記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本門脈圧亢進症学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)南江堂  

＜文献概要＞消化管吻合における縫合不全は,吻合法,吻合部の緊張・血流などが主な原因とされ,時に致命傷となる.さらに,食道切除再建では,再建経路・部位などの要因もあげられる.根治的には再手術であるが,侵襲が大きく,また従来行われているドレナージによる自然閉鎖は改善するまでに長期入院を要する.われわれは,縫合不全の閉鎖に対して内視鏡的治療が有効であることを報告してきた.さまざまな治療法を,大きさや状況に応じて使い分けることが重要である.

researchmap

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2022&ichushi_jid=J00393&link_issn=&doc_id=20220527040005&doc_link_id=10.15106%2Fj_geka84_736&url=https%3A%2F%2Fdoi.org%2F10.15106%2Fj_geka84_736&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Chemosensitivity tests have been a widely discussed research topic for many years. Our group performed the collagen gel droplet embedded culture-drug sensitivity test (CD-DST) in patients with advanced gastric cancer over the period from December 2012 to December 2017. By considering how the sensitivities to cisplatin (CDDP), docetaxel (DOC), paclitaxel (PTX), and CPT11 correlated with the clinical outcome, we sought mainly to verify how the CD-DST should be used. METHODS: Patients with advanced gastric cancer underwent gastrectomy with lymph node dissection, and the surgical samples were retrospectively examined by the CD-DST to assess chemosensitivity in Nippon Medical School Tama Nagayama hospital. The patients went on to receive postoperative adjuvant chemotherapies either as standard adjuvant therapies or chemotherapies.CD-DST test was not performed for S1 because S-1 is a key drug commonly used in chemotherapy for gastric cancer. While oxaliplatin has also become a key drug for advanced gastric cancer recently, it was still not adopted for gastric cancer in 2012 so CD-DST test was not performed.The χ2 test was used for all statistical analyses. A p-value of <0.05 was assumed to indicate statistical significance. 3-year survival rates were estimated using the Kaplan-Meier method, and the log-rank test was used to compare the obtained curves. RESULTS: Seventy-seven percent (77/115) of the tumors derived from gastric cancer patients could be cultured in this study. The rate of sensitivity was 41% (30/73) for CDDP, 83% (57/69) for DOC, 83% (58/70) for PTX, and 49% (33/67) for CPT11. No correlation between CDDP sensitivity and outcome was observed in patients who underwent the CDDP. Likewise, the sensitivities to CDDP, DOC, PTX, and CPT11 were not found to be correlated with the various patient characteristics. Patients with poorly differentiated adenocarcinoma tended to be sensitive to the CDDP (P=0.051). CONCLUSIONS: No difference between CDDP sensitivity or outcome was observed in the patients administered CDDP. The CD-DST demonstrated a high rate of sensitivity to DOC and PTX in the patients studied.

DOI： 10.1272/jnms.JNMS.2022_89-408

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)癌と化学療法社  

進行胃癌に対する化学療法first-lineとして胃癌治療ガイドライン第5版にFOLFOXが追加された。同レジメンは静脈内投与で完結するため、経口摂取の安定しない進行胃癌において有用と考えられる。本稿ではFOLFOXが著効した進行胃癌症例を報告する。多発肝転移、傍大動脈リンパ節転移を伴うStage IVBの75歳、男性。S-1+CDDP導入後早期に重篤な有害事象を認めFOLFOXへ変更した。oxaliplatinによるアレルギーを来すまで継続投与しPRを維持した。経口摂取不良や内服コンプライアンス不良の進行胃癌症例において、FOLFOXは有用な選択肢である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：金原出版(株)  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本創傷治癒学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

症例は86歳の女性で,ふらつき・黒色便を主訴に当院受診となった.来院時にHb 7.3g/dlの貧血を認め,腹部造影CTで膵体尾部に56×28mm大の,内部不均一で一部に造影効果を伴う腫瘤性病変を認めた.上部消化管内視鏡検査にてVater乳頭より噴出する出血を認め,膵体尾部癌に伴うhemosuccus pancreaticus(以下,HPと略記)と診断した.同日緊急血管造影検査および脾動脈コイル塞栓術を施行し,塞栓術後に貧血は一過性に改善したが,濃厚赤血球製剤の投与を終了すると再び貧血の進行を認めた.第18病日に膵体尾部切除術を施行し,標本摘出後の術中内視鏡にてHPの消失を確認しえた.術後は貧血の速やかな改善を認め,第35病日に退院となった.摘出標本の病理結果はinvasive ductal carcinoma(pT3N1M0 pStage IIB)であった.(著者抄録)

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

症例は85歳の女性で,局所進行膵頭部癌(上腸間膜動脈,門脈浸潤)に対し,化学放射線療法後に亜全胃温存膵頭十二指腸切除術,門脈合併切除再建術を施行した.術後経過は良好であったが3ヵ月目に下血と貧血を認めた.CTで肝外門脈閉塞(extrahepatic portal vein obstruction;以下,EHOと略記)と肝管空腸吻合部周囲に増生した側副血行路を認めた.ダブルバルーン小腸内視鏡検査で静脈瘤を肝管空腸吻合部に認め,同部からの出血と診断した.門脈圧減圧による出血予防を目的に部分的脾動脈塞栓術(partial splenic embolization;以下,PSEと略記)を施行した.その後は出血を認めていない.EHOにより生じる異所性静脈瘤出血は診断・治療の困難な致命的な合併症であるが治療法は確立していない.PSEは肝管空腸吻合部静脈瘤出血に対し一考すべき治療法である.(著者抄録)

researchmap

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01117&link_issn=&doc_id=20210901310004&doc_link_id=10.5833%2Fjjgs.2020.0049&url=https%3A%2F%2Fdoi.org%2F10.5833%2Fjjgs.2020.0049&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Portal vein thrombosis (PVT) following hepatectomy is potentially life-threatening. We aimed to evaluate the incidence of PVT after hepatectomy for hepatocellular carcinoma and identify coagulation and fibrinolytic factors that could predict early-stage postoperative PVT. METHODS: A retrospective analysis was conducted on 65 hepatocellular carcinoma patients who underwent radical hepatectomy. The risk factors for postoperative PVT were identified based on univariate and multivariate analyses, and the levels of coagulation and fibrinolytic factors were measured during the perioperative period. RESULTS: The incidence of PVT after hepatectomy was 20.0%. The patients were divided into two groups: those with PVT (n=13; PVT group) and those without PVT (n=52; no-PVT group). The frequency of the use of the Pringle maneuver during surgery was higher in the PVT group than in the no-PVT group, and the postoperative/preoperative ratios of thrombin-antithrombin III complex (TAT) and of D-dimer were significantly higher in the PVT group. CONCLUSION: A high incidence of PVT was found in hepatocellular carcinoma patients after hepatectomy. The frequency of the Pringle maneuver is a potential risk factor for postoperative PVT, and the postoperative/preoperative TAT and D-dimer ratios may be used as early predictors of PVT after hepatectomy for hepatocellular carcinoma.

DOI： 10.1007/s00423-021-02125-9

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BackgroundRecently, transnasal endoscopy has become common in Japan. While transnasal endoscopy has many advantages, nasal pain and epistaxis are typical complaints. Consequently, we developed a new tube sheath system for transnasal endoscopy to reduce nasal pain and epistaxis. This new tube sheath system (outer sheath and inner tube) has been named Nasal Slider® and is produced by TOP Corporation, Japan.MethodsA tube sheath longer than the nasal concha is inserted to reduce pain along the nasal turbinate. Since the sheath is left in place, tubes can be passed through the nose multiple times without causing additional pain.A total of 34 consecutive patients (mean age 68.1 years, 22 males and 12 females) who had experienced transnasal endoscopy in the past, would undergo transnasal endoscopy with Nasal Slider® again. After the transnasal endoscopy was completed, patients who gave consent for use of the nasal slider® were interviewed using 3 questionnaires about nasal discomfort, nasal pain and epistaxis.ResultsSince the transnasal endoscope passes inside the sheath, epistaxis can be prevented. Thirty patients for whom trans nasal endoscopy using Nasal Slider® could be carried out. Twenty-seven and 28 patients of all patients used Nasal Slider® expressed feeling less nasal discomfort and pain compared to an examination without Nasal Slider®. No epistaxis was detected in all patients using Nasal Slider®.ConclusionsTo reduce nasal pain and epistaxis, Nasal Slider® for transnasal endoscopy was considerably available. It is currently in use at many hospitals in Japan.

DOI： 10.1272/jnms.JNMS.2022_89-101

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本化学療法学会  

researchmap

記述言語：日本語   出版者・発行元：(株)日本臨床社  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本化学療法学会  

researchmap

記述言語：日本語   出版者・発行元：(株)日本臨床社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本病院薬剤師会  

日本医科大学多摩永山病院では外来がん化学療法室にがん薬物療法認定薬剤師1名を専任配置している。2016年10月より医師との連携強化のため、これまでの業務体制を変更し、がん患者指導管理料3(現行ハ)の算定患者を中心に診察前面談および診察同席を行い、処方介入や服薬指導を行う取り組みを開始した。そこで今回、2016年10月〜2017年9月において、診察同席時における処方介入の内容の検討と有用性を評価した。対象期間においてかかわった診療科は外科のみであった。処方介入は224件、採択率は97.8%だった。主な介入内容は副作用対策60.3%、疼痛コントロール11.6%、レジメン変更10.7%、用量調節の提案6.7%であった。薬剤師の診察同席は、副作用対策だけでなく治療方針への介入も可能となるため、より質の高い治療へつながる薬物療法支援体制であると考えられた。(著者抄録)

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Postoperative infections can be classified as surgical site infections and remote infections. Postoperative respiratory tract infections (PRTI) are a type of remote infection and may be associated with prolonged hospitalization and increased medical expenses. This study compared postoperative duration of hospitalization and medical expenses between patients with and without PRTI after gastrointestinal surgery. METHODS: We retrospectively analyzed data from a multicenter study of centers affiliated with the Japan Society for Surgical Infection and used 1-to-1 matching analysis to evaluate 86 patients who underwent gastrointestinal surgery during the period from March 1, 2014 through February 29, 2016. RESULTS: Duration of postoperative hospitalization was significantly longer for patients with PRTI (38.6 days) than for those without PRTI (16.1 days), and postoperative medical expenses were significantly higher for patients with PRTI (1388.2 USD) than for those without PRTI (629.4 USD). CONCLUSIONS: Duration of hospitalization is longer and medical expenses are higher for patients that develop surgical site infections. This study found that this was also the case for patients with PRTI after gastrointestinal surgery. However, further studies are needed in order to confirm these results.

DOI： 10.1272/jnms.JNMS.2020_87-501

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：日本外科系連合学会  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本救急医学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本門脈圧亢進症学会  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本門脈圧亢進症学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本門脈圧亢進症学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本門脈圧亢進症学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Most surveillance programs for postoperative infection focus on surgical site infections (SSI). However, postoperative remote infections are of emerging clinical importance. Using data from a multicenter survey administered to patients who underwent gastrointestinal surgery, we investigated the incidence of SSI and remote infection after colorectal surgery. METHODS: From September 2015 through March 2016, 1,724 patients underwent colorectal surgery in 28 affiliated centers in Japan. We retrospectively recorded patient age, sex, surgical site, surgical approach, wound classification, performance status at discharge, and postoperative infection status. RESULTS: Postoperative infection was noted in 236 (13.7%) patients; 150 and 86 patients underwent colon and rectal surgeries, respectively (incidence of postoperative infection: 13.7% and 14.8%). The incidence of postoperative infection was significantly lower after laparoscopic surgery than after open surgery, in colon and rectal surgery (p < 0.001). Among patients with postoperative infections, 211 (89.4%) had a single infection and 25 (10.6%) had multiple infections. Among patients with a single postoperative infection, SSI and remote infection occurred in 143 (60.6%) and 68 (28.8%) patients, respectively. The most common multiple postoperative infections were "incisional and organ/space SSIs" and "organ/space SSI and bacteremia of unknown origin" (n = 3 each). CONCLUSIONS: This study revealed the prevalence distributions for postoperative SSI and remote infections. Because of the substantial effect of remote infections on patient quality of life and the associated social burden, prospective periodic surveillance for SSI and remote infection is necessary for careful evaluation and prevention.

