgeons perform rectal washout beyond an occlusive clamp to remove these exfoliated malignant cells, which may lead to local recurrence. A meta-Analysis showed that intraoperative rectal washout at the surgical anastomosis site can reduce the risk of local recurrence after rectal cancer resection. Therefore, intraluminal lavage is useful to prevent local recurrence. Although intraoperative rectal washing is considered to be important, there is probably room for improvement on this method. We described the idea of a new transanal irrigation and aspiration system for small rectal contents. The aim of this research was to investigate the effect of a new rectal washout system using a chemiluminescent imaging system. We attempted to evaluate and compare the washout efficiency between this new system and the conventional irrigation system using a cylindrical rectum model. Our results implied that, at the same volume of solution, the irrigation-Aspiration rectal washout system was more effective than the irrigation washout system. This new rectal washout system was easy to use and allowed a good washout. To the best of our knowledge, this was the first report that evaluated the efficacy of a rectal washout system using quantitative data.

DOI： 10.1115/1.4048114

Scopus

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-四国支部  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-四国支部  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-四国支部  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-四国支部  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-四国支部  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Wilms tumor (WT) is the most common malignant kidney tumor in children. High blood pressure is seen in up to 55% of children with WT. However, hypertensive cardiomyopathy with congestive heart failure due to WT is remarkably rare, with only several cases reported worldwide. In this report, a pediatric case of WT with hypertension causing hypertensive cardiomyopathy and congestive heart failure is presented. An 8-month-old male child with abdominal distension was seen by his primary physician. He was referred to our hospital for further examination and treatment. Abdominal contrast-enhanced computed tomography demonstrated a weakly enhancing, large abdominal mass, which was larger than 12 cm. Two-dimensional transthoracic echocardiography showed a diffuse hypokinetic left ventricle. The patient was diagnosed with cardiomyopathy caused by hypertension. Open surgical resection of the mass was successfully performed. His postoperative course was uncomplicated, and the patient was successfully discharged. The plasma renin activity was maintained at a high level even after left nephrectomy, suggesting that the right kidney was likely the source of renin secretion. Mechanical compression of the right renal blood vessels by a greatly enlarged left kidney can cause right renal ischemia, which activates renin excretion. Nephrectomy can be an effective treatment for a WT patient with hypertension causing hypertensive cardiomyopathy, and then cardiac function will be improved within several weeks. We recommend routine echocardiography surveillance in patients with WT. This report can help pediatric surgeons become more familiar with cardiomyopathy caused by WT.

DOI： 10.1272/jnms.JNMS.2021_88-513

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Rubinstein-Taybi syndrome is an extremely rare autosomal dominant genetic disorder that occurs in 1/125,000 and is characterized by distinctive facial appearance, short stature, mild to severe mental retardation, and higher risk for cancer. In addition, variable organ anomalies had been reported. Paraovarian cyst causing torsion of the ipsilateral fallopian tube is less common, with an estimated incidence of 1/1,500,000, but it can adversely affect tubal function. It occurs mainly in women in the reproductive age and is very rare in prepubescent girls. Here, we described the successful treatment of an extremely rare case of paraovarian cyst causing torsion of the ipsilateral fallopian tube in a patient with Rubinstein-Taybi syndrome. A 14-year-old girl with Rubinstein-Taybi syndrome was referred to our hospital for abdominal pain. Her medical history was unremarkable, except for moderate hirsutism and keloid scar. Physical examination revealed tenderness in the lower abdominal midline. The preoperative diagnosis was torsion of a left ovarian cyst. An exploratory laparoscopy was performed because of acute abdominal pain and revealed a left fallopian tube that was twisted twice due to an ipsilateral paraovarian cyst. The huge paraovarian cyst required laparotomy cystectomy, and the left ovary was preserved. Her postoperative course was uncomplicated. Preoperative diagnosis of paraovarian cysts can be difficult. The moderate hirsutism seen in our patient suggested the presence of a large paraovarian cyst due to androgen receptor-mediated effects. Therefore, Rubinstein-Taybi syndrome patients with hirsutism should be screened and assessed by pediatric surgeons for the presence of paraovarian cysts.

DOI： 10.1272/jnms.JNMS.2021_88-311

PubMed

researchmap

記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Angiogenesis, the formation of new blood vessels, is involved in a variety of diseases including the tumor growth. In response to various angiogenic stimulations, a number of proteins on the surface of vascular endothelial cells are activated to coordinate cell proliferation, migration, and spreading processes to form new blood vessels. Plasma membrane localization of these angiogenic proteins, which include vascular endothelial growth factor receptors and integrins, are warranted by intracellular membrane trafficking. Here, by using a siRNA library, we screened for the sorting nexin family that regulates intracellular trafficking and identified sorting nexin 9 (SNX9) as a novel angiogenic factor in human umbilical vein endothelial cells (HUVECs). SNX9 was essential for cell spreading on the Matrigel, and tube formation that mimics in vivo angiogenesis in HUVECs. SNX9 depletion significantly delayed the recycling of integrin β1, an essential adhesion molecule for angiogenesis, and reduced the surface levels of integrin β1 in HUVECs. Clinically, we showed that SNX9 protein was highly expressed in tumor endothelial cells of human colorectal cancer tissues. High-level expression of SNX9 messenger RNA significantly correlated with poor prognosis of the patients with colorectal cancer. These results suggest that SNX9 is an angiogenic factor and provide a novel target for the development of new antiangiogenic drugs.

DOI： 10.1002/jcp.28346

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Obstructive colitis (OC) is a nonspecific inflammatory condition that occurs at the proximal side of a completely or partially stenotic lesion typically caused by colorectal cancer. Impaired blood flow caused by these stenotic changes in the colon or rectum results in this condition. During surgery for sigmoid colon carcinoma with OC, complete surgical removal of the OC lesions is required. However, it is difficult to anticipate the range of OC before surgery. Diagnosing the potential ischemia during surgery would decrease the need for re-operation. This is the first report of HyperEye Medical System (HEMS) angiography for surgery of colon cancer with OC. We report a case of sigmoid colon carcinoma in which HEMS angiography was used and found to be useful for real-time detection of the OC lesion.

DOI： 10.1272/jnms.JNMS.2019_86-210

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Elderly patients usually have concurrent ailments, and the safety and effectiveness of laparoscopy-assisted distal gastrectomy (LADG) for these patients have been controversial. This study aimed to evaluate whether laparoscopy-assisted distal gastrectomy is safe and effective for elderly patients aged 80 years and over, as well as to clarify their long-term prognosis. METHODS: A total of 31 patients aged 80 years and over who underwent LADG in our hospital were retrospectively reviewed. Peri- and postoperative data were compared with those of 38 patients aged 65 years and younger. The median follow-up period of the elderly and younger group was 56.0 and 63.0 months, respectively, and their prognosis was examined. RESULTS: There were significant differences between the two groups in preoperative respiratory and renal functions, hemoglobin, and nutritional index. Significant differences in postoperative complications were seen only in pneumonia and delirium. There were no hospital deaths, but the 3-year and 5-year overall survival rates were significantly lower in the elderly group than in the non-elderly group. However, in the elderly group, only one patient died of gastric cancer recurrence, whereas four died of cardiovascular disease and three died of pneumonia during follow-up. Therefore, the recurrence-free survival rate was not significantly different between the groups. CONCLUSIONS: LADG seems to be safe and effective even for elderly patients, and their prognosis was satisfactory. However, careful monitoring for cardiovascular and pulmonary disease should be observed during the follow-up period.

DOI： 10.1007/s00464-017-5493-1

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：SPIE-INT SOC OPTICAL ENGINEERING  

Raman spectroscopy provides a wealth of diagnostic information to the surgeon with in situ cancer detection and label-free histopathology in clinical practice. Raman spectroscopy is a developing optical technique which can analyze biological tissues with light scattering. The difference in frequencies between the incident light and the scattering light are called Raman shifts, which correspond to the vibrational energy of the molecular bonds. Raman spectrum gives information about the molecular structure and composition in biological specimens. We had been previously reported that Raman spectroscopy could distinguish various histological types of human lung cancer cells from normal cells in vitro. However, to identify and detect cancer diagnostic biomarkers in vivo on Raman spectroscopy is still challenging, because malignancy can be characterized not only by the cancer cells but also by the environmental factors including immune cells, stroma cells, secretion vesicles and extracellular matrix. Here we investigate morphological and molecular dynamics in both cancer cells and their environment in xenograft models and spontaneous metastasis models using Raman spectroscopy combined with fluorescence microscopy and photoluminescence imaging. We are also constructing a custom-designed Raman spectral imaging system for both in vitro and in vivo assay of tumor tissues to reveal the metastasis process and to evaluate therapeutic effects of anti-cancer drugs and their drug delivery toward the clinical application of the technique.

