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Nakagawa J, Terui K, Hosoi K, Ueno K, Yokoyama Y, Hayakari M. Passage of irinotecan and its active metabolite, SN-38, into human milk. J Clin Pharm Ther 2016; 41:579-82. [DOI: 10.1111/jcpt.12428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 06/29/2016] [Indexed: 11/28/2022]
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Yamada T, Takahashi G, Iwai T, Takeda K, Koizumi M, Shinji S, Yokoyama Y, Hara K, Hotta M, Matsuda A, Matsumoto S, Ohta K, Uchida E. Tracking emerging KRAS and BRAF mutations through ccfDNA in colorectal cancers treated with EGFR blockade. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Terada H, Kamata N, Yokoyama Y, Ohashp K, Akiyama H, Sakamaki H. T1-Hypersignal Foci in Cerebral Toxoplasmosis after Stem Cell Transplantation. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140090101400610] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We present here the unique image of toxoplasma encephalitis in a transplant recipient, characterized by the finding of T1-hypersignal foci. It is emphasized that cerebral toxoplasmosis after stem cell transplantation may show a high signal on T1-weighted images even without any hemorrhagic or calcified lesions.
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Furukawa T, Matsui K, Kitano M, Kitano S, Yokoyama Y, Sekiguchi M, Azuma N, Sano H. AB0646 The Role of Serum YKL-40 in Systemic Sclerosis (SSC). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Takata M, Tsunoda S, Ogita C, Yokoyama Y, Abe T, Maruoka M, Furukawa T, Yoshikawa T, Tanaka K, Saitou A, Nishioka A, Sekiguti M, Azuma N, Kitano M, Matsui K, Shimizu E, Sano H. AB0365 The Efficacy and Safety of Abatacept as A First Biologics in Japanese Rheumatoid Arthritis Patients Complicated by Pulmonary Involvement. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Yokoyama Y, Iwasaki T, Satake A, Shibasaki S, Karasaki M, Moriya N, Kitano S, Matsui K, Sano H. FRI0061 Involvement of Regulatory T Cells and Micrornas in Regulation of Collagen-Induced Arthritis in Mice Treated with IL-2/anti-IL-2 Immune Complexes. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yokoyama Y, Nishi M, Murayama H, Amano H, Taniguchi Y, Nofuji Y, Narita M, Matsuo E, Seino S, Kawano Y, Shinkai S. Association of Dietary Variety with Body Composition and Physical Function in Community-dwelling Elderly Japanese. J Nutr Health Aging 2016; 20:691-6. [PMID: 27499301 DOI: 10.1007/s12603-015-0632-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To examine the associations of dietary variety with body composition and physical function in community-dwelling elderly Japanese. DESIGN Cross-sectional study. SETTING Community-based. PARTICIPANTS A total of 1184 community-dwelling elderly adults aged 65 and over. MEASUREMENTS Dietary variety was assessed with a food frequency questionnaire (maximum, 10 points) that encompassed the 10 main food components of Japanese meals (meat, fish/shellfish, eggs, milk, soybean products, green/yellow vegetables, potatoes, fruit, seaweed, and fats/oils). Body composition was determined by multifrequency bioelectrical impedance analysis. Physical function was assessed by measuring grip strength and usual walking speed. Multiple linear regression analysis was used to examine the associations of dietary variety with body composition and physical function. RESULTS After adjusting for potential confounders, higher dietary variety scores were independently associated with higher lean mass (β (SE): 0.176 (0.049), p<0.001) and appendicular lean mass (β (SE): 0.114 (0.027), p<0.001) but not with body fat mass. Elders with a higher dietary variety score had greater grip strength and faster usual walking speed (β (SE): 0.204 (0.071), p=0.004, and β (SE): 0.008 (0.003), p=0.012, respectively). CONCLUSION Greater dietary variety was significantly associated with greater lean mass and better physical function in Japanese elders. The causal relationship warrants investigation in a prospective study.