DOI： 10.1272/jnms.JNMS.2020_87-403

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(株)へるす出版  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：英語  

Herein we report a case of laparoscopic cholecystectomy in a 26-year-old pregnant woman with no remarkable medical history. Laparoscopic cholecystectomy was performed at 21 weeks of gestation. To prevent uterus injury, the first trocar was inserted into the right hypochondrium using the open method after marking the site of the uterus via ultrasonography. After confirming the site of the uterus, the second trocar with a balloon was inserted 3 finger widths above the umbilicus. Additional 5-mm trocars were inserted into the epigastric and hypochondrial regions. A good surgical view was obtained with a pneumoperitoneal pressure of 8 mmHg. Laparoscopic cholecystectomy was successfully performed without any complications during or after the operation. She had a normal delivery at 39 weeks of gestation. Laparoscopic cholecystectomy is a viable treatment option during pregnancy, provided there is close consultation and cooperation between obstetricians and anesthesiologists.

DOI： 10.7759/cureus.7656

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(株)日本臨床社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

DOI： 10.1272/jnms.JNMS.2019_86-502

PubMed

researchmap

DOI： 10.1272/jnms.JNMS.2020_87-204

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

症例は52歳女性で、乳房に腫瘤を自覚し、当院を受診、触診にて左乳房中央部領域に長径25mmの円形腫瘍を認めた。針生検による病理診断は浸潤性乳管癌、Nuclear grade 2、Estrogen receptor 0%、Progesterone receptor 0%、HER2スコア0、Ki67陽性率10%、サブタイプはtriple negativeであった。化学療法を行うも病変の縮小は得られず、乳腺部分切除術および腋窩リンパ節郭清を施行した。術後、放射線療法と化学療法を施行したが倦怠感が出現し、血液検査にて血小板数の著明な減少を認め緊急入院となった。骨髄穿刺を施行し、乳癌の骨髄転移と診断された。血小板輸血を施行したが、輸血を中止すると血小板数は数日で2.0×10^4/μL以下に減少し、化学療法を再開することはできなかった。血小板輸血を中止しbest supportive careを選択されてから1週間後、上肢筋力の低下が出現し、頭部CT検査にて脳出血の所見を認めた。翌日に意識レベルが低下し、乳癌術後7ヵ月目に永眠された。

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J04260&link_issn=&doc_id=20191127430004&doc_link_id=10.1272%2Fmanms.15.182&url=https%3A%2F%2Fdoi.org%2F10.1272%2Fmanms.15.182&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

researchmap

DOI： 10.1272/jnms.JNMS.2018_86-405

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本外科系連合学会  

症例は71歳,男性.直腸癌に対し低位前方切除術を施行.術後に急性腎不全,心不全,誤嚥性肺炎,腹腔内膿瘍を併発したが保存的加療にて改善した.術後15ヵ月頃から下腹部膨満感が出現し,左下腹部のドレーン挿入部周囲の皮下気腫,および腹部単純CT検査で腹腔内にfree airを認めた.症状および炎症所見が軽度であったため腹腔穿刺・吸引を行い経過観察としていたが,症状が増悪したため精査を行った.下部消化管内視鏡検査で盲端部(S状結腸)に2mm大の穿孔部を認めたため,クリップによる閉鎖を施行した.経口摂食開始後,腹腔内の気体の微増と軽度の腹部膨満感を認めたが保存的に加療した.完全閉鎖は得られなかったが腸管内容の腹腔内への流出は認めなかったため外来で経過観察とした.穿孔後約1年経過したが全身状態は良好で現在通院加療中である.直腸切除術15ヵ月後の端側吻合盲端部に微小穿孔を認めた症例を経験したため報告する.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本乳癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A 59-year-old woman who complained of melena and lightheadedness visited the outpatient clinic at our hospital.According to her blood test result, she had anemia, and her tumor marker levels were high.Enhanced computed tomography(CT) findings showed small intestinal cancer with multiple liver metastases.Partial resection of the small bowel for the small intestinal cancer was performed.Following the administration of fourth-line outpatient chemotherapy containing S-1 plus irinotecan( IRIS)and IRIS plus bevacizumab(IRIS plus Bev), S-1 plus oxaliplatin plus Bev(SOX plus Bev), and weekly paclitaxel (wPAC), she survived with good condition for 19 months after the surgery.

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)癌と化学療法社  

症例は59歳、女性。下血、ふらつきを主訴に当科を受診となった。高度貧血と腫瘍マーカーの上昇を認め、腹部造影CTにて多発肝転移を伴う小腸癌と診断した。小腸部分切除術を施行した。病理組織診断は高分化型腺癌であった。術後からS-1+irinotecan(IRIS)併用療法、IRIS+bevacizumab(IRIS+Bev)併用療法、S-1+oxaliplatin+Bev(SOX+Bev)併用療法、weekly paclitaxel(wPAC)療法とfourth-lineまで化学療法を施行し得たが、1年7ヵ月後に原病死となった。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：医薬品相互作用研究会  

症例は60代女性で、胃癌多発皮膚・骨転移と診断された。一次治療としてSP療法(S-1/CDDP)を6クール施行するも改善なく、SOX療法(S-1/L-OHP)へ変更になった。しかし、腹水の貯留傾向を認めPDの診断となり、Paclitaxel/Ramucirumab療法(PTX+RAM)が外来で導入となった。1クール目Day 4に両上下肢の末梢神経障害が悪化し、PTX+RAM療法のPTXによる末梢神経障害の増悪および関節痛の診断となった。このため、DXT 20mg/日およびロキソプロフェン180mg/日を開始となった。Day 8では末梢神経障害はGrade 1に改善し、関節痛の消失を認め、2クール目施行後も増悪を認めなかった。7クール目Day 15〜8クール目のDay 1にかけて末梢神経障害Grade 1の診断であったが、歩きづらさの改善、さらに末梢神経障害の増悪以前のように家事を実施できるようになった。その後も末梢神経障害の増悪は認めなかった。

researchmap

DOI： 10.1186/s40792-019-0623-8

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

症例は69歳女性で、子宮癌肉腫術後、腹腔内再発および盲腸癌を認め、回盲部切除術、小腸部分切除術、腫瘍摘出術を施行されていた。今回、腹部CT検査にて多発肝腫瘍を指摘され、精査加療目的にて入院となった。画像所見から子宮癌肉腫の肝転移と診断し、他に再発部位は画像上認められなかったため肝切除術を施行した。S7の腫瘍が最も大きく、S7グリソンに近接していたため、S7グリソンを切離する必要があった。そのほかの腫瘍は肝表面に認めているため腫瘍核出術を行う方針とした。術後経過は良好で、術後15日目に退院となった。3ヵ月後、腹部CTおよびPET検査にて骨盤内に再発所見を認め、術後経過良好で退院ののち、化学療法を行ったが、腫瘍の縮小は得らなかった。緩和病棟を持つ病院に転院し、肝切除術41ヵ月後に永眠された。

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(公社)日本化学療法学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本感染症学会  

researchmap

DOI： 10.7759/cureus.3767

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本門脈圧亢進症学会  

61歳男性。C型肝硬変、アルコール性肝硬変、慢性腎不全にて近医を通院中、透析中に羽ばたき振戦を伴う意識障害が出現し、前医へ救急搬送された。前医では脾腎シャントに伴うシャント型肝性脳症と診断され、内服治療が行われるも抵抗性が強く、肝性脳症を繰り返すため当科へ紹介となった。各検査により、巨大側副血行路を有するシャント型肝性脳症と診断されたが、患者が透析症例で腹水コントロールに難渋すること、短絡路の最大径が5cmで血管内治療が不可能であったことから、外科的に短絡路を保存して脾静脈結紮切離(分流術)を施行することとなった。その結果、術後は肝性脳症は速やかに改善し、患者は目下、職場復帰している。

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)へるす出版  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本肝臓学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：金原出版(株)  

症例は83歳男性で、高血圧、高尿酸血症、脂質異常症、慢性腎臓病、急性心筋梗塞:冠動脈重症3枝病変に対し右胃大網動脈(RGEA)を用いた冠動脈バイパス(CABG)を施行した。CABG施行10ヵ月後、黒色便で受診し胃角部進行胃癌と診断した。上部消化管内視鏡検査では、胃角部前壁に3型病変を認めた。生検結果は、中分化型管状腺癌、低分化腺癌であった。上部消化管造影検査では、胃角部前壁に、バリウムの貯留を伴う陰影欠損を認めた。腹部単純CT検査では、胃角部前壁に壁肥厚を認めた。リンパ節転移や遠隔転移は認めなかった。冠動脈造影検査では、術前3右冠動脈に90%の狭窄を認めた。RGEAグラフトは開存し、右冠動脈末梢の血流はRGEAグラフトに依存していた。胃角部の進行癌と診断し、上腹部正中切開にて開腹幽門側胃切除術、D2郭清、Roux-en-Y再建を施行した。心血管イベントを含め合併症を認めず経過し、術後13日目に軽快退院した。現在術後1年2ヵ月、無再発生存中である。

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00620&link_issn=&doc_id=20180427160016&doc_link_id=10.18888%2Fop.0000000685&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fop.0000000685&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer New York LLC  

Introduction: We introduced laparoscopic simulator training for medical students in 2007. This study was designed to identify factors that predict the laparoscopic skill of medical students, to identify intergenerational differences in abilities, and to estimate the variability of results in each training group. Our ultimate goal was to determine the optimal educational program for teaching laparoscopic surgery to medical students. Methods: Between 2007 and 2015, a total of 270 fifth-year medical students were enrolled in this observational study. Before training, the participants were asked questions about their interest in laparoscopic surgery, experience with playing video games, confidence about driving, and manual dexterity. After the training, aspects of their competence (execution time, instrument path length, and economy of instrument movement) were assessed. Results: Multiple regression analysis identified significant effects of manual dexterity, gender, and confidence about driving on the results of the training. The training results have significantly improved over recent years. The variability among the results in each training group was relatively small. Conclusions: We identified the characteristics of medical students with excellent laparoscopic skills. We observed educational benefits from interactions between medical students within each training group. Our study suggests that selection and grouping are important to the success of modern programs designed to train medical students in laparoscopic surgery.

DOI： 10.1007/s00464-017-5643-5

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s12328-017-0767-7

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科感染症学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

Web of Science

researchmap

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

Background: Laparoscopic anti-reflux surgery (LARS) is generally the treatment of choice for patients with gastroesophageal reflux disease (GERD). This report describes our experiences in performing LARS on patients with GERD, and focuses retrospectively on the pathophysiology of individual patients and the current status of Japanese patients who have undergone LARS. We demonstrate that patients with non-erosive reflux disease resistant to proton pump inhibitors (PPI-resistant NERD) and high-risk giant hernia, whom we are sometimes hesitant to treat surgically, can be safely and successfully treated with LARS (depending on the pathophysiology of individual patients).
Methods: Between January 2007 and June 2015, 37 patients underwent LARS at Nippon Medical School Hospital. These patients were retrospectively subgrouped according to pathophysiology; 9 of them had PPI-resistant NERD (Group A), 19 had a giant hiatal hernia (Group B), and 9 had erosive esophagitis (Group N). Patient characteristics, intraoperative bleeding, operation duration, perioperative complications, and length of hospital stay were determined, along with symptomatic outcomes and patient satisfaction.
Results: Patients in Group A were the youngest (average: 43.9 years), and those in Group B were the oldest (75.9 years) (P=0.002). The percentage of high-risk patients, as determined by performance status (P=0.047) and American Society of Anesthesiologists physical status classification (P=0.021), was highest in Group B, whereas the percentage of patients with mental disorders was highest in Group A (P=0.012). There were no significant differences among the groups in terms of intraoperative bleeding, surgery duration, or postoperative hospital stay. Thirty-three patients (89.2%), including all 19 in Group B, expressed excellent or good postoperative satisfaction levels.
Conclusions: The characteristics of the patients who underwent LARS at our hospital differed according to pathophysiology and from those in western countries. Satisfactory outcomes depended on the pathophysiology of individual patients.