DOI： 10.1117/12.2250748

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Spontaneous esophageal rupture is a rare condition with a high mortality rate, and it is generally treated by surgery. In the present report, successful non-surgical closure of spontaneous esophageal rupture by endoscopic ligation with snare loops in a patient with pyopneumothorax and septicemia is presented. CASE DESCRIPTION: The case of an 80-year-old man patient with spontaneous esophageal rupture who was cured by endoscopic ligation with snare loops is reported. The patient was admitted with severe chest pain. Chest CT scan revealed pneumomediastinum, and an upper gastrointestinal series using gastrografin showed leakage of contrast medium from the lower esophagus. Therefore, a diagnosis of spontaneous esophageal rupture to the thorax was made. Since the family refused surgery, the patient was treated conservatively. Since extensive blood in the stool was noted on day 5, an emergency endoscopic examination was performed. Clipping was performed around the perforation, and the clips were ligated with snare loops. The patient was discharged on day 83 without recurrence. DISCUSSION AND EVALUATION: We suggest that endoscopic ligation with snare loops should be chosen for elderly people and high-risk cases.

DOI： 10.1186/s40064-016-2624-4

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: The aim of this study was to clarify the risk factors for discontinuing tegafur/gimeracil/oteracil potassium (S-1) adjuvant chemotherapy following gastrectomy in patients with gastric cancer. METHODS: We retrospectively investigated patients with curatively-resected gastric cancer who received S-1 adjuvant chemotherapy. S-1 was administered orally at 80-120 mg/day, depending on body surface area, on days 1-28 every 6 weeks for 1 year. The dose and treatment schedule were modified at the clinicians' discretion, according to toxicity. RESULTS: Seventy-one patients were included in the study, 26 of whom discontinued S-1 therapy. The relapse-free survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 88.1% and 55.8%, respectively. The overall survival rates in the S-1-completed and S-1-discontinuation groups at 5 years post-surgery were 89.4% and 59.8%, respectively. The hazard ratios for relapse and death were significantly lower in the S-1-completed group compared with those in the S-1-discontinuation group (0.18; p<0.001 and 0.19; p=0.002, respectively). Multivariate logistic regression analysis revealed that S-1 discontinuation was significantly associated with an initial overdose of S-1, having stage I cancer, creatinine clearance <66 mL/min, and a side effect of nausea. CONCLUSIONS: These results suggest that assessing renal function to avoid initial overdose of S-1, together with the early management of side effects, may support the continuation of S-1 adjuvant chemotherapy in patients with gastric cancer.

DOI： 10.7150/jca.11189

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Recently, there has been growing interest in applying fluorescence imaging techniques to the study of various disease processes and complex biological phenomena in vivo. To apply these methods to clinical settings, several groups have developed protocols for fluorescence imaging using antibodies against tumor markers conjugated to fluorescent substances. Although these probes have been useful in macroscopic imaging, the specificity and sensitivity of these methods must be improved to enable them to detect micro-lesions in the early phases of cancer, resulting in better treatment outcomes. To establish a sensitive and highly specific imaging method, we used a fluorophore-conjugated anti-carcinoembryonic antigen (CEA) antibody to perform macroscopic and microscopic in vivo imaging of inoculated cancer cells expressing GFP with or without CEA. Macroscopic imaging by fluorescence zoom microscopy revealed that bio-conjugation of Alexa Fluor 594 to the anti-CEA antibody allowed visualization of tumor mass consisting of CEA-expressing human cancer cells, but the background levels were unacceptably high. In contrast, microscopic imaging using a two-photon excitation microscope and the same fluorescent antibody resulted in subcellular-resolution imaging that was more specific and sensitive than conventional imaging using a fluorescence zoom microscope. These results suggest that two-photon excitation microscopy in conjunction with fluorophore-conjugated antibodies could be widely adapted to detection of cancer-specific cell-surface molecules, both in cancer research and in clinical applications.

DOI： 10.1111/cas.12500

PubMed

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

CiNii Books

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Cholecystectomy can become hazardous when inflammation develops, leading to anatomical changes in Calot's triangle. We attempted to study the safety and efficacy of laparoscopic subtotal cholecystectomy (LSC) to decrease the incidence of complications and the rate of conversion to open surgery. METHODS: Patients who underwent LSC between January 2005 and December 2008 were evaluated retrospectively. The operations were performed laparoscopically irrespective of the grade of inflammation estimated preoperatively. However, patients with severe inflammation of the gallbladder underwent LSC involving resection of the anterior wall of the gallbladder, removal of all stones and placement of an infrahepatic drainage tube. To prevent intraoperative complications, including bile duct injury, intraoperative cholangiography was performed. RESULTS: LSC was performed in 26 elective procedures among 26 patients (eight females, 18 males). The median patient age was 69 years (range 43-82 years). The median operative time was 125 min (range 60-215 min) and the median postoperative inpatient stay was 6 days (range 3-21 days). Cholangiography was performed during surgery in 24 patients. One patient underwent postoperative endoscopic sphincterotomy for a retained common bile duct stone that was found on cholangiography during surgery. Neither complications nor conversion to open surgery were encountered in this study. CONCLUSIONS: LSC with the aid of intraoperative cholangiography is a safe and effective treatment for severe cholecystitis.

DOI： 10.1007/s00595-013-0626-1

PubMed

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

CiNii Books

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND AIM: We have studied and reported the usefulness of tumor local chemohyperthermia at a low-grade temperature below 43°C with docetaxel-embedded magnetoliposome (DML) and an applied alternating current magnetic field. However, the mechanisms of this treatment and the dynamics of the injected docetaxel were not investigated in our previous study. Thus, we investigated the interaction of chemotherapy and hyperthermia in the treated tumor. METHODS: Human MKN45 gastric cancer cells were implanted in the hind limbs of Balb-c/nu/nu mice. DML, magnetite-loaded liposome, and docetaxel were injected into the tumors with or without being exposed to an alternating current magnetic field. Docetaxel and tumor necrosis factor-α concentrations, the cell cycle, and cell death rates in the tumor were examined. RESULTS: Docetaxel concentrations were significantly higher in the DML-injected group than in the docetaxel-injected group 3 days after injection. A G2/M peak was observed 1 day after treatment in the DML-injected and exposed group and the docetaxel-injected group, while it was observed 3 days after treatment in the DML-injected without heating group and the magnetite-loaded liposome group. The tumor cell death rate gradually increased in the DML-injected group, with or without being exposed, while it gradually decreased after its peak in other groups. The tumor necrosis factor-α concentration in the tumor treated with DML with heating remained at a high level on the 7th day after treatment, while it decreased after its peak in other groups. CONCLUSION: The antitumor effect of this treatment derives from a combination of hyperthermia and chemotherapy locally in the tumor.

DOI： 10.1111/j.1440-1746.2011.06972.x

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We assessed the effects of direct injection of docetaxel-loaded immuno-(trastuzumab)-liposomes (IDL) on a xenograft mouse tumor model to determine potential clinical applications of intratumoral tailored chemotherapy against Her2/neu-overexpressing gastric cancer. The NCI-N87 Her2/neu overexpressing gastric cancer cell line xenograft mouse model was treated with IDL or docetaxel-loaded liposomes (DL). The ratio of the tumor volume of the treatment:control was determined. In addition, docetaxel pharmacokinetics in tumors were measured using high-performance liquid chromatography, and the cell viability and cell cycle distribution of Her2/neu positive cells were determined by flow cytometric analysis. The IDL group showed a significantly higher distribution of docetaxel in the N87 xenograft tumor tissues and superior antitumor efficacy compared to crude administration of docetaxel and/or trastuzumab and DL. The number of viable Her2/neu positive cells decreased following treatment with either free trastuzumab or IDL. On day 7 after treatment, a decrease in the G0/G1 phase of the cell cycle was observed in the DL and IDL groups compared to the control group. No local adverse effects were observed. These results suggest that intratumoral administration of IDL maintains a high concentration of docetaxel within the tumor leading to a safe and effective regional cancer therapeutic strategy. In addition to the inherent cytotoxic effect of trastuzumab, conjugation of trastuzumab to a liposome further enhanced the retention of docetaxel within the tumors. These data suggest that immuno-liposome mediated delivery of drugs is a promising new therapeutic option for patients with advanced gastric cancer that overexpress Her2/neu.

PubMed

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A 57-year-old man underwent total gastrectomy with D2 lymphadenectomy for advanced gastric cancer. The post operative diagnosis was Stage IIIB (tubular adenocarcinoma, moderately-differentiated type, SE, N2, M0). The patient's postoperative course was uneventful, and S-1 was administered as adjuvant chemotherapy. However, about 14 months later, a gradual left cervical lymph node swelling became evident, with an increase in the level of the tumor marker CA19-9, suggesting recurrence of the gastric cancer. After obtaining informed consent, S-1 (100 mg/body), cisplatin (60 mg/m2), and docetaxel (40 mg/m2) combination chemotherapy (DCS) was performed. After 5 courses of DCS, the patient's swollen left cervical lymph nodes became non-palpable, and also undetectable by diagnostic imaging, together with normalization of the CA19-9 level. At three months since the last chemotherapy, the patient showed no signs of recurrence. DCS is a potentially effective treatment for recurrent gastric cancer with resistance to S-1.

