160 results on '"T, Iwazawa"'
Search Results
2. Characteristics and performance of the Improved Limb Atmospheric Spectrometer-II (ILAS-II) on board the ADEOS-II satellite
- Author
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Hirokazu Kobayashi, Hideaki Nakajima, Y. Mogi, Katsunori Waragai, T. Togami, N. Kimura, T. Ishigaki, Takafumi Sugita, Mariko Horikawa, Akihiko Kuze, Nobuyuki Uemura, T. Iwazawa, Jun Tanii, Tatsuya Yokota, N. Araki, Hiroyuki Kawasaki, and Yasuhiro Sasano
- Subjects
Atmospheric Science ,Ozone ,Soil Science ,Aquatic Science ,Air mass (solar energy) ,Oceanography ,Atmospheric sciences ,Occultation ,chemistry.chemical_compound ,Geochemistry and Petrology ,Earth and Planetary Sciences (miscellaneous) ,Nitrogen dioxide ,Earth-Surface Processes ,Water Science and Technology ,Remote sensing ,Ecology ,Spectrometer ,Chlorine nitrate ,Paleontology ,Forestry ,Ozone depletion ,Geophysics ,chemistry ,Space and Planetary Science ,Environmental science ,Water vapor - Abstract
[1] The Improved Limb Atmospheric Spectrometer-II (ILAS-II) monitored components associated with Polar ozone depletion. ILAS-II was on board the Advanced Earth Observing Satellite-II (ADEOS-II, “Midori-II”), which was successfully launched on 14 December 2002 from the Tanegashima Space Center of the Japan Aerospace Exploration Agency (JAXA). ILAS-II used a solar occultation technique to measure vertical profiles of ozone (O3), nitric acid (HNO3), nitrogen dioxide (NO2), nitrous oxide (N2O), methane (CH4), water vapor (H2O), chlorine nitrate (ClONO2), dinitrogen pentoxide (N2O5), CFC-11, CFC-12 and aerosol extinction coefficients at high latitudes in both the Northern and Southern hemispheres. ILAS-II included Sun-tracking optics and four spectrometers, a Sun-edge sensor, and electronics. The four spectrometers measured in the infrared (channel 1) between 6.21 and 11.76 μm, in the midinfrared (channel 2) between 3.0 and 5.7 μm, at high resolution in the infrared (channel 3) between 12.78 and 12.85 μm, and in the visible (channel 4) between 753 and 784 nm. The vertical height of the entrance slit was 1 km at the tangent point. A Sun-edge sensor accurately registered tangent height. After an initial check of the instruments, ILAS-II recorded routine measurements for about 7 months, from 2 April 2003 to 24 October 2003, a period that included the formation and collapse of an Antarctic ozone hole in 2003 that was one of the largest in history. All of the ILAS-II data were processed using the version 1.4 data-processing algorithm. Validation analyses show promising results for some ILAS-II measurement species, which can be used to elucidate mechanisms of Polar ozone depletion. Studies are ongoing on ozone depletion, on the formation mechanisms of Polar stratospheric clouds, on denitrification, and on air mass descent. A state-of-the-art data retrieval algorithm that is currently being developed will yield more sophisticated data sets from the ILAS-II data in the near future.
- Published
- 2006
3. Laparoscopic management for local recurrence of early gastric cancer after endoscopic mucosal resection
- Author
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H. Yano, T. Monden, T. Iwazawa, and Yutaka Kimura
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Male ,medicine.medical_specialty ,medicine.medical_treatment ,Endoscopic mucosal resection ,Adenocarcinoma ,Endoscopy, Gastrointestinal ,Stomach Neoplasms ,medicine ,Humans ,Laparoscopy ,Stomach cancer ,Aged ,Laparotomy ,medicine.diagnostic_test ,business.industry ,Cancer ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,Endoscopy ,Early Gastric Cancer ,Gastric Mucosa ,Gastrectomy ,Female ,Neoplasm Recurrence, Local ,business ,Abdominal surgery - Abstract
Endoscopic mucosal resection (EMR) is a widely accepted technique for early gastric cancer because it is minimally invasive; however, incomplete resection with subsequent cancer recurrence in the remnant remains a difficult problem. Generally, the margins of the local recurrence lesions are unclear, and second EMR is difficult to perform because of scar formation after the first EMR. We performed a laparoscopic treatment on six patients with residual lesions after EMR and reviewed the safety and efficacy of this management. Laparoscopic management consisted of two techniques: laparoscopic wedge resection with a lesion-lifting method and laparoscopic-assisted distal gastrectomy with mini-laparotomy. Cancerous lesions were completely resected with sufficient surgical margins circumferentially. Mean operative time was 171 min, mean estimated blood loss was 16.5 g, time to first walking was 1 day, duration of epidural analgesia was 2.2 days, and mean length of hospital stay was 13.5 days. There were no intra- and postoperative complications, no conversion to open surgery, and no recurrence after surgery. No patients died of gastric cancer during a median follow-up of 60.3 months (range, 38-84). Laparoscopic management for residual lesions of early gastric cancer after EMR is a safe, effective, and minimally invasive procedure by which curative resection can be expected.
- Published
- 2004
4. Dissecting thoracic aorta and fusiform aneurysm of the abdominal aorta
- Author
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K Goda, Jun-ichi Kambayashi, H. Fukuda, K. Shinozaki, Makoto Watase, Joonghee Kang, M Miyamoto, Takumi Kawasaki, Yoshihisa Tsuji, and T Iwazawa
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congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Aortography ,Fusiform Aneurysm ,Dissection (medical) ,Diagnosis, Differential ,Necrosis ,Aortic aneurysm ,Aneurysm ,Blood vessel prosthesis ,medicine.artery ,medicine ,Humans ,Thoracic aorta ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Polytetrafluoroethylene ,Aortic Aneurysm, Thoracic ,medicine.diagnostic_test ,business.industry ,Abdominal aorta ,Middle Aged ,medicine.disease ,Blood Vessel Prosthesis ,Aortic Dissection ,cardiovascular system ,Female ,Surgery ,Radiology ,Tunica Media ,Cardiology and Cardiovascular Medicine ,business ,Aortic Aneurysm, Abdominal ,Syphilis, Cardiovascular - Abstract
A 59-year-old woman with dissection of the thoracic aorta and a fusiform aneurysm of the abdominal aorta without evidence of Marfan's syndrome underwent aneurysmorrhaphy with a bifurcated expanded polytetrafluoroethylene graft. Histological specimens of the aneurysmal wall revealed the presence of idiopathic cystic medial necrosis. As typical findings of idiopathic cystic medial necrosis in the aortic wall are very rare except in cases of Marfan's syndrome, the present case is reported and the implications of this condition are discussed.
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- 1995
5. [Significant role of cisplatin and 5-FU combination chemotherapy for first-line intensive treatment for advanced esophageal cancer]
- Author
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S, Matsui, T, Iwazawa, H, Yano, T, Tono, Y, Nakano, T, Kanoh, M, Kinuta, and T, Monden
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Male ,Esophageal Neoplasms ,Antineoplastic Combined Chemotherapy Protocols ,Remission Induction ,Carcinoma, Squamous Cell ,Humans ,Fluorouracil ,Cisplatin ,Middle Aged ,Combined Modality Therapy ,Aged - Abstract
We evaluated the efficacy of first-line chemotherapy consisting of cisplatin and 5-fluorouracil combination therapy (in the following, FP) in intensive treatment for esophageal cancer. This first-line chemotherapy was administered to 18 patients with squamous cell carcinoma. Three patients had T2 tumor, 10 had T3 and 5 had T4. Lymph node metastasis was detected in 10 patients and not detected in 8 patients. Five patients had distant metastasis. Ten patients showed a partial response and the response rate was 55.6%. Of these 10 patients, 5 were followed with surgery, 3 of whom survived without recurrence of the disease. Five patients were treated by FP, radiation therapy or combination of FP and radiation. Of these 5 patients, 2 showed a complete response. On the other hand, 8 nonresponders died from progressive disease, despite following intensive treatment. These results suggest that first-line chemotherapy by FP, which requires following intensive treatment, improves the overall long-term survival of advanced esophageal cancer patient.
- Published
- 2001
6. [Usefulness of hepatic arterial infusion chemotherapy for liver metastasis in gastric cancer]
- Author
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H, Takahashi, T, Tono, S, Tamagaki, A, Yasue, K, Okada, T, Kano, T, Iwazawa, S, Matsui, Y, Nakano, H, Yano, M, Kinuta, M, Matsushita, J, Okamura, and T, Monden
- Subjects
Male ,Liver Neoplasms ,Infusion Pumps, Implantable ,Middle Aged ,Survival Rate ,Hepatic Artery ,Stomach Neoplasms ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Infusions, Intra-Arterial ,Female ,Fluorouracil ,Cisplatin ,Aged - Abstract
We have performed intra-hepatic arterial chemotherapy for 9 patients with liver metastasis arising from gastric cancer. We mainly used 5-FU and CDDP as antineoplastic drugs.The median survival after gastrectomy was 600 days. Of 9 cases, 2 showed CR, 4 PR, 2 NC, 1 PD. The response rate was 67%. The 9 cases were classified into 2 groups. One group, the short-term survival group, concised of 5 patients that had no more than 2 years survival and the other, the long-term survival group, consisted 4 patients that had more than 2 years survival. We compared these 2 groups and found no difference in the primary lesions between the 2 groups. The patients in the long-term survival group had fewer and smaller metastatic lesions in the liver than the patients of the short-term survival group. The patients in the long-term survival group had no unresectable lesions except liver metastasis when gastrectomy was performed. However, 2 patients in the short term survival group had unresectable lymphatic involvement at the time gastrectomy was performed. Of 9 patients, 6 died from the extrahepatic lesion.The intra-arterial chemotherapy was effective and useful for liver metastasis arising from gastric cancer. However, the majority of patients died from extrahepatic lesions. We should therefore consider the use of systemic chemotherapy with intra-arterial chemotherapy.