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Kumasaka R, Yokoyama Y, Fuchinoue K, Mizunuma H, Taniguchi R, Hashimoto T, Oda T, Kusumi T. A case of ovarian small cell carcinoma of the pulmonary type that was observed as it developed. EUR J GYNAECOL ONCOL 2016; 37:710-713. [PMID: 29787016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION In the case reported here, the authors observed ovarian small cell carcinoma of the pulmonary type as it developed. CASE The patient was a 48-year-old woman who underwent a hysterectomy for CIN3 in 2007. A year later, the woman underwent screening for ovarian cancer. A gradually growing ovarian mass was noted. This mass was found to be a mixed tumor. This mixed tumor grew to 36 mm in size, and six months later it had enlarged to 119 mm. After surgery, the tumor was pathologically diagnosed as an ovarian small cell carcinoma of the pulmonary type with a neuroendocrine nature that was positive for CD56 and synaptophysin. Postoperatively, the patient received six courses of combined therapy with irinotecan and cisplatin (CPT-P therapy), and the patient has survived disease- free for over two years. CONCLUSION Findings suggested that ovarian small cell carcinoma of the pulmonary type is a type I ovarian malignancy that develops through an adenoma-carcinoma sequence.
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Takahashi G, Yamada T, Kan H, Matsumoto S, Koizumi M, Shinji S, Matsuda A, Yokoyama Y, Iwai T, Masuda Y, Watanabe A, Uchida E. 153P Novel, highly sensitive molecular biomarkers for metastatic colorectal cancer. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv523.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Arakawa M, Ohata C, Tsuruta D, Ishii N, Sogame R, Nakama T, Yasumoto S, Yokoyama Y, Takeishi E, Hashimoto T. A severe and prolonged case of pemphigoid gestationis successfully treated with combination therapies. Br J Dermatol 2015; 174:925-7. [PMID: 26521896 DOI: 10.1111/bjd.14265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sakata K, Yokoyama Y, Kobayashi S, Ogawa A. Change of the Health Condition of the Victims of the Great East Japan Earthquake. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nishiguchi K, Yokoyama Y, Fujii Y, Furukawa T, Ono F, Shimozawa N, Togo M, Suzuki M, Nakazawa T. Association between drusen and blood test results in a colony of 1,174 monkeys. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yamauchi A, Futagami M, Yokoyama Y, Iino K, Shigeto T, Mizunuma H, Kato N, Watanabe J. 2722 The clinicopathological features of relapsed stage IA endometrial cancer. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31489-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Takahashi G, Yamada T, Kan H, Matsumoto S, Koizumi M, Shinji S, Matsuda A, Yokoyama Y, Iwai T, Watanabe A, Nakayama M, Kitano S, Uchida E. 2028 Self-expandable colonic stent increases plasma level of circulating cell free DNA significantly in patients with obstructive colorectal cancer. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30951-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Iwai T, Yamada T, Kan H, Matumoto S, Koizumi M, Shinji S, Matuda A, Yokoyama Y, Takahashi G, Watanabe A, Nakayama M, Shiro K, Uchida E. 434 Follow-up after resection of metastatic liver tumor from colorectal cancer using circulating cell-free DNA. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30268-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Takagi T, Yokoyama Y, Kokuryo T, Yamaguchi J, Nagino M. Liver regeneration following experimental major hepatectomy with choledochojejunostomy. Br J Surg 2015; 102:1410-7. [PMID: 26312457 DOI: 10.1002/bjs.9908] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 06/30/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Surgical treatment for perihilar cholangiocarcinoma frequently involves hepatectomy and extrahepatic bile duct resection with a choledochojejunostomy (CJ). Cholangitis owing to bilioenteric anastomosis is a common complication. The impact of CJ or regurgitating cholangitis on the