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

A 61-year-old man with an intraductal papillary mucinous neoplasm (IPMN) and carcinoma in situ (CIS) of the pancreatic body initially underwent a distal pancreatectomy. Postoperative follow-up included computed tomography (CT) and ultrasonography (US) every 6 months. Intraductal papillary mucinous neoplasm of the pancreatic head was diagnosed 17 months later using peroral pancreatoscopy (POPS) including a biopsy, revealing IPMN with highly dysplastic changes. A total pancreatectomy was therefore performed. The pathological examination revealed IPMN with CIS. The patient was discharged from the hospital and is doing well as of 1 year postoperatively. Although cautious surveillance seems mandatory, consensus has not yet been reached regarding postoperative surveillance. This report presents an unreported case of metachronously arising IPMN with CIS within a relatively early interval, thus suggesting that surveillance every 6 months is preferable to > or = 1 year. In addition, endoscopic US, endoscopic retrograde cholangiopancreatography, intraductal US, or POPS should be included in pathological examinations to avoid missing opportunities to treat lesions such as noninvasive IPMN with a good prognosis. Surgically indicated patients with noninvasive recurrence should therefore be strongly considered to undergo a total pancreatectomy.

DOI： 10.1007/s00595-008-4101-3

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Hyperthermia is a minimally invasive approach to cancer treatment, but it is difficult to heat only the tumor without damaging surrounding tissue. To solve this problem, we studied the effectiveness of chemohyperthermia with docetaxel-embedded magnetoliposomes (DMLs) and an applied alternating current (AC) magnetic field. Human MKN45 gastric cancer cells were implanted in the hind limb of Balb-c/nu/nu mice. Various concentrations of docetaxel-embedded DMLs were injected into the tumors and exposed to an AC magnetic field (n = 6, each). For comparison with hyperthermia alone, magnetite-loaded liposome (ML)-injected tumors were exposed to an AC magnetic field. Furthermore, the results of DML without AC treatment and docetaxel diluted into PBS with AC treatment were also compared (n = 10, each). Tumor surface temperature was maintained between 42 and 43 degrees C. Tumor volume was reduced in the DML group with a docetaxel concentration > 56.8 microg/ml, while a docetaxel concentration > 568.5 microg/ml was required for tumor reduction without hyperthermia. Statistically significant differences in tumor volume and survival rate were observed between the DML group exposed to the magnetic field and the other groups. The tumor disappeared in 3 mice in the DML group exposed to the magnetic field; 2 mice survived over 6 months after treatment, whereas all mice of the other groups died by 15 weeks. Histologically, hyperthermia with DML damaged tumor cells and DML diffused homogeneously. To the best of our knowledge, this is the first report to show that hyperthermia using chemotherapeutic agent-embedded magnetoliposomes has an anticancer effect.

DOI： 10.1002/ijc.24864

PubMed

researchmap

記述言語：英語  

Primary pancreatic lymphoma (PPL) is a rare disease that is difficult to diagnose preoperatively. We describe the youngest case of PPL treated by surgical excision and chemotherapy. A 16-year-old male presented with abdominal pain and jaundice. Abdominal computed tomography showed a 3.0 × 4.5 cm homogeneously enhanced mass localized between the inferior vena cava and pancreatic head; the common pancreatic duct was dilated and the common bile duct was stenosed. Magnetic resonance imaging findings showed a 4.5 cm tumor localized between the inferior vena cava and pancreatic head with low signal intensity on T1W images and high intensity on T2W images, which enhanced inhomogeneously. Endoscopic retrograde cholangiopancreatography findings were compatible with smooth stenosis of the common bile duct. He was diagnosed as pancreatitis secondary to pancreatic tumor and pylorus-preserving pancreaticoduodenectomy was performed. Postoperative diagnosis was PPL and chemotherapy was performed. After 4 years of treatment he has no signs of recurrence.

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

UNLABELLED: BACKGOUND/AIMS: The aim of this study is to present the new method of continuously irrigated around the pancreaticojejunostomy to reduce postoperative complications after pancreaticoduodenectomy. METHODOLOGY: Twenty-seven patients underwent pancreaticoduodenectomy in our institution between 2002 and 2007. Pancreaticojejunostomy was performed with the external pancreatic duct stent tube, and continuous irrigation around the pancreaticojejunostomy was started on the operative day with physiological saline solution containing gabexate mesilate. RESULTS: Mean duration of irrigation was 7.1 +/- 4.4 days, mean duration of drainage tube placement was 14.2 +/- 9 days, and mean duration of pancreatic duct drainage tube placement was 24.9 +/- 4.7 days. Pancreatic fistula was diagnosed in 8 patients. Three cases were classified as grade A and 5 cases were grade B. These pancreatic fistulae were closed by non-invasive treatment and the in-hospital death rate was 0%. CONCLUSIONS: External total drainage of the main pancreatic duct and continuous irrigation around pancreaticojejunostomy appears to avoid severe postoperative complications.

PubMed

researchmap

記述言語：英語  

A 34-year-old woman presented with pain during menstruation and was diagnosed with endometriosis of the lower rectum. Despite treatment with an LH-RH agonist, she was unable to become pregnant and surgical removal of her endometriosis was recommended. Preoperative magnetic resonance imaging revealed endometriosis localized between the neck of the uterus and rectum with indentation and scuffing. Laparoscopically assisted low anterior resection was performed. Exfoliation was started from the right side of the rectum to the presacral and retrorectal space, and the rectococcygeus ligament was transected. Exfoliation of the retrorectal space was continued to the levator ani muscle and mobilization of the right side of the rectum was performed. In front of the rectum, exfoliation was started posterior to the wall of the vagina, but layers became unclear near the tumor as the tissue was solid in this region. The left hypogastric nerve close to the tumor was inflamed and it was cut. The layer of the exfoliation was connected to the right side of the rectum, the tumor was isolated from the vagina, and the lower rectum was transected at a point 1 cm distal to the tumor with a 60-mm linear stapler. Reconstruction with a 31-mm circular stapler was performed using the double stapling technique. Operative time was 520 min with a blood loss of 320 ml. On the 9th post operative day, a rectovaginal fistula occurred, and ileostomy was performed. The patient was discharged from the hospital on the 25th postoperative day, and 4 months later, stoma closure was performed.

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Atherosclerosis with hypoadiponectinemia can be further aggravated by intestinal ischemia/reperfusion (II/R)-induced injuries, such as bacterial translocation and lung injury. We investigated the effect of statin administration on the risk of II/R-induced injury in atherosclerotic rats with hypoadiponectinemia. METHODS: Wistar rats were divided into 4 groups: (1) the Normal group (normal diet), (2) the Chol group (2% high cholesterol diet), (3) the St-1w group, and (4) the St-2w group (Chol group plus pitavastatin administration for 1 or 2 weeks, respectively). The serum concentrations of lipids and adiponectin were measured preoperatively. After midline laparotomy (time, T0), the superior mesenteric artery was occluded with a microvascular clamp for 30 min, followed by 360 min of reperfusion (T1). Intestinal and lung nitric oxide (NO) concentrations were measured. Intestinal injury was assessed by microcirculatory flow, histology, and permeability. Bacterial translocation was assessed by analysis of serum peptidoglycan concentration. Lung injury was assessed by histologic examination, pulmonary permeability index, and wet/dry lung weight ratio. RESULTS: The 2-week administration of statins with high-cholesterol feeding (St-2w group) improved hypoadiponectinemia to levels similar to those of the Normal group. Intestinal and lung NO concentrations were significantly lower at T1 in the Normal and St-2w groups than in the Chol group. Statin administration improved poor recovery of intestinal microcirculatory flow in the Chol group. At T1, intestinal and lung injuries were significantly aggravated and serum peptidoglycan concentration was significantly elevated in the Chol group compared with the Normal and St-2w groups. The 1-week administration of statins had no significant influence on serum adiponectin levels, tissue NO concentration, or tissue injury. CONCLUSION: Administration of pitavastatin reduces the risk of II/R-induced injury in atherosclerotic rats with hypoadiponectinemia by improving hypoadiponectinemia and inhibiting inducible NO synthase-produced NO. Furthermore, preoperative improvement of hypoadiponectinemia may be important as an index of the protective effect of pitavastatin for II/R-induced injury in atherosclerotic rats with hypoadiponectinemia.

DOI： 10.1016/j.surg.2009.01.002

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Intestinal ischemia/reperfusion causes intestinal mucosal injury, which may result in bacterial translocation (BT) and multiple organ failure. Lung injury is a common complication after intestinal ischemia/reperfusion. Adiponectin is an antiinflammatory adipokine, and it plays an important role in the development of metabolic syndrome in hypoadiponectinemia. In atherosclerosis with hypoadiponectinemia, BT also may aggravate injuries induced by intestinal ischemia/reperfusion. METHODS: Wistar rats were divided into 3 groups: Normal group (normal diet), Chol group (2% high cholesterol diet), and Chol+1400W group (Chol group plus 1400W, an inducible nitric oxide [iNOS] inhibitor, at 1 mg/kg intraperitoneally 30 minutes preoperatively). The serum concentrations of lipids and adiponectin and vascular responses were measured. After midline laparotomy (time, T0), the superior mesenteric artery was occluded with a microvascular clamp for 30 minutes, followed by 360 minutes of reperfusion (T1). Intestinal injury was assessed from microcirculatory flow, histology, serum diamine oxidase activity, and permeability. Lung injury was assessed by histology, pulmonary permeability index (PPI), and wet-to-dry lung weight (W/D) ratio. Intestinal and lung nitric oxide (NO) concentrations were also measured. BT was assessed by serum peptidoglycan (PG) concentration. RESULTS: The Chol and Chol+1400W groups developed hyperlipidemia and hypoadiponectinemia; the 2 groups also had vascular endothelial dysfunction without histological changes, indicating early atherosclerosis. These groups also showed poor recovery of intestinal microcirculatory flow at T1. The serum diamine oxidase activity, histological intestinal damage, and permeability were elevated at T1 in the Chol group; however, these findings were not significant in the Normal and Chol+1400W groups. Histological lung damage and lung PPI and W/D ratio were increased only in the Chol group. Intestinal and lung NO concentrations were significantly elevated at T1 in the Chol group. The serum PG concentration was elevated significantly in the Chol group. CONCLUSION: In atherosclerotic rats with hypoadiponectinemia, intestinal microcirculatory flow does not recover adequately after intestinal ischemia/reperfusion because of endothelial dysfunction. Atherosclerosis with hypoadiponectinemia increased the incidence of BT further by aggravating intestinal mucosal injury and, moreover, it aggravated lung injury. Although inhibition of iNOS does not lead to adequate recovery of intestinal microcirculatory flow, it reduces injury by decreasing the amount of NO derived from high enzymatic iNOS activity in the intestine.