- Published
- 2001
7. [Evaluation of chemosensitivity testing by CD-DST, and TS and DPD activity in cases of colorectal liver]
- Author
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T, Tono, H, Takahashi, T, Kanoh, Y, Nakano, S, Tamagaki, A, Yasue, K, Okada, S, Matsui, T, Iwazawa, H, Yano, M, Kinuta, J, Okamura, and T, Monden
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Survival Rate ,Liver Neoplasms ,Humans ,Thymidylate Synthase ,Drug Screening Assays, Antitumor ,Colorectal Neoplasms ,Oxidoreductases ,Dihydrouracil Dehydrogenase (NADP) - Abstract
We evaluated the usefulness of the following three in vitro assays in cases of resected colorectal liver metastases. Chemosensitivity by collagen gel droplet drug sensitivity test (CD-DST) was very low in all cases, suggesting this method is not predictive for this disease. In contrast, thymidylate synthetase (TS) activity and dihydropyrimidine dehydrogenase (DPD) activity in tumor tissue were high in many patients with recurrent disease. Thus, these enzyme activities are promising for assessment of clinical outcome following hepatic resection of colorectal liver metastases. Further analyses with large numbers of cases are needed to determine the significance of these in vitro studies.
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- 2001
8. [A case of hepatocellular carcinoma growing in bile duct: usefulness of enhanced power doppler ultrasonography]
- Author
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H, Takahashi, T, Tono, K, Okada, T, Hata, T, Iwazawa, M, Kinuta, J, Okamura, and T, Monden
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Male ,Carcinoma, Hepatocellular ,Bile Duct Neoplasms ,Liver Neoplasms ,Humans ,Neoplasm Invasiveness ,Ultrasonography, Doppler ,Image Enhancement ,Aged - Published
- 2001
9. [Malignant islet cell tumor of the pancreas with multiple liver metastases effectively treated by transcatheter arterial embolization with degradable starch microspheres--a case report]
- Author
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H, Takahashi, T, Tono, M, Matsushita, A, Yasue, K, Okada, T, Hata, T, Kano, T, Iwazawa, S, Matsui, Y, Nakano, H, Yano, M, Kinuta, J, Okamura, and T, Monden
- Subjects
Pancreatic Neoplasms ,Antineoplastic Combined Chemotherapy Protocols ,Liver Neoplasms ,Humans ,Carcinoma, Islet Cell ,Female ,Iodized Oil ,Starch ,Chemoembolization, Therapeutic ,Cisplatin ,Middle Aged ,Microspheres ,Epirubicin - Abstract
A 57-year-old woman underwent distal pancreatectomy for malignant islet cell tumor of the pancreas in 1991. One year later, multiple liver metastases appeared. Although three transcatheter arterial embolizations (TAE) with spongel and nine ethanol injections were performed over seven years, the tumors were growing gradually. Therefore, TAE with degradable starch microspheres (DSM) was selected. Under angiography, TAE of the left hepatic artery was done using 900 mg of DSM following injection of Farumorubicin (20 mg), Lipiodol (3 ml) and cisplatin (90 mg). The tumors in the embolized hepatic area were remarkably decreased in size, and satisfactory local control was obtained. Thereafter, TAE with DSM was carried out twice, and she is still living with outpatient treatment. Thus, it is suggested that TAE with DSM could be a promising, alternative therapeutic modality for liver metastases from malignant islet cell tumor of the pancreas.
- Published
- 2000
10. [Evaluation of hepatic resection following hepatic arterial infusion chemotherapy for colorectal liver metastases]
- Author
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T, Tono, H, Takahashi, Y, Nakano, M, Matsushita, H, Ohzato, M, Fukunaga, H, Watanabe, Y, Kanoh, A, Yasue, K, Okada, T, Hata, T, Iwazawa, S, Matsui, H, Yano, M, Kinuta, J, Okamura, and T, Monden
- Subjects
Male ,Mitomycin ,Liver Neoplasms ,Middle Aged ,Combined Modality Therapy ,Hepatic Artery ,Antineoplastic Combined Chemotherapy Protocols ,Hepatectomy ,Humans ,Infusions, Intra-Arterial ,Female ,Fluorouracil ,Cisplatin ,Colorectal Neoplasms ,Aged - Abstract
We evaluated the significance of hepatectomy following hepatic arterial infusion (HAI) chemotherapy for colorectal liver metastases. The prognosis of 4 cases with initially resectable tumors was discouraging, indicating no benefit of preoperative HAI for resectable tumors. The 2- and 3-year survival of patients who underwent hepatectomy after downstaging by HAI of originally unresectable metastases were 100% and 67%, respectively, suggesting that hepatectomy combined with HAI is a promising modality for those patients. However, it seems that the control of extrahepatic disease and decision making for the timing for surgical therapy are issues requiring improvement.
- Published
- 2000
11. Gene Transfection Using Particle Bombardment
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T. Iwazawa, T. Kitagawa, M. T. Lotze, and H. Tahara
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chemistry.chemical_compound ,Chemistry ,Naked DNA ,Somatic cell ,Electroporation ,Transfection ,Gene delivery ,Gene ,DNA ,Gene gun ,Cell biology - Abstract
A number of non-viral methods have been applied to transfer foreign genes into mammalian somatic tissues or organs using non-viral vectors. Among these techniques, particle-mediated gene transfer (PMT) or “gene gun” has been developed and promising results have been reported in the last few years. Other approaches include use of naked DNA injection (particlularly into muscle), protein coupled DNA to target cellular receptors, calcium phosphate transfection, electroporation and liposomal gene delivery. Depending in part on the cell type, PMT appears to be the most efficient of these techniques with transfection efficiencies of 1–15%. In this article, we summarize the characteristics of this approach, present our preliminary results and discuss possible future application of this gene transfer technology.
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- 1999
12. Effect of epidermal growth factor on cadherin-mediated adhesion in a human oesophageal cancer cell line
- Author
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H Shiozaki, T Kadowaki, Y Doki, M Inoue, S Tamura, H Oka, T Iwazawa, S Matsui, K Shimaya, M Takeichi, and T Mori
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Cancer Research ,Esophageal Neoplasms ,Lactams, Macrocyclic ,Fluorescent Antibody Technique ,Protein tyrosine phosphatase ,Biology ,Cell Line ,chemistry.chemical_compound ,Cell–cell interaction ,Epidermal growth factor ,Culture Techniques ,Benzoquinones ,Cell Adhesion ,Tumor Cells, Cultured ,Humans ,Neoplasm Invasiveness ,Phosphorylation ,Cell adhesion ,Phosphotyrosine ,Tumor Stem Cell Assay ,beta Catenin ,Cell Aggregation ,Epidermal Growth Factor ,Cell adhesion molecule ,Cadherin ,Quinones ,Tyrosine phosphorylation ,Fibroblasts ,Cadherins ,Cell biology ,Neoplasm Proteins ,ErbB Receptors ,Cytoskeletal Proteins ,Phenotype ,Oncology ,chemistry ,Rifabutin ,Cancer research ,Carcinoma, Squamous Cell ,Trans-Activators ,Tyrosine ,Vanadates ,Gels ,Protein Processing, Post-Translational ,alpha Catenin ,Signal Transduction ,Research Article - Abstract
Epidermal growth factor (EGF) mediates many pleiotrophic biological effects, one of which is alteration of cellular morphology. In the present study, we examine the possibility that this alteration in cell morphology is caused in part by the dysfunction of cadherin-mediated cell-cell adhesion using the human oesophageal cancer cell line TE-2R, which expresses E-cadherin and EGF receptor. In the presence of EGF, TE-2R changed its shape from round to fibroblastic and its colony formation from compact to sparse. Vanadate, a tyrosine phosphatase inhibitor, further potentiated the EGF response, whereas herbimycin A, a tyrosine kinase inhibitor, interfered with it. Moreover, EGF enabled the cells to invade in organotypic raft culture. These phenomena were accompanied not by decreased expression of the E-cadherin molecule but by a change in its localisation from the lateral adhesion site to the whole cell surface. Both alpha- and beta-catenin, cadherin-binding proteins, were also expressed at the same level throughout these morphological changes. Finally, we examined tyrosine phosphorylation of E-cadherin and alpha- and beta-catenin, and observed tyrosine phosphorylation of beta-catenin induced by EGF. These results suggest that EGF counteracts E-cadherin-mediated junctional assembly through phosphorylation of beta-catenin and modulates tumour cell behaviour to a more aggressive phenotype. Images Figure 1 Figure 2 p253-a Figure 3 Figure 4 Figure 6 Figure 7
- Published
- 1995
13. PP117-SUN TOTAL GASTRECTOMY INDUCES NOT ONLY BODY WEIGHT LOSS BUT SARCOPENIC CHANGES IN GASTRIC CANCER PATIENTS
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K. Kwanishi, M. Kitatada, T. Iwazawa, and J. Fujita
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medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,medicine.medical_treatment ,Medicine (miscellaneous) ,Cancer ,Critical Care and Intensive Care Medicine ,Body weight ,medicine.disease ,Gastroenterology ,Internal medicine ,medicine ,Gastrectomy ,business - Published
- 2012
14. Immunohistochemical evaluation of alpha-catenin expression in human gastric cancer
- Author
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S. Matsui, H. Shiozaki, M. Inoue, S. Tamura, Y. Doki, T. Kadowaki, T. Iwazawa, K. Shimaya, T. Mori, A. Nagafuchi, and S. Tsukita
- Subjects
Adult ,Pathology ,medicine.medical_specialty ,Alpha catenin ,Biology ,Pathology and Forensic Medicine ,Metastasis ,Stomach Neoplasms ,medicine ,Humans ,Neoplasm Invasiveness ,cardiovascular diseases ,Neoplasm Metastasis ,Molecular Biology ,Lymph node ,Aged ,Cadherin ,Stomach ,Cancer ,Cell Biology ,General Medicine ,Middle Aged ,medicine.disease ,Cadherins ,Immunohistochemistry ,Cytoskeletal Proteins ,medicine.anatomical_structure ,Adenocarcinoma ,alpha Catenin - Abstract
E-cadherin (E-cad) plays a major role in the maintenance of cell-cell adhesion in epithelial tissues, and impaired E-cad expression correlates with tumour invasion and metastasis. Alpha-catenin (alpha-cat), an undercoat protein of adherens junctions, binds to the cytoplasmic domain of E-cad and is essential for linking E-cad to actin-based cytoskeleton. We investigated E-cad and alpha-cat expression in 60 human gastric cancers immunohistochemically. The 60 gastric cancers were classified into 18 (30%) in which alpha-cat expression was preserved, and 42 (70%) reduced cases. The reduction of alpha-cat expression was significantly related to dedifferentiation, depth of invasion, infiltrative growth and lymph node metastasis. We also examined the co-expression of alpha-cat and E-cad. Seventeen (28%) tumours preserved both molecules [alpha-cat(+)/E-cad(+)] and 33 (55%) tumours reduced both [alpha-cat(-)/E-cad(-)], whereas 9 (15%) tumours exhibited alpha-cat(-)/E-cad(+). The frequency of lymph node metastasis in alpha-cat(-)/E-cad(+) tumour (67%) was significantly higher than that in alpha-cat(+)/E-cad(+) tumours (24%) and was close to that in alpha-cat(-)/E-cad(-) tumours (82%). The frequency of haematogenous liver metastasis in alpha-cat(-)/E-cad(+) tumours (44%) was significantly higher than that in alpha-cat(+)/E-cad(+) tumours (6%) or alpha-cat(-)/E-cad(-) tumours (9%). Thus, in all E-cad(+) tumours, the frequency of lymph node and liver metastasis was higher in alpha-cat(-) tumours than in alpha-cat(+) tumours. alpha-Cat expression is apparently better at predicting tumour invasion and metastasis than E-cad expression.