liver regeneration process after major hepatectomy is unknown. METHODS Rats underwent 70 per cent hepatectomy (Hx group) or hepatectomy with CJ (Hx + CJ group). The intrahepatic inflammatory response, hepatic regeneration rate, and expression of regeneration-associated genes in the liver and blood were compared between these two groups. RESULTS Levels of hepatobiliary markers in the blood were significantly higher 4 and 7 days after operation in the Hx + CJ group than the Hx group. Intrahepatic expression of inflammation-associated genes, such as interleukin 6 and tumour necrosis factor α, was also significantly higher in the Hx + CJ group on days 4 and 7. A progressive periportal inflammatory response was identified in the Hx + CJ group by histological examination. The hepatic regeneration rate was significantly lower in the Hx + CJ group than in the Hx group on day 2 (mean(s.d.) 14·2(6·3) versus 21·4(2·6) per cent; P = 0·013) and day 4 (32·4(5·3) versus 41·3(4·4) per cent; P = 0·004). Gene expression levels of hepatic regeneration-promoting factors such as hepatocyte growth factor were significantly lower in the Hx + CJ group than the Hx group on day 1. CONCLUSION CJ perturbs early liver regeneration after hepatectomy. An excessive inflammatory response in the liver and suppression of liver regeneration-associated factors may play a role. Surgical relevance Patients with perihilar cholangiocarcinoma may need major hepatectomy with extrahepatic bile duct resection and choledochojejunostomy. This carries a substantial risk of postoperative complications including liver failure. A rat model of partial hepatectomy with choledochojejunostomy was established. The molecular mechanisms underlying liver regeneration, and perturbation of this process by duodenobiliary reflux via the choledochojejunostomy, are described. The results give insight into the pathophysiological events following major hepatectomy with extrahepatic bile duct resection and choledochojejunostomy. This may help to develop a treatment strategy to reduce postoperative liver failure.
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Kitano M, Kitano S, Sekiguchi M, Azuma N, Abe T, Ogita C, Yokoyama Y, Yoshikawa T, Furukawa T, Hino T, Saito A, Nishioka A, Tsunoda S, Hashimoto N, Matsui K, Iwasaki T, Sano H. SAT0158 Comparison of Early Effect on Bone Metabolism in Patients with Active Rheumatoid Arthritis After Tocilizumab or Abatacept Therapy: Results from Propensity Score Analysis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Iwasaki T, Yokoyama Y, Kitano S, Satake A, Matsui K, Sano H. THU0071 Paradoxical Effects of Interleukin-2/Anti-interleukin-2 Monoclonal Antibody Immune Complex on Collagen-Induced Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yamaguchi K, Okusaka T, Shimizu K, Furuse J, Ito Y, Hanada K, Shimosegawa T, Yamaguchi K, Okusaka T, Shimizu K, Nakaizumi A, Itoi T, Mizuno N, Hatori T, Yamaue Y, Hanada K, Yamaguchi K, Fujii T, Endo W, Egawa S, Yamaue Y, Yokoyama Y, Furuse J, Ohigashi H, Nagaori T, Kanno S, Uesaka K, Okusaka T, Nakamura S, Ito Y, Shibuya K, Nakamura S, Ohguri T, Nagakura H, Okusaka T, Uesaka K, Kihara Y, Ito T, Furuse J, Hanada K, Itoi T, Mizuno N, Isayama H, Kanno A, Majima Y. EBM-based Clinical Guidelines for Pancreatic Cancer (2013) Issued by the Japan Pancreas Society: A Synopsis. Jpn J Clin Oncol 2014; 44:883-8. [DOI: 10.1093/jjco/hyu127] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kato T, Sakata-Yanagimoto M, Nishikii H, Ueno M, Miyake Y, Yokoyama Y, Asabe Y, Kamada Y, Muto H, Obara N, Suzukawa K, Hasegawa Y, Kitabayashi I, Uchida K, Hirao A, Yagita H, Kageyama R, Chiba S. Hes1 suppresses acute myeloid leukemia development through FLT3 repression. Leukemia 2014; 29:576-85. [PMID: 25234168 DOI: 10.1038/leu.2014.281] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 08/25/2014] [Accepted: 09/09/2014] [Indexed: 12/11/2022]
Abstract