DOI： 10.1016/j.surg.2008.07.018

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

This report describes a very rare case of an adenoendocrine carcinoma of the accessory papilla of the duodenum. A 70-year-old woman was admitted to the hospital complaining of epigastralgia. Gastrointestinal endoscopy showed a protruding tumor with ulceration at the accessory papilla of the duodenum. A biopsy revealed a small-cell carcinoma. Computed tomography showed a highly enhanced tumor in the early phase. No metastatic lesions were shown. Magnetic resonance cholangiopancreatography showed dilatation of the pancreatic duct, but a normal common bile duct. A pyloruspreserving pancreaticoduodenectomy was performed with lymph node dissection. Microscopically, the tumor was a small-cell neuroendocrine carcinoma with adenomatous differentiation. An immunohistochemical analysis showed positive staining for synaptophysin, chromogranin A, CD56, and carbohydrate antigen 19-9. The final diagnosis was an adenoendocrine carcinoma with lymph node metastasis. The postoperative course was uneventful and the patient is now doing well as an outpatient after 14 months of follow-up.

DOI： 10.1007/s00595-008-3874-8

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Magnetic metal particles are known to induce heat energy under an alternating magnetic field (AMF). We developed a local tumor-heating device incorporating an MgFe(2)O(4) needle for the purpose of mild ablation for cancer treatment. A needle made from sintered MgFe(2)O(4) particles was embedded in the hepatic or breast tumors. Tumors were then heated by the energy dissipated from the needle exposed to an AMF. We sequentially evaluated histological changes, cellular activity of tumors, and the extent of thermal effect using nicotinamide adenine dinucleotide (NADH) diaphorase and terminal deoxynucleotidyl tranferase-mediated digoxigenin-DUTP nick-end labeling (TUNEL) staining. The mean temperature of the tumor tissue during heating was about 60 degrees C. Nuclei of the tumor cells became hyper-chromatin immediately after heating. The injured area spread progressively until 3 days after heating; when the area was surrounded by fibroblasts (meaning is not clear). Tumors disappeared after treatment without complications. This is the first time that the complete death of tumor cells has been realized by raising the tumor temperature above 60 degrees C using the heat generated by magnetic metal particles exposed to AMF. This device may be useful in the future for local hyperthemic treatment of human cancers.

DOI： 10.3233/BME-2009-0569

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: This study investigated the efficacy of repeated thermotherapy for breast cancer utilising a novel sintered MgFe(2)O(4) needle and alternating current (AC) magnetic field in xenograft animal models mimicking human breast cancer. MATERIALS AND METHODS: A sintered MgFe(2)O(4) needle and an apparatus to apply an AC magnetic field were prepared for this study. Animals bearing BT-474 tumours (mean (+/-standard deviation) volume, 471 +/- 153 mm(3)) were divided into four groups. A sintered MgFe(2)O(4) needle (length, 5 mm) was placed in the centre of each tumour. An AC magnetic field (amplitude, 4 kA/m; 2 kW; 540 kHz) was applied for 10 min once, twice or three times for the first, second and third groups, respectively, and was not applied for the control group. Temperature during treatment and tumour volume 8 weeks after first treatment were assessed. RESULTS: Maximum tumour temperature tended to increase in repeated-application groups: group 1, 59.2 +/- 4 degrees C; group 2, 58.9 +/- 3.3 degrees C and 61.2 +/- 8.9 degrees C for the first and second applications; and group 3, 60.4 +/- 4.6 degrees C, 62.1 +/- 7.8 degrees C and 71.1 +/- 6.1 degrees C for the first, second and third applications. Tumour volumes in control, groups 1, 2 and 3 at 8 weeks after treatment were 3633 +/- 2478 mm(3), 3240 +/- 1031 mm(3), 1252 +/- 1289 mm(3) and 0 mm(3), respectively. Tumours were significantly smaller in group 3 than in the control and group 1 at 8 weeks. CONCLUSIONS: The efficacy of repeated inductive heating utilising a sintered MgFe(2)O(4) needle was demonstrated. Thermotherapy using the present method may offer an effective non-surgical treatment for human breast cancer.

DOI： 10.1080/02656730902991459

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Conversion rate to open surgery is higher for patients with acute cholecystitis than in those without acute cholecystitis. We attempted to develop a laparoscopic subtotal cholecystectomy to decrease this conversion rate. METHODS: From 2000 to 2005, laparoscopic cholecystectomy for acute cholecystitis was performed in 60 patients (22 women, 38 men). Patients were divided into two groups: group A (2000 to 2002, n = 22) and group B (2003 to 2005, n = 38). When significant difficulty was encountered dissecting the gallbladder from its bed, we incised the gallbladder wall leaving the posterior wall and cauterizing the remnant mucosa (subtotal cholecystectomy, SC-1). When dissection of the gall bladder neck and triangle of Calot was difficult, the neck of the gallbladder was sutured despite clipping (SC-2). RESULTS: Mean duration from onset of symptoms to operation was 55.3 +/- 52.0 days. SC-1 was performed in 8 patients in group A and 18 patients in group B. SC-2 was performed in three patients in Group B. Conversion rate was 18.1% (4/22) in group A and 0% (0/38) in group B, compared to 0.4% (1/221) for patients without acute cholecystitis. No complications were associated with ablated gallbladder mucosa. CONCLUSION: Laparoscopic subtotal cholecystectomy offers safe and effective treatment for acute cholecystitis. The conversion rate in group B is decreased by avoiding hazardous dissection of the cystic duct.

DOI： 10.1007/s00464-008-9879-y

PubMed

researchmap

記述言語：英語  

Carcinosarcoma of the esophagus is a malignant neoplasm involving both carcinomatous and sarcomatous components. We report a patient with true esophageal carcinosarcoma who underwent laparoscopy-assisted surgery. An upper gastrointestinal barium study revealed a lobulated intraluminal filling defect in the lower intrathoracic esophagus. The patient underwent esophagectomy and regional lymphadenectomy with gastric tube reconstruction by laparoscopy-assisted surgery and thoracotomy. The esophageal hiatus was entered and the mediastinal esophagus was dissected using a laparoscopic approach. Microscopically, the tumor comprised poorly differentiated squamous cell carcinoma and spindle-shaped cells resembling leiomyosarcoma. Immunohistochemically, spindle-shaped sarcomatous cells displayed strongly positive reaction to vimentin and negative reaction to cytokeratin AE1/AE3 and CD68. No transitional zone was seen between sarcomatous and carcinomatous elements. The patient was finally diagnosed with true esophageal carcinosarcoma. Laparoscopic transhiatal esophagectomy seems to be a rational and safe procedure for lower esophageal neoplasms, even for patients with impaired respiratory function.

DOI： 10.1159/000151584

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND AND AIMS: We have developed a novel tumor-ablation device for liver tumors utilizing heat energy induced by magnesium ferrite (MgFe(2)O(4)) particles under an alternating magnetic field (AMF) produced by electric currents. This novel device can repeatedly heat liver tumors at lower temperature than usual heating devices, such as radiofrequency ablation therapy, with slight infliction of pain. This study assesses its heating effect on rat liver tumors as local therapy. METHOD: The small needle was manufactured from MgFe(2)O(4) particles by sintering at 1100 degrees C. After a MgFe(2)O(4) needle was inserted into liver tumors comprising of dRLh-84 cells, the tumors were heated for 30 min under an AMF. We examined cellular activity by using nicotinamide adenine dinucleotide (NADH) diaphorase staining and terminal deoxynucleotidyl transferase-mediated digoxigenin-dUTP nick-end labeling (TUNEL) staining, and evaluated the effect of suppressing tumor growth by sequentially comparing the tumor diameter with that of the control group. RESULTS: The mean temperature of the heated tumors was 60.2 +/- 1.8 degrees C. The tumor cells were constricted, and chromatin of nuclei had shrunk immediately after heating. The heat-injury area that contained the tumors was negative for NADH diaphorase activity. After 3 days, the tumor cells in the heat-injury area became positive for TUNEL staining, which detects cell death. At 7 days, the mean tumor diameters were significantly smaller in the heating group than in the control group (6.15 +/- 0.47 mm vs 16.89 +/- 2.69 mm; P < 0.05). CONCLUSION: This device, utilizing heat energy induced by ferromagnetic metal under an AMF, appears useful as local thermotherapy for human liver cancer.

