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Sato S, Nakatani E, Hawke P, Nagai E, Taki Y, Nishida M, Watanabe M, Ohata K, Kanemoto H, Oba N. Systemic inflammation score as a predictor of death within one year after esophagectomy. Esophagus 2024:10.1007/s10388-024-01059-7. [PMID: 38625663 DOI: 10.1007/s10388-024-01059-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 04/01/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND After radical resection for esophageal cancer, death within 1 year of surgery can occur due both to recurrence and to other diseases, even after postoperative complications have been overcome. This study identified risk factors for early death within 1 year of esophagectomy for reasons other than death in hospital in patients undergoing esophagectomy for esophageal cancer or esophagogastric junction cancer. METHODS We reviewed 366 patients who underwent esophagectomy without adjuvant treatment between January 2009 and July 2022 for thoracic esophageal cancer or esophagogastric junction cancer. Patients who died within 1 year excluding in-hospital death were compared with those who did not. Multivariable logistic regression analysis was used to identify predictors of death within 1 year after surgery. RESULTS Death within 1 year occurred in 32 of 366 patients, 24 from primary disease and 8 from other diseases. Deaths within 1 year were significantly older than the other cases, had significantly lower % vital capacity (%VC), and occurred significantly more often in cases in advanced stages of disease. In a multivariable analysis, a systemic inflammation score (SIS) based on serum albumin level and lymphocyte-to-monocyte ratio was identified as an independent predictor of death within 1 year. As SIS increased, %VC decreased significantly, and CRP level and neutrophil-lymphocyte ratio increased significantly. There was no relationship between SIS and pN. Death within 1 year increased as SIS increased (p = 0.001 for trend). CONCLUSION SIS assessment undertaken before beginning esophageal cancer treatment is a useful predictor of death within 1 year of surgery.
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Affiliation(s)
- Shinsuke Sato
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, Japan.
| | - Eiji Nakatani
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Philip Hawke
- School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Erina Nagai
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, Japan
| | - Yusuke Taki
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, Japan
| | - Masato Nishida
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, Japan
| | - Ko Ohata
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, Japan
| | - Hideyuki Kanemoto
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, Japan
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Takeuchi A, Taki Y, Furuya K, Ito K, Suzuki M, Sato S, Watanabe M, Ohata K, Kanemoto H, Oba N. Gas Gangrene of the Spleen Caused by Clostridium perfringens After Mild Blunt Trauma. Cureus 2024; 16:e57429. [PMID: 38699113 PMCID: PMC11063976 DOI: 10.7759/cureus.57429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 05/05/2024] Open
Abstract
Splenic gas gangrene caused by Clostridium perfringens is rare. A 73-year-old woman was referred to our hospital because of fatigue, dyspnea, and left hypochondrial pain. She had a history of blunt trauma to the left abdomen eight days ago. She presented with hypoxemia and a high inflammatory response on blood tests. A CT showed left pleural effusion and gas in the spleen. She was treated with antimicrobials and underwent splenectomy. C. perfringens was identified from blood and intraoperative ascites cultures. She recovered and was discharged on day 34 of hospitalization. As C. perfringens is part of the normal gut microbiota and can translocate to other parts of the body, this bacterium should be considered a splenic abscess pathogen when an intracorporeal anaerobic environment is suspected.