In leukemogenesis, Notch signaling can be up and downregulated in a context-dependent manner. The transcription factor hairy and enhancer of split-1 (Hes1) is well-characterized as a downstream target of Notch signaling. Hes1 encodes a basic helix-loop-helix-type protein, and represses target gene expression. Here, we report that deletion of the Hes1 gene in mice promotes acute myeloid leukemia (AML) development induced by the MLL-AF9 fusion protein. We then found that Hes1 directly bound to the promoter region of the FMS-like tyrosine kinase 3 (FLT3) gene and downregulated the promoter activity. FLT3 was consequently upregulated in MLL-AF9-expressing immortalized and leukemia cells with a Hes1- or RBPJ-null background. MLL-AF9-expressing Hes1-null AML cells showed enhanced proliferation and ERK phosphorylation following FLT3 ligand stimulation. FLT3 inhibition efficiently abrogated proliferation of MLL-AF9-induced Hes1-null AML cells. Furthermore, an agonistic anti-Notch2 antibody induced apoptosis of MLL-AF9-induced AML cells in a Hes1-wild type but not a Hes1-null background. We also accessed two independent databases containing messenger RNA (mRNA) expression profiles and found that the expression level of FLT3 mRNA was negatively correlated with those of HES1 in patient AML samples. These observations demonstrate that Hes1 mediates tumor suppressive roles of Notch signaling in AML development, probably by downregulating FLT3 expression.
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Yamada T, Kan H, Matsumoto S, Koizumi M, Matsuda A, Shinji S, Yokoyama Y, Yamagishi A, Iwai T, Kitano S, Nakayama M, Watanabe A, Uchida E. Liquid Biopsy Detection of Kras and Braf Mutations May Be Useful As a Prognostic or Predictive Marker. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sato S, Shimada M, Ohta T, Kojimahara T, Tokunaga H, Takano T, Yamaguchi S, Fujiwara K, Tanabe H, Okamoto A, Nishio S, Ushijima K, Futagami M, Yokoyama Y, Fujimoto H, Nakamura H, Nakamura T, Moriyama M, Kai Y, Kigawa J. Adjuvant Chemotherapy Using Taxane Plus Carboplatin for Stage Ib-Iib Cervical Non-Squamous Cell Carcinoma with Pathologic High-Risk Factor. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu338.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Itatsu K, Yokoyama Y, Sugawara G, Kubota H, Tojima Y, Kurumiya Y, Kono H, Yamamoto H, Ando M, Nagino M. Incidence of and risk factors for incisional hernia after abdominal surgery. Br J Surg 2014; 101:1439-47. [PMID: 25123379 DOI: 10.1002/bjs.9600] [Citation(s) in RCA: 164] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 05/12/2014] [Accepted: 06/03/2014] [Indexed: 01/17/2023]
Abstract
BACKGROUND Few larger studies have estimated the incidence of incisional hernia (IH) after abdominal surgery. METHODS Patients who had abdominal surgery between November 2009 and February 2011 were included in the study. The incidence rate and risk factors for IH were monitored for at least 180 days. RESULTS A total of 4305 consecutive patients were registered. Of these, 378 were excluded because of failure to complete follow-up and 3927 patients were analysed. IH was diagnosed in 318 patients. The estimated incidence rates for IH were 5·2 per cent at 12 months and 10·3 per cent at 24 months. In multivariable analysis, wound classification III and IV (hazard ratio (HR) 2·26, 95 per cent confidence interval 1·52 to 3·35), body mass index of 25 kg/m(2) or higher (HR 1·76, 1·35 to 2·30), midline incision (HR 1·74, 1·28 to 2·38), incisional surgical-site infection (I-SSI) (HR 1·68, 1·24 to 2·28), preoperative chemotherapy (HR 1·61, 1·08 to 2·37), blood transfusion (HR 1·46, 1·04 to 2·05), increasing age by 10-year interval (HR 1·30, 1·16 to 1·45), female sex (HR 1·26, 1·01 to 1·59) and thickness of subcutaneous tissue for every 1-cm increase (HR 1·18, 1·03 to 1·35) were identified as independent risk factors. Compared with superficial I-SSI, deep I-SSI was more strongly associated with the development of IH. CONCLUSION Although there are several risk factors for IH, reducing I-SSI is an important step in the prevention of IH. REGISTRATION NUMBER UMIN000004723 (University Hospital Medical Information Network, http://www.umin.ac.jp/ctr/index.htm).