DOI： 10.1111/j.1440-1746.2008.05328.x

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Magnetic metal particles such as magnesium ferrite (MgFe2O4) induce heat energy under an alternating magnetic field that was produced by electric current. We have developed a new heating device using a sintered MgFe2O4 needle under an alternating magnetic field. This device can repeatedly heat target tissue at lower temperatures than that for radiofrequency ablation therapy. This study aims to assess whether the new heating device has the ability to heat rat liver tissue. METHOD: A small needle made from MgFe2O4 particles was prepared by sintering at 1100 degrees C and inserted into rat liver tissue. The rat liver was then heated under an alternating magnetic field, 4 kA/m, for 30 min. We measured the temperature of rat tissue during the heat treatment, and sequentially evaluated histological changes and hepatocyte cellular activity after heat stimulus by using nicotinamide adenine dinucleotide diaphorase staining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining. RESULTS: The mean temperature of the liver tissue during heating was 60.7 +/- 1.1 degrees C. Immediately after heating, nuclei of the hepatocytes were hyper-chromatin, with hepatocytes negative for nicotinamide adenine dinucleotide diaphorase activity in the heat-injury area. The injury area spread progressively until 3 d after heating, when the area was surrounded by fibroblasts, with hepatocytes positive for terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling staining. CONCLUSIONS: This is the first time that a ferromagnetic metal heating device under an alternating magnetic field has achieved a temperature beyond 60 degrees C and led hepatocytes to complete cell death. This device would be of future use as a local heat-treatment for human liver cancer.

PubMed

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

The efficacy of the collagen gel droplet-embedded culture drug sensitivity test (CD-DST) was estimated clinically among breast cancer patients to select a rational chemotherapy. Twenty-five specimens of breast cancer (n=21) or lymph nodes (n=4) were investigated. Four anticancer drugs (5-Fluorouracil, Adriamycin (ADM), Docetaxel (DOC), Paclitaxel (PTX)) were estimated for CD-DST. Sixteen samples among 25 samples (64.0%) seemed to be worth estimation. The chemosensitivity values were as follows: 5-FU 30.8%, ADM 30.8%, DOC 53.8% and PTX 46.2%, respectively. Thus, CD-DST may predict the chemosensitivity with high accuracy in breast cancer patients and seems to be superior to the conventional predictors.

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We present a female patient with sigmoid colon endome-triosis who was diagnosed correctly preoperatively and underwent minimally invasive surgery. She was admitted to our hospital with rectal bleeding and constipation. We performed several workups. Colonoscopy and endoscopic ultrasonography showed sigmoid colon stenosis caused by submucosal tumor, and magnetic resonance imaging revealed a sigmoid colon tumor displaying signal hy-pointensity on both T1- and T2-weighted imaging. However, colonoscopic ultrasonography-assisted needle aspiration biopsy could not specify tumor characteristics. From these examinations, the lesion was diagnosed as sigmoid colon endometriosis and laparoscopy-assisted sigmoidectomy was performed. Pathological diagnosis from the resected specimen was identical to preoperative diagnosis, i.e., colonic endometriosis. Since differential diagnosis of intestinal endometriosis seems difficult, a cautious preoperative diagnosis is required to select treatments including minimally invasive surgery.

PubMed

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: To study the significance of scoring systems assessing severity and prognostic factors in patients with colonic perforation. METHODS: A total of 26 patients (9 men, 17 women; mean age 72.7+/-11.6 years) underwent emergency operation for colorectal perforation in our institution between 1993 and 2005. Several clinical factors were measured preoperatively and 24 h postoperatively. Acute physiology and chronic health evaluation II (APACHE II), Mannheim peritonitis index (MPI) and peritonitis index of Altona (PIA II) scores were calculated preoperatively. RESULTS: Overall postoperative mortality rate was 23.1% (6 patients). Compared with survivors, non-survivors displayed low blood pressure, low serum protein and high serum creatinine preoperatively, and low blood pressure, low white blood cell count, low pH, low PaO2/FiO2, and high serum creatinine postoperatively. APACHE II score was significantly lower in survivors than in non-survivors (10.4+/-3.84 vs 19.3+/-2.87, P=0.00003). Non-survivors tended to display high MPI score and low PIA II score, but no significant difference was identified. CONCLUSION: Pre- and postoperative blood pressure and serum creatinine level appear related to prognosis of colonic perforation. APACHE II score is most associated with prognosis and scores>or=20 are associated with significantly increased mortality rate.

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: This study was aimed at investigating the efficacy and safety of minimally invasive laparoscopic splenectomy in patients with hypersplenism secondary to cirrhosis. BACKGROUND: While advances have been made in the treatment of liver cancer and chronic hepatitis, certain treatments such as radio frequency ablation (RFA) must often be discontinued due to thrombocytopenia caused by hypersplenism. Laparoscopic splenectomy is performed to treat diseases as idiopathic thrombocytopenic purpura, but is contraindicated for hypersplenism in many institutions. Few studies have thus examined the safety and efficacy of this approach. METHODS: Efficacy and safety were retrospectively analyzed for laparoscopic splenectomies starting from January 2003. Relationships between postoperative increases in platelet count and thrombopoietin, platelet-associated immunoglobulin, excised spleen weight, and serum parameters were examined. Perioperative data of open splenectomies starting from January 1990 were compared with those of laparoscopic splenectomies. RESULTS: No laparoscopic cases were converted to open surgery in this series. Mean operative times of open and laparoscopic splenectomy were 205 and 173 min respectively. Mean blood losses were 750 and 359 ml (P < 0.05) and the mean weights of excised spleen were 460 and 525 g respectively. Postoperatively, no changes in liver function were noted, and platelet and leukocyte counts were significantly increased. Compared with preoperative platelet count, degree of increase at 2 weeks postoperatively did not correlate with preoperative thrombopoietin levels, but significantly correlated with levels of platelet-associated immunoglobulin and spleen volume (P < 0.05). Postoperative portal or splenic vein thrombosis (PSVT) was seen in 3 patients and these patients did not exhibit any clinical symptoms. CONCLUSIONS: Laparoscopic splenectomy is a safe technique for the treatment of hypersplenism and contributes to postoperative increases in platelet counts. Postoperative increases in platelet count seem to depend on platelet-associated immunoglobulin level and spleen weight, which may be valuable prognosticators.

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report a case of metastatic osteosarcoma in the jejunum causing intestinal intussusception. A 58-year-old woman underwent right femoral region amputation, lower lobectomy of the left lung and complete left pneumonectomy after four courses of chemotherapy for osteosarcoma of the right femur with left lung metastases. She was referred to our department 13 months later with progressive abdominal pain and vomiting. Abdominal radiography showed a small-bowel obstruction. She underwent emergency laparotomy, which revealed jejunal intussusception. The lead point was found to be an intraluminal tumor. We resected the jejunum containing the tumor and histological examination confirmed that the tumor was osteosarcoma metastasis.

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

When familial adenomatous polyposis (FAP) is diagnosed in a patient, prophylactic surgery must be performed whether colorectal cancer is present or not. Operations for FAP have been performed through a large median abdominal incision or an additional perineal incision, depending on the coexistence of rectal cancer. Recently, we reported a technique of laparoscopic rectal amputation without abdominal skin incision for patients with rectal cancer to minimize postoperative cardiac and respiratory complications [6]. In this article, we report a case of laparoscopically assisted proctocolectomy with ileostomy through a minimal abdominal and perineal skin incision performed by a hand-assisted procedure. The purpose of combining the perineal and laparoscopic approaches is to minimize the skin incision, while retaining a rate of cure and safety equivalent to those of conventional rectal amputation, by using the advantages of laparoscopic procedures, and to facilitate postoperative recovery and improve the quality of life for relatively young patients with FAP.

DOI： 10.1007/s004640000175

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-四国支部  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：金原出版(株)  

症例は71歳男性。胃潰瘍の既往歴があり、黒色便と貧血の精査で紹介受診した。来院時に嘔吐を認め、その後胸痛と呼吸苦が出現した。胸腹部造影CTで縦郭気腫を広範囲に認め、下縦郭で食物残渣の食道外への漏れを伴っていた。胃内には出血と思われる高濃度域を伴う液体貯留を認めた。特発性食道破裂、縦郭限局型に加えて上部消化管出血と診断し、経口内視鏡を併用した腹腔鏡下食道破裂修復術を施行した。経口内視鏡による観察で胃潰瘍と出血点を認め、クリップと高張ナトリウム・エピネフリン法で止血した。食道には左壁に縦走する裂創と筋層外膜に至る穿破を認めた。無送気で裂創部をクリッピングし、粘膜と粘膜下層を閉鎖した。その後腹腔鏡操作を行い、破裂した外膜筋層を縫合閉鎖した。縦郭内にドレーンを留置し閉創した。これらの治療により救命できた。

researchmap

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J00620&link_issn=&doc_id=20220114040017&doc_link_id=10.18888%2Fop.0000002585&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fop.0000002585&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(株)南江堂  

＜文献概要＞横行結腸進行癌に対する腹腔鏡下手術は,バリエーションが多い静脈系や膵・十二指腸損傷に注意しながら十分なリンパ節郭清を行う必要があり,難易度が高い手術に位置づけられている.横行結腸中央部に存在する進行癌をターゲットとする頭側尾側混合アプローチ(pincer approach)は安全なリンパ節郭清に有用で,発生学に準じた,剥離層を大切にした授動と,丁寧に血管分枝を確認しながら郭清操作を行うことが重要と考えている.