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Affiliation(s)
- Akira Takeuchi
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Yusuke Taki
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Kento Furuya
- Department of Clinical Laboratory Medicine, Shizuoka General Hospital, Shizuoka, JPN
| | - Kenta Ito
- Department of Clinical Laboratory Medicine, Shizuoka General Hospital, Shizuoka, JPN
| | - Makoto Suzuki
- Department of Pathology, Shizuoka General Hospital, Shizuoka, JPN
| | - Shinsuke Sato
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Ko Ohata
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Hideyuki Kanemoto
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
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Sakaguchi K, Satoh T, Kawaguchi S, Aoyama T, Asahara K, Endo S, Shirane N, Kanemoto H, Oba N, Ohno K. Safety and efficacy of atezolizumab plus bevacizumab combination therapy in patients with unresectable hepatocellular carcinoma undergoing dialysis: a case series. Clin J Gastroenterol 2024:10.1007/s12328-024-01946-7. [PMID: 38502472 DOI: 10.1007/s12328-024-01946-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
Three patients aged 79, 75, and 81 years with unresectable hepatocellular carcinoma (HCC) and undergoing maintenance hemodialysis were treated with a combination of atezolizumab and bevacizumab. The patients, respectively, received their 22nd, 2nd, and 4th treatment cycles, and one achieved long-term stable disease. No serious adverse events, including immune-related adverse events, were observed in any patient. Remarkable progress has been made in chemotherapy for cancer; however, the efficacy and safety of chemotherapy in patients undergoing hemodialysis have not been adequately elucidated. This report provides novel insights into the feasibility and outcomes of atezolizumab and bevacizumab combination therapy in patients with HCC undergoing hemodialysis, highlighting its potential as a viable treatment option with manageable side effects.
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Affiliation(s)
- Koki Sakaguchi
- Department of Gastroenterology, Shizuoka General Hospital, 4-27-1 Kita Ando, Aoi-Ku, Shizuoka City, Shizuoka, Japan
| | - Tatsunori Satoh
- Department of Gastroenterology, Shizuoka General Hospital, 4-27-1 Kita Ando, Aoi-Ku, Shizuoka City, Shizuoka, Japan.
| | - Shinya Kawaguchi
- Department of Gastroenterology, Shizuoka General Hospital, 4-27-1 Kita Ando, Aoi-Ku, Shizuoka City, Shizuoka, Japan
| | - Takuya Aoyama
- Department of Gastroenterology, Yaizu City Hospital, Shizuoka, Japan
| | - Kazuhisa Asahara
- Division of Interventional Radiology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shinya Endo
- Department of Gastroenterology, Shizuoka General Hospital, 4-27-1 Kita Ando, Aoi-Ku, Shizuoka City, Shizuoka, Japan
| | - Naofumi Shirane
- Department of Gastroenterology, Shizuoka General Hospital, 4-27-1 Kita Ando, Aoi-Ku, Shizuoka City, Shizuoka, Japan
| | - Hideyuki Kanemoto
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazuya Ohno
- Department of Gastroenterology, Shizuoka General Hospital, 4-27-1 Kita Ando, Aoi-Ku, Shizuoka City, Shizuoka, Japan
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4
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Tokuda S, Fujita A, Takagi A, Kanemoto H, Oba N. Repair of Bile Duct Injury Using Indocyanine Green Following Laparoscopic Cholecystectomy. Cureus 2023; 15:e49312. [PMID: 38143614 PMCID: PMC10749145 DOI: 10.7759/cureus.49312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Bile duct injury (BDI) is a potential complication that may arise during cholecystectomy and continues to occur with a certain frequency in the present day. Numerous reports have been published regarding the utilization of indocyanine green (ICG) for the prevention of biliary injury, and we feel that the importance of ICG is being recognized. In this context, we present a case wherein a BDI occurred following cholecystectomy, and ICG was employed for the safe repair of the biliary tract.