DOI： 10.1272/jnms.84.25

Web of Science

PubMed

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1272/manms.13.38

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：Institute of Electrical and Electronics Engineers Inc.  

In this paper, the operation cycle for Motion Vector Search is evaluated between the proposed search method and the conventional Full Search algorithm. As a result, the operation cycle of the proposed method is 74% smaller than Full Search algorithm but the circuit size is 0.8% larger than that of Full Search algorithm and the vector matching accuracy of the proposed search method deteriorate to 66.8%, when compared with Full Search algorithm.

DOI： 10.1109/GCCE.2016.7800439

Scopus

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

We compared the therapeutic outcomes of mediastinoscopy- assisted transhiatal esophagectomy (MATHE) with transthoracic esophagectomy (TTE), and with video-assisted thoracoscopic esophagectomy (VATS-E) for the treatment of esophageal cancer. Twenty patients underwent MATHE in our institute from 2001 to 2005 were enrolled. We evaluated the therapeutic outcomes, including perioperative complications and longterm prognosis after surgery, and compared these with 15 patients who underwent TTE during the same time period and 15 who underwent VATS-E at a later date. MATHE was performed safely and the long-term prognosis were satisfactory compared with TTE. However, the number of dissected mediastinal lymph nodes, total blood loss, and sophistication of the procedure were inferior to VATS-E. MATHE represents a less invasive surgical procedure. However, in light of the risk of leaving lymph node metastasis around the tracheal bifurcation in patients with tumor invasion beyond the muscularis mucosa, MATHE should only be adopted in a minority of patients.

DOI： 10.1097/SLE.0000000000000348

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

DOI： 10.15106/J00393.2017097383

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

DOI： 10.4030/jjcs.41.719

researchmap

記述言語：英語  

researchmap

記述言語：英語  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：英語  

DOI： 10.1046/j.1440-1746.2003.03025.x

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

The uterus, ovary, and fallopian tube are rarely present in an inguinal hernia. We report on an operation to treat just such a rare condition for a right inguinal hernia. An 87-year-old Japanese woman was admitted with swelling in the right inguinal region and a purulent discharge from the vagina. Vital signs were stable, but the mobile mass was irreducible. Computed tomography of the abdomen indicated uterine tissue in a right inguinal hernia. We diagnosed an inguinal hernia with an incarcerated uterus and performed surgery on that basis. An incision approximately 6 cm long was made in the skin above the swollen area to open the inguinal sac, disclosing a tumor enveloped by a hernial sac. Opening the hernial sac revealed the prolapsed uterus, the fallopian tube, and the right ovary. Because no ischemic change was noted, the incarcerated uterus was returned to the abdominal cavity, and the hernial opening was closed with the onlay mesh technique. The posterior wall of the inguinal canal was found to have prolapsed laterally to the inferior epigastric artery, resulting in an external inguinal hernia. This case demonstrates that careful attention must be paid to inguinal hernias in female patients because the uterus, ovary, and fallopian tube may be involved.

DOI： 10.1272/jnms.83.93

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

DOI： 10.15106/J00393.2016089685

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: A clear operative view of the middle and lower mediastinum is possible in prone position during video-assisted thorocoscopic surgery of esophagus (VATS-E), but the working space in the upper mediastinum is limited and lymph node dissection along the left recurrent laryngeal nerve (RLN) is difficult in this position. METHODS: Esophagectomy and lymph node dissection are performed for pneumothorax by maintaining CO2 insufflation in the prone position. Working space in the left upper mediastinal area for lymph node dissection around RLN is limited in this position. To create space, the residual esophagus is stripped in the reverse direction and retracted toward the neck after the stomach tube is removed through the nose. Lymph node dissection is performed after stripping the residual esophagus. RESULTS: We could obtain a clear operative field in the upper left mediastinum by stripping the residual esophagus in the prone position, enabling safe and straightforward lymph node dissection along the left RLN. The rate of permanent RLN paralysis was 1.2%. CONCLUSIONS: Lymph node dissection along the left RLN after esophageal stripping is possible in the prone position during VATS-E.

DOI： 10.21037/jovs.2016.11.01

PubMed

researchmap

DOI： 10.14309/00000434-201510001-01628

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

We describe the spontaneous rupture of a simple hepatic cyst. A 62-year-old woman was admitted for right upper quadrant pain of sudden onset. The patient denied a history of abdominal trauma. Computed tomography of the abdomen showed a 13-cm-diameter solitary hepatic cyst in the right lobe. Part of the cyst surface was irregular, and the internal echo was heterogeneous. Retained fluid was detected under the liver capsule. Ten days after admission, computed tomography revealed that the volume of fluid retained under the liver capsule had decreased but that the hepatic cyst had enlarged again. The patient was referred to our hospital for further evaluation and treatment. Physical examination revealed mild right upper quadrant pain, but no signs or symptoms of peritonitis or abnormalities of the chest or heart. Percutaneous puncture was performed with a needle and an 8-French pigtail catheter under ultrasonographic guidance. Brown serous fluid was aspirated. After the removal of approximately 1,000 mL of fluid, contrast medium was injected to check for communications between the cyst and the biliary tree and to document the absence of leakage into the peritoneal cavity. After complete aspiration of the cyst fluid, 200 mg of minocycline hydrochloride dissolved in 10 mL of saline was injected into the cyst, and the catheter was flushed with 10 mL of saline (total volume of saline, 20 mL). The catheter was then clamped for 30 minutes. After percutaneous aspiration, the patient's symptoms resolved. Minocycline hydrochloride was injected daily for 7 days, and the catheter was removed. There has been no evidence of recurrence after 2 years.

DOI： 10.1272/jnms.82.113

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

We report a case of cholelithiasis followed by gallstone ileus, documented with serial computed tomography (CT) scans, that responded to conservative therapy. An 80-year-old woman was admitted because of abdominal pain and vomiting. Six months previously, she had presented with abdominal pain and nausea of sudden onset A CT scan showed thickening of the gallbladder wall and a gallbladder stone. She refused cholecystectomy, and the abdominal pain gradually improved in response to conservative treatment On admission, plain abdominal radiographs showed obstruction of the proximal small bowel. A CT scan revealed disappearance of the gallbladder stone, fluid-filled bowel loops, and the presence in the small bowel of an impacted stone (major axis, 45 mm; minor axis, 23 mm). We diagnosed gallstone ileus. Because the gallstone was not large, we inserted a stomach tube and administered conservative treatment One day after admission, CT showed that the impacted stone had migrated to the transverse colon. Four days after admission the impacted stone was not seen on plain abdominal radiography. Five days after admission, follow-up CT revealed pneumobilia but no impacted stone. Because the symptoms had improved the patient resumed oral intake of liquids The patient was discharged 14 days after admission and is doing well.

DOI： 10.1272/jnms.81.388

Web of Science

PubMed

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

A case of esophageal small cell carcinoma successfully treated with combination therapy consisting of preoperative chemotherapy, radiation therapy, and surgical resection. A 76-yearold man presented with a small cell carcinoma measuring 6 cm in diameter in the middle third of the thoracic esophagus. After preoperative therapy, the gross tumor was completely resected. The patient eventually died of metastatic disease 25 months after diagosis. We discuss the treatment of esophageal small cell carcinoma.

DOI： 10.1272/jnms.81.97

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)オプトロニクス社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER PHYSIOLOGICAL SOC  

Apurinic/apyrimidinic endonuclease-1 (APE-1) is a key enzyme responsible for DNA base excision repair and is also a multifunctional protein such as redox effector for several transcriptional factors. Our study was designed to investigate APE-1 expression and to study its interaction with cyclo-oxygenase (COX)-2 expression and VEGF production in the esophageal cancer. The expression of APE-1, COX-2, monocyte chemoattractant protein (MCP)-1, CC-chemokine receptor (CCR) 2, and VEGF were evaluated by immunohistochemistry in 65 human esophageal squamous cell carcinoma (ESCC) tissues. Real-time PCR and Western blotting were performed to detect mRNA and protein expression of APE-1 and p-signal transducer and activator of transcription 3 (STAT3) expression in MCP-1-stimulated ESCC cell lines (KYSE 220 and EC-GI-10). siRNA for APE-1 was treated to determine the role of APE-1 in the regulation of COX-2 expression, VEGF production, and antiapoptotic effect against cisplatin. In human ESCC tissues, nuclear localization of APE-1 was observed in 92.3% (60/65) of all tissues. There was a significant relationship (P = 0.029, R = 0.49) between nuclear APE-1 and cytoplasmic COX-2 expression levels in the esophageal cancer tissues. In KYSE 220 and EC-GI-10 cells, MCP-1 stimulation significantly increased mRNA and protein expression of APE-1. Treatment with siRNA for APE-1 significantly inhibited p-STAT3 expression levels in MCP-1-stimulated cells. Furthermore, treatment of siRNA for APE-1 significantly reduced COX-2 expression and VEGF production in MCP-1-stimulated esophageal cancer cell lines. Treatment with APE-1 siRNA significantly increased apoptotic levels in cisplatin-incubated KYSE 220 and EC-GI-10 cells. We concluded that APE-1 is overexpressed and associated with COX-2 expression and VEGF production in esophageal cancer tissues.

DOI： 10.1152/ajpgi.00057.2013

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

We describe a cystic intraductal papillary neoplasm of bile duct (IPNB) of adenocarcinoma treated with surgical resection. An 82-year-old man was admitted to our hospital because of distension of the right upper quadrant of the abdomen. On admission, a huge nontender mass was palpated in the right upper abdomen. Initial laboratory tests revealed the following serum values: aspartate aminotransferase, 123 IU/L; alanine aminotransferase, 113 IU/L; alkaline phosphatase, 376 IU/L; bilirubin, 1.6 mg/dL; alpha-fetoprotein, 7.4 ng/mL; CA19-9, 39.8 U/mL; carcinoembryonic antigen, 4.1 ng/mL; and Duke pancreatic monoclonal antigen type 2, 200 U/mL. Abdominal ultrasonography revealed an anechoic mass with an elevated papillary lesion in the right paramedian section. Computed tomography showed a low-density hepatic lesion, measuring 12 x 10 cm, with thick, irregular walls. A T2-weighted magnetic resonance scan showed mural nodules with signal intensity higher than that of the liver. The cystic lesion was suspected to be a cystic IPNB, but we could not determine whether it was a carcinoma. We performed extensive right paramedian sectionectomy and cholecystectomy. The resected multilocular tumor was filled with a yellow fluid, and the cut surface showed multiple, yellowish papillary nodules lining the cystic wall. On histologic examination, the neoplastic biliary epithelium showed papillary growth in the dilated lumen. Papillary and micropapillary lesions exhibited cellular atypia: nuclear enlargement and hyperchromasia, mutilayering, and mitosis. Ovarian-like stroma was not detected. The tumor was diagnosed as an IPNB (carcinoma in situ lesion). These lesions had expanded into several intrabiliary ducts. No recurrence has been detected 2 year after operation.