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00393&link_issn=&doc_id=20210824070006&doc_link_id=10.15106%2Fj_geka83_1088&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_geka83_1088&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-四国支部  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-四国支部  

researchmap

記述言語：日本語   出版者・発行元：(株)南江堂  

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00393&link_issn=&doc_id=20210618050041&doc_link_id=10.15106%2Fj_geka83_648&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_geka83_648&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：日本Acute Care Surgery学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

経肛門的に挿入された巨大なシリコン製玩具に対して、経肛門的に摘出困難であったため、開腹術を要した症例を経験したので報告する。症例は52歳男性。自慰行為にて肛門よりシリコン製玩具を挿入したが、自力で摘出できないため当院に救急搬送された。腹部症状は比較的軽度であり、反跳痛や筋性防御は認めなかった。単純腹部CTにて20cm×12cmの巨大な直腸内異物を認めたが、free airや腹水は認めなかった。外来での無麻酔下での抜去は困難で、全身麻酔下に摘出する方針とした。経肛門的に摘出を試みるも異物が骨盤腔につかえ摘出困難であった。開腹手術へと移行するも、異物は骨盤腔に挟まれており摘出に難渋した。腸管を半周切開し、切開部より異物を摘出した。術後は合併症など認めず、術後18日目に退院した。直腸異物では腹部症状も軽度にあらわれる可能性があり、治療方針決定においては病歴聴取、理学所見、画像診断が重要であることが認識された。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：医学書院  

＜文献概要＞ポイント ◆2012年のガイドライン公表後,わが国でも医師・歯科医師による献体を用いた手術手技研修が可能となった.◆Thiel法での献体保存により,感染対策と同時に臓器の質感を保つことが可能となった.◆臨床を再現できる優れたトレーニング法であるが,さらなる普及にはコストやマンパワーの面で課題も多い.

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2020248278

記述言語：日本語   出版者・発行元：愛媛医学会  

症例は73歳、女性。S状結腸癌術後にRS3PE症候群を発症した。当初は発熱および血液検査での炎症所見から感染症を疑っていたが、抗生剤に反応が乏しいこと、両側四肢末梢の浮腫に気づくことでRS3PE症候群と診断し得た。疾患概念があまり知られていないことから診断に時間を要する症例も散見され、診療の際は鑑別に注意が必要と考えた。また、RS3PE症候群を発症した場合、悪性腫瘍合併の可能性があり長期的なフォローが必要である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児血液・がん学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本肥満学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本肥満学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：日本ストーマ・排泄リハビリテーション学会  

<p> 症例は84歳、男性。直腸癌術後11年後に挙上腸管穿孔、膿瘍形成、そして外瘻化をきたし、手術治療を要した。瘻孔発生に関しては、クローン病、腫瘍性病変、慢性便秘による宿便、そして人工的な原因などはなく、特発性と考えられた。さらに本症例に関しては、皮下脂肪層の厚みの減少と、内圧上昇によるものと推察した。本邦のストーマ保有者は年々増加している。一方で、直腸癌術後の生存率も改善してきており、ストーマ保有者の長期生存が珍しくなくなってきている。ストーマの晩期合併症としてストーマ瘻孔も念頭に置く必要があると考えられた。</p>

DOI： 10.32158/jsscr.34.2_8

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2018358858

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本小児外科学会  

<p>メッケル憩室の多くは無症状であるが，さまざまな病態を引き起こすことがある．今回，我々はメッケル憩室が腹壁に穿通し膀胱前腔膿瘍を形成した稀な1例を経験したので報告する．症例は6歳，男児．4日前より下腹部痛を認め，腹痛の増強，発熱を認めるようになったため，前医を受診した．消化管穿孔が疑われたため当院に救急搬送され，同日緊急手術を行った．腹腔鏡で観察したところ，メッケル憩室と大網が腹壁に癒着し，腹壁に1 cm弱の孔を認め，同部位より膿の流出を認めた．メッケル憩室が腹壁に穿通して膀胱前腔膿瘍を形成したと診断し，メッケル憩室の切除及び膿瘍ドレナージを施行した．術後経過は良好であり，術後8日目に退院した．病理所見では，メッケル憩室先端に異所性胃粘膜を認め，潰瘍穿孔が原因であると考えられた．メッケル憩室穿通の術前診断は困難であるが，審査腹腔鏡から開始したことで術中診断が可能となり，良好な経過を得ることができたと考えられる．</p>

DOI： 10.11164/jjsps.55.7_1193

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2020134426

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-四国支部  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：日本ストーマ・排泄リハビリテーション学会  

researchmap

記述言語：日本語   出版者・発行元：日本ストーマ・排泄リハビリテーション学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本外科系連合学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：日本ストーマ・排泄リハビリテーション学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

researchmap

記述言語：日本語   出版者・発行元：日本外科系連合学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本ストーマ・排泄リハビリテーション学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本膵・胆管合流異常研究会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本外科系連合学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

DOI： 10.1117/12.2079092

Web of Science

researchmap

記述言語：日本語   出版者・発行元：金原出版(株)  

70歳女。既往歴に心房細動・慢性心不全・高血圧症があった。舌癌術後23日目より腹痛・下痢が出現し、精査を受けるも原因がはっきりせず、対症療法で改善なく、術後31日目に敗血症性ショックを呈し当科コンサルトとなった。腹部造影CTで大量の腹水、遊離ガス像を認め、動脈叢では上腸間膜動脈の造影欠損を、静脈叢では広範囲小腸の造影不良と右腎梗塞を認めた。上腸間膜動脈塞栓による腸管壊死、穿孔性腹膜炎と診断して緊急手術を行い、小腸が広範囲に壊死していたため、小腸切除空腸人工肛門造設、回腸粘液瘻造設の方針となった。Hyper Eye Medical systemを使用して腸管血流を確認し、切除範囲を口側はTreitz靱帯より約20cmの部位、肛門側は回腸末端より20cmの部位とした。術後は血液血管内凝固症候群や腎不全を合併し、ICUにて長期の集中治療を要したものの徐々に改善し、術後88日目にリハビリ目的で近医転院となった。

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

Undifferentiated pleomorphic sarcoma（UPS）は主に四肢に発生する腫瘍であり，腹腔内や腹直筋直下に発生する例は稀である．<BR>症例は79歳の男性で，左中腹部腫瘤を主訴に当科受診した．腹部超音波検査で腹壁から栄養血管の流入を確認し，positron emission tomography/CTで高度FDGの集積がみられた．開腹幽門側胃切除術の正中切開創があったためデスモイド腫瘍を鑑別として挙げたが，悪性腫瘍の可能性も否定できず腫瘍の発生起源の鑑別およびマージンを確保するため腹腔鏡観察を併用し，腹直筋合併腫瘍摘出術を行った．最終的にUPSであり，腫瘍マージンが確保できていることを病理診断で確認した．<BR>腹直筋直下に発生するUPSを経験したが，腹腔鏡観察は腫瘍起源確認のみならずマージン確保の点からも有用であると考える．

DOI： 10.3919/jjsa.75.3384

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)へるす出版  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本小児外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)へるす出版  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：日本外科代謝栄養学会  

【目的】癌患者に対する化学療法時には、口内炎などの副作用のために治療を継続することが困難な場合が多い。今回それらに対して成分栄養剤が効果的であった症例を経験したので報告する。【症例1】75歳男性、平成15年1月直腸癌、前立腺癌に対して手術施行後平成21年1月局所再発認め化学療法開始。平成22年5月、PDにてレジメ変更した。化学療法の継続に伴い口内炎の悪化が認められた。成分栄養剤(エレンタール)を投与し口内炎の改善が認められた。【症例2】70歳代女性、平成22年10月左乳癌に対して乳房切除術施行された。外来で術後補助化学療法(TC)行ったが全身倦怠感および口内炎による口腔内痛のため経口摂取困難となり緊急入院し抗生剤投与と成分栄養剤の投与を行った。症状は改善し外来化学療法継続可能となった。【結語】成分栄養剤の投与により化学療法の副作用が軽減したと思われる例を経験した。私達の取り組みを含めて報告する。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(株)メディカ出版  

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J03018&link_issn=&doc_id=20120502120004&doc_link_id=issn%3D2434-4575%26volume%3D17%26issue%3D5%26spage%3D451&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D2434-4575%26volume%3D17%26issue%3D5%26spage%3D451&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

記述言語：日本語   出版者・発行元：(一社)日本小児血液・がん学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本小児外科学会  

DOI： 10.11164/jjsps.48.2_273_5

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J01113&link_issn=&doc_id=20120424070030&doc_link_id=10.11164%2Fjjsps.48.2_273_5&url=https%3A%2F%2Fdoi.org%2F10.11164%2Fjjsps.48.2_273_5&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本小児外科学会  