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Affiliation(s)
- Satoshi Tokuda
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Akitsugu Fujita
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Akihiko Takagi
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Hideyuki Kanemoto
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, JPN
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Hayashi A, Taki Y, Arai K, Sato S, Higashizono K, Nagai E, Nishida M, Watanabe M, Ohata K, Kanemoto H, Suzuki M, Oba N. Esophageal ulcer related to zinc deficiency following a total gastrectomy. Nutrition 2023; 110:111999. [PMID: 36924754 DOI: 10.1016/j.nut.2023.111999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 01/24/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
A 76-y-old Japanese man who had undergone gastrectomy 4.5 y earlier experienced 2 wk of sore throat, heartburn, and difficulty swallowing. Endoscopy showed deep, craterlike, longitudinal ulcers in the lower and middle esophagus. Immunohistochemistry and blood tests were negative for herpes simplex virus and cytomegalovirus infections. The patient reported no other symptoms affecting the gastrointestinal tract. Although his symptoms ameliorated after initial hospitalization and treatment, they re-emerged a few days after being discharged. Fifty-one days after being first admitted, he complained of glossalgia. The serum zinc level was found to be 38 µg/dL, which was below the reference range; the patient was diagnosed with zinc deficiency. After oral zinc administration, the patient was relieved of the symptoms, and his pain was alleviated. Upper gastrointestinal endoscopy after symptom relief showed improvement in the esophageal ulcers. He has continued taking zinc supplementations, and has not developed similar symptoms in the 5 y since being treated. To the best of our knowledge, this is the first case report of esophageal ulcers related to zinc deficiency.
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Affiliation(s)
- Asumi Hayashi
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Yusuke Taki
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan.
| | - Kazumori Arai
- Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan
| | - Shinsuke Sato
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazuya Higashizono
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Erina Nagai
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Masato Nishida
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Ko Ohata
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Hideyuki Kanemoto
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Makoto Suzuki
- Department of Pathology, Shizuoka General Hospital, Shizuoka, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
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Muacevic A, Adler JR, Takagi A, Masui Y, Oba N. A Case of Resection of Hepatocellular Carcinoma in a Patient With Fontan-Associated Liver Disease. Cureus 2023; 15:e33382. [PMID: 36751192 PMCID: PMC9898843 DOI: 10.7759/cureus.33382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
The Fontan procedure (FP) is an operation used in patients with congenital single ventricle disease. The long-term prognosis after surgery has improved due to technological advances. However, the hemodynamics after FP are complicated. There are some reports of Fontan-associated liver disease (FALD) after FP. We report a case of a young woman who developed hepatocellular carcinoma due to FALD.
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Sekimori K, Sato S, Higashizono K, Nagai E, Taki Y, Nishida M, Watanabe M, Miyakoshi A, Oba N. Esophageal cancer presenting with brain abscess. Int Cancer Conf J 2023; 12:87-91. [PMID: 36605845 PMCID: PMC9807726 DOI: 10.1007/s13691-022-00584-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/31/2022] [Indexed: 11/08/2022] Open
Abstract
A 76-year-old man experienced fatigue and progressive dysphagia. He underwent endoscopy at another hospital and was diagnosed with thoracic esophageal cancer. Three days after the endoscopy, the patient was rushed to our hospital with sudden seizures of the right upper and lower extremities. Contrast-enhanced computed tomography scan revealed a ring-shaped contrast-enhanced mass formation in the left parietal lobe with edema in the surrounding brain parenchyma. Contrast-enhanced magnetic resonance imaging showed a ring-shaped lesion with a high intensity on diffusion-weighted images. He was diagnosed with a brain abscess in the left parietal lobe. For abscess drainage, a quasi-emergent small craniotomy was performed. Culture of the drainage fluid revealed Streptococcus species and Haemophilus parainfluenzae. After 6 weeks of antibiotic therapy, the patient underwent a thoracoscopic esophagectomy. After the esophagectomy, there was no recurrence of the brain abscess for more than 2 years and only symptomatic epilepsy remained. Conclusively, although brain abscesses caused by esophageal cancer are rare, the possibility of brain abscess and metastasis should be considered when patients present with convulsions or higher brain disorders.