- Published
- 1994
15. E-cadherin and alpha-catenin expression in human esophageal cancer
- Author
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T, Kadowaki, H, Shiozaki, M, Inoue, S, Tamura, H, Oka, Y, Doki, K, Iihara, S, Matsui, T, Iwazawa, and A, Nagafuchi
- Subjects
Adult ,Aged, 80 and over ,Male ,Esophageal Neoplasms ,Immunoblotting ,Middle Aged ,Cadherins ,Cytoskeletal Proteins ,Lymphatic Metastasis ,Carcinoma, Squamous Cell ,Humans ,Female ,alpha Catenin ,Aged - Abstract
Intercellular adhesion of the epithelial tissue is mainly regulated by the E-cadherin (E-cad) molecule. alpha-Catenin (alpha-cat) is one of the E-cad-associated cytoplasmic proteins that forms a linkage to the cytoskeleton and regulates E-cad function. To investigate the mechanism of dysfunction in cell-cell adhesion in cancerous tissues, we examined E-cad and alpha-cat expression by immunohistochemical staining on 46 human esophageal cancers using our specific monoclonal antibodies. By grading of E-cad and alpha-cat expression as uniformly positive (+), heterogeneous (+/-), or uniformly negative (-), the 46 tumors could be classified into 9 (20%) E-cad(+)/alpha-cat(+), 15 (33%) E-cad(+/-)/alpha-cat(+/-), 21 (46%) E-cad(+/-)/alpha-cat(-), and 1 (2%) E-cad(-)/alpha-cat(-). Twenty-five (54%) of the 46 tumors showed a similar expression of both molecules, while the other 21 tumors (46%) showed E-cad(+/-)/alpha-cat(-). Thus, although the expression of alpha-cat was significantly correlated with that of E-cad, in some tumors the reduction of alpha-cat was greater. Regarding the clinicopathological features, the reduction of alpha-cat expression, as well as that of E-cad, was significantly associated with tumor dedifferentiation, infiltrative growth, and lymph node metastasis (P0.01). Furthermore, the frequency of lymph node metastasis in E-cad(+/-)/alpha-cat(-) tumors was significantly higher (90%) than in E-cad(+)/alpha-cat(+) tumors (22%) (P0.01) or in E-cad(+/-)/alpha-cat(+/-) tumors (47%) (P0.05). These results suggest that not only E-cad but also alpha-cat are important regulators of intercellular adhesion and that alpha-cat is also involved in invasion and metastasis. In particular, reduction of alpha-cat expression is more correlated with invasive phenotype and lymph node metastasis than E-cad expression in human esophageal cancer.
- Published
- 1994
16. [Postoperative brain metastasis from esophageal carcinomas: report of 4 cases]
- Author
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T, Kaneko, M, Hirao, M, Shimada, T, Takayama, T, Iwazawa, K, Murata, M, Inoue, T, Terashima, S, Mizunoya, and K, Okagawa
- Subjects
Aged, 80 and over ,Male ,Esophageal Neoplasms ,Brain Neoplasms ,Humans ,Middle Aged ,Neoplastic Cells, Circulating ,Aged - Abstract
Out of 83 cases received resection of primary esophageal lesion, 4 patients were affected by metastatic brain tumor which was reported to rarely occur. All 4 patients had symptoms of central nervous system. Three of them were diagnosed by CT and the other one at autopsy. All of the primary esophageal tumors were advanced and of histological stage III or IV. They located in the middle or lower thoracic esophagus. Brain tumor of one case was removed and this case was of progression free at the last presentation. The other 3 cases were not received resection of metastatic brain tumors and died. All of 3 were autopsied and two of them had no metastasis in the lung. Therefore, it was considered that these hematogenic metastases were not through lung filtrations but through other routes, which Batson O. V. experimentally proved and designated as vertebral vein system in 1940. It is concluded that aggressive surgical intervention to metastatic brain tumors was beneficial with regard to prognosis for cases without other metastatic lesions.
- Published
- 1991
17. Intra-arterial infusion of fluorouracil as adjuvant chemotherapy by using removable catheters with shape-memory alloy following curative hepatectomy of metastatic colorectal carcinoma
- Author
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Tadashi Ohnishi, T. Monden, Yoshiaki Nakano, H. Yano, Yutaka Kimura, T. Kanoh, Takeshi Tono, T. Iwazawa, and Masaki Matsushita
- Subjects
Cancer Research ,Chemotherapy ,medicine.medical_specialty ,Colorectal cancer ,Adjuvant chemotherapy ,business.industry ,medicine.medical_treatment ,Intra arterial infusion ,medicine.disease ,Surgery ,Hepatic arterial infusion ,Oncology ,Fluorouracil ,medicine ,Hepatectomy ,business ,Adjuvant ,medicine.drug - Abstract
3721 Background: Although there are some reports that adjuvant hepatic arterial infusion (HAI) chemotherapy reduces the hepatic recurrence following curative resection of colorectal liver metastase...
- Published
- 2004
18. Diagnosis of lung cancer metastasis with CEA extracted from the dissected regional lymph nodes
- Author
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T Monden, T Iwazawa, T Kanoh, and S Matsui
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Pulmonary and Respiratory Medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Pathology ,business.industry ,medicine.disease ,Metastasis ,Internal medicine ,medicine ,Lymph ,Lung cancer ,business - Published
- 2000
19. Hand-Assisted Laparoscopic Splenectomy for Splenic Tumors.
- Author
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H. Yano, Y. Nakano, T. Tono, T. Ohnishi, T. Iwazawa, Y. Kimura, T. Kanoh, and T. Monden
- Subjects
LAPAROSCOPIC surgery ,SPLENECTOMY ,SPLEEN surgery ,TUMORS ,CANCER patients - Abstract
Background: The feasibility of hand-assisted laparoscopic splenectomy (HALS) for splenic tumors including benign or malignant neoplasms and the associated clinical outcome of the patients remain unclear. Methods: A total of 10 patients with splenic tumors undergoing HALS were retrospectively analyzed in this study. The intraoperative course, postoperative course, and postoperative recovery were evaluated. Results: Ten patients with splenic tumors consisted of 5 with benign tumors and 5 with malignant tumors. HALS was not converted to an open splenectomy in any of the patients. Mean operative time was 170 min (range 100310 min). Mean estimated blood loss was 105 g (range 10900 g). Mean splenic size and splenic weight was 13 cm and 478 g, respectively. Splenomegaly based on size or weight occurred in 50% of the patients. There were no intra- or postoperative complications. Postoperative chemotherapy was given to 4 patients with malignant tumors including metastatic carcinomas and malignant lymphomas. All the patients were alive at a mean follow-up of 26 months, ranging from 15 to 43 months after surgery. There was no port-site recurrence after surgery in our study. Mean time to first flatus, mean time to first walking, mean time to resumption of oral intake, mean length of hospital stay, and mean duration of epidural analgesia were 1.8, 1, 1.5, 10.8 and 3.1 days, respectively. The results were equal in terms of intra- and postoperative course to those seen with a standard laparoscopic splenectomy for 13 patients with idiopathic thrombocytopenic purpura. Conclusion: HALS may be a good indication for malignant tumors as well as benign tumors of the spleen.Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Published
- 2004
- Full Text
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20. [Malignant pericardial effusion after esophageal cancer surgery successfully treated by intrapericardial instillation of CDDP]
- Author
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K, Murata, T, Iwazawa, Y, Doki, M, Inoue, T, Kaneko, T, Terashima, S, Mizunoya, and K, Okagawa
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Male ,Postoperative Complications ,Esophageal Neoplasms ,Carcinoma, Squamous Cell ,Drainage ,Humans ,Cisplatin ,Middle Aged ,Combined Modality Therapy ,Pericardial Effusion ,Cardiac Tamponade - Abstract
The patient is a 63-year-old male with pericardial effusion who fell into cardiac tamponade one year and eight months following radical operation for esophageal cancer (stage IV). Because the cytological diagnosis for the punctured specimen of pericardial effusion indicated class V, we recognized it as pericardial recurrence and instilled CDDP 20 mg and 25 mg into the pericardial cavity. The pericardial effusion disappeared completely. There are many reports of CDDP instillation into the pleural cavity or the peritoneal cavity, but few into the pericardial cavity. For esophageal cancer, this is the first report in Japan. The patient is still alive at present after fourteen months have passed. It is considered that this method is effective for malignant pericardial effusion due to advanced esophageal cancer.
