10 results on '"Shuichi Tange"'
Search Results
2. Clinical Outcomes of Intraductal Papillary Mucinous Neoplasms With Dilatation of the Main Pancreatic Duct
- Author
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Tsuyoshi Hamada, Hiroki Oyama, Yousuke Nakai, Shuichi Tange, Junichi Arita, Ryunosuke Hakuta, Hideaki Ijichi, Kazunaga Ishigaki, Sachiko Kanai, Yoshikuni Kawaguchi, Hirofumi Kogure, Suguru Mizuno, Kei Saito, Tomotaka Saito, Tatsuya Sato, Tatsunori Suzuki, Naminatsu Takahara, Mariko Tanaka, Keisuke Tateishi, Tetsuo Ushiku, Kiyoshi Hasegawa, and Mitsuhiro Fujishiro
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Hepatology ,Gastroenterology - Published
- 2023
3. A rare case of gallbladder cancer with multiple metastases to the colon
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Yousuke Nakai, Hiroki Oyama, Toshio Kumasaka, Shuichi Tange, Kensaku Noguchi, Yukiko Ito, Yuan Bae, Hideo Yoshida, and Ryunosuke Hakuta
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Male ,medicine.medical_specialty ,Pathology ,Endoscopic mucosal resection ,Adenocarcinoma ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Gallbladder cancer ,Aged ,business.industry ,Gastroenterology ,Bone metastasis ,Sigmoid colon ,General Medicine ,Hepatology ,medicine.disease ,Primary tumor ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Colonic Neoplasms ,Gallbladder Neoplasms ,030211 gastroenterology & hepatology ,Lymph Nodes ,business - Abstract
Gallbladder cancer is often diagnosed with metastasis and is known to have poor prognosis. Although, gallbladder cancer often metastasizes to liver, lung, or lymph nodes, metastasis to gastrointestinal tract is not common. Several autopsy studies reported colorectal metastasis from gallbladder cancer, but most of these cases were supposed to be gastrointestinal invasion from peritoneal dissemination. We experienced a rare case of hematogenous colon metastasis from gallbladder cancer. Colonoscopy for a 76-year-old man who was diagnosed as gallbladder cancer revealed two 5-mm flatly elevated lesions with central erosion in the transverse and sigmoid colon. Endoscopic mucosal resection (EMR) revealed poorly differentiated adenocarcinoma in hematoxylin and eosin staining. Additional immunohistochemistry examination showed strongly positive CK7 expression with negative CDX2, and suggested colon metastases from gallbladder cancer. Despite the positive vertical margin in EMR specimens, autopsy finding denied colorectal invasion from peritoneal dissemination and proved vascular spread colon metastases. Gastrointestinal metastasis is often misdiagnosed as a primary tumor, and thus, it is important to recognize gallbladder cancer as a potential origin of gastrointestinal metastasis.
- Published
- 2021
4. Acute Liver Failure Due to Hypereosinophilic Syndrome Accompanied by Duodenal Perforation
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Yukiko Ito, Haruna Onoyama, Shuichi Tange, Hirotoshi Kakiwaki, Hirobumi Suzuki, Harumi Shirai, Shinzo Yamamoto, Koji Uchino, Takeshi Suzuki, Hideo Yoshida, Toshio Kumasaka, Sakae Nagaoka, and Hiroyoshi Taniguchi
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medicine.medical_specialty ,Biopsy ,Gastroenterology ,Adrenal Cortex Hormones ,Internal medicine ,Hypereosinophilic Syndrome ,Internal Medicine ,medicine ,Eosinophilia ,Humans ,Medical history ,Duodenal Perforation ,Aged ,medicine.diagnostic_test ,business.industry ,Hypereosinophilic syndrome ,General Medicine ,Eosinophil ,Liver Failure, Acute ,medicine.disease ,medicine.anatomical_structure ,Liver biopsy ,Duodenal Ulcer ,Peptic Ulcer Perforation ,Etiology ,Female ,Liver function ,medicine.symptom ,business - Abstract
A 78-year-old woman presenting with severe acute liver failure was admitted to our hospital. On screening for the etiology of acute liver failure, it was diagnosed as being due to idiopathic hypereosinophilic syndrome (eosinophil count reported as 4766/μL; 33.8% of the white blood cells). Her medical history included marked eosinophilia, as observed six months prior to this admission. Corticosteroid therapy was initiated. During the clinical course, duodenal perforation occurred but was managed promptly by appropriate surgery. A liver biopsy, following the initiation of corticosteroid therapy, revealed degenerating hepatic cells with mild eosinophilic infiltration. With corticosteroid therapy, the liver function improved.