DOI： 10.1272/jnms.80.234

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3164/jcbn.12-95

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

It is now evident that changes in microRNA are involved in cancer progression, but the mechanisms of transcriptional regulation of miRNAs remain unknown. Ski-related novel gene (SnoN/SKIL), a transcription co-factor, acts as a potential key regulator within a complex network of p53 transcriptional repressors. SnoN has pro- and anti-oncogenic functions in the regulation of cell proliferation, senescence, apoptosis, and differentiation. We characterized the roles of SnoN in miRNA transcriptional regulation and its effects on cell proliferation using esophageal squamous cell carcinoma (ESCC) cells. Silencing of SnoN altered a set of miRNA expression profiles in TE-1cells, and the expression levels of miR-720, miR-1274A, and miR-1274B were modulated by SnoN. The expression of these miRNAs resulted in changes to the target protein p63 and a disintegrin and metalloproteinase domain 9 (ADAM9). Furthermore, silencing of SnoN significantly upregulated cell proliferation in TE-1 cells, indicating a potential anti-oncogenic function. These results support our observation that cancer tissues have lower expression levels of SnoN, miR-720, and miR-1274A compared to adjacent normal tissues from ESCC patients. These data demonstrate a novel mechanism of miRNA regulation, leading to changes in cell proliferation. © 2012 Elsevier Inc.

DOI： 10.1016/j.bbrc.2012.11.005

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：医学図書出版(株)  

肝胆膵領域におけるステンティング療法について胆管ステントと膵管ステントに分けて述べる。胆管ステントでは、切除不能悪性胆道狭窄に対しては、金属ステント(Expandable metallic Stent:EMS)、悪性胆道狭窄術前および良性胆道狭窄に対しては、Plastic stentが適応である。胆管(肝管)消化管吻合部の減圧および狭窄防止目的として、内ステント(internal stent)や外ステント(external stent)が留置される。膵管ステントでは、良性疾患に対する膵液ドレナージ目的として、主にPlastic stentが使用される。膵消化管吻合部の減圧および狭窄防止目的には、節付き膵管チューブをexternal stentとして使用しているが、internal stentを留置する施設やstentを使用しない施設もある。さまざまなステントが開発され、目的に応じて留置するステントの種類も異なってくる。各ステントには長所短所があるため、各ステントの特性を把握し使用することが肝要である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：英語   出版者・発行元：(一社)日本癌学会  

researchmap

記述言語：日本語   出版者・発行元：Japan Surgical Association  

症例は44歳，男性．発熱，右季肋部痛を主訴に当院受診．白血球，CRP高値およびCTにて上行結腸癌が疑われ，また多発肝腫瘍を認めたため精査目的で入院となった．CT等の諸検査にて感染性疾患は否定的であり，大腸内視鏡検査を施行し上行結腸癌と診断．右半結腸切除術，術中肝生検を施行し，病理学的検査にてG-CSF産生大腸癌，多発肝転移の診断となった．<BR>術後も発熱と炎症反応高値が持続．全身状態増悪傾向であったが，本人と家族の希望があり化学療法（mFOLFOX6）を開始し，3コース目よりBevacizumabを併用した．4コース後には全身状態良好となり退院，外来にて化学療法を継続した．その後，全身倦怠感を主訴に再入院し，入院後突然の意識消失出現し広範囲脳梗塞と診断．術後約4カ月で死亡となった．

DOI： 10.3919/jjsa.73.1753

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2012360911

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPANDIDOS PUBL LTD  

The urinary trypsin inhibitor (UTI) is responsible for most of the antitryptic activity in urine and is excreted in increased amounts in urine under certain pathological conditions such as cancer and bacterial infections. Our aim in this study was to better understand the mechanisms responsible for the increase in UTI excretion on surgical stress and thus to better appreciate the information provided by inflammatory mediators. Thirty-one consecutive patients who underwent radical esophagectomy for esophageal cancer were investigated in this study. We determined serum UTI and polymorphonuclear cell elastase (PMNE), urine UTI and evaluated the effectiveness of preoperative administration of methylprednisolone on the postoperative clinical course and adverse inflammatory reactions. The results revealed that urine UTI and serum PMNE levels in the steroid group were significantly lower than those in the non-steroid group. In addition, UTI levels correlated positively with scrum levels of aminotransferases. More importantly, the maximum level of urine UTI in patients without complications was lower than that in patients with complications. These results suggest that urine UTI provides useful information concerning postoperative clinical course, and that preoperative administration of methylprednisolone may contribute to decrease postoperative complications following esophagectomy.

DOI： 10.3892/etm.2012.554

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPANDIDOS PUBL LTD  

Evidence-based guidelines for the prevention of surgical site infection (SSI) have been published by the U.S. Centers for Disease Control and Prevention (CDC). According to these guidelines, a wound should usually be covered with a sterile dressing for 24 to 48 h when a surgical incision is closed primarily. However, it is not recommended that an incision be covered by a dressing beyond 48 h. In this study, patients were stratified into two groups for analysis: patients whose surgical wound was sterilized and whose gauze was changed once daily until postoperative day 7 (7POD; group A); and patients whose surgical wound was sterilized and whose gauze was changed once daily until 2POD (group B). We evaluated the incidence of SSI, nursing hours and cost implications. The results showed that there was no significant difference in SSI occurrence between the two groups (group A, 10% vs. group B, 7.3%). By contrast, the average nursing time differed by 2.8 min (group A, 3.8 min vs. group B, 0.9 min). The material costs per patient were also reduced by $14.70 (group A, $61.80 vs. group B, $47.10). In conclusion, we applied our knowledge of the evidence-based CDC guidelines to determine whether 48-h wound management can be made easier, more uniform and more cost-effective compared to conventional wound management. The results of the present study showed that surgical wound management methods can be more convenient and inexpensive.

DOI： 10.3892/ol.2012.687

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

Objective: The aim of this study was to analyze the efficacy and feasibility of gemcitabine monotherapy in patients with unresectable advanced or recurrent biliary tract cancer (BTC).
Methods: Six patients with unresectable advanced BTC and 12 patients with recurrent BTC received gemcitabine monotherapy. Gemcitabine (800-1.000 mg/m(2)) was administered intravenously over 30 minutes on days 1, 8, and 15 every 28 days. Disease and toxicity were assessed once a week in all patients until the completion of gemcitabine treatment. Computed tomographic/magnetic resonance imaging studies were done every 8 weeks during chemotherapy, and every 4 weeks if progressive disease was suspected. Tumor response was determined according to the Response Evaluation Criteria in Solid Tumors. Toxicity was assessed using the National Cancer Institute Common Toxicity Criteria version 2.0. The time to progression and survival time were also calculated.
Results: In patients with unresectable BTC, the overall response rate and the median time to progression for patients with partial response or stable disease was 66.7% and 5.68 months, respectively. Clinical benefit was observed in 3 patients with stable disease (50%). The median survival time was 5.2 months. In patients with recurrent BTC, 4 patients (33%) obtained partial responses and 2 patients (17%) had stable disease. The median time to progression was 8.2 months. Six of 12 patients (50%) obtained clinical benefit. The median survival time for cancer of the intrahepatic bile duct, the extrahepatic bile duct, and the ampulla of Vater were 2.8 months, 8.5 months, and 10.7 months, respectively. No significant correlation between the survival time and the resectability of the initial procedure (R number) was detected. The survival time for patients with a performance status of 0 or 1 was significantly longer than that for patients with a performance status of 2 (P=0.0051). Neither grade 3/4 hematologic toxicity nor grade 3/4 nonhematologic toxicity was observed. No treatment-related deaths were observed.
Conclusion: Gemcitabine monotherapy may provide a more favorable prognosis in patients with advanced BTC than does best supportive care alone. Moreover, this regimen may represent a therapeutic option for the adjuvant setting in patients with BTC. (J Nippon Med Sch 2012; 79: 204-212)

DOI： 10.1272/jnms.79.204

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：日本外科代謝栄養学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

An internal hernia may be either congenital or acquired. The reported incidence of such hernias is 1-2%. In rare cases, internal hernias are the cause of small bowel obstruction, with a reported incidence of 0.2-0.9%. Transmesocolic hernia of the ascending colon is especially rare. We report a case of transmesocolic hernia of the ascending colon with intestinal obstruction diagnosed preoperatively. A 91-year-old Japanese female was admitted to our hospital with abdominal distention and vomiting of 3 days duration. She had no past history of any abdominal surgery. Abdominal examination revealed distention and tenderness in the right iliac fossa. Abdominal computed tomography revealed ileus in the sac at the left side of the ascending colon and dilatation of the oral side of the intestine. We diagnosed a transmesocolic hernia of the ascending colon with intestinal obstruction and performed emergency surgery. At the time of operation, there was internal herniation of ileal loops through a defect in the ascending mesocolon, without any strangulation of the small bowel. The contents were reduced and the tear in the ascending mesocolon was closed. The postoperative course was uneventful and the patient was discharged 14 days after surgery. In conclusion, preoperative diagnosis of bowel obstruction caused by a congenital mesocolic hernia remains difficult despite the techniques currently available, so it is important to consider the possibility of a transmesocolic hernia when diagnosing a patient with ileus with no past history of abdominal surgery. Copyright © 2012 S. Karger AG, Basel.

DOI： 10.1159/000339691

Scopus

PubMed

researchmap

Web of Science

researchmap

DOI： 10.1158/1538-7445.AM2012-3623

Web of Science

researchmap

DOI： 10.1158/1538-7445.AM2012-5358

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

DOI： 10.1272/jnms.79.213

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

We report a case of esophageal squamous cell carcinoma (ESCC) directly invading the liver and causing a pyogenic liver abscess. The patient was a 66-year-old man who presented with dysphagia. Esophagography, endoscopic study, and computed tomography (CT) showed a mass lesion in the lower third of the esophagus. A high fever developed on hospital day 17 and another CT scan revealed a liver abscess, 50 x 45 mm, in the left lateral lobe of the liver. Although imaging demonstrated a liver abscess continuous with the tumor, we performed percutaneous transhepatic drainage, followed thereafter by distal esophagectomy and total gastrectomy with a left lateral segmental resection of the liver. The pathological findings confirmed a diagnosis of ESCC with direct invasion (T4N1M0, stage IVa in the TNM classification). The patient had an uneventful postoperative recovery. Microscopic examination of the resected specimen revealed the expansive growth of tumor cells into the hepatocellular tissues. To our knowledge, this is the first report of the direct invasion of esophageal cancer to the liver causing a pyogenic liver abscess; however, it should be borne in mind when a patient with esophageal cancer becomes febrile.

DOI： 10.1007/s00595-010-4455-1

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

In spite of the undisputed importance of altered expression patterns of microRNAs (miRNAs) in various cancers, there is little information on the clinicopathologic significance of cancer-related miRNAs (MIR21, MIR143, MIR144, MIR145, and MIR205) in esophageal squamous cell carcinoma (ESCC). We examined the expression levels of the precursor and mature miRNA genes in ESCC using real-time polymerase chain reaction (PCR). We also investigated the mRNA expression levels of processing elements (RNASEN, DGCR8, and DICER1) that participate in miRNA-biogenesis pathway. Furthermore, we analyzed the relationships between the expression levels of these five miRNAs and the clinicopathologic parameters of ESCC patients. The expression levels of mature MIR21 and mature MIR145 were higher in ESCC than those in normal epithelium (P &lt; 0.05). The mature/pre ratio of MIR21 in ESCC was higher than that in normal epithelium (P &lt; 0.05). With regard to miRNA-processing elements, the expression level of RNASEN was higher in ESCC than in normal epithelium (P &lt; 0.05). Furthermore, altered expression of these miRNAs was related to the clinicopathologic features of ESCC patients. The high expression of mature MIR21 and mature MIR205 was associated with lymph node positivity in ESCC patients (P &lt; 0.05). The high levels of expression of mature MIR143 and mature MIR145 were associated with recurrence of metastasis in ESCC patients (P &lt; 0.05). The findings may imply that miRNA biogenesis is aberrantly accelerated in ESCC. Analysis of the expression levels of miRNAs should provide useful information for evaluation of the staging, prognosis, and treatment of ESCC patients.