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Affiliation(s)
- Kenichi Sekimori
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-Ku, Shizuoka, 420-8527 Japan
| | - Shinsuke Sato
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-Ku, Shizuoka, 420-8527 Japan
| | - Kazuya Higashizono
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-Ku, Shizuoka, 420-8527 Japan
| | - Erina Nagai
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-Ku, Shizuoka, 420-8527 Japan
| | - Yusuke Taki
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-Ku, Shizuoka, 420-8527 Japan
| | - Masato Nishida
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-Ku, Shizuoka, 420-8527 Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-Ku, Shizuoka, 420-8527 Japan
| | - Akinori Miyakoshi
- Department of Neurosurgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-Ku, Shizuoka, 420-8527 Japan
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Tatsuta K, Taki Y, Nakatani E, Higashizono K, Nagai E, Nishida M, Sato S, Ohata K, Watanabe M, Kanemoto H, Oba N. Risk factors for candidiasis as an intra-abdominal infection after gastrectomy in patients with gastric cancer. Jpn J Infect Dis 2022; 75:461-465. [DOI: 10.7883/yoken.jjid.2021.893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Kyota Tatsuta
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Yusuke Taki
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Eiji Nakatani
- Division of Statistical Analysis, Research Support Center, Shizuoka General Hospital, Japan
| | - Kazuya Higashizono
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Erina Nagai
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Masato Nishida
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Shinsuke Sato
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Ko Ohata
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Hideyuki Kanemoto
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
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Takagi A, Hawke P, Tokuda S, Toda T, Higashizono K, Nagai E, Watanabe M, Nakatani E, Kanemoto H, Oba N. Serum carnitine as a biomarker of sarcopenia and nutritional status in preoperative gastrointestinal cancer patients. J Cachexia Sarcopenia Muscle 2022; 13:287-295. [PMID: 34939358 PMCID: PMC8818668 DOI: 10.1002/jcsm.12906] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 09/05/2021] [Accepted: 11/29/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Sarcopenia is an important factor in the postoperative outcome of gastrointestinal cancer patients. However, little research has been carried out on potential biomarkers of sarcopenia. Carnitine is an amino acid derivative that is stored in skeletal muscle and is essential for muscle energy metabolism. The primary purpose of this study was to investigate whether serum carnitine level is a biomarker of sarcopenia in preoperative patients with gastrointestinal cancer. The secondary purposes were (i) to examine the associations between carnitine, nutritional status, and albumin level, and (ii) to determine whether carnitine is a prognostic factor for postoperative complications. METHODS One hundred fourteen patients scheduled to undergo gastroenterological surgery between August 2016 and January 2017 were enrolled. Their mean age was 68.4 ± 10.5, and 64.9% were male. Serum carnitine fractions [total carnitine (TC), free l-carnitine (FC), and acylcarnitine (AC)] were measured prior to surgery. The correlation between carnitine level and a variety of clinical features was analysed, including skeletal muscle index (SMI), sarcopenia, prognostic nutritional index (PNI), and postoperative complications. RESULTS Tumour locations included the oesophagus (n = 17), stomach (n = 16), pancreas (n = 20), bile duct (n = 9), liver [n = 33; primary liver cancer (n = 18), liver metastasis (n = 15)], and colorectal region (n = 19). TC and FC levels varied significantly by tumour location. TC and FC showed significant positive correlations with SMI [TC (r = 0.295, P = 0.0014), FC (r = 0.286, P = 0.0020)] and PNI [TC (P = 0.0178, r = 0.222), FC (P = 0.0067, r = 0.2526)]. These levels were significantly lower in the sarcopenia group (TC, P = 0.0124; FC, P = 0.0243). In addition, TC and FC showed significant positive correlations with ALB level [TC (P = 0.038 r = 0.19), FC (P = 0.016 r = 0.23)]. When patients were divided into high ALB (≥3.5 g/dL, 96 patients) and low ALB (<3.5 g/dL, 18 patients) groups, these correlations were no longer significant, but in the low ALB group there was a tendency towards a negative relationship between ALB level and both TC and FC. No significant relationship was found between postoperative complications and carnitine level. CONCLUSIONS This study suggests that carnitine level is a biomarker of sarcopenia and nutritional status. However, it did not find an association between carnitine level and postoperative complications.