- Published
- 2021
5. Site Specific Evaluation of Lymphatic Vessel Sclerosis in Lower Limb Lymphedema Patients
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Han Peng Zhou, Makoto Mihara, Shuichi Tange, Yoshihisa Kawakami, Takuya Iida, Hisako Hara, and Kazuki Kikuchi
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Adult ,Male ,Pathology ,medicine.medical_specialty ,Contraction (grammar) ,030230 surgery ,Lymphatic System ,03 medical and health sciences ,0302 clinical medicine ,Lower limb lymphedema ,medicine ,Lymphatic vessel ,Humans ,In patient ,Lymphedema ,Aged ,Lymphatic Vessels ,Aged, 80 and over ,Sclerosis ,business.industry ,Lymphography ,Middle Aged ,medicine.disease ,medicine.anatomical_structure ,Lymphatic system ,Lower Extremity ,030220 oncology & carcinogenesis ,Female ,sense organs ,Cardiology and Cardiovascular Medicine ,business ,Lymphoscintigraphy - Abstract
Histological changes in the collecting lymphatics in patients with lymphedema are classified as Normal type, Ectasis type, Contraction type, and Sclerosis type (NECST) classification. In this study, we investigated the condition of the lymphatic vessels in different sites of the legs.We prospectively investigated the lymphatic vessels of patients with lymphedema who underwent lymphaticovenous anastomosis (LVA) from August 8, 2014 to August 4, 2015 based on the NECST classification. Lymphedema was diagnosed using lymphoscintigraphy, indocyanine green (ICG) lymphography, and the International Society of Lymphology (ISL) Classification. The affected limbs were divided into four sites: proximal thigh (Site 1), distal thigh (Site 2), proximal crus (Site 3), and distal crus (Site 4).A total of 109 patients (205 limbs and 1028 lymphatics) were included in this study. Of the 109 patients, there were 100 women and 9 men with an average age of 61 years. The ratio of Ectasis type vessels increased toward the distal end of the limb with the highest occurrence rate being 54% at Site 4. As ISL stage, ICG stage, and lymphoscintigraphy stage advanced, so too did the ratio of Sclerosis type. In secondary lymphedema patients with lymphedema, the ratio of Ectasis type was more predominant in the distal end of the limb, whereas this tendency was not observed in primary lymphedema patients.Sclerotic lymphatics are more predominantly found in the proximal limb whereas nonsclerotic vessels are more often found toward the distal end. These findings help lymphatic surgeon determine incision sites.
- Published
- 2018
6. Lymphatic Venous Anastomosis Can Release the Lymphedema-Associated Pain of Upper Limb after Breast Cancer Treatment
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Han Peng Zhou, Makoto Mihara, Shuichi Tange, Hisako Hara, Yoshihisa Kawakami, and Kazuki Kikuchi
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medicine.medical_specialty ,business.industry ,Visual analogue scale ,visual analog scale ,lcsh:Surgery ,Chronic pain ,lcsh:RD1-811 ,lymphedema ,Anastomosis ,lymphaticovenous anastomosis ,medicine.disease ,Surgery ,body regions ,Lymphedema ,medicine.anatomical_structure ,Cellulitis ,medicine ,Upper limb ,Local anesthesia ,business ,Prospective cohort study - Abstract
Background Sometimes, chronic pain in the arm or chest could occur in postmastectomy patients. Although the pathology of the pain is unclear, the involvement of neurological mechanism, cicatricial contracture, or lymphedema is considered. The purpose of this study was to investigate the effectiveness of lymphaticovenous anastomosis (LVA) in reducing chronic pain in upper limb lymphedema patients. Patients and Methods This prospective study included consecutive 13 patients with upper limb lymphedema who received LVA. Preoperative lymphoscintigraphy and indocyanine green lymphography were performed. Pre- and postoperative pain scale were recorded using the visual analog scale (VAS). The number of cellulitis 1 year before and after LVA were compared. LVA was performed under local anesthesia, using a surgical microscope, and 12–0 nylon suture was used in the anastomosis. Results Two out of 13 patients were excluded from this study, and 11 patients were subjected to this study. All subjects were females with an average age of 64.3 years. The average lymphedema duration was 76.7 months. The average number of LVA sites was 5.7 per limb and the average follow-up period was 10.6 months. The average pre- and postoperative VAS scores were 3.5 and 0.59, respectively; the significant decrease was observed (p = 0.017). Three of the patients who had experienced cellulitis (once, twice, and four times, respectively) did not develop any cellulitis after LVA. Conclusion LVA was shown to be an effective surgical remedy for treating the lymphedema-associated pain of upper limb after breast cancer treatment.