DOI： 10.1111/j.1442-2050.2011.01177.x

Web of Science

researchmap

その他リンク： http://orcid.org/0000-0003-4698-460X

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

We describe a 54-year-old man in whom esophageal carcinoma was diagnosed and who underwent video-assisted thoracoscopic surgery of the esophagus (VATS-E) in the prone position. initially, the patient was fixed in a semiprone position, from which he could be rotated to a prone or left lateral position. Four ports were inserted, and then the patient was rotated to the prone position. Once the patient was prone, gravity caused the lung to move downwards. Next, the chest cavity was inflated with a CO(2) insufflation pressure of 6 mm Hg. Esophagectomy was then performed, and the lymph nodes in the middle and lower mediastinum and along the right recurrent laryngeal nerve were dissected. In the left upper mediastinum, lymph node dissection was performed after the residual esophagus was stripped. Stripping of the residual esophagus created sufficient working space and a clear operative field for lymph node dissection. VATS-E in the prone position has achieved remarkable results in Japan. It allows a clear operative view of the middle and lower mediastinum, but the working space in the upper mediastinum is limited. Our results indicate that esophageal stripping in prone VATS-E allows for safe and straightforward lymph node dissection along the left recurrent laryngeal nerve. Our technique overcame the difficulties usually encountered with this type of lymph node dissection. (J Nippon Med Sch 2011; 78: 199-204)

DOI： 10.1272/jnms.78.199

Web of Science

PubMed

researchmap

DOI： 10.1007/s10388-011-0263-y

Web of Science

researchmap

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

DOI： 10.1158/1538-7445.AM2011-3187

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本胃癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

DOI： 10.1272/jnms.78.224

PubMed

researchmap

記述言語：英語   出版者・発行元：The Medical Association of Nippon Medical School  

DOI： 10.1272/jnms.78.54

researchmap

記述言語：日本語   出版者・発行元：The Medical Association of Nippon Medical School  

DOI： 10.1272/manms.7.110

CiNii Books

researchmap

その他リンク： https://jlc.jst.go.jp/DN/JALC/00371971190?from=CiNii

記述言語：日本語   出版者・発行元：The Medical Association of Nippon Medical School  

DOI： 10.1272/manms.7.148

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：(株)勁草書房コミュニケーション事業部  

researchmap

DOI： 10.1158/1538-7445.AM10-1755

Web of Science

researchmap

DOI： 10.1158/1538-7445.AM10-815

Web of Science

researchmap

DOI： 10.1016/j.gie.2010.03.519

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Medical Association of Nippon Medical School  

An 80-year-old woman was admitted to our hospital with severe chest and back pains after vomiting. Computed tomography (CT) of the chest revealed left-sided pneumothorax and pleural effusion. Some food was drained from an inserted chest tube, and we diagnosed spontaneous esophageal rupture (Boerhaave's syndrome). A left thoracotomy was performed 7 hours after the onset of symptoms. A 3-cm perforation was discovered in the lateral wall of the distal esophagus. The perforation was repaired with a primary two-layered closure and covered with pericardial fat. The patient had a good postoperative course and was discharged 1 month after surgery. This case suggests the importance of early surgical treatment, even in elderly patients with spontaneous esophageal rupture.

DOI： 10.1272/jnms.77.338

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：H G E UPDATE MEDICAL PUBLISHING S A  

Background/Aims: To determine whether increases in soluble tumor necrosis factor receptors (sTNFRs) are associated with the levels of cytokines and proteinases in patients undergoing major surgery.
Methodology: Eleven patients who underwent esophagectomy for squamous cell carcinoma of the thoracic esophagus were studied. The circulating blood concentrations of interleukin-6 (IL-6), IL-8, sTNF-R55, sTNF-R75, elastase/alpha 1-proteinase inhibitor complex (elastase) and matrix metalloproteinase-9 (MMP-9) were measured by ELISA or EIA before surgery, just after surgery, and on postoperative days (POD) 1 and 3.
Results: The levels of serum IL-6, plasma IL-8, plasma elastase and plasma MMP-9 increased significantly after surgery, peaking just after surgery or on POD 1 and then declining. In contrast, the serum levels of sTNFRs increased approximately 2-fold just after surgery compared with the preoperative values and then remained elevated. The IL-6 level correlated with the levels of sTNF-R55 and sTNF-R75 after surgery.
Conclusions: These results suggest that increases of IL-6, serine proteinases and MMPs may be involved in the upregulation of sTNFRs in patients undergoing major surgery.

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ACADEMIC PRESS INC ELSEVIER SCIENCE  

The Akt-Mdm2 pathway plays an important role in carcinogenesis in a variety of malignant tumors. However, the Akt-Mdm2 pathway in esophageal squamous cell carcinoma (ESCC) has not been fully studied. We investigated the proteins and mRNA expression of Akt and Mdm2 to elucidate the roles of these proteins in ESCC. We also examined the effect of Akt knockdown on Mdm2 expression in ESCC cells. ESCC tissue samples were obtained from 23 individuals who underwent surgical resection with no preoperative treatment. Akt1-3 and Mdm2 gene and protein expression were analyzed. The effect of siRNA-mediated Akt knockdown on Mdm2 expression was also studied, using ESCC cell lines. Akt1 and Mdm2 immunoreactivity was detected in 77.8 and 66.7% of tumor specimen from ESCC patients, respectively. Akt1 and Mdm2 mRNA expressions were correlated and significantly elevated in tumor tissue (p&lt;0.0001 and p&lt;0.05, respectively). The siRNA-targeted reduction of each Akt isoform reduced Mdm2 protein expression. The overexpression of Akt1 and Mdm2 may be related to esophageal carcinogenesis. Furthermore, Akt expression regulates Mdm2 expression, which may in turn regulate the function of wildtype p53. These results may provide the basis for future preventative or clinical therapies for esophageal cancer. (C) 2008 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.yexmp.2008.11.013

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPANDIDOS PUBL LTD  

The genomic region containing PIK3CA was found to be amplified in esophageal squamous cell carcinoma (ESCC) tissue. PIK3CA at 3q26, which encodes the p110 alpha catalytic subunit of phosphatidylinositol (PI) 3-kinase, is a unique intracellular signal transducer characterized by its lipid substrate specificity. In order to characterize PIK3CA in ESCC, we investigated hot-spot mutations in exons 1, 9 and 20, the copy number gain, the expression levels of mRNA and protein. Analysis in exon 9 of the PIK3CA gene revealed mutation in 7.7%0 (4 of 52) of ESCC samples. No mutation was detected in either exon 1 or exon 20. Copy number amplifications of PIK3CA were found in 12 of the 45 patients (26.7%). PIK3CA mRNAs were examined in 37 ESCC patients as determined by quantitative RT-PCR and the mean mRNA level of PIK3CA in ESCC tissues was 2.61-fold higher compared with that in corresponding non-tumorous esophageal epithelia (P &lt; 0.001). Immunohistochemically, positive immunoreaction for PIK3CA was detectable in 33 of 66 (50.0%) ESCC cases, while it was not detectable in the remaining 33 cases. Furthermore, comparing the cases with negative staining with those with positive staining for PIK3CA, the presence of node metastasis was significantly correlated with those with positive staining (P &lt; 0.05). This study is the first report providing comprehensive analysis of PIK3CA expression in ESCC. These results indicate that PIK3CA may play a crucial role in the development of ESCC and serve as an indicator for lymph node metastasis.

DOI： 10.3892/ijo_00000202

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Abdominal hernias are not rare in women, but incisional bladder hernias are rare. The incisional hernia is a condition caused by protrusion of the abdominal viscera through the abdominal fascia. The presenting symptoms in the cases reported included suprapubic discomfort, irritative voiding symptoms, and urinary incontinence. We present a case of bladder herniation with temporary bowel incarceration through a lower midline incision, which followed operative intervention. The temporary bowel herniation was managed conservatively because the impairment of the blood supply was not severe.

DOI： 10.1272/jnms.76.34

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Basaloid squamous cell carcinoma is an uncommon malignancy of the esophagus. We present two cases of basaloid squamous carcinoma of the esophagus. Both tumors histologically consisted of solid cell nests and displayed focal immunoreactivity for type IV collagen. The nests comprised pseudoglandular structures containing myxoid matrix. Transthoracic esophagectomy with lymph node dissection was performed in both patients. The patients had uneventful postoperative courses. One patient showed no evidence of recurrence or metastasis in the 6-month postoperative period, and the other patient died of lung metastasis 28 months after the primary treatment.

DOI： 10.1272/jnms.75.354

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

A diverticulum in the lower third of the esophagus is rare. A 62-year-old woman presented with symptoms of dysphagia and regurgitation associated with recurrent aspiration. Endoscopic examination disclosed a large epiphrenic diverticulum, for which esophagoscopy-guided thoracoscopic surgery was performed. The postoperative course was uneventful. It is proposed that this method could be a possible alternative to the standard classical thoracotomy approach for a large epiphrenic diverticulum of the esophagus. © 2008 Japan Esophageal Soceity and Springer.

DOI： 10.1007/s10388-008-0176-6

Scopus

researchmap

DOI： 10.1007/s12328-008-0032-1

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Patients who undergo definitive chemoradiotherapy (CRT) face a risk of residual resistant disease or disease recurrence at the primary site
therefore, salvage treatment may be required. An optimum strategy to minimize these risks clearly needs to be established. Argon plasma coagulation (APC) is a safe and convenient procedure now applied widely for therapeutic endoscopy. In this report we describe the successful use of APC over 6 years for the treatment of recurrent esophageal cancer after CRT. A 61-year-old Japanese man underwent CRT for a thoracic esophageal cancer. Pathological examination before CRT revealed a well-differentiated squamous cell carcinoma. Locoregional failure was observed 2 years after CRT, and an initial APC treatment was performed. The patient has now undergone APC ablation 7 times with no postoperative complications. No metastasis to lymph nodes or to other organs has been detected during the last 6 years. The usefulness of APC as a salvage treatment for locoregional failure after definitive CRT has not been established. In our experience, salvage APC is the best treatment option for some patients.

DOI： 10.1272/jnms.75.280

Scopus

PubMed

researchmap

DOI： 10.1245/s10434-008-9986-y

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

BACKGROUND: Our institute started laparoscopic simulator training for medical students in 2006. During the training, we observed considerable interindividual differences in laparoscopic skills among those students. This study aimed to investigate are the predictive factors that affect laparoscopic skill by assessing the students' training, results data.
METHODS: Forty-three, fifth-year medical students were asked several questions and were divided into 2 groups depending on their answers. The participants performed an object-positioning module on a ProMIS simulator (Haptica, Inc., Dublin, Ireland). Execution time, instrument path length, and economy, of movement for each trial were recorded on ProMIS. Comparisons of mean performance measures between the 2 groups were made using a Mann-Whitney U test.
RESULTS: Interest about laparoscopic surgery and accomplishment in playing piano did not affect the skillfulness significantly. The students who had an interest in television (TV) games completed the task in less time (p = 0.046) and had a shorter left instrument path length (p = 0.012). The students who thought themselves manually dexterous completed the task in less time (p = 0.008). The students who were confident about driving completed the task in less time (p = 0.0247).
DISCUSSION: In our interview, the factors that had a relationship to laparoscopic skills were favorableness to TV games, manual dexterity, and confidence about driving. These results were expected because TV games and driving a car require the same abilities as laparoscopic surgery. Psychomotor, perceptual, or visuospatial ability are essential for good performance. In conclusion, our study suggests that the interview can be an effective measure to examine the aptitude of medical students without the use of a simulator.