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Affiliation(s)
- Akihiko Takagi
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Philip Hawke
- School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan
| | - Satoshi Tokuda
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Takeo Toda
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazuya Higashizono
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Erina Nagai
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Eiji Nakatani
- Division of Statistical Analysis, Research Support Center, Shizuoka General Hospital, Shizuoka, Japan
| | - Hideyuki Kanemoto
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
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10
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Toda T, Kanemoto H, Tokuda S, Takagi A, Oba N. Pancreaticoduodenectomy preserving aberrant gastroduodenal artery utilized in a previous coronary artery bypass grafting: A case report and review of literature. Medicine (Baltimore) 2021; 100:e27788. [PMID: 35049175 PMCID: PMC9191372 DOI: 10.1097/md.0000000000027788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022] Open
Abstract
RATIONALE Pancreaticoduodenectomy (PD) is a technically demanding procedure with high rates of morbidity and mortality. Therefore, preoperative evaluation of anatomy is indispensable. Multi-detector row computed tomography (CT) enables us to precisely understand arterial anatomy. It is a well-known fact that anatomical variants are often present in the hepatic artery (HA) but rarely in the gastroduodenal artery (GDA). We present the case of a patient with ampullary cancer with a rare anatomical anomaly, "replaced GDA (rGDA) " arising from the superior mesenteric artery, along with a history of coronary artery bypass grafting (CABG) using right gastroepiploic artery (RGEA). PATIENT CONCERNS A 69-year-old male patient was referred to our department for further investigation of elevated hepatobiliary enzymes. He presented with no symptoms besides intermittent fever of 38°C. He had an operative history of CABG using the RGEA. DIAGNOSIS Abdominal CT and esophagogastroduodenoscopy showed an ampullary tumor and biopsy specimen from the lesion revealed adenocarcinoma. CT angiography revealed the rGDA instead of a normal common HA. INTERVENTION We performed a safe PD, preserving the rGDA and the RGEA to maintain hepatic and cardiac perfusion. OUTCOMES Owing to the presence of a refractory pancreatic fistula, the length-of-hospital stay was extended, and he was discharged on postoperative day 72 without vascular complications. At present, the patient is in good physical condition and does not present with cardiovascular complications as well as tumor recurrence at 6 months after surgery. LESSONS This is possibly the first case of a patient who underwent PD and has a proper HA following a GDA arising from a superior mesenteric artery (rGDA) and has a previous operative history of CABG using the gastroepiploic artery. The coexistence of the history of cardiovascular surgery made PD for this patient considerably more challenging.In the case of a rare anatomical anomaly, a coronary artery bypass via the RGEA should not be considered as an obstacle when R0 resection is achievable.
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Affiliation(s)
- Takeo Toda
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi-Ku, Shizuoka-Shi, Shizuoka, Japan
| | - Hideyuki Kanemoto
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi-Ku, Shizuoka-Shi, Shizuoka, Japan
| | - Satoshi Tokuda
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi-Ku, Shizuoka-Shi, Shizuoka, Japan
| | - Akihiko Takagi
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi-Ku, Shizuoka-Shi, Shizuoka, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kita-Ando, Aoi-Ku, Shizuoka-Shi, Shizuoka, Japan
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11
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Taki Y, Watanabe M, Sato S, Higashizono K, Nagai E, Nishida M, Oba N. Duplicate left gastric artery identified during laparoscopic distal gastrectomy. Asian J Endosc Surg 2021; 14:290-292. [PMID: 32875746 DOI: 10.1111/ases.12854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/30/2020] [Accepted: 08/02/2020] [Indexed: 11/29/2022]
Abstract
The reported incidence of duplicate left gastric artery is not very low, with a rate of 0.4%. However, there have been no reports of the surgical management of patients with a duplicate left gastric artery. Here, we report a 60-year-old Japanese man diagnosed with clinical T1bN0M0 stage IA gastric cancer. Preoperative 5-mm slice CT showed no anatomical abnormality, and the patient underwent laparoscopic distal gastrectomy. When we dissected the nerve plexus around the left gastric artery with an ultrasonic vessel-sealing device, pulsating bleeding was observed from a small vessel in the nerve plexus. The bleeding was stopped by suture and clipping. A 1.2-mm vessel was identified on 1-mm slice preoperative CT and postoperative CT angiography. The patient was discharged without any complications. To the best of our knowledge, this is the first report of a patient undergoing surgery for a duplicate left gastric artery.