- Published
- 2018
7. Modified lymph vessel flap transplantation for the treatment of refractory lymphedema: A case report
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Zhou Han Peng, Makiko Haragi, Shuichi Tange, Hisako Hara, Noriyuki Muarai, and Makoto Mihara
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medicine.medical_specialty ,Groin ,business.industry ,medicine.medical_treatment ,030230 surgery ,Microsurgery ,medicine.disease ,Surgery ,body regions ,Transplantation ,Abdominal wall ,03 medical and health sciences ,0302 clinical medicine ,Lymphedema ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine.artery ,medicine ,Lymph ,business ,Lymph node ,Superficial circumflex iliac artery - Abstract
Lymph vessel flap transplantation (LFT), lymphaticovenous anastomosis (LVA), or lymph node flap transfer are sometimes used to treat lymphedema that is resistant to conservative treatment. LFT harvested from the contralateral limb has been reported for the treatment of lymphedema. Here we report the use of modified LFT from the abdominal wall for the treatment of refractory lymphedema. Our patient was a 57-year-old patient with secondary lower limb lymphedema was previously treated with conservative therapy and lymphaticovenous anastomosis. We first examined the lymphatic function of the lower abdominal region in the patient using indocyanine green (ICG) lymphography. After confirming the good lymphatic function in the right abdominal region, we harvested the pedicled abdominal adiposal flap containing multiple abdominal lymph vessels and transferred it to the left groin region. The flap (20 × 10 cm2 ) was based on the superficial circumflex iliac artery perforator. We anastomosed one lymph vessel in the flap to that in the recipient site. We also performed multiple fibrotripsy using a 3-mm-diameter stainless steel stick inserted into small incisions. The postoperative course was uneventful. The circumference measurement was decreased by 2.2-13.5 cm at 1 year after the operation. The lower abdominal region has many lymph vessel networks and is thought to be a less risky donor site in patients with lymphedema than the lower limbs. Thus, LFT may be an option for the treatment of chronic lymphedema. © 2015 Wiley Periodicals, Inc. Microsurgery 36:695-699, 2016.
- Published
- 2015
8. Multi-site lymphatic venous anastomosis using echography to detect suitable subcutaneous vein in severe lymphedema patients
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Takuya Iida, Shuichi Tange, Yoshihisa Kawakami, Makoto Mihara, Hisako Hara, Kazuki Kikuchi, and Hang Peng Zhou
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Adult ,Male ,medicine.medical_specialty ,Operative Time ,030230 surgery ,Anastomosis ,Veins ,03 medical and health sciences ,0302 clinical medicine ,Subcutaneous Tissue ,Medicine ,Humans ,Lymphedema ,Vein ,Aged ,Lymphatic Vessels ,Retrospective Studies ,Ultrasonography ,Aged, 80 and over ,Leg ,business.industry ,Echo (computing) ,Ultrasound ,Anastomosis, Surgical ,Multi site ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Lymphatic system ,030220 oncology & carcinogenesis ,Venous anastomosis ,Female ,business - Abstract
Summary Background The method of lymphatic venous anastomosis (LVA), including its indications or preoperative examinations, has not been established. The purpose of this study is to reveal the possible application of preoperative echography in surgical LVA outcome. Methods We performed a retrospective case-control study on patients with lower limb lymphedema who underwent LVA between August 15, 2013 and August 15, 2014. As a preoperative examination, we used venous echography to identify subcutaneous veins in the echo group, while we only used Accuvein visualizing system in the control group. The operation time, number of anastomoses, and limb circumference were compared between the two groups. Results Seventeen patients (34 limbs) were included in the echo group, and 21 patients (42 limbs) were included in the control group. The average follow-up period was 11.9 (6–16) and 12.4 (6–27) months, respectively. The average operation time in the echo group was 258.6 min, and that in the control group was 216.5 min. The average number of anastomoses was 9.8 and 7.0 in the echo and control group, respectively. The average time per anastomosis was 27.4 and 32.6 min, respectively. The diameter of the vein had a tendency to be larger in the echo group than in the control group. In 5.8% of the echo group, we observed a circumference increase, compared with 23.8% in the control group. Conclusions Preoperative venous echography allowed surgeons to increase the number of anastomoses performed within the operating time, resulting in improvement of surgical outcomes.