DOI： 10.1016/j.jsurg.2008.07.008

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Our institution introduced laparoscopic surgery for esophageal achalasia in 2001. The present report summarizes 15 cases of achalasia treated with laparoscopic Heller myotomy and anterior fundoplication according to the method of Dor, and we have investigated the therapeutic effects on specific symptoms such as dysphagia, reflux, and chest pain. From February 2001 through January 2007, the laparoscopic Heller-Dor operation was performed in 15 patients, including 7 men and 8 women. Achalasia was classified morphologically on esophagography as spindle type in 11 cases, flask type in 3 cases and sigmoid type in 1 case. The degree of esophageal dilatation was classified as grade I in 8 cases, grade II in 6 cases, and grade III in 1 case. Dysphagia was the main symptom and was present in all cases. The mean disease duration was 4.3 years (range, 5 months to 20 years), and the mean weight loss was 4.2 kg. All patients underwent endoscopic dilatation preoperatively. Intraoperative blood loss ranged from 0 to 100 mL (mean, 21 mL). Adequate Heller myotomy was considered more than 6 cm and more than 3 cm in the esophagus and the stomach, respectively. Injury to the esophageal mucosa occurred during the myotomy in 3 cases but could be repaired in all cases during the laparoscopic procedure. All patients reported an excellent level of satisfaction postoperatively. In conclusion, the laparoscopic Heller-Dor operation for esophageal achalasia is a useful procedure because the postoperative satisfaction level of patients is excellent. Despite the risk of mucosal injury, adequate Heller myotomy should be achieved to obtain a good prognosis. It is, therefore, of utmost importance to obtain mastery over the surgical technique to repair any mucosal injury that might occur.

DOI： 10.1272/jnms.75.207

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The carcinosarcoma of the esophagus is a rare malignant neoplasm consisting of both carcinomatous and sarcomatous components. A case of so-called carcinosarcoma of the esophagus is described herein. A 69-year-old man presented with dysphagia and was admitted to our hospital. Imaging studies revealed a localized ulcerative tumor in the middle intrathoracic esophagus without any invasion or metastasis. The patient was initially thought to have squamous cell carcinoma and underwent subtotal esophagectomy with lymphadenectomy. Final diagnosis of the tumor was so-called carcinosarcoma of the esophagus. The patient had an uneventful postoperative course and showed no evidence of recurrence or metastasis in the 4-year postoperative period.

DOI： 10.1272/jnms.75.171

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Intussusception in adults represents only 5% of all cases and is usually caused by a small bowel lesion acting as the apex of the intussusception. We report an unusual case of intussusception in man caused by a lipomatous lesion located in the ileum acting as the lead point. After repeated admissions to our hospital for ileus, the possibility of intussusception was finally raised by a computed tomographic scan of the abdomen. The patient underwent primary resection of the intussuscepted intestine, which resulted in a long-lasting resolution of the symptoms. The resected specimen contained a round tumor measuring 27 x 27 x 40 mm which was diagnosed histopathologically as an intestinal lipoma. This case highlights the uncommon causation of adult intussusception by an intestinal lipoma.

DOI： 10.1272/jnms.75.166

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

DOI： 10.1007/s10620-006-9423-7

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The hypothalamic-pituitary-adrenal axis is an essential component for the maintenance of homeostasis following trauma. Major surgical trauma often induces overwhelming inflammatory responses leading to sepsis and organ dysfunction. This study was designed to evaluate the adrenal responses both before and after various degrees of surgical trauma and to determine the incidence of postoperative relative adrenal insufficiency resulting in the marked inflammatory response often associated with postoperative complications. Fifty-one surgical patients were divided into groups who underwent major, moderate, and minor surgeries. Before the operation and during resting conditions, a short corticotropin (ACTH) stimulation test was performed in each patient. The postoperative concentrations of serum Cortisol, interleukin (IL)-6, IL-10, C-reactive protein (CRP), and plasma ACTH were measured. Fifty of 51 patients were identified as responders to ACTH. The postoperative Cortisol levels were the same as those obtained by ACTH stimulation in highly and moderately stressful surgeries. The increases in postoperative IL-6 and CRP levels were greatest with major surgery, intermediate with moderate surgery, and least with minor surgery. Furthermore, plasma ACTH levels increased after major and moderate surgeries
however, there was no significant differences in postoperative serum IL-10 levels. Systemic inflammatory response syndrome (SIRS) was found in 11 of 17 patients (64.7%) who underwent major surgery and in 4 of 16 patients (25%) who underwent moderate surgery (p=0.037). The duration of SIRS was significantly longer in patients undergoing major surgery (62 ± 20 hrs) than in patients undergoing moderate surgery (21 ± 3 hrs. p=0.038). Postoperative complications were more frequent in patients undergoing major surgery (41.2%) than in patients undergoing moderate surgery (6.3%, p=0.039). Furthermore, there were significant differences in the length of the postoperative stay among the three groups (p&lt
0.01). One nonresponder had serious postoperative inflammatory complications. These results suggest that a short ACTH stimulation test performed preoperatively is a helpful method for determining the maximal Cortisol response to surgical trauma and to identify high-risk individuals and that a relative postoperative adrenal insufficiency may be closely related to the decreased Cortisol secretion following major surgical trauma.

DOI： 10.1272/jnms.74.274

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)医薬情報研究所  

LES圧検査により診断されたアカラシア症例45例に対するバルーン拡張術の効果を検討し有効例・無効例の特徴について考察した。その結果、45例中有効例31例(68.9%)・無効例14例(31.1%)で、穿孔などの合併症は認めなかった。年齢別でみると有効例は36〜79歳・中央値62.0歳、無効例は12〜76歳・37.5歳と有効例は有意に高齢であり、40歳をcut-off値とすると40歳以上の有効率は81.8%、40歳未満では33.3%であった。性別・LES圧別・体重減少・悩病期間との関連では有効例・無効例に有意差を認めなかった。LES弛緩残圧では有効例で23例中19例が20mmHg以下であり、有意差は認めなかったもののLES弛緩残圧が20mmHg以下の症例で拡張術の効果が良好であり、また今回の検討では拡張型と拡張術の関連は認めなかった。以上より40歳以上の患者ではバルーン拡張術が有効であるが、40歳未満の若年者症例では筋が柔らいため当初から外科的手術を考慮する必要があると考えられた。

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objectives: Vascular endothelial growth factor (VEGF) plays an important role in angiogenesis. We evaluated the changes in serum levels of VEGF following major surgical trauma and postoperative inflammatory complications. Materials and Methods: The serum concentration of VEGF was measured with enzyme-linked immunosorbent assay in 41 patients with esophageal cancer who underwent right transthoracic esophagectomy with extensive lymphadenectomy and in 13 patients with gallstones who underwent less-invasive laparoscopic cholecystectomy for comparison. Serum and plasma samples were obtained before the operation and on postoperative days (PODs) 1, 7, 14, 21, and 28. The changes in serum VEGF levels were compared among groups categorized by age, sex, blood loss volume during operation, amount of transfusion, pathological stage of the tumor, and postoperative inflammatory complications. The correlation between serum VEGF levels and inflammatory factors, such as peripheral blood cell count, interleukin-6 (IL-6), C-reactive protein (CRP), and severity of postoperative inflammatory complications, was also investigated. Furthermore, because platelets are a potential source of serum VEGF, platelet-poor plasma (PPP) was prepared from plasma samples, and the VEGF concentration in PPP was measured to compare with those in sera. Results: Serum VEGF levels increased significantly postoperatively. After reaching maximal levels on POD 14, VEGF levels gradually decreased until POD 28. The increase in the tranthoracic esophagectomy group was approximately twice that in laparoscopic cholecystectomy group on POD 14. Serum VEGF levels were not correlated with sex, age, blood loss, amount of transfusion, or tumor stage. However, serum VEGF levels were significantly higher in patients with postoperative inflammatory lung complications than in patients without such complications, and the maximal level of serum VEGF correlated with the severity of postoperative lung complications. However, there were no significant correlations between the increase in the level of serum VEGF and that of serum IL-6 or CRP. The increase of platelet counts in the peripheral blood correlated with that of the serum VEGF level, and VEGF levels in PPP were significantly lower than those in sera. Conclusions: Serum VEGF levels increased in the angiogenesis phase of wound healing following major surgical injury. Platelets are a potential source of increased serum VEGF levels, whereas inflammatory lung complications might also be related to increased serum VEGF levels.

DOI： 10.1272/jnms.74.223

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)先端医学社  

non-erosive reflux disease(NERD)患者の食道運動機能を評価すると、LES圧、一次蠕動波(波高、出現率)は、健常者と同様であったが、二次蠕動波の出現率は、健常者にくらべ有意な低下がみられた。二次蠕動波は食道内の空気、液体などの伸展刺激により出現し、食道内に逆流した内容の排出に重要である。逆流発生時の逆流症状は、多因子の関与により出現していると考えられているが、その因子の一つとして、食道口側へ達する逆流、食道内の胃酸曝露時間の延長が考えられている。逆流後に二次蠕動波が出現しない場合には、逆流液のより食道口側への上昇、また逆流液の排出遅延の原因となり、二次蠕動波の出現率低下がNERD患者の症状出現に関連する可能性も考えられる。(著者抄録)

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Aims: Recently, endoscopic mucosal resection (EMR) has become the first choice of treatment for superficial esophageal cancer without metastasis. However, EMR is not safe for all patients. Argon plasma coagulation (APC) is a noncontact electrocoagulation technique that creates tissue damage. The risk of bleeding may be lower with APC than with EMR. Therefore, we selected APC for the treatment of patients with superficial esophageal cancer who could not undergo EMR. The aim of the present study was to describe these cases and analyze the results of this treatment. Patients and Methods: Ten patients with superficial esophageal cancer underwent APC at our institution from February 2001 through January 2002. None of the patients could undergo EMR because of complications. Ablation was performed using an APC probe (ERBE APC probe: ERBE Elektromedizin, Tübingen, Germany), a high-frequency electrosurgical generator (ERBE ICC200). and an argon delivery unit (ERBE APC 300). All patients had uneventful recoveries. Results: No incidents of bleeding from the ablated lesion or infection occurred. Oral intake was resumed on the day after treatment. The mean duration of the procedure was 20 minutes (range, 10 to 40 minutes). Disease recurred in two patients. Two patients died of laryngeal cancer and liver failure, respectively. Conclusion: APC is a safe and easy to perform procedure, but the effect of therapy is inferior to that of EMR in terms of the complete resection of the lesion. In conclusion. APC should be limited to cases of superficial esophageal cancer without metastasis in which EMR has been deemed difficult.

DOI： 10.1272/jnms.74.163

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

経鼻内視鏡(EG-530N;FUJINON社製)の構造から生じる操作性のメリットは、内視鏡径の細さと、内視鏡自体のしなやかさである。鼻腔を通過するためには、内視鏡径は6mm以下である必要があるが、EG-530Nの径は5.9mmである。通常の経口内視鏡では通過することのできなかった食道癌、逆流性食道炎による食道狭窄部を、EG-530Nでは通過できることがある。また、EG-530Nは食道内、十二指腸内の反転操作を可能とする。内視鏡のしなやかさは、スムーズな鼻腔挿入に重要であるが、EG-530Nは、鼻腔挿入に十分なしなやかさを有している。しなやかな内視鏡の操作性に関しては、当初は戸惑うが、ゆっくり検査を施行することにより、なんら問題なく、ゆっくり検査を行うことにより更なる内視鏡検査に対する苦痛が軽減される。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

下咽頭食道全摘出後の再建は頭頚部外科医にとって難手術の一つである。その異なる3再建術式の利点・欠点を明らかにするため、出血量・手術時間、合併症、術後機能を比較した。対象は54〜72歳男性、下咽頭癌・頚胸境界部食道癌17例で、術式は胃管(n=5)、延長胃管(n=7)、遊離空腸+胃管(n=5)であった。各術式で出血量・手術時間に差はなく、胃管で部分壊死、空腸+胃管で小瘻孔が各1例に生じたが、延長胃管では切除関連合併症が多かったものの、縫合不全はなかった。摂食内容に差はなく、食道発声は延長胃管と空腸+胃管の各1例で可能になった。この結果から3術式に顕著な差はないが、全身・社会的要因に基づき術式を選択すると良いと考えた。(著者抄録)

DOI： 10.5981/jjhnc.33.17

Scopus

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS INC  

It is reported that surveillance of serum p53 antibody (Ab) is a useful marker in detecting esophageal squamous cell carcinoma (ESCC). But there is little reported about prognostic significance of serum p53-Ab in postoperative patients with ESCC. The aim of this study is to evaluate the significance of preoperative serum p53-Ab as a marker of early recurrence after curative resection for ESCC. Enzyme-linked immunosorvent assay (ELISA) was used to analyze serum p53-Ab before treatment in 44 patients with ESCC. Carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC-Ag) were examined by immunoradiometric assay. The patients who were strongly positive and positive in serum p53-Ab were more likely to have early recurrence after curative resection than seronegative patients. There were no significant correlations between CEA, SCC-Ag positivity and early recurrence. We found that serum p53-Ab was useful to predict a risk of early recurrence after curative surgical resection for ESCC.