- Published
- 1989
21. [Clinical application of a lysozyme, Leftose, in chronic sinusitis]
- Author
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T, Iwazawa
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Adult ,Male ,Adolescent ,Chronic Disease ,Humans ,Female ,Muramidase ,Sinusitis ,Child - Published
- 1967
22. [Fundamental and clinical studies on Minocycline Syrup against otorhinolaryngological infections]
- Author
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T, Iwazawa
- Subjects
Male ,Adolescent ,Furunculosis ,Infant ,Minocycline ,Microbial Sensitivity Tests ,Staphylococcal Infections ,Tetracycline ,Pneumococcal Infections ,Otitis Media ,Otorhinolaryngologic Diseases ,Tonsillitis ,Child, Preschool ,Streptococcal Infections ,Humans ,Female ,Child - Published
- 1973
23. CD98 heavy chain protein is overexpressed in non-small cell lung cancer and is a potential target for CAR T-cell therapy.
- Author
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Yaga M, Hasegawa K, Ikeda S, Matsubara M, Hiroshima T, Kimura T, Shirai Y, Tansri W, Uehara H, Tachikawa M, Okairi Y, Sone M, Mori H, Kogue Y, Akamine H, Okuzaki D, Kawagishi K, Kawanaka S, Yamato H, Takeuchi Y, Okura E, Kanzaki R, Okami J, Nakamichi I, Nakane S, Kobayashi A, Iwazawa T, Tokunaga T, Yokouchi H, Yano Y, Uchida J, Mori M, Komuta K, Tachi T, Kuroda H, Kijima N, Kishima H, Ichii M, Futami S, Naito Y, Shiroyama T, Miyake K, Koyama S, Hirata H, Takeda Y, Funaki S, Shintani Y, Kumanogoh A, and Hosen N
- Subjects
- Animals, Female, Humans, Mice, Antibodies, Monoclonal immunology, Cell Line, Tumor, Fusion Regulatory Protein 1, Heavy Chain metabolism, Receptors, Chimeric Antigen metabolism, Receptors, Chimeric Antigen immunology, T-Lymphocytes immunology, T-Lymphocytes metabolism, Xenograft Model Antitumor Assays, Carcinoma, Non-Small-Cell Lung therapy, Carcinoma, Non-Small-Cell Lung immunology, Carcinoma, Non-Small-Cell Lung metabolism, Carcinoma, Non-Small-Cell Lung pathology, Immunotherapy, Adoptive methods, Lung Neoplasms therapy, Lung Neoplasms immunology, Lung Neoplasms metabolism, Lung Neoplasms pathology
- Abstract
Chimeric antigen receptor (CAR) T cells are effective against hematological cancers, but are less effective against solid tumors such as non-small cell lung cancer (NSCLC). One of the reasons is that only a few cell surface targets specific for NSCLC cells have been identified. Here, we report that CD98 heavy chain (hc) protein is overexpressed on the surface of NSCLC cells and is a potential target for CAR T cells against NSCLC. Screening of over 10,000 mAb clones raised against NSCLC cell lines showed that mAb H2A011 bound to NSCLC cells but not normal lung epithelial cells. H2A011 recognized CD98hc. Although CAR T cells derived from H2A011 could not be established presumably due to the high level of H2A011 reactivity in activated T cells, those derived from the anti-CD98hc mAb R8H283, which had been shown to lack reactivity with CD98hc glycoforms expressed on normal hematopoietic cells and some normal tissues, were successfully developed. R8H283 specifically reacted with NSCLC cells in six of 15 patients. R8H283-derived CAR T cells exerted significant anti-tumor effects in a xenograft NSCLC model in vivo. These results suggest that R8H283 CAR T cells may become a new therapeutic tool for NSCLC, although careful testing for off-tumor reactivity should be performed in the future., (© 2024. The Author(s).)
- Published
- 2024
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24. [Questionnaire Survey on Oral Care and Oral Troubles for Patients with Gastric Cancer Received Chemotherapy].
- Author
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Kawase T, Imamura H, Yanagimoto Y, Odagiri K, Suzuki Y, Takeyama H, Yamashita M, Sato Y, Kobayashi A, Ikenaga M, Shimizu J, Akagi K, Iwazawa T, Tomita N, and Dono K
- Subjects
- Humans, Aged, Dysgeusia etiology, Surveys and Questionnaires, Stomach Neoplasms drug therapy, Stomach Neoplasms complications, Stomatitis etiology, Xerostomia complications
- Abstract
Background: The actual situation of oral care and oral troubles for patients with gastric cancer received chemotherapy is not clear., Methods: Questionnaire survey in the form of oral questions was performed for patients with gastric cancer who received chemotherapy from December 2021 to February 2022. The relevance between the survey results and background factors was examined using the χ2 test., Results: We performed the questionnaire survey for 36 patients. Of the 36 patients, 29 patients received dental check-up before starting chemotherapy. Fourteen of the 29 patients(48%)continued the dental check-up. Of 14 patients who continued the dental check-up, 9 patients were 65 years or older, while 14 of 15 patients who discontinued the dental check-up were 65 years or older. Continuity of dental check-up was low among the elderly patients. The rate of dysgeusia were 78 vs 30% in the patients who adopted and who did not adopt oral care other than toothbrushing(p=0.01). The frequency of oral troubles was dysgeusia(47%), stomatitis(42%), and dry mouth(36%). The severity of the oral troubles was, in order, dysgeusia, dry mouth, and pain. The most common side effect due to chemotherapy causing decreased food intake was dysgeusia., Conclusions: Dysgeusia was the most frequent and severe oral trouble.
- Published
- 2024
25. [Regimen Selection by Narrative Approach in Patients with Advanced Gastric Cancer-Paclitaxel or Nab-Paclitaxel?]
- Author
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Kawase T, Imamura H, Yanagimoto Y, Odagiri K, Suzuki Y, Takeyama H, Yamashita M, Sato Y, Kobayashi A, Ikenaga M, Shimizu J, Akagi K, Iwazawa T, Tomita N, and Dono K
- Subjects
- Male, Female, Humans, Aged, Paclitaxel, Albumins, Comorbidity, Stomach Neoplasms drug therapy
- Abstract
Background: According to the sixth Gastric Cancer Treatment Guideline, the regimen included nab-paclitaxel(nab-PTX) is a conditional recommendation as second-line treatment for advanced gastric cancer. However, the selection criteria of nab-PTX is not clear., Method: Questionnaire survey as narrative approach on the problems of paclitaxel premedication, the symptoms due to paclitaxel containing alcohol, and infusion time was conducted for patients who had been treated with paclitaxel., Results: Thirty-six patients answered the questionnaire. Nonelderly patients(<65 years)or patients without comorbid medications complained of dissatisfaction with the inconvenience due to premedication significantly more than elderly patients(≥65 years)or patients with comorbid medications. Females or nonelderly patients were significantly more troubled by sleepiness due to premedication than males or elderly patients. Eight out of 11 patients who had visited hospital by driving a car for first-line treatment were troubled by prohibition of driving on the day of treatment. Thirty out of 36 patients answered that they would feel benefits from 30-minutes shortening of infusion time., Conclusion: Questionnaire survey suggests that we may select the patients for nab-PTX properly by clarifying the inconvenience of daily life associated with premedication, the way of transportation for visiting hospital, and the benefits by shortening of infusion time.
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- 2024
26. [A Case of Fibromatosis-Like Tumor Which Was Difficult to Differentiate from Local Recurrence of Ascending Colon Cancer].
- Author
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Suzuki Y, Ikenaga M, Sato Y, Odagiri K, Yanagimoto Y, Yamashita M, Takeyama H, Kobayashi A, Shimizu J, Kawase T, Akagi K, Iwazawa T, Tamura H, Adachi S, and Imamura H
- Subjects
- Female, Humans, Colon, Ascending surgery, Anastomosis, Surgical, Combined Modality Therapy, Colonic Neoplasms surgery, Fibroma diagnostic imaging, Fibroma surgery
- Abstract
A 60s female, who had undergone single-incision laparoscopic ileocecal resection for ascending colon cancer with pathological diagnosis of T3N1bM0, Stage Ⅲb, followed by adjuvant therapy with 8 courses CAPOX 2 years ago, had enhanced- computed tomography(CT)for follow-up and a 15-mm nodule near anastomotic site was found. 18F-fluorodeoxyglucose (FDG)-positron emission tomography(PET)CT revealed abnormal accumulation of 18F-FDG only to the lesion and diagnosis of"anastomotic recurrence"was made. We planned and safely performed resection of the anastomotic site and the nodule. The pathological diagnosis was fibromatosis-like tumor without evidence of recurrence, and margin was negative. Postoperative course was smooth and she was discharged on postoperative day 9. When we diagnose local recurrence, we need to keep it in mind that fibromatosis is one of the differential diagnoses, although its incidence rate is low.
- Published
- 2024
27. [A Case of Diffuse Large B-Cell Lymphoma Which Was Diagnosed during the Best Supportive Care of Recurrent Ascending Colon Cancer].
- Author
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Suzuki Y, Ikenaga M, Sato Y, Odagiri K, Yanagimoto Y, Yamashita M, Takeyama H, Kobayashi A, Shimizu J, Kawase T, Akagi K, Iwazawa T, Tamura H, Adachi S, and Imamura H
- Subjects
- Male, Humans, Colon, Ascending surgery, Neoplasm Recurrence, Local, Ileal Neoplasms, Colonic Neoplasms drug therapy, Colonic Neoplasms surgery, Lymphoma, Large B-Cell, Diffuse drug therapy, Lymphoma, Large B-Cell, Diffuse surgery
- Abstract
A 70s male, who had undergone single-incision laparoscopic ileocecal resection for ascending colon cancer with pathological diagnosis of T3N3M0, Stage Ⅲc(without adjuvant chemotherapy), had enhanced-computed tomography(CT)for 3-month follow-up and a hepatic low-density area, an newly emergent nodule behind inferior vena cava and distal ileal tumor were found. Three months later, enhanced CT showed that the distal ileal tumor got exponentially larger and the diagnosis of"malignant lymphoma"was suspected. The patient became sepsis, so we planned and safely performed partial resection of the tumor. The pathological diagnosis was diffuse large B-cell lymphoma. Postoperative course was smooth except for the Clostridium difficile colitis and he was discharged on postoperative day 19. Although the regrowth of the remnant tumor was observed soon after surgery, partial response was confirmed after introduction of systemic chemotherapy. When we cope with malignant lymphoma of small intestine, we need to keep it in mind that surgery is an option for the prevention of perforation and bacterial translocation.