- Published
- 2017
9. Multisite Lymphaticovenular Bypass Using Supermicrosurgery Technique for Lymphedema Management in Lower Lymphedema Cases
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Han Peng Zhou, Hisako Hara, Mari Kawahara, Makoto Mihara, Noriyuki Murai, Yohei Shimizu, and Shuichi Tange
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Adult ,Indocyanine Green ,Male ,medicine.medical_specialty ,Microsurgery ,030230 surgery ,Anastomosis ,Lower limb ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,hemic and lymphatic diseases ,Medicine ,Humans ,Lymphedema ,Coloring Agents ,Aged ,Lymphatic Vessels ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Anastomosis, Surgical ,Follow up studies ,Lymphography ,Retrospective cohort study ,Middle Aged ,medicine.disease ,humanities ,Surgery ,Lymphaticovenous anastomosis ,body regions ,Treatment Outcome ,Lower Extremity ,Clinical evidence ,Male patient ,030220 oncology & carcinogenesis ,Female ,business ,Vascular Surgical Procedures ,Lymphoscintigraphy ,Follow-Up Studies - Abstract
The impact of lymphaticovenous anastomosis on lymphedema has yet to be defined. The authors investigated the clinical evidence regarding the effectiveness of lymphaticovenous anastomosis in lower limb lymphedema.Eighty-four patients (162 limbs; 73 female and 11 male patients) with lower limb lymphedema who underwent multisite lymphaticovenous anastomosis in the authors' clinic between August of 2010 and May of 2014 were included in this retrospective study. Lymphedema was diagnosed using lymphoscintigraphy and indocyanine green lymphography. All lymphaticovenous anastomoses were performed under local anesthesia. The lymphatic vessels that were identified were classified using the normal, ectasis, contraction, and sclerosis type (NECST) classification. Limb circumference, subjective symptoms, and frequency of cellulitis were evaluated.The average patient age was 60 years (range, 24 to 94 years); mean postoperative follow-up period was 18.3 months (range, 6 to 51 months). The postoperative change rate in limb circumference indicated that 67 limbs (47.7 percent) were classified as improved, 35 (27.3 percent) were classified as stable, and 32 (25 percent) were classified as worse. Postoperative interview revealed improvement in subjective symptoms in 67 limbs (61.5 percent), no change in 38 (34.9 percent), and exacerbation in four (3.7 percent). The postoperative mean occurrence of cellulitis was decreased to 0.13 times per year compared with 0.89 preoperatively, which was statistically significant (p = 0.00084). Multiple regression analysis using the postanastomosis limb circumference and NECST classification confirmed the following results: change rate (percent) = -0.40 + (0.30 × N) + (-0.84 × E) + (0.22 × C) + (-0.61 × S).Lymphaticovenous anastomosis is effective for lower limb lymphedema, in point of limb circumference, subjective symptoms, and the frequency of cellulitis.Therapeutic, IV.
- Published
- 2016
10. Case report: a new hybrid surgical approach for treating mosaic pattern secondary lymphedema in the lower extremities
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Han Peng Zhou, Makiko Haragi, Makoto Mihara, Hisako Hara, and Shuichi Tange
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medicine.medical_specialty ,Secondary lymphedema ,Uterine Cervical Neoplasms ,Hysterectomy ,Surgical Flaps ,chemistry.chemical_compound ,hemic and lymphatic diseases ,Female patient ,medicine ,Effective treatment ,Humans ,Lymphedema ,Lymph node ,Surgical approach ,business.industry ,Anastomosis, Surgical ,Lymphography ,General Medicine ,Middle Aged ,medicine.disease ,Bandages ,humanities ,Lymphaticovenous anastomosis ,Surgery ,body regions ,medicine.anatomical_structure ,chemistry ,Lower Extremity ,Lymph Node Excision ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Indocyanine green - Abstract
Two of the most common surgical lymph reconstructive interventions for the treatment of secondary lymphedema today are lymphaticovenous anastomosis (LVA) and lymph node transplant. However, neither of these approaches has proven enough evidence to be considered as an effective treatment measure. In this case report, we will introduce a “hybrid method” where combinations of these two conventional methods are used in treating a 52-year-old female patient who displays a mosaic pattern of aggravating secondary lymphedema. Preoperative indocyanine green lymphography assessment was used to identify the different stages of lymphedema within the symptomatic limbs. The application of the hybrid method has resulted in a faster improvement in limb circumference and tissue tenderness compared with when only LVA is performed and has resulted in successful recovery from lymphedema in our case. The hybrid method allows surgeons to select the most appropriate surgical approach for each region displaying a different severity staging of lymphedema, establishing a new order-made remedy for chronic secondary lymphedema patients.
- Published
- 2014
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