DOI： 10.1111/j.1442-2050.2007.00656.x

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report a case of perforation of the esophagus associated with mediastinitis and pneumomediastinum during endoscopic treatment. The patient was successfully treated by means of nonsurgical computed tomography-guided mediastinal drainage. Esophagoscopy demonstrated a scar on the 14th day at the perforation site. This nonsurgical treatment with computed tomography-guided mediastinal drainage is proposed as a less invasive treatment for iatrogenic perforation of the esophagus.

DOI： 10.1272/jnms.73.337

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report on a 41-year-old man with hematemesis and severe epigastric pain. Three hours after the onset of symptoms, we carefully performed upper gastrointestinal endoscopy for suspected upper gastrointestinal perforation. Endoscopy revealed a 2.5-cm-long longitudinal laceration of the lower esophagus without active gastric or duodenal ulcers. The laceration could be partially closed with endoscopic clipping. Computed tomography of the chest revealed a small amount of extraluminal air in the mediastinum. Neither pleural effusion nor pneumothorax was detected. We treated the patient conservatively on the basis of the following factors: a stable general condition without sepsis, limitation of the esophageal disruption to the mediastinum, and early diagnosis. The treatment course was uneventful, and the patient was discharged from the hospital after we had confirmed with endoscopy that the esophageal ulcer was completely healed. Although Boerhaave syndrome is generally considered to have poor prognosis, conservative therapy may be effective in select cases with early detection of the perforation.

DOI： 10.1272/jnms.73.341

Scopus

PubMed

researchmap

記述言語：英語  

Cyclo-oxygenase (COX)-2 is not usually detectable in normal tissues but is induced in inflammation and carcinogenesis. The level of COX-2 is elevated in cancer tissues of the colon, bladder, and skin. In the esophagus, squamous cell carcinoma and adenocarcinoma are known to express COX-2. The purpose of this study was to clarify the association of COX-2 expression with clinicopathological factors of squamous cell carcinoma. The immunohistochemical expression of COX-2 was examined in 48 surgical specimens of esophageal squamous cell carcinoma. Although COX-2 over-expression was more frequently observed in tumors invading the submucosa (T1b, 76.4%), muscularis propria (T2, 57.1%), adventitia, or adjacent organs (T3 approximately 4, 83.3%), even 33.3% of mucosal cancers, such as T1a, showed COX-2 over-expression. COX-2 over-expression was present in 82.3% of lymph node-negative patients but in only 54.8% of lymph node positive patients. There was no difference in COX-2 over-expression between the earlier stages (0 and I, 60%) and more advanced stages (II approximately IV, 69.6%). COX-2 over-expression did not correlate with survival during 3 years of follow-up. These findings suggest that COX-2 is associated with the phenotype of the esophageal squamous cell carcinoma cells, including superficial cancer cells, and may be related to tumor growth in esophageal squamous cell carcinoma.

DOI： 10.1272/jnms.73.308

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER ASSOC CANCER RESEARCH  

In lung tumors, the p53 tumor suppressor gene is commonly mutated with a characteristic mutation spectrum. The amount of and alterations in plasma DNA, such as mutations in p53, were associated with several cancers. Few studies used quantitative methods of high sensitivity. Previously, we observed p53 mutations in the noncancerous tissue that differed from those in lung tumors using the highly sensitive p53 mutation load assay. Based on our observation of an increased p53 mutation load in nontumorous lung tissue in smokers, we hypothesized that plasma DNA may contain mutant p53 indicative of tobacco smoke exposure and will be an effective biomarker of lung cancer or smoking exposure. We modified the p53 mutation load assay to detect mutations at p53 codons 248 and 249, common mutations in lung cancer, in plasma DNA samples with a sensitivity of 1:5,000. The assay was applied to a set of lung cancer cases (n = 39), hospital controls (n = 21), and population controls (n = 20) from a larger study. Controls were selected to consist of equal numbers of both ever and never smokers. The p53 mutation load (mutated p53 copies per total number of p53 copies) was associated with smoking (P = 0.06), but not with lung cancer (P = 0.59). Most of the individuals with p53 mutations observed in plasma DNA were ever smokers and the p53 mutation load was higher in those who smoked for longer durations (P = 0.04). In summary, we were able to detect p53 mutations in plasma DNA from healthy individuals and our data suggest that p53 mutations in plasma DNA may be a marker of carcinogen exposure from tobacco smoke.

DOI： 10.1158/0008-5472.CAN-06-0991

Web of Science

PubMed

researchmap

記述言語：英語  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report a rare case of cardiac tamponade after esophageal resection for esophageal cancer. A 69-year-old man underwent subtotal esophagectomy and reconstruction of the gastric tube with cervical anastomosis via the poststernal route and three-field lymphadectomy via a median sternotomy. On postoperative day 4, the patient developed dyspnea, chest oppression, and hemodynamic instability due to cardiac tamponade. Emergency percutaneous catheter drainage was performed to manage the cardiac tamponade. Acute pericarditis due to the original surgical procedure was suspected to be the cause of the tamponade. Although rare, cardiac tamponade should be considered as a cause of hemodynamic instability after esophageal resection. © JSA 2005.

DOI： 10.1007/s00540-005-0326-0

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report a case of double cancer of the liver and esophagus, an extremely rare condition that can be very difficult to treat. A tumorous lesion was pointed out in segment 6 of the liver of a 69-year-old man under treatment for liver cirrhosis. Abdominal computed tomography and angiography revealed a hepatocellular carcinoma. The patient underwent transcatheter arterial embolization and partial resection of segments 5 and 6. Fourteen months later, a small elevated lesion was detected in the esophagus during an endoscopic examination. The patient was treated by endoscopic mucosal resection and radiation therapy at a total dose of 50 Gy. Histological examination revealed a squamous cell carcinoma with cancer cells confined within the epithelium of the esophagus. Over the 6 years since the hepatectomy, there have been no signs of recurrence. We report a successful curative resection in an extremely rare form of double cancer with a poor prognosis.

DOI： 10.1272/jnms.72.187

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ACADEMIC PRESS INC ELSEVIER SCIENCE  

Hypoxia inducible factor (HIF)-1 alpha is a transcription factor that regulates the transcription of genes associated with cell proliferation and vascular development. In various cancer tissues, HIF-1 alpha is associated with clinicopathological factors, such as the tumor size, histological grade, and lymph node status. Although HIF-1 alpha plays a critical role in tumor growth by inducing vascular endothelial growth factor (VEGF), it is unclarified whether HIF-1 alpha affects lymphatic metastasis. The purpose of this study is to clarify the correlation of HIF-1 alpha protein expression with lymph node metastasis in esophageal squamous cell carcinoma (ESCC). The expressions of HIF-1 alpha and VEGF-C, which is one of the main lymphangiogenic factors, were examined in five ESCC cell lines and 48 surgical specimens of ESCC. HIF-1 alpha and VEGF-C mRNAs were expressed in all the five ESCC cell lines as determined by RT-PCR analysis. Inummohistochemically, 34 of the 48 patients (70.8%) were positive for HIF-1 alpha and 29 patients (60.4%) were positive for VEGF-C. Clinicopathologically, HIF-1 alpha expression correlated with lymphatic invasion and VEGF-C expression (P= 0.003 and P = 0.01, respectively). Furthermore, HIF-1 alpha expression tended to correlate with lymph node metastasis (P = 0.09). These findings suggest that HIT-lot plays a role in lymphatic invasion and lymph node metastasis through the induction of VEGF-C in ESCC. (c) 2004 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.yexmp.2004.11.002

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：MEDIMOND PUBLISHING CO  

The hypothalamic-pituitary-adrenal (HPA) axis is essential for the maintenance of homeostasis and acts as a major determinant of the host's response to surgical trauma. Since cortisol plays a central role for modulating inflammatory mediators and immune factors in surgical trauma, the adrenal response and inflammatory mediators to various degrees of surgical trauma was evaluated. The postoperative serum cortisol was significantly higher than the preoperative levels. In stressful surgeries, serum cortsol reached the maximal level determined by ACTH test and there was a remarkable increase in IL-6. Inflammatory complications were often found as outcome, and therefore, backup of corticosteroid is proposed to prevent surgery-induced relative adrenal insufficiency.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING ASIA  

To find new genes involved in esophageal squamous cell carcinogenesis, we constructed custom cDNA arrays and used the arrays to compare gene expression profiles of 12 matched normal and malignant esophageal samples including seven superficial cancer tissues. The arrays represented nearly 4000 genes, including 1728 that were specifically selected based on pilot studies to find genes that were differentially expressed in esophageal cancers. Expression values for all genes were normalized for each sample and were compared in normal versus tumor tissues. There was a marked decrease in the levels of the transcriptional elongation factor A gene in all 12 of the squamous cell cancer samples compared to matched normal samples. Because the transcription elongation factor A gene has not been previously reported to be involved in cancer development, our results suggest that further investigation of its role in esophageal carcinogenesis is warranted.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

We introduce the advanced rectangular styled Wallace-tree construction method. This method realizes a compact layout and high-speed operation of multiplier. A 32X24-bit multiplier-accumulator was constructed using this new method. 540 umX840 um area size and 300 MHz clock speed were achieved using 0.15 um CMOS logic process technology with flash memory. © 2005 IEEE.

DOI： 10.1109/ISCAS.2005.1464527

Scopus

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本救急医学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：MEDIMOND PUBLISHING CO  

The activation of the hypothalamic-pituitary-adrenal (HPA) axis is an essential component for the maintenance of homeostasis. The HPA axis is a major determinant of the host's response to surgical trauma. Serum cortisol concentrations after corticotropin (ACTH) stimulation were almost same as those postoperatively. The surgery-induced adrenal response correlated with the extent of surgical procedure except highly stressful surgery. The results suggested that short ACTH test performed before surgery was a helpful method to expect the maximal cortisol levels in surgical trauma and that severe surgical stress might cause relative adrenal insufficiency resulting in prominent inflammatory response often associated with postoperative complications.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：MEDIMOND PUBLISHING CO  

To test the hypothesis whether cytokeratin-19 fragment (CYFRA 21-1) in bronchoalveolar lavage fluid (BALF) reflects broncho-cpithelial cell damage following major surgery, we measured the CYFRA 21-1 and inflammatory mediators in BALF. Bronchoalveolar lavage was performed through a bronchoscope on 4 and 20 hr after esophgectomy in 20 patients. Postoperatively, acte lung injury (ALI) was observed in 6 patients (30%). The CYFRA 21-1 levels in patients with ALI were significantly higher than those in control. Neutrophils count/elastase level in BALF correlated with the levels of CYFRA 21-1. The CYFRA 21-1 levels in the BALF arc accurate indicators of the inflammatory intensity in the alveolar structures.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Mucoepidermoid carcinoma of the esophagus (MEC) is uncommon and has not been fully investigated. The biological behavior and clinical aspects of MEC were studied. The clinical features of eight patients with MEC were compared with 51 cases of squamous cell carcinoma of the esophagus (SCC). Proliferating cell nuclear antigen (PCNA), p53, and carcinoembryonic antigen (CEA) were stained in the resected specimens by immunohistochemistry Seven out of 8 cases (87.5%) had stage III by TNM classification. Four cases died of widespread metastases and 2 cases died of local recurrence within 2 years after the surgery. Neither chemotherapy and radiotherapy were effective against MEC. Overall median survival periods were 10.8 months for MEC and 32.1 months for SCC (P&lt
0.05). When patients in stage III alone were compared, MEC tended to have a worse prognosis than SCC (P=0.058). Immunohistochemical studies revealed that the positive rates of PCNA and CEA were significantly higher in MEC than in SCC (P&lt
0.05), while there was no significant difference in p53 positive rate. Esophageal MEC had an aggressive biological nature and was resistant to adjuvant therapies. The poor prognosis of esophageal MEC may be caused by high proliferative and metastatic potential.