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Affiliation(s)
- Yusuke Taki
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Shinsuke Sato
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazuya Higashizono
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Erina Nagai
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Masato Nishida
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
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12
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Taki Y, Sato S, Nakatani E, Higashizono K, Nagai E, Nishida M, Watanabe M, Ohata K, Kanemoto H, Oba N. Preoperative skeletal muscle index and visceral-to-subcutaneous fat area ratio are associated with long-term outcomes of elderly gastric cancer patients after gastrectomy. Langenbecks Arch Surg 2021; 406:463-471. [PMID: 33515316 DOI: 10.1007/s00423-021-02092-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/14/2021] [Indexed: 12/09/2022]
Abstract
PURPOSE Sarcopenia is a risk factor of severe surgical complications, short-term outcomes, and long-term outcomes for patients with gastric cancer. Several computed tomography (CT) measurements have been performed to diagnose sarcopenia. However, the optimal CT measurements for determining long-term outcomes have not been revealed. METHODS A retrospective review of gastric cancer patients with clinical stage I, II, or III who underwent gastrectomy at age 75 years or more at Shizuoka General Hospital from 2007 to 2015 was performed. Using preoperative CT, skeletal muscle index (SMI), total psoas area, intramuscular adipose tissue content in multifidus muscle, morphologic change of psoas muscle, and visceral-to-subcutaneous adipose tissue area ratio (VSR) were measured in the third lumbar section. A Cox regression analysis was used to explore prognostic factors for overall survival. RESULTS A total of 257 patients were reviewed. There were 171, 53, and 33 patients with clinical stages I, II, and III, respectively. A multivariate analysis indicated that, in addition to age, performance status, clinical stage, and types of resection, which are known prognostic factors, SMI and VSR are prognostic factors (p = 0.016, 0.046, respectively). The prognostic score, which was the frequency of positive SMI and VSR values within the cutoff, also indicates overall survival. The five-year OS rates of patients with prognostic scores of 0, 1, and 2 were 90.9%, 62.3%, and 52%, respectively (p < 0.001). CONCLUSION Preoperative SMI and VSR were prognostic factors for the overall survival of elderly patients with gastric cancer after gastrectomy.
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Affiliation(s)
- Yusuke Taki
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan.
| | - Shinsuke Sato
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Eiji Nakatani
- Division of Statistical Analysis in Research Support Center, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazuya Higashizono
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Erina Nagai
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Masato Nishida
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Ko Ohata
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Hideyuki Kanemoto
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi-ku, Shizuoka, 420-8527, Japan
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13
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Sato S, Higashizono K, Nagai E, Taki Y, Nishida M, Watanabe M, Oba N. Hand-assisted robotic surgery in the abdominal phase of robot-assisted oesophagectomy. J Minim Access Surg 2021; 17:415-417. [PMID: 32964879 PMCID: PMC8270039 DOI: 10.4103/jmas.jmas_68_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Robot-assisted minimally invasive oesophagectomy (RAMIE) has been developed to overcome the technical limitations of conventional thoracoscopic oesophagectomy. Hand-assisted laparoscopic surgery (HALS) is used as a practical and useful technique during the abdominal phase of thoracoscopic oesophagectomy. During RAMIE, a robotic vessel sealer cannot be used with HALS; another vessel sealer or ultrasonic coagulating device for laparoscopic surgery is required. We report an initial experiment using hand-assisted robotic surgery (HARS) for abdominal manipulation during RAMIE as a novel method. Under the pneumoperitoneum induced by insufflating the abdomen to 10 mmHg with carbon dioxide, the assistant surgeon lifted the stomach and greater omentum using the left hand through a 7 cm upper abdominal midline incision at approximately 2 cm below the xiphoid. Subsequently, gastric mobilisation was performed by robot-assisted surgery. Between January 2019 and February 2020, eight patients with thoracic oesophageal cancer underwent RAMIE with HARS at our hospital. The median operative time for extracorporeal manipulation and preparation for the roll-in of the robot was 39.5 min. The median console time was 47.5 min. There were no intraoperative or postoperative complications related to the use of the robot and no in-hospital mortality. In conclusion, HARS seems to be feasible and safe for abdominal manipulation during oesophageal cancer surgery.