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Kakudate N, Sumida F, Matsumoto Y, Yokoyama Y, Gilbert GH, Gordan VV. Patient age and dentists' decisions about occlusal caries treatment thresholds. Oper Dent 2014; 39:473-80. [PMID: 24809540 DOI: 10.2341/13-141-c] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES This study was performed to 1) quantify dentists' treatment thresholds for occlusal primary caries; 2) determine if the patient's age affects dentists' decisions to surgically treat these carious lesions; and 3) test the hypothesis that patients', dentists', and practices' characteristics are significantly associated with surgical enamel intervention. METHODS The study used a cross-sectional design consisting of a questionnaire survey in Japan. This study queried dentists working in outpatient dental practices who were affiliated with the Dental Practice-Based Research Network Japan (JDPBRN), which aims to allow dentists to investigate research questions and share experiences and expertise (n=282). Participants were asked whether they would surgically intervene in a series of cases depicting occlusal caries. Each case included a photograph of an occlusal surface displaying typical characteristics of caries penetration and written descriptions of adult and pediatric patients at high caries risk. RESULTS In a case of a carious lesion within inner enamel, the proportion of dentists who indicated surgical intervention was significantly higher in adult patients (48%) when compared with pediatric patients (34%; p<0.01). Logistic regression analysis showed that using a dental explorer for the diagnosis of primary occlusal caries, type of practice, practice busyness, and percentage of patients who self-pay were significantly associated with dentists' decisions to intervene surgically into the inner enamel carious lesion. CONCLUSIONS These findings demonstrate that more than one-third of participants chose to intervene surgically into inner enamel carious lesions, and patients' age affects dentists' decisions about when to intervene surgically (clinicaltrials.gov registration number NCT01680848).
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Yokoyama Y, Nishigaki E, Abe T, Fukaya M, Asahara T, Nomoto K, Nagino M. Randomized clinical trial of the effect of perioperative synbiotics versus no synbiotics on bacterial translocation after oesophagectomy. Br J Surg 2014; 101:189-99. [PMID: 24402842 DOI: 10.1002/bjs.9385] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2013] [Indexed: 12/19/2022]
Abstract
BACKGROUND The impact of perioperative synbiotics on bacterial translocation and subsequent bacteraemia after oesophagectomy is unclear. This study investigated the effect of perioperative synbiotic administration on the incidence of bacterial translocation to mesenteric lymph nodes (MLNs) and the occurrence of postoperative bacteraemia. METHODS Patients with oesophageal cancer were randomized to receive perioperative synbiotics or no synbiotics (control group). MLNs were harvested from the jejunal mesentery before dissection (MLN-1) and after the restoration of digestive tract continuity (MLN-2). Blood and faeces samples were taken before and after operation. Microorganisms in each sample were detected using a bacterium-specific ribosomal RNA-targeted reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) method. RESULTS Some 42 patients were included. There was a significant difference between the two groups in detection levels of microorganisms in the MLN-1 samples. Microorganisms were more frequently detected in MLN-2 samples in the control group than in the synbiotics group (10 of 18 versus 3 of 18; P = 0·035). In addition, bacteraemia detected using RT-qPCR 1 day after surgery was more prevalent in the control group than in the synbiotics group (12 of 21 versus 4 of 21; P = 0·025). Neutrophil counts on postoperative days 1, 2 and 7 after surgery were all significantly higher in the control group than in the synbiotics group. CONCLUSION Perioperative use of synbiotics reduces the incidence of bacteria in the MLNs and blood. These beneficial effects probably contribute to a reduction in the inflammatory response after oesophagectomy. REGISTRATION NUMBER ID 000003262 (University Hospital Medical Information Network, http://www.umin.ac.jp).
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