DOI： 10.1272/jnms.70.401

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌学会  

researchmap

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER-VERLAG TOKYO  

Background. The prevalence of gastroesophageal reflux disease has been increasing in Japan as it has in Western countries, but Barrett's esophagus (BE) is less common in Japan than in Western countries. The aim of this study, therefore, was to investigate esophageal motility and clinical characteristics in Japanese patients with BE. Methods. Ten patients with BE were compared with ten patients with mild reflux esophagitis (RE), ten patients with severe RE, and ten healthy subjects of comparable age and sex. The prevalence of Helicobacter pylori was investigated in the patients with BE. The intraluminal microtransducer method was used to test for esophageal motility. Basal lower esophageal sphincter (LES) pressure was assessed by the rapid pull-through method. The esophageal wave after ten repeated 5-ml water swallowings at 30-s intervals was measured at 3, 8, 13, and 18 cm above the LES. Results. The basal LES pressure, the amplitude of the esophageal wave at 3 and 8 cm above the LES, and the frequency of primary peristalsis in the severe RE group and BE group were significantly lower than the values in the healthy subjects and the mild RE group. The amplitude of the esophageal wave 13 cm above the LES in the BE group was significantly lower than that in the healthy subjects and the mild RE group. There was no difference between the severe RE group and the BE group in the basal LES pressure and the amplitude of the esophageal wave. The frequency of primary peristalsis in the BE group, however, was significantly lower than that in the severe RE group. Nine of the ten patients with BE were H. pylori-negative. Conclusions. Our conclusions are that esophageal dysmotility in Japanese patients with BE represents an advanced stage of severe RE, and that most Japanese patients with BE are H. pylori-negative.

DOI： 10.1007/s00535-003-1193-9

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：ELSEVIER SCIENCE BV  

Background: Vascular endothelial growth factor (VEGF) is important in the wound healing process. We aimed to evaluate the changes of serum levels of VEGF in major surgical trauma. Patients/methods: Serum concentration of VEGF was measured by enzyme-linked immunosorbent assay in 16 patients who underwent esophagectomy for esophageal cancer. Serum samples were taken before the operation and on the 1st, 7th, 14th, 21st, 28th, 56th, and 84th postoperative days (POD). Results: Serum VEGF levels increased significantly on the 14th POD compared with the preoperative levels. Following the maximal levels on the 14th POD, serum VEGF levels decreased gradually until the 84th POD. There were no significant differences in relationships between serum levels of VEGF on the 14th POD and each of gender, age, and operative procedures. However, the increased ratio of platelet count in peripheral blood correlated with an increase in the serum VEGF level (r=0.683, p&lt;0.05, Spearman's rank). Conclusions: Increased serum levels of VEGF may indicate an angiogenesis phase of the postoperative wound healing process, which is most prominent on approximately the 14th POD. Platelets may be a potential source of increased circulating VEGF. (C) 2003 Elsevier Science B.V. All rights reserved.

DOI： 10.1016/S0531-5131(03)00196-1

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING ASIA  

The effect of preoperative chemotherapy on prognosis is still controversial. We have investigated the relationship between responses to preoperative chemotherapy and prognosis after curative operations in patients with esophageal squamous cell carcinoma. Thirty-nine patients received preoperative chemotherapy with continuous infusion of 500 mg/m(2) of 5-fluorouracil (5-FU) and intravenous injection of 20 mg/m(2) of leucovorin every 12 hours for 5 days. On the 5th day alone, 70 mg/m(2) of cisplatin was also infused. The effect was evaluated approximately 14 days after the end of one course of chemotherapy. The rates of responders and non-responders were 64.1% and 35.9%, respectively. After an interval of 21-28 days, transthoracic esophagectomy was performed. Significant histological effect by chemotherapy was found in responders compared to non-responders (P &lt; 0.05). Responders had a significantly better prognosis than non-responders by Log-rank test (P &lt; 0.01). This suggests that preoperative chemotherapy may contribute to better prognosis when the tumor is sensitive to chemotherapy.

Web of Science

researchmap

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ACADEMIC PRESS INC ELSEVIER SCIENCE  

Background. The circulating level of soluble L-selectin (sL-selectin) has been reported to be low in adult respiratory distress syndrome and acute lung injury. This study explores the role of L-selectin in the development of ventilator-associated pneumonia (VAP) in patients undergoing major surgery.
Patients and methods. Thirty-four patients who underwent esophagectomy were maintained by mechanical ventilation in a surgical intensive care unit. Fourteen patients developed VAP by postoperative day (POD) 7, while 20 patients did not. The plasma levels of soluble adhesion molecules and elastase were measured serially by ELISA or EIA. The expression of L-selectin on polymorphonuclear neutrophils (PMNs) was analyzed by flow cytometry.
Results. In multiple logistic regression analysis, only the preoperative plasma level of sL-selectin was significantly associated with VAP. The plasma sL-selectin level before surgery was significantly lower in the patients who developed VAP compared with the patients who did not develop VAP. After surgery, the level of sL-selectin did not change. The plasma level of soluble intercellular adhesion molecule-1 increased in the patients with and without VAP. The plasma level of soluble vascular cell adhesion molecule-1 was significantly higher in the patients with VAP. L-selectin expression on PMNs showed a peak on POD 2 in the patients without VAP, whereas it was impaired in the patients with VAP.
Conclusions. Determination of the preoperative plasma level of sL-selectin may help to identify patients at high risk for VAP after esophagectomy. (C) 2002 Elsevier Science (USA).

DOI： 10.1006/jsre.2002.6373

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

DOI： 10.1272/jnms.69.196

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The aim of this study was to evaluate the effect of preoperative chemotherapy on metastatic lymph nodes and on the outcome of patients who underwent esophagectomy for advanced squamous cell carcinoma of the esophagus. Fifty-nine patients with potentially resectable squamous cell carcinoma of the esophagus were studied. Twenty patients (group A) were treated by preoperative chemotherapy with cisplatin, 5-fluorouracil, and leucovorin, followed by surgery. Thirty-nine patients underwent surgery alone (group B). A total of 2591 resected lymph nodes were histologically evaluated for metastasis and the effect of chemotherapy. The metastasis rate in the resected lymph nodes, the number of metastatic lymph nodes, and outcome of the patients were statistically analyzed between groups. In group A, the clinical and pathological response rates were 75% and 75% respectively. The metastasis rate in the resected lymph nodes was significantly higher in group B (P &lt
0.01). The mean number of metastatic lymph nodes was significantly lower in group A (P &lt
0.05). Furthermore, the mean number of metastatic lymph nodes was significantly lower in the chemotherapy responders than in non-responders. The survival rate in group A was better than in group B (P = 0.07). Preoperative chemotherapy reduced the number of metastatic lymph nodes and may contribute to improving the outcome of the patients who have undergone esophagectomy for squamous cell carcinoma of the esophagus.

DOI： 10.1046/j.1442-2050.2002.00260.x

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING ASIA  

A 63-year-old man presented to our hospital with persistent dysphagia. Radiologic and endoscopic examination disclosed a 2.0-cm exophytic tumor in the middle third of the esophagus. An endscopically obtained biopsy specimen was found to represent undifferentiated small cell carcinoma. Computed tomography of the chest, abdomen, and cervical region was performed, as were gallium and bone scintigraphy. Metastasis to an adjacent lymph node was detected, without metastasis to distant organs. After neoadjuvant chemotherapy with carboplatin ( CBDCA) ( 400 mg/m(2)) and etoposide (VP-16) ( 100 mg/m(2)), endoscopy and barium-swallow esophagography showed regression. Thoracic esophagectomy then was performed with mediastinal, abdominal and cervical lymph node dissection. The resected tumor was polypoid, measuring 0.5 x 0.5 cm. The lesion consisted mainly of small anaplastic cells, but included a small focus of squamous cell carcinoma. The patient has survived for more than 7 months with no further treatment and no evidence of recurrent disease.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-LISS  

Background and Objectives: Cyclin D1 is known to play important roles in the GUS check-point of the cell cycle. We investigated the correlation between cyclin D1 overexpression and clinical characteristics to clarify its significance in patients with esophageal cancer.
Methods: From 1991 to 1998, cyclin D1 was investigated in esophageal cancers from 86 patients who underwent esophagectomy. Overexpression of cyclin D1 was demonstrated using an immunohistochemical method.
Results: Overexpression of cyclin D1 was found in 23 (26.7%) of 86 cases. Overexpression of cyclin D1 correlated with lymph node metastasis (P = 0.0083) and lymphatic vessel invasion (P = 0.018). Cyclin D1 overexpression may indicate resistance to chemotherapy. The patients with cyclin D1 overexpression had a significantly lower survival rate than those without overexpression (P = 0.013). The multivariate analysis revealed cyclin D1 overexpression to be an important prognostic factor in patients with esophageal cancer.
Conclusions: Immunohistochemical examination of cyclin D1 expression may provide important prognostic information in univariate and multivariate analysis and may be necessary for determining therapeutic strategies for esophageal cancer. (C) 2001 Wiley-Liss, Inc.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

症例は83歳女.Barrett食道として近医で経過観察していた.その後,上部消化管内視鏡検査で中部から下部食道にかけて小発赤と粗大顆粒状の凹凸を示す部位を認め,生検により腺癌と診断した.精査加療目的で入院した.生検により高分化型腺癌と診断した.経食道裂孔的に縦隔鏡補助下に食道切除術とリンパ節郭清を行い,胃管を後縦隔経路で挙上し,頸部で食道胃管吻合術を施行した.内視鏡所見で食道炎は認められなかったが,食道裂孔ヘルニアが認められた.術中術後に特に問題は認めず,現在外来通院中である

researchmap

記述言語：日本語   出版者・発行元：(一社)日本外科学会  

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：MEDIMOND S R L  

The effect of preoperative chemotherapy on prognosis is still controversial. We have analyzed the effects of preoperative chemotherapy and long-term survival after surgical therapy in patients with esophageal squamous cell carcinoma. In 39 patients, continuous infusion of 500 mg/m(2) of 5 FU and intravenous injection of 20 mg/m2 of leucovorin in every 12 hours were performed for 5 days. On the 5(th) day, 70 mg/m(2) of cisplatin was infused. The effect was evaluated approximately 14 days after the end of I course, After an interval of 21-28 days, en-bloc esophagectomy was performed. Responders (64.1%) had a significantly better prognosis than non-responders (35.9%) by Logrank test (p&lt;0.01,). This suggests that preoperative chemotherapy may contribute to the improved prognosis of the patients when tumor responds to chemotherapy. Prediction of chemo-sensititvity will be focused in the future study.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：日本臨床外科学会  

researchmap