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Affiliation(s)
- Shinsuke Sato
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Kazuya Higashizono
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Erina Nagai
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Yusuke Taki
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Masato Nishida
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Shizuoka, Japan
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14
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Sato S, Nakatani E, Higashizono K, Nagai E, Taki Y, Nishida M, Watanabe M, Oba N. Size of the thoracic inlet predicts cervical anastomotic leak after retrosternal reconstruction after esophagectomy for esophageal cancer. Surgery 2020; 168:558-566. [PMID: 32611514 DOI: 10.1016/j.surg.2020.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 04/10/2020] [Accepted: 04/12/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Although an anastomotic leak after esophagectomy is one of the most common postoperative complications, it is not well understood whether specific anatomic factors of the different route of reconstruction can predispose to the development of anastomotic leak after esophagectomy. This study aimed to clarify whether various factors related to the size of the thoracic inlet are independent predictors of anastomotic leak after esophagectomy. METHODS We reviewed 248 patients who underwent esophagectomy with retrosternal reconstruction of the gastric conduit between January 2013 and March 2019. Various factors related to the size of the thoracic inlet were measured using computed tomography. Multivariate logistic regression was used to analyze the association between various measurements and anastomotic leak. RESULTS Anastomotic leak occurred in 38 patients (15.3%). On univariate analysis, the thickness of the sternum, the thickness of the clavicle, the sternum-trachea distance, the ratio of the sternum-trachea distance/sternum-vertebral body distance, sex, body mass index, and method of anastomosis were statistically significantly associated with anastomotic leak. On multivariate analysis, the ratio of the sternum-trachea distance/sternum-vertebral body distance and the method of anastomosis were the independent risk factors for anastomotic leak. CONCLUSION The ratio of the sternum-trachea distance/sternum-vertebral body distance is associated with cervical anastomotic leak after retrosternal gastric conduit reconstruction after esophagectomy. Measurement of the thoracic inlet space may contribute to preoperative planning, such as for the route of the conduit for reconstruction and anastomotic site.
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Affiliation(s)
- Shinsuke Sato
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan.