DOI： 10.11164/jjsps.48.3_546_2

researchmap

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本小児外科学会  

DOI： 10.11164/jjsps.48.3_453

researchmap

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本小児外科学会  

DOI： 10.11164/jjsps.48.2_275_1

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)小切開・鏡視外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本外科代謝栄養学会  

researchmap

記述言語：日本語   出版者・発行元：日本DDS学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：英語   出版者・発行元：H G E UPDATE MEDICAL PUBLISHING S A  

Backgound/Aims: The aim of this study is to present the new method of continuously irrigated around the pancreaticojejunostomy to reduce postoperative complications after pancreaticoduodenectomy.
Methodology: Twenty-seven patients underwent pancreaticoduodenectomy in our institution between 2002 and 2007. Pancreaticojejunostomy was performed with the external pancreatic duct stent tube, and continuous irrigation around the pancreaticojejunostomy was started on the operative day with physiological saline solution containing gabexate mesilate.
Results: Mean duration of irrigation was 7.1+4.4 days, mean duration of drainage tube placement was 14.2+9 days, and mean duration of pancreatic duct drainage tube placement was 24.9+4.7 days. Pancreatic fistula was diagnosed in 8 patients. Three cases were classified as grade A and 5 cases were grade B. These pancreatic fistulae were closed by non-invasive treatment and the in-hospital death rate was 0%.
Conclusions: External total drainage of the main pancreatic duct and continuous irrigation around pancreaticojejunostomy appears to avoid severe postoperative complications.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(株)癌と化学療法社  

症例は57歳、男性。56歳時に胃前庭部の進行胃癌に対して胃全摘術およびD2郭清を施行し、病理検査にて中分化型腺癌、SE、N2、M0、Stage IIIBと診断され、退院後S-1の内服を継続していた。しかし術後1年2ヵ月経過したころより左頸部のリンパ節腫脹を認め徐々に増大傾向を示し、CA19-9の上昇も認めたことから再発を疑われ、加療目的で再入院となった。S-1 100mg/body、14日間連続内服、day 8にCDDP 60mg/m2、docetaxel 40mg/m2をそれぞれ投与し、day 15〜21まで休薬期間とし、これを1コース(以下DCS療法)とし、合計5コースを投与した。5コース終了後、画像検査上、左頸部のリンパ節再発は消失し、腫瘍マーカーも正常化した。投与後13ヵ月経過した現在も頸部リンパ節を含め再発所見は認めず、外来通院中である。進行胃癌術後の術後補助化学療法後に認めた頸部リンパ節再発に対して、DCS療法は長期生存を期待し得る有用な治療法の一つとなる可能性が示唆された。(著者抄録)

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J00296&link_issn=&doc_id=20100727600042&doc_link_id=%2Fab8gtkrc%2F2010%2F003707%2F043%2F1385-1388%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2010%2F003707%2F043%2F1385-1388%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：公益社団法人 日本生体医工学会  

In a previous study, we investigated electromagnetic heating with various types of metals for the purpose of mild ablation in cancer treatment. The aim of this study is to determine the efficacy of induction heating in the treatment of cervical cancer by using xenograft animal models of human cervical cancer. Nude mice with CaSki cells mimicking human cervical cancer were treated by induction heating. To investigate the influence of this method on tumor growth, 9 nude mice were assigned to 3 experimental groups: heating group, non-heating group, and control group. In the heating group, tumor-bearing mice were placed for 10 min under an alternating magnetic field (AMF) after needle insertion, while in the non-heating group, a needle was inserted into each animal, but AMF treatment was administered. The tumor growth could be controlled using this method without any risk of skin burn injury. The mean tumor volume was lesser in the heating group than in the control group. Thus, this new ablation method may be a feasible technique for cervical cancer therapy.

DOI： 10.11239/jsmbe.47.535

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2010140830

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

当科では待期手術が可能な腸閉塞症例に対し、Multidetector-row Computed Tomography(以下、MDCT)を用いたガストログラフィン造影CTにて癒着部位の同定を行っている。同法を用いて腹腔鏡下腸閉塞手術を施行した5例を経験したので報告する。対象:2005〜2007年までに経験した腸閉塞手術症例15例のうち、腹腔鏡下手術を施行した5例とした。方法:術前に経口的または経イレウス管的にガストログラフィンを内服または注入し、数時間後にCTを撮影し、閉塞機転を同定した。結果:全例、閉塞機転は術前に評価した部位と一致した。結語:MDCTによる術前評価を行うことにより閉塞機転の同定が可能であり、腹腔鏡下手術に有用であると考えられた。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：日本外科代謝栄養学会  

researchmap

記述言語：英語   出版者・発行元：H G E UPDATE MEDICAL PUBLISHING S A  

Right aortic arch is a rare abnormality. Esophageal cancer associated with a vascular ring is even more rare. We describe a patient with right aortic arch who had previously undergone a graft replacement of descending aorta for aneurysmal rupture followed by subsequent surgery for advanced esophageal cancer. Preoperative three-dimensional computed tomography revealed mirror image branching type right aortic arch and Kommerell&apos;s diverticulum of the descending aorta. The patient underwent total esophagectomy with laryngopharyngectomy and regional lymphadenectomy via a left thoracotomy. A permanent tracheal fistula was constructed. Postoperative chemo-radiotherapy was applied. The patient was discharged from hospital and is doing well. Early division of the ligamentum arteriosum with careful management of the aortic diverticulum led to release of the esophagus from the vascular ring that rendered the following procedures safe and afforded a good operative view.

Web of Science

researchmap

記述言語：英語   出版者・発行元：H G E UPDATE MEDICAL PUBLISHING S A  

Background/Aims: Portal and splenic venous thrombosis (PSVT) is not a rare complication of splenectomy. We report a retrospective study of PSVT after splenectomy in patients with liver cirrhosis and clarify the risk factors and discuss the necessity of preventive pharmacotherapy.
Methodology: Potential subjects comprised 27 patients who underwent splenectomy (including laparoscopic splenectomy) at our hospital between January 2003 and December 2005 for hypersplenism due to liver cirrhosis. Perioperative data were assessed for 17 patients who did not have portal tumor thrombus and followed-up regularly.
Results: PSVT occurred in 5 of the 17 patients (29%), none of them were symptomatic throughout follow-up. PSVT disappeared spontaneously in 2 of the 5 patients (40%) without any treatment. Patients with PSVT showed significant differences in comparison with patients without PSVT in age, preoperative platelet count, intraoperative bleeding, splenic weight and platelet-associated immunoglobulin G (PAIgG),
Conclusions: PSVT occured at a high rate in patients after splenectomy, but at a lower than in patients with hematopathies. According to our results, thrombolytic agent may be required only when patients show symptoms of PSVT. Preoperative serum PAIgG level may represent worthwhile markers for predicting PSVT.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：日本DDS学会  

researchmap

記述言語：日本語   出版者・発行元：金原出版  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2008211167

記述言語：日本語   出版者・発行元：(株)癌と化学療法社  

当科では2002年より検体採取可能な乳癌に対し、CD-DST法(Collagen Gel Droplet Embedded Culture-drug Sensitivity Test)を用いた抗癌剤感受性試験を行っている。今回われわれは、その検査成績および問題点について若干の文献的考察を含めて報告する。対象:2002年3月より2005年8月までの検体採取可能であった乳癌患者23例25検体(乳腺・リンパ節)。方法:CD-DST法を用い5-FU,adriamycin(ADM),docetaxel(DOC),paclitaxel(PTX)について抗癌剤感受性試験を行った。結果:検体は乳腺21検体、所属リンパ節4検体。5-FU 23検体中13検体(56.5%)が評価可能で、うち4検体が高感受性であった。ADM 23検体中13検体(56.5%)が評価可能で、うち3検体が高感受性であった。DOC 24検体中13検体(54.1%)が評価可能で、うち7検体が高感受性であった。PTX 23検体中12検体(52.1%)が評価可能で、うち5検体が高感受性であった。25検体中9検体(36.0%)が検査不能であり、その理由として腫瘍細胞数不足が6検体、細胞viability低下2検体、細胞増殖度低下1検体であった。結語:CD-DST法は乳癌化学療法を選択する上で判断材料となり得る検査であるが、今後さらなる検査精度の向上が望まれる。(著者抄録)

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J00296&link_issn=&doc_id=20080520480015&doc_link_id=%2Fab8gtkrc%2F2008%2F003505%2F016%2F0793-0796%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fab8gtkrc%2F2008%2F003505%2F016%2F0793-0796%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

J-GLOBAL

researchmap

記述言語：英語   出版者・発行元：INT INST ANTICANCER RESEARCH  

Background: This study investigated a novel approach for tumor ablation therapy using an alternating magnetic field combined with a sintered MgFe(2)O(4) needle. This method differs from radiofrequency ablation (RFA) by dielectric heating with regard to the heating mechanism and improves some weak points of these conventional thermotherapies. Materials and Methods: Nude mice mimicking human breast cancer BT474 were treated using this method. The extent of tumor death was assessed after ablation. Results: Staining with hematoxylin and eosin showed gradual expansion of the pyknotic area until 48 h after ablation. Nicotinamide adenine dinucleotide diaphorase staining also showed complete tumor death by 48 h after treatment. The ablation area was well controlled and reablation was not necessary. The tumor could be completely controlled using this method without any risk of skin burn. Conclusion: This novel ablation therapy appeared to be more effective and less invasive for treatment of breast cancer treatment than RFA.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：英語   出版者・発行元：H G E UPDATE MEDICAL PUBLISHING S A  