- Published
- 2024
28. [A Case of 30s Female with Advanced Anal Canal Adenocarcinoma Managed with Adolescent-And-Young-Adult Team].
- Author
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Suzuki Y, Ikenaga M, Sato Y, Odagiri K, Yanagimoto Y, Yamashita M, Takeyama H, Kobayashi A, Noura S, Shimizu J, Kawase T, Akagi K, Iwazawa T, Tomita N, and Imamura H
- Subjects
- Female, Humans, Adolescent, Adult, Anal Canal, Pelvis, Fluorodeoxyglucose F18, Adenocarcinoma surgery, Anus Neoplasms surgery
- Abstract
A 30s female complaining of anal pain and melena was referred to our hospital. The support by adolescent-and-young- adult(AYA)team was initiated after the first encounter. Colonoscopic examination revealed an ulcerated tumor on the anterior wall of anal canal with its anal margin on anal verge and the tumor was diagnosed as an adenocarcinoma. Contrast- enhanced CT and MRI revealed adjacency of tumor and vagina, enlarged lymph nodes and multiple pulmonary nodules. 18F-fluorodeoxyglucose(FDG)-positron emission tomography(PET)additionally revealed tracer accumulation in left sciatica, which led us to the diagnosis of advanced anal cancer. We planned and safely performed concomitant partial vaginal resection in robot-assisted laparoscopic abdominoperineal resection for the palliative purpose after discussion on physical and psychosocial issues including stoma and fertility with the patient, her family and AYA members. The pathological diagnosis was pT4b(vagina)N1aM1b, pStage ⅣB, and the local margin was pathologically negative. The postoperative course was smooth and she was discharged on postoperative day 16. Fifty one days after operation, she started systemic chemotherapy after decision on not to take ovarian samples and continues systemic chemotherapy as of writing. Support by AYA team was effective to facilitate the patient's decision-making and the communication between the patient and the medical team.
- Published
- 2024
29. Robot-assisted laparoscopic surgery with a fluorescent near-infrared ray ureteral catheter for a rectal cancer patient with pelvic kidney: A case report.
- Author
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Hasegawa N, Takeyama H, Suzuki Y, Noura S, Ikenaga M, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Iwazawa T, Tomita N, and Dono K
- Subjects
- Female, Humans, Aged, 80 and over, Rectum, Infrared Rays, Urinary Catheters, Kidney, Robotic Surgical Procedures, Robotics, Laparoscopy methods, Rectal Neoplasms complications, Rectal Neoplasms surgery, Rectal Neoplasms pathology, Ureter diagnostic imaging, Ureter surgery, Situs Inversus surgery
- Abstract
An 85-year-old woman presented with a stomachache after a meal and was admitted to the previous clinic. Multi-detector computed tomography (CT) of the abdomen showed wall thickening in the rectum and right ectopic pelvic kidney. Colonoscopy revealed a mass at the rectum, and a biopsy showed adenocarcinoma. CT showed no lymphadenopathy or distant metastasis. Hartmann's procedure with fluorescent near-infrared ray ureteral catheters was used to avoid causing urinary injury. Robotic surgery was performed while checking the route of the ureter in near-infrared mode. The patient was discharged on postoperative day 14 without specific complications. This case appears to be the first of robot-assisted laparoscopic surgery for a rectal cancer patient with pelvic kidney., (© 2022 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)
- Published
- 2023
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30. [A Case of Peritoneal Recurrence from Ascending Colon Cancer Successfully Treated with Laparoscopic Concomitant Right Seminal Vesiculectomy in Low Anterior Resection].
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Suzuki Y, Ikenaga M, Takeyama H, Noura S, Sato Y, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Akagi K, Iwazawa T, Tomita N, and Dono K
- Subjects
- Humans, Male, Colon, Ascending pathology, Fluorodeoxyglucose F18, Peritoneal Neoplasms surgery, Colonic Neoplasms surgery, Colonic Neoplasms pathology, Laparoscopy
- Abstract
A 60s male, who had laparoscopic ileocecal resection for ascending colon cancer 2 years ago, had enhanced computed tomography(CT)for follow-up and a 12-mm nodule in Douglas' pouch adjacent to right seminal vesicle and rectum was found. 18F-fluorodeoxyglucose(FDG)-positron emission tomography CT revealed abnormal accumulation of 18F-FDG only to the lesion(standardized uptake value max 2.60)and the diagnosis of peritoneal recurrence of ascending colon cancer was made. We planned and safely performed laparoscopic concomitant right seminal vesiculectomy in low anterior resection. The pathological diagnosis was peritoneal dissemination of colon cancer and the margin was pathologically negative. The postoperative course was smooth except for temporary dysuria and he was discharged on postoperative day 17. As of writing 1 year after surgery, the patient continues to do well with no sign of recurrence. Laparoscopic concomitant seminal vesiculectomy in low anterior resection can be a good option for the curative resection of peritoneal recurrence.
- Published
- 2022
31. Higher Body Mass Index Is a Simple Favorable Non-cancer Prognostic Marker for Japanese Elderly Colorectal Cancer Patients after Curative Resection.
- Author
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Takeyama H, Noura S, Suzuki Y, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Iwazawa T, Tomita N, and Dono K
- Abstract
Objectives: In elderly colorectal cancer (CRC) patients, preoperative surgical indications can be controversial in some cases depending on the patient's physical condition. In comparison with younger patients, both cancer-specific survival (CSS) and non-CCS (NCSS) have an impact on the prognosis and both CSS and NCSS should be considered in the preoperative assessment. We aimed to investigate the impact of body mass index (BMI) on CSS and NCSS in Japanese elderly CRC patients., Methods: We retrospectively collected data from 471 Japanese elderly patients (≥80 years) with stage I-III CRC who underwent curative surgery from 1998 to 2017. A Kaplan-Meier survival analysis with propensity score matching (PSM) and a multivariate Cox regression analysis were performed., Results: After PSM, 123 higher BMI (≥23) and 123 lower BMI (<23) cases were matched. The higher BMI group had significantly better survival than the lower BMI group regarding NCSS and overall survival (OS; P < .001 and P < .001, respectively). The multivariate survival analysis further confirmed that the higher BMI group had significantly better survival than the lower BMI group regarding CSS, NCSS, and OS ( P = .027, P < .001, and P < .001, respectively)., Conclusions: In Japanese elderly patients with stage I-III CRC who underwent curative surgery, preoperative higher BMI was a significant and simple favorable prognostic predictor, especially for NCSS and OS., Competing Interests: Conflicts of Interest There are no conflicts of interest., (Copyright © 2022 by The Japan Society of Coloproctology.)
- Published
- 2022
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32. Efficacy of pleural coverage with polyglycolic acid sheet after bullectomy for postoperative recurrence of spontaneous pneumothorax in young patients: a multi-institutional cohort study.
- Author
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Iwazawa T, Kadota Y, Takeuchi Y, Yokouchi H, Shiono H, Hayakawa M, Sakamaki Y, Kurokawa E, Nishioka K, and Shintani Y
- Subjects
- Adolescent, Adult, Cohort Studies, Humans, Pleura surgery, Polyglycolic Acid, Recurrence, Retrospective Studies, Thoracic Surgery, Video-Assisted, Treatment Outcome, Young Adult, Pneumothorax etiology, Pneumothorax prevention & control, Pneumothorax surgery
- Abstract
Objective: Various surgical procedures have been performed to decrease the recurrence of primary spontaneous pneumothorax after video-assisted thoracic surgery. This study aimed to examine the efficiency of pleural coverage for the prevention of postoperative recurrence in relatively young patients., Methods: Between January 2008 and December 2012, a total of 357 cases of 345 patients (age 15-29 years) with primary spontaneous pneumothorax who underwent bullectomy at 13 institutions were enrolled in this multi-institutional retrospective cohort study. A concurrent bilateral operation was counted as two cases. Polyglycolic acid sheets were used in 238 cases, and oxidized regenerated cellulose sheets were used in 37 cases to cover the visceral pleura, with no pleural coverage in 82 cases. The average observation period was 4.2 ± 2.0 years., Results: Postoperative recurrence was observed in 50 cases (14.0%) after video-assisted thoracic surgery. Twenty-six cases (10.9%) in the polyglycolic acid group, eight (21.6%) in the oxidized regenerated cellulose group, and sixteen (19.5%) in the non-coverage group experienced postoperative recurrence. Kaplan-Meier analysis revealed that the rate of freedom from postoperative recurrence in the polyglycolic acid group was significantly higher than that in the non-coverage group. Multivariate analysis showed that age ≥ 20 years and coverage with polyglycolic acid sheets were associated with reduced risk factors for postoperative recurrence., Conclusion: Pleural coverage with a polyglycolic acid sheet is suggested to be effective in preventing postoperative recurrence of pneumothorax compared with non-coverage in relatively young patients., (© 2021. The Japanese Association for Thoracic Surgery.)
- Published
- 2021
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33. Left paraduodenal hernia treated by single-incision laparoscopic surgery: a case report.
