Search

This article discusses a surgical technique called Japanese D3 dissection for transverse colon cancer. The authors explain that performing laparoscopic transverse colectomy can make lymph node dissection challenging, but it is necessary for advanced cancer cases. The authors describe their department's approach, which involves mesenterizing the transverse mesocolon from a cranial perspective. This technique allows for a highly curative dissection that combines complete mesocolic excision and central vascular ligation. The article includes a video demonstrating the procedure. The authors declare no conflicts of interest, and the study design was approved by an ethics review board. [Extracted from the article]

Total pelvic exenteration (TPE) was first reported by Brunschwig in 1948 as an extensive surgery for treatment of advanced cancer in the pelvis [[1]]. Indications for TPE at our hospital are as follows: when urinary tract preservation is difficult because of invasion of the prostate, seminal vesicle or vagina and with bladder invasion that exposes the bladder lumen. At present, TPE for advanced rectal cancer with pelvic visceral invasion is recognized as a useful surgical procedure for increasing the R0 resection rate. [Extracted from the article]

Background: Pancreaticobiliary malignant diseases are primarily treated by surgical resection. However, the surgical indications for elderly patients, especially for pancreaticoduodenectomy (PD), must be carefully considered due to patient compliance. Whether PD can contribute to better prognoses in elderly patients remains unclear. Therefore, we aimed to evaluate the complications, compliance, and survival of elderly and non‐elderly patients who underwent PD in our department. Methods: We retrospectively analyzed 282 patients who underwent PD from 2000 to 2017 and divided them into non‐elderly (aged ≤ 79 years, n = 238) and elderly (aged ≥ 80 years, n = 44) groups. The estimation of physiologic ability and surgical stress (E‐PASS) system was used to evaluate morbidity and mortality using preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS). Results: Preoperative risk score was higher in the elderly group than in the non‐elderly group, although SSS and CRS were similar. No significant differences were detected in the occurrence of postoperative complications. In the elderly group, CRS was higher in patients with complications than in those without. Long‐term outcomes evaluated by overall and disease‐specific survival were not significantly different. Conclusions: In the elderly patients, E‐PASS especially CRS can predict the occurrence of complications. The safety and prognoses of elderly patients after PD are comparable with those of non‐elderly patients. [ABSTRACT FROM AUTHOR]

Background: The prognosis of intrahepatic cholangiocarcinoma (ICC) is based on tumor localization; however, the mechanism remains unknown. Therefore, we investigated the biological characteristics of perihilar and peripheral ICC in a mouse model. Methods: The model was established by the administration of three oncogenic plasmids harboring myristoylated AKT, mutated human YAP, and pCMV‐Sleeping Beauty into the mice. The perihilar and peripheral ICC tumors that developed in the same mouse were assessed for the expression of cell adhesion factors and driver genes with immunohistochemistry and reverse transcription polymerase chain reaction (RT‐PCR). Results: The perihilar ICC tumors were irregularly shaped, whereas the peripheral tumors were mostly circular, similar to the differences found in patients. Alpha‐smooth muscle actin was strongly expressed in the perihilar tumors at 10 weeks, and vimentin expression was significantly up‐regulated in the perihilar ICC at 14 weeks. Fgfr2 level significantly increased in peripheral ICC at 10 weeks, whereas Idh2 expression was up‐regulated in perihilar ICC. Conclusions: Despite diffuse injection of oncogenic plasmid, expression of driver genes and oncogenes in ICC tumor cells differs depending on the tumor localization, resulting in changes in epithelial‐mesenchymal transition, which may explain the different outcomes of patients with peripheral and perihilar ICC. [ABSTRACT FROM AUTHOR]

SUMMARY1. Few studies have been reported concerning the effect of ageing on renal functional and vascular responses to various stresses during ordinary life. In the present study, we examined the effect of age on changes in renal sodium handling and renal vascular resistance (RVR) in response to standing from a supine position in subjects with normal renal function. 2. We selected 43 healthy males in the second through to the seventh decade of life and gave them a constant dietary sodium intake before the study period. Renal function was estimated by standard clearance methods with the subject in a state of euvolaemia. 3. The mean daily urinary excretion of sodium was 236 ± 22 mEq. Standing from a supine position was associated with significant decreases (P < 0.0001) in creatinine clearance (from 125 ± 18 to 117 ± 19 mL/min per 1.73 m2), sodium excretion (from 178 ± 29 to 97 ± 23 μEq/min) and fractional excretion of sodium (from 1.02 ± 0.19 to 0.60 ± 0.13%). A significant increase (P < 0.0001) in the RVR index (from 0.11 ± 0.03 to 0.14 ± 0.04 units) was noted. Univariate analysis indicated that while the change in RVR associated with standing was significantly diminished (P < 0.05) in older subjects, orthostatic changes in other parameters associated with standing were minimally influenced by age. 4. In conclusion, although the renal vascular response is impaired in advanced age, the renal functional response to orthostasis is otherwise maintained in healthy elderly subjects under conditions of normal sodium intake and clinical euvolaemia. [ABSTRACT FROM AUTHOR]

A Framework for supporting the organization and structuring of product development teams tinder concurrent engineering environment is presented. The concepts of Team Structuring Dimensions TSD) and Development Characteristics and Factors (DCF) are defined. Based on the concepts. the framework analyzes the emphasis that should be placed on each TSD according to the DCFs, and each different combination of the emphasis defines a more appropriate team organization and structuring. A inure appropriate team organization facilitates the communication and information sharing between the team members. and the quality of this communication is essential for product development effectiveness and efficiency. The effectiveness of the framework is discussed by real cases in product development projects. [ABSTRACT FROM AUTHOR]

Large and middle-sized manufacturers need to carry out multiple development projects simultaneously to serve a variety of products to markets with different customer needs. The purpose of this article is to explore product development project and team organization with respect to technology and design transfer strategy among multiple development projects, as well as their impact on project integrity and performance. The focus is on the strategic and cross-functional integration of product and process generations with distinctive platforms and their derivative projects. First, this study proposes a concept of multilayer development project and team organization, which builds a creative environment through effective information sharing among and within the individual development projects and teams. Second, using analysis results on six product development projects at a large Japanese computer manufacturer, it is concluded that multilayer teams are effective in realizing project integrity through implementing inter- and intraproduct and process generation technology and design transfer strategy. © 1998 John Wiley & Sons, Inc. [ABSTRACT FROM AUTHOR]