Background/Aims: Although the mortality rate related to pancreatic surgery has been reduced, postoperative pancreatic fistula (POPF) remains high. The rate of POPF is reportedly between 5 and 34%. The pancreatic stump is typically closed by hand using suture materials. Recently, linear stapling devices have been employed in pancreatic resection, but the efficacy and safety of this procedure remain uncertain.
Methodology: Efficacy and safety were retrospectively analyzed for distal pancreatic resection using a linear stapling device in open and laparoscopic. procedures starting from January 1999 (Group A: n=20), and perioperative data were compared with those for hand-sewn stump closure starting from January 1990 (Group 13: n=28). Results: Mean operative times in Group A. and Group B were 165 min and 200 min, respectively (p &lt; 0.05). POPF was observed in two cases in Group A (10%) and 10 cases in Group B (35%) (p &lt; 0.05). POPF was not observed in the three patients who underwent laparoscopic pancreatic resection with the linear stapling device. Mean hospital stay for Groups A and B was 14 days and 20 days, respectively (p &lt; 0.05). In POPF patients, no clinical symptoms were observed, but drains were removed 10 postoperative days later than in patients without POPF, from whom drains were withdrawn at 7 days (p &lt; 0.05). Patients exhibiting POPF were treated conservatively and all patients were discharged in good health.
Conclusions: It may be concluded that: 1) drains should be withdrawn carefully according to the volume and characteristics of exudates; 2) mechanical staplers are promising devices for distal pancreatic resection; and 3) laparoscopic procedures are: also promising for distal pancreatic resection.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：鳥居薬品(株)  

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本小児がん学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

2001年1月〜2005年8月に経験した急性肺塞栓症で経皮的心肺補助装置(PCPS)を必要とした5例の成績を報告した.全例において比較的良好なPCPS流量(1.9〜2.3L/分)を確保できたが,比較的大量の輸液・輸血を必要とした.PCPSの効果としては混合静脈血酸素飽和度が施行前46〜51%から施行後78〜86%に改善し,動脈血酸素分圧が施行前39〜61 torrから施行後144〜286 torrに改善した.体外循環は,PCPSにより容易に移行しえた.PCPSからの離脱は4例が可能,1例が不能であり,不能の症例は右延髄に出血性梗塞を起こしていた

researchmap

記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：(株)永井書店  

64歳女.右下腹部痛を自覚し,増強した.腹部単純X線検査で軽度の小腸ガス像は認めたが,他にイレウスや遊離ガス像などの異常所見は認めなかった.腹部CT検査では盲腸の腹側に脂肪織の増生と不均一な濃度の上昇を認めた.大腸憩室炎などを疑い,輸液および抗生剤の投与を行った.翌日,発熱を認め,腹痛も増強し,汎発性腹膜炎の診断で緊急手術を行った.病理組織所見は,絞扼性の大網出血性壊死の所見であった.術後経過は良好で第10病日に退院した

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2006&ichushi_jid=J00396&link_issn=&doc_id=20060208110019&doc_link_id=%2Faf2gktye%2F2006%2F009402%2F019%2F0237-0239%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Faf2gktye%2F2006%2F009402%2F019%2F0237-0239%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：一般社団法人 日本消化器外科学会  

症例は51歳の男性で, 人間ドックにおける上部消化管造影検査で異常を指摘されたため近医を受診し, 上部消化管内視鏡検査にて粘膜下腫瘍を認めたため当院を紹介され受診した. 胃十二指腸造影検査, 胃内視鏡検査では胃前庭部から発生し, 十二指腸球部に嵌入した球形の腫瘍を認め, また, 同時に行った生検では正常粘膜のみであった. X 線造影CTでは内部に嚢胞を形成し, 周囲が軽度造影される3cm大の球形の腫瘍を認めた. 変性したGISTなどを疑ったが確定診断は得られず, また内視鏡下の切除は困難であると考えられたため, 腹腔鏡補助下胃内手術にて腫瘍を摘出し, 術後病理診断にて最終的に迷入膵と診断した. 迷入膵は胃粘膜下腫瘍の鑑別の際に疑うべき疾患であり, まれであるが本症例のような形態を呈することも念頭におくべきであると考えられた.

DOI： 10.5833/jjgs.39.1511

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：特定非営利活動法人 日本小児外科学会  

DOI： 10.11164/jjsps.42.1_107_6

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

researchmap

記述言語：日本語   出版者・発行元：一般社団法人日本消化器外科学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：医学書院  

13歳男.排便後の肛門出血を主訴とした.歯状線直上に冠状に多発する直腸腫瘍を3個認め,経肛門的腫瘍局所切除術を行った.腫瘍は最大のもので20×15×5mm大,表面易出血性,軟で,明らかな悪性所見は認めなかった.腫瘍細胞は腺管腺腫と絨毛構造が混在,ないし共存している腺腫であり,直腸管状絨毛腺腫と診断した.術後経過は良好で,術後2年が経つが再発徴候は認められない

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2005156377

記述言語：日本語   出版者・発行元：(公社)日本小児科学会  

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本血管外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本脈管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本脈管学会  

researchmap

記述言語：日本語   出版者・発行元：社団法人日本循環器学会  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：(株)南江堂  

78歳女.背部痛を主訴とした.巨大な上行弓部大動脈瘤にDeBakey II型解離を合併したものと診断して手術を施行した.超低体温脳分離体外循環下open distal法により上行弓部大動脈人工血管置換術を施行した.術後は合併症なく良好に経過し,術後の大動脈造影では人工血管が良好に描出され,解離の残存等の所見は認められなかった

researchmap

記述言語：日本語   出版者・発行元：愛媛医学会  

過去10年間の大腸癌手術症例831例のうち40歳以下の若年者症例15例について検討した.若年者の割合は全症例の1.8%で,男女比,悪性腫瘍の家族歴の有無,発生部位については一般の大腸癌と同様であった.肉眼型は2型,組織型は分化型,進行度はv0,n0,1が多かった.治癒切除率は95.6%で,5年生存率は86.7%であった.以上より,若年者大腸癌の予後は一般の大腸癌と同様に病理組織学的因子が影響するため,早期の発見治療が重要と考えられた

researchmap

記述言語：英語   出版者・発行元：H G E UPDATE MEDICAL PUBLISHING S A  

For borderline malignant diseases of the pancreas such as cystic adenoma, partial pancreatectomy or pancreatoduodenectomy including pylorus-preserving pancreaticoduodenectomy have been performed depending on tumor location under large median laparotomy. To investigate the feasibility of a technique with minimal skin incision, while retaining safety equivalent to conventional resection of the pancreatic tail, by making use of the advantages of laparoscopic procedure, we performed a minimally invasive laparoscopic resection of the pancreatic tail with preservation of the spleen.
A 69-year-old woman underwent surgery for a diagnostic therapy for a cystic lesion of the pancreatic tail. The procedure was performed as follows: All procedures were performed completely laparoscopically under CO2 insufflation. After dissection of the omentum, laparoscopic ultrasound was performed to identify the location of the tumor and splenic vessels. The splenic hilus was dissected with preservation of the splenocolic ligament to maintain the lower blood supply to the spleen. The left gastroepiploic artery and the short gastric arteries and veins could be preserved. After division of the splenic hilus, the splenic artery and vein were identified from behind the pancreas by being held up and dissected individually by intracorporeal ligation by 3-0 Nylon. Then, pancreatic transection was performed 1cm proximal to the tumor with the Endo-GIAII.
The duration of operation was 4.5 hours. Intraoperative blood loss was under 50mL. Histological examination revealed mucinous cytadenoma. She could walk the day after surgery and was discharged from the hospital uneventfully. CT prior to discharge from the hospital revealed sufficient blood flow in the spleen.
Thus, it may be feasible to select laparoscopic spleen-preserving distal pancreatectomy as a first choice for diagnostic therapy for cystic lesions of the pancreatic tail.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本超音波医学会  

researchmap

記述言語：英語   出版者・発行元：TAYLOR & FRANCIS AS  

Objective: To assess the feasibility of cure of early gastric cancer by the endoscopic procedure done through a temporary gastrostomy and to use it to treat patients with various severe complications.
Design: Prospective study.
Setting: University hospital, Japan.
Subjects: Four patients who required gastric mucosal resection for early gastric cancer.
Main outcome measures: Ease of the procedure, cure rate, safety under epidural anaesthesia, and outcome.
Results: ALI patients had the procedure under epidural anaesthesia without pain or complaints during operation. Mean operation time was 120 minutes (60-200). Histological examination showed that the surgical margin was free of tumour in 3 of the cases. One patient who had microscopic invasion of lymph nodes subsequently underwent second-look conventional,gastrectomy with lymphadenectomy. Postoperative recovery was rapid, and all patients were discharged from the hospital uneventfully.
Conclusion: This organ-preserving procedure enables good visualisation of the tumour and is useful even for high-risk patients.

DOI： 10.1080/110241501750215258

Web of Science