- Author
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Hasegawa N, Takeyama H, Suzuki Y, Noura S, Odagiri K, Yanagimoto Y, Yamashita M, Shimizu J, Kawase T, Imamura H, Iwazawa T, Tomita N, and Dono K
- Abstract
Background: Paraduodenal hernia is a rare internal hernia which accounts for only 1% of all intestinal hernias. There have been limited reported cases of paraduodenal hernia treated by laparoscopic surgery. We report a case of left paraduodenal hernia that was successfully treated by single-incision laparoscopic surgery (SILS)., Case Presentation: A 17-year-old woman presented with left upper abdominal pain. An abdominal enhanced multi-detector computed tomography demonstrated encapsulated cluster of small bowel loops in the left upper quadrant which passed through the dorsal side of the inferior mesenteric vein, and showed that blood flow of the prolapsed small bowel was preserved. We preoperatively diagnosed left paraduodenal hernia without ischemia or necrosis. We performed elective SILS because she was a young actress training school student and cosmetic benefit was thought to be important. We pulled out the protruded small bowel and closed a defect with a running suture by SILS. The patient was discharged 3 days after the surgery with no complications., Conclusions: We reported the case of left paraduodenal hernia successfully diagnosed and treated by SILS., (© 2021. The Author(s).)
- Published
- 2021
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34. [A Case of Anastomotic Recurrent Descending Colon Cancer Successfully Treated with Single-Incision Laparoscopic Partial Colectomy with Intracorporeal Anastomosis].
- Author
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Suzuki Y, Tanida T, Noura S, Yanagimoto Y, Noguchi K, Hirota M, Oshima K, Shimizu J, Kawase T, Imamura H, Akagi K, Iwazawa T, and Dono K
- Subjects
- Anastomosis, Surgical, Colectomy, Colon surgery, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Colon, Descending, Laparoscopy
- Abstract
A 60s-year-old male, who had laparoscopic partial colectomy with resection of left colic artery for descending colon cancer 8 years ago and completed 5-year-follow-up without the evidence of recurrence, was diagnosed as anastomotic recurrence of descending colon cancer, and referred to our hospital. We planned and safely performed single-incision laparoscopic colectomy(SILC)with intracorporeal anastomosis(ICA)(operation time of 390 min and estimated blood loss of 60 g). Following the adhesiolysis, the intracorporeal resection of the lesion was performed with automatic stapling device preserving middle colic and inferior mesenteric arteries and veins. Then, after the recovery of the specimen, ICA was performed as follows; after making a small hole just below the staple line at the opposite side of mesenteric attachment, the oral and the anal stump of colon was pulled-up and placed side-by-side with temporary strings and automatic suturing device was inserted into the holes and fired to form a side-to-side anastomosis, then the common stab incision was pulled- up with 3 temporary strings and closed with a stapler. The postoperative course was smooth and discharged on postoperative day 8. The ICA can be a good option for SILC when colonic and vascular tension would be the limiting factor of anastomosis.
- Published
- 2021
35. [A Case of Locally Advanced Rectal Cancer with Multiple Liver Metastases Could Be Resected after Triplet Chemotherapy].
- Author
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Tanida T, Noura S, Yanagimoto Y, Noguchi K, Hirota M, Oshima K, Shimizu J, Kawase T, Imamura H, Akagi K, Iwazawa T, and Dono K
- Subjects
- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bevacizumab therapeutic use, Humans, Male, Rectum, Liver Neoplasms drug therapy, Liver Neoplasms surgery, Rectal Neoplasms drug therapy, Rectal Neoplasms surgery
- Abstract
The patient was a 60's man, whose chief complaints were melena and weight loss. He visited our hospital, and further evaluation revealed rectal cancer(Ra)invading the abdominal wall with multiple liver metastases. The clinical diagnosis was cT4b(abdominal wall)N2bM1a(H1), cStage Ⅳ. We performed a transverse colostomy on the day prior to chemotherapy administration. He was administered 8 courses of FOLFOXIRI plus bevacizumab. After the chemotherapy, the primary tumor and liver metastases showed PR, with a diagnosis of ycT3N1bM1a(H1), Stage Ⅳ. We performed a robot-assisted laparoscopic low anterior resection for the primary tumor. Two months later, the partial resection of liver S6 and S8 was performed. The patient has been cancer-free for 6 months now.
- Published
- 2021
36. Surgical Outcome of Laparoscopic Cholecystectomy in Patients With a History of Gastrectomy.
- Author
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Harino T, Tomimaru Y, Yokota Y, Noguchi K, Shimizu J, Taguchi T, Yanagimoto Y, Suzuki Y, Hirota M, Tanida T, Noura S, Imamura H, Iwazawa T, and Dono K
- Subjects
- Aged, Female, Gastroenterostomy, Humans, Male, Retrospective Studies, Treatment Outcome, Cholecystectomy, Laparoscopic, Gastrectomy
- Abstract
Background: Although laparoscopic cholecystectomy (LC) has been applied to patients with a history of abdominal surgery, we lack data on the surgical outcome of LC in patients with a history of gastrectomy. Here, we assessed the outcomes of LC and investigated predictive factors for conversion from laparoscopic to open surgery in patients with a gastrectomy history., Patients and Methods: We retrospectively compared the surgical outcomes of LC between patients with and without a history of gastrectomy. We performed multivariate regressions to identify independent predictive factors for open conversion during an LC., Results: Among 2235 patients who underwent LCs, 39 (1.7%) had undergone a previous gastrectomy (29 men, 10 women; mean age, 72 y; 34 with distal gastrectomy and 5 with total gastrectomy). The operation time, intraoperative bleeding, postoperative hospital stays, and conversion rate were significantly worse in patients with, compared with those without the history of gastrectomy. Conversion during an LC in the cases with a history of gastrectomy was significantly correlated with age and the type of gastrectomy., Conclusions: These results suggested that LC in patients with a history of gastrectomy exhibited worse outcomes in terms of operation time, intraoperative bleeding, postoperative hospital stay, and conversion rate than those without it. Furthermore, it was also implied that age and the type of gastrectomy were significant predictive factors for conversion during an LC in patients with a history of gastrectomy., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2020
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37. Significance of fistulography findings to the healing time of postoperative pancreatic fistula after pancreaticoduodenectomy.
- Author
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Tomimaru Y, Tanaka K, Noguchi K, Noura SO, Imamura H, Iwazawa T, and Dono K
- Subjects
- Aged, Drainage methods, Female, Humans, Male, Middle Aged, Time Factors, Pancreatic Fistula diagnosis, Pancreatic Fistula physiopathology, Pancreaticoduodenectomy, Postoperative Complications diagnosis, Radiography methods, Wound Healing
- Abstract
Purpose: Pancreatic fistula (PF) is a common and serious complications after pancreaticoduodenectomy (PD). However, few studies have discussed the time required for PF healing in patients with this complication. This study investigates the PF healing time (PF-HT) and its association with findings of postoperative fistulography performed via the drainage tubes., Methods: The subjects of this study were 35 patients with PF among a total of 144 patients who underwent PD for periampullary diseases in our hospital. PF-HT, which was defined as the duration from the first postoperative fistulography to removal of the drainage tubes, was assessed in the enrolled patients. Fistulography findings were classified into four types based on fluid collection and communication with the jejunal loop. We investigated the factors affecting the PF-HT, including the fistulography findings., Results: The average PF-HT was 22 ± 20 days. Multivariate analysis revealed that the fistulography type was the only independent factor that affected PF-HT significantly. The PF-HT was significantly shorter in patients without fluid collection than in those with fluid collection. Moreover, those patients with fluid collection and a communication had a significantly shorter PF-HT than those without a communication., Conclusions: We found that fistulography findings were significantly associated with the PF-HT. This suggests that fistulography findings could help to predict the time needed for PF healing.
- Published
- 2020
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38. Lung Cancer Surgery for Patients on Hemodialysis: A Decade of Experience at Multicenter Institutions.
- Author
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Yamamoto Y, Kanzaki R, Ose N, Funakoshi Y, Ikeda N, Takami K, Iwasaki T, Iwazawa T, Yokouchi H, Shiono H, Kodama K, and Shintani Y
- Subjects
- Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Japan epidemiology, Kidney Failure, Chronic complications, Lung Neoplasms complications, Lung Neoplasms mortality, Male, Middle Aged, Morbidity trends, Retrospective Studies, Risk Factors, Survival Rate trends, Thoracic Surgery, Video-Assisted methods, Time Factors, Treatment Outcome, Kidney Failure, Chronic therapy, Lung Neoplasms surgery, Pneumonectomy methods, Postoperative Complications epidemiology, Renal Dialysis, Risk Assessment methods
- Abstract
Background: The clinical outcome of patients undergoing hemodialysis (HD) has not yet been clarified in lung cancer surgery. The aims of this study were to assess the clinical features, outcomes, and main cause of death after lung cancer surgery in patients undergoing HD and to evaluate the risk factors for postoperative complications., Methods: The study identified 39 patients undergoing HD who had lung cancer surgery in 9 institutions under the Thoracic Surgery Study Group of Osaka University in Japan between 2007 and 2016. Study investigators retrospectively analyzed the surgical outcomes of these patients., Results: Most patients were male and were smokers. Diabetes mellitus was the most common cause of primary renal disease. Lobectomy with systemic lymph node dissection was performed in 16 patients, and an extended operation was performed in 6 patients. Most patients had a diagnosis of pathologic stage IA (69.2%) lung cancer. The overall complication and mortality rates were 30.8% and 7.7%, respectively. Pneumonia was the most frequently observed complication. Extended operation was significantly associated with complications (P = .04). The 5-year overall survival rate was 57.9%, and the most common cause of death was not primary lung cancer but was a disease related to HD., Conclusions: Lung cancer surgery for patients undergoing HD provides favorable long-term outcomes despite higher postoperative mortality and morbidity rates. Because an extended operation is significantly associated with postoperative complications, thoracic surgeons should carefully select the type of resection on the basis of a balance between therapeutic benefit and invasiveness in these patients., (Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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39. [Long-Term Survival in a Case of Colon Cancer with Peritoneal Dissemination and Ovarian Metastasis after Multimodality Therapy].
- Author
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Tanida T, Noura S, Ogino T, Nagase H, Noguchi K, Hirota M, Oshima K, Tomimaru Y, Kawase T, Imamura H, Akagi K, Iwazawa T, and Dono K
- Subjects
- Aged, Antineoplastic Combined Chemotherapy Protocols, Female, Humans, Neoplasm Recurrence, Local, Peritoneal Neoplasms secondary, Positron Emission Tomography Computed Tomography, Colonic Neoplasms therapy, Ovarian Neoplasms secondary, Ovarian Neoplasms therapy, Peritoneal Neoplasms therapy
- Abstract
A 70-year-old woman underwent treatment for cecal cancer(pT4bN1M0, Stage Ⅲb)in 2010. Four years and 2 months after the first surgery, she underwent ileum resection for stenosis due to perineal dissemination(P3). Two years after this recurrence, during which time she had completed 26 courses of FOLFIRI plus bevacizumab(Bmab), 9 courses of capecitabine plus oxaliplatin(CapeOX)plus Bmab, and 3 courses of Cape, no peritoneal dissemination was detected by computed tomography( CT). Thereafter, an additional 19 courses of Cape plus Bmab were introduced, but CEA continued to increase. Right ovarian metastasis was suspected based on CT and FDG-PET/CT examination. Four years and 1 month after the initial recurrence of perineal dissemination, the patient underwent bilateral ovarian resection, during which the lack of peritoneal dissemination was confirmed. Pathologically, right ovarian metastasis was diagnosed. The patient is still alive 4 years and 6 months after the first operation.
- Published
- 2020
40. [A Resected Case of Hemorrhagic Hepatic Cyst Difficult to Differentiate from Mucinous Cystic Neoplasm of the Liver].
- Author
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Park SA, Tomimaru Y, Noguchi K, Nagase H, Ogino T, Hirota M, Oshima K, Tanida T, Noura S, Kawase T, Imamura H, Akagi K, Iwazawa T, and Dono K
- Subjects
- Aged, Female, Humans, Cysts complications, Cysts diagnosis, Diagnosis, Differential, Hemorrhage etiology, Liver Neoplasms diagnosis
- Abstract
Case: A 77-year-old woman was referred to our hospital for detailed examination of a cystic liver tumor. Contrast-enhanced CT and MRIshowed a cystic liver tumor with an enhanced mural nodule in S6 of the liver. Under a preoperative diagnosis of hemorrhagic hepatic cyst and mucinous cystic neoplasm(MCN)of the liver, extended posterior segmentectomy was performed. Histological examination of the tumor revealed no neoplastic cells, and the tumor was finally diagnosed as a hemorrhagic hepatic cyst of the liver., Conclusion: Similar to previous reports of hemorrhagic hepatic cysts, preoperative differential diagnosis from MCN of the liver was difficult in this case. Hemorrhagic hepatic cysts are rare and are sometimes confused with MCN of the liver, especially when an enhanced mural nodule is found in the cyst. The possibility of hemorrhagic hepatic cysts should be considered during diagnosis of liver cystic tumors.
- Published
- 2020
41. [A Case of Resection of a Metastatic Tumor Combined with the Spleen, Preserving the Remnant Stomach, for Recurrent Gastric Cancer of the Splenic Hilar Region after Distal Gastrectomy].
- Author
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Hirota M, Tomimaru Y, Nagase H, Noguchi K, Ogino T, Oshima K, Tanida T, Kawase T, Noura S, Imamura H, Iwazawa T, Akagi K, and Dono K
- Subjects
- Aged, Gastrectomy, Gastroenterostomy, Humans, Male, Neoplasm Recurrence, Local, Spleen, Gastric Stump, Stomach Neoplasms
- Abstract
We describe a case of residual stomach preserving surgery performed under evaluation of residual gastric blood flow with indocyanine green(ICG)fluorography, for gastric cancer with recurrence of splenic lymph node metastasis after distal gastrectomy( DG)in a 65-year-old man. After 4 courses of S-1 plus CDDP(SP)therapy for advanced gastric cancer with ascites, DG, D2 dissection, and Billroth Ⅰ reconstruction were performed and radical resection was obtained(L, Type 3, pap/tub, ypT3N1H0P0CY0M0, ypStage ⅡB). Three years and 6 months after the surgery, a mass 4 cm in diameter was found in the splenic hilum, and a pancreatosplenial resection was performed to remove the tumor for diagnosis and treatment purposes. We confirmed that there was no problem with blood flow, and we were able to preserve the stomach. Intraoperative ICG fluorescence imaging was considered a promising method for evaluating residual gastric blood flow.
- Published
- 2020
42. [Gastric Gastrointestinal Stromal Tumor Appearing Nine Years after Resection of a Duodenal Gastrointestinal Stromal Tumor-A Case Report].
- Author
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Taguchi T, Nagase H, Noguchi K, Hirota M, Oshima K, Tanida T, Noura S, Kawase T, Imamura H, Iwazawa T, Akagi K, Andou H, Tamura Y, Adachi S, and Douno K
- Subjects
- Antineoplastic Agents, Drug Resistance, Neoplasm, Humans, Imatinib Mesylate, Male, Middle Aged, Neoplasm Recurrence, Local, Duodenal Neoplasms, Gastrointestinal Stromal Tumors, Stomach Neoplasms
- Abstract
Multiple sporadic gastrointestinal stromal tumor(GIST)are rare, except for those restricted to von Recklinghausen disease or hereditary conditions.We reported a case of a gastric GIST resected 9 years after the resection of a duodenal GIST.The patient was a 58-year-old male who had been followed-up with computed tomography scans after pancreatoduodenectomy for a duodenal GIST when he was 49-years-old.The patient was admitted to our hospital for anemia examination.A CT scan detected a tumor in the stomach, with a diameter of over 10 cm, and necrosis.Esophagogastroduodenoscopy revealed the presence of a delle on the gastric SMT.Due to suspected invasion of the spleen and left diaphragm by the tumor, we performed subtotal gastrectomy with splenectomy and left diaphragm segmental resection.In the pathological diagnosis, the tumor was diagnosed as a gastric GIST, because the cell type of the tumor was spindle and tested positive for c-kit.Based on the tumor size and mitotic count, the patient was diagnosed with high-risk GIST by the modified-Fletcher classification, and imatinib 400mg/day was administered.There have been no signs of recurrence for 2 years since the operation.
- Published
- 2020
43. [Long-Term Survival after Surgical Treatment of Neuroendocrine Carcinoma of the Ampulla of Vater-A Case Report].
- Author
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Yoshioka R, Tomimaru Y, Noguchi K, Nagase H, Ogino T, Hirota M, Oshima K, Tanida T, Noura S, Imamura H, Iwazawa T, Akagi K, Tamura H, Adachi S, and Dono K
- Subjects
- Humans, Male, Neoplasm Recurrence, Local, Pancreaticoduodenectomy, Time Factors, Ampulla of Vater surgery, Carcinoma, Neuroendocrine surgery, Common Bile Duct Neoplasms surgery
- Abstract
A 60s man underwent upper gastrointestinal endoscopy at a regular medical check-up without symptoms, which showed an ulcerative region in the duodenal ampulla, measuring 3 cm in diameter. He was diagnosed with poorly differentiated adenocarcinoma on biopsy and referred to our hospital. Abdominal contrast-enhanced CT scan revealed an enhanced-ulcerative tumor, measuring 3 cm, at the duodenal ampulla. After the preoperative diagnosis of adenocarcinoma of the duodenal ampulla, subtotal stomach-preserving pancreatoduodenectomy with regional lymph node dissection was performed. The final diagnosis was neuroendocrine carcinoma(NEC)of the duodenal ampulla. He has been alive for 9 years with no recurrences. NEC of the duodenal ampulla is rare, and its prognosis is poor. We report a case of long-term survival after resection of NEC of the duodenal ampulla.
- Published
- 2019
44. [A Case of Resected Primary Hepatic Neuroendocrine Tumor].
- Author
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Fujimoto N, Tomimaru Y, Noguchi K, Nagase H, Hirota M, Ogino T, Oshima K, Tanida T, Noura S, Kawase T, Imamura H, Akagi K, Iwazawa T, Adachi S, and Dono K
- Subjects
- Aged, Humans, Male, Neoplasm Recurrence, Local, Liver Neoplasms, Neuroendocrine Tumors
- Abstract
A 70s man presented with a solitary liver tumor measuring 4.5 cm on CT. On contrast-enhanced CT, the tumor appeared partly well-enhanced in the late phase, and the remaining part was enhanced in the early phase and washed out in the late phase. Contrast-enhanced MRIshowed fused multiple nodules, and the enhancement/washout pattern was clearer than that of the contrast-enhanced CT. The tumor showed a defective image in the hepatobiliary phase and a high signal on diffusionweighted imaging. Then, the tumor was diagnosed as hepatocellular carcinoma, and thus, left liver lobectomy was performed. On histological examination of the resected specimen, the tumor was found to be composed of uniform and small tumor cells with solid or trabecular growth fashion. On immunohistochemical staining, synaptophysin and chromogranin A positivity was noted, and the Ki-67 index was 14%. Finally, the tumor was diagnosed as a NET G2. Postoperatively, somatostatin receptor scintigraphy was performed to identify the primary site; however, no obvious primary site could not be identified, and thus a diagnosis of primary hepatic NET was made. Eighteen months postoperatively, the patient is alive without relapse. Preoperative diagnosis of primary hepatic NETs is difficult because NETs present various imaging findings and are rare. Moreover, no accurate preoperative diagnosis was reached in our case, suggesting the difficulty in the preoperative diagnosis of NETs.
- Published
- 2019
45. [Surgical Outcomes of Laparoscopic Repeat Hepatectomy at Our Institution].
- Author
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Kaketaka K, Noguchi K, Tomimaru Y, Shimizu J, Nagase H, Ogino T, Hirota M, Oshima K, Tanida T, Noura S, Kawase A, Imamura H, Akagi K, Iwazawa T, and Dono K
- Subjects
- Hepatectomy, Humans, Length of Stay, Postoperative Complications, Retrospective Studies, Treatment Outcome, Laparoscopy, Liver Neoplasms surgery
- Abstract
Laparoscopic hepatectomy has gained popularity owing to its merits, such as low invasiveness and reduced bleeding. However, the efficacy of laparoscopic repeat hepatectomy(LRH)has not been confirmed. The aim of this study was to evaluate the feasibility and efficacy of LRH compared to that of open repeat hepatectomy(ORH). We performed 60 repeat hepatectomies from January 2011 to March 2019, of which 19 were LRH(Lap group)and 41 were ORH(Open group). This study retrospectively compared the patient characteristics and short-term outcomes of repeat hepatectomy between the Lap and Open groups. There were no significant differences in patient characteristics, except for the type of approach in the previous hepatectomy(p<0.01). The Lap group had lesser blood loss(median: 150 mL vs 355 mL, p<0.01)and shorter postoperative hospital stays(median: 8 days vs 11 days, p<0.01). There were no differences in operation time or severe postoperative complications. LRH is feasible and useful, providing good short-term outcomes.
- Published
- 2019
46. [Pulmonary Metastases of Hepatocellular Carcinoma Treated with Repeated Pulmonary Resection-A Case Report].
- Author
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Kondo H, Tomimaru Y, Iwazawa T, Fujimoto N, Noguchi K, Nagase H, Ogino T, Hirota M, Oshima K, Tanida T, Noura S, Imamura H, Akagi K, Adachi S, and Dono K
- Subjects
- Aged, Hepatectomy, Humans, Male, Neoplasm Recurrence, Local, Carcinoma, Hepatocellular secondary, Carcinoma, Hepatocellular surgery, Chemoembolization, Therapeutic, Liver Neoplasms, Lung Neoplasms secondary, Lung Neoplasms surgery
- Abstract
A 65-year-old man visited our hospital for hepatocellular carcinoma(HCC)and underwent extended posterior sectionectomy. Eight months after the hepatic resection, follow-up computed tomography(CT)revealed a solitary, recurrent tumor in S4 of the liver, and transcatheter arterial chemoembolization and radiofrequency ablation were performed for the intrahepatic recurrence. After 12 postoperative months, follow-up CT demonstrated pulmonary metastases in S5 of the right lung and S10 of the left lung. Since there were no other metastases, the 2 metastatic lesions were resected using video-assisted thoracoscopic surgery(VATS). The resected tumors were histologically diagnosed as pulmonary metastases of HCC. Three years after the pulmonary resection, 3 additional pulmonary metastases were detected on CT in S3 and S10 of the right lung and S4 of the left lung. No other metastases were found. Bilateral VATSmetastasectomy was performed for the metastases. The tumors were diagnosed as pulmonary metastases of HCC on histological examination. One year and 8 months after the surgery, he was alive in a good condition, with no recurrences. The present case suggested that some patients with pulmonary metastasis of HCC can have long-term survival with surgical resection of the metastasis. Therefore, while systemic chemotherapy is generally considered the standard treatment for extrahepatic metastasis of HCC, surgical resection might be an option.
- Published
- 2019
47. [A Case with Three Resections of the Pulmonary Metastases of a Distal Bile Duct Carcinoma].
- Author
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Ando K, Tomimaru Y, Iwazawa T, Noguchi K, Nagase H, Ogino T, Hirota M, Oshima K, Tanida T, Noura S, Kawase T, Imamura H, Akagi K, and Dono K
- Subjects
- Aged, Bile Ducts, Drug Combinations, Humans, Male, Neoplasm Recurrence, Local, Pancreaticoduodenectomy, Pneumonectomy, Antimetabolites, Antineoplastic therapeutic use, Bile Duct Neoplasms drug therapy, Bile Duct Neoplasms surgery, Lung Neoplasms drug therapy, Lung Neoplasms secondary, Lung Neoplasms surgery, Oxonic Acid therapeutic use, Tegafur therapeutic use
- Abstract
A 68-year-old man underwent a subtotal stomach-preserving pancreatoduodenectomy(SSPPD)for a distal bile duct carcinoma(BDC)pT3aN1M0, pStage ⅡB and adjuvant chemotherapy with gemcitabine. One year 7 months after the initial surgery, CT revealed a nodule with an increasing tendency in the left lung. As it was difficult to distinguish primary lung cancer from BDC lung metastasis, we performed a thoracoscopic left wedge resection. The histopathology of the resected specimen was BDC lung metastasis. In the follow-up with adjuvant chemotherapy with S-1 for 10 months, 2 nodules were found in the right lung, and we performed thoracoscopic right S6 segmentectomy. Eight months later, another nodule was found in the left lung, and we performed thoracoscopic left wedge resection. The histopathology was BDC lung metastasis for all the resected specimens. The patient is alive with no evidence of recurrence after 9 months of the latest surgery(4 years 11 months after the initial surgery). Although the standard treatment for metastatic recurrence of BDC is systemic chemotherapy, some cases treated with surgical resection had relatively good prognosis, such as the present case. Surgical resection might be feasible as a treatment option for metastatic recurrence of BDC.
- Published
- 2019
48. [Intraoperative Assessment of Blood Flow in the Remnant Stomach Using Indocyanine Green and Regional Oxygen Saturation Monitoring at Distal Pancreatectomy Following Gastrectomy].
- Author
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Ezaki S, Tomimaru Y, Noguchi K, Nagase H, Ogino T, Hirota M, Oshima K, Tanida T, Noura S, Imamura H, Iwazawa T, Akagi K, and Dono K
- Subjects
- Aged, 80 and over, Gastrectomy, Humans, Indocyanine Green, Male, Neoplasm Recurrence, Local, Oxygen, Pancreatectomy, Gastric Stump, Stomach Neoplasms surgery
- Abstract
A92 -year-old man was diagnosed with pancreatic cancer 14 years after undergoing distal gastrectomy for gastric cancer. His remnant stomach was fed by the cardiac branch of the left inferior phrenic artery, short gastric artery, and posterior gastric artery. We planned distal pancreatectomy(DP). Intraoperative indocyanine green(ICG)fluorography showed that the remnant stomach was perfused under the clamp of the splenic artery. We also confirmed that regional oxygen saturation (rSO2)of the remnant stomach was not decreased by the clamp. Based on the findings, we judged that blood flow in the remnant stomach was preserved at the clamp. We then performed DP with preservation of the remnant stomach. Postoperative complications associated with the remnant stomach were not observed. The patient is alive without any postoperative recurrences of pancreatic cancer or trouble associated with the remnant stomach 22 months after the surgery. This case suggested that ICG fluorography and rSO2 monitoring are useful to evaluate blood flow in the remnant stomach.
- Published
- 2019
49. Outcomes of laparoscopic cholecystectomy for xanthogranulomatous cholecystitis.
- Author
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Takeda Y, Tomimaru Y, Yokota Y, Noguchi K, Noura S, Imamura H, Iwazawa T, Akagi K, Adachi S, Shirakawa T, and Dono K
- Abstract
Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder with distinct histopathological characteristics. Laparoscopic cholecystectomy (LC) is currently the standard treatment for gallbladder disease. However, the outcomes of LC for XGC have not been completely investigated, due to the rarity of XGC. The present study aimed to assess the surgical outcomes of LC for XGC. Among 3,037 patients undergoing cholecystectomy between 2005 and 2017 at our institution, 58 patients (1.9%) were diagnosed with XGC based on histopathology. Of the patients, LC was performed in 38 (65.5%), and they were enrolled in the present study. The outcome of LC for XGC in the cases was assessed, and was compared with outcomes of LC for other diseases. The average operation time was 109±36 min, and average intraoperative blood loss was 58±85 ml. LC was converted to open cholecystectomy in 6 (15.8%) of the 38 cases. No operative mortality occurred. One patient developed postoperative complications greater than grade II in the Clavien-Dindo classification, and the mean postoperative hospital stay was 6.1±5.8 days. Based on previous reports and the nature of XGC itself, the outcomes reported herein of LC for XGC seemed acceptable. It should be also noted that LC for XGC exhibited a higher conversion rate compared with LC than other benign gallbladder diseases, implying that LC for XGC remains challenging.
- Published
- 2019
- Full Text
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50. [A Rare Case of Adenosquamous Carcinoma in the Liver with Hepatolithiasis].
- Author
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Harino T, Tomimaru Y, Noguchi K, Nagase H, Ogino T, Hirota M, Oshima K, Tanida T, Noura S, Imamura H, Akagi K, Iwazawa T, Tamura H, Adachi S, and Dono K
- Subjects
- Aged, Bile Ducts, Intrahepatic, Humans, Male, Bile Duct Neoplasms diagnosis, Bile Duct Neoplasms surgery, Carcinoma, Adenosquamous diagnosis, Carcinoma, Adenosquamous surgery, Cholangiocarcinoma diagnosis, Cholangiocarcinoma surgery
- Abstract
This report describes a case of primary adenosquamous carcinoma of the liver with hepatolithiasis. A 70's man was followed up at a clinic for hepatolithiasis, gallbladder stone, and dilatation of the intrahepatic duct. He visited our hospital for computed tomography(CT)examination. CT showed a 30mm diameter low-density mass in the S2 liver and dilatation of the intrahe- patic duct filled with hepatolithiasis. Blood examination showed elevated levels of tumor markers(CEA 8.0 ng/mL, CA19-9 19,196 U/mL). We diagnosed the tumor as cholangiocellular carcinoma(cT2N1M0, cStage ⅣA)with hepatolithiasis and performed left hepatectomy and lymphadenectomy. In the specimen, a 39×22mm diameter solid tumor was detected and the intrahepatic duct was filled with haptolithiasis. Pathologically, a mixture of adenocarcinoma and squamous cell carcinoma was observed adjacent to the bile duct. Accordingly, a diagnosis of adenosquamous carcinoma was made(pT3N0M0, pStage Ⅲ). Multiple liver metastases were detected 8 months after the operation, and chemotherapy was started. He remains alive 11 months after the operation. We experienced a rare case of adenosquamous carcinoma in the liver with hepatolithiasis.
- Published
- 2019
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