| | - Eiji Nakatani
- Division of Statistical Analysis, Research Support Center, Shizuoka General Hospital, Japan
| | - Kazuya Higashizono
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Erina Nagai
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Yusuke Taki
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Masato Nishida
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Masaya Watanabe
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
| | - Noriyuki Oba
- Department of Gastroenterological Surgery, Shizuoka General Hospital, Japan
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15
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Furiya Y, Tomiyama T, Oba N, Ikeda M, Ueno S. Rivastigmine improves patients’ appetite by increasing serum active ghrelin and cortisol in Alzheimer’s disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Abe K, Yuda S, Yasui K, Oba N, Okubo A, Kobayashi C, Yanagihara N, Kawano Y, Nagahara D, Teramoto A, Nagoya S, Yamashita T, Takahashi S, Miura T. P5246Preoperative soleal vein diameter determined by ultrasonography is an independent predictor of deep vein thrombosis regardless of the type of major orthopedic surgery. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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17
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Taki Y, Kenzaka T, Ohata K, Watanabe M, Kanemoto H, Sato S, Nakamura T, Takeshima T, Oba N, Takagi M. Cause and Responsible Microorganisms of Bacteremia after Gastrointestinal Surgery. J Am Coll Surg 2016. [DOI: 10.1016/j.jamcollsurg.2016.08.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Sato S, Nagai E, Hazama H, Taki Y, Takahashi M, Kyoden Y, Watanabe M, Ohata K, Kanemoto H, Oba N, Takagi M. Video-assisted thoracoscopic esophagectomy in the left lateral decubitus position in an esophageal cancer patient with pectus excavatum. Asian J Endosc Surg 2015; 8:333-6. [PMID: 26303731 DOI: 10.1111/ases.12195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 02/11/2015] [Accepted: 04/16/2015] [Indexed: 11/28/2022]
Abstract
During thoracic cavity operations, it is difficult to obtain sufficient working space and good operative field visibility in patients with pectus excavatum because the space between the vertebral bodies and sternum is very narrow. Here, we report the successful treatment of esophageal cancer in a patient with pectus excavatum. A 77-year-old man with esophageal cancer was referred to our hospital for further treatment. He was diagnosed with multiple early esophageal squamous cell carcinomas. The patient had pectus excavatum, but because it was asymptomatic, a video-assisted thoracoscopic radical esophagectomy in the left lateral decubitus position without pectus excavatum repair was selected. Despite the patient's unusual anatomy, video-assisted thoracoscopic esophagectomy in the left decubitus position allowed for good operative field visibility, as the videoscope was inserted from the side of the diaphragm. This operative procedure is useful in patients with esophageal cancer who also have pectus excavatum. To the best of our knowledge, this is the second report of video-assisted thoracoscopic esophagectomy in an esophageal cancer patient with pectus excavatum.
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Affiliation(s)
- Shinsuke Sato
- Department of Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Erina Nagai
- Department of Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Hiroyuki Hazama
- Department of Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Yusuke Taki
- Department of Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | | | - Yusuke Kyoden
- Department of Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Masaya Watanabe
- Department of Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Ko Ohata
- Department of Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | | | - Noriyuki Oba
- Department of Surgery, Shizuoka General Hospital, Shizuoka, Japan
| | - Masakazu Takagi
- Department of Surgery, Shizuoka General Hospital, Shizuoka, Japan
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19
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Matsui Y, Ishibashi H, Ota S, Hirose M, Oba N, Tanio N, Nakajima N, Muro H. [Bilateral pulmonary metastases from hepatocellular carcinoma successfully treated by surgical resection and stereotactic radiotherapy; report of a case]. Kyobu Geka 2011; 64:944-946. [PMID: 21899135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We report a case of 68-year-old-man with pulmonary metastases from hepatocellular carcinoma (HCC). Following right hepatic lobectomy in January 2005, 4 pulmonary metastases in the right lung were detected by chest computed tomography (CT) in September 2007. As chemotherapy was not effective, surgical resection (right upper lobectomy, partial resection of middle and lower lobe ) was performed. Secondary metastases in the left lung was detected in March 2008, and stereotactic radiotherapy was performed considering the site of tumor location and poor pulmonary function. Two years after radiotherapy, the patient is alive without recurrence.
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Affiliation(s)
- Yuya Matsui
- Department of Thoracic Surgery, Shizuoka General Hospital, Shizuoka, Japan
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20
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Mori H, Oba N, Miyazaki T, Kozakai T. Changes in surface topography during the early stage of cyclic deformation of b.c.c. iron-alloy single crystals. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/01418618008239371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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21
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Imai R, Ito K, Ishigami N, Oba N, Nakajima N. Occlusion of the left superficial femoral artery during hepatic arterial infusion of chemotherapy for liver metastases from colon cancer 18 months after the implantation of a port system: a case report. Jpn J Clin Oncol 2002; 32:68-70. [PMID: 11948232 DOI: 10.1093/jjco/hyf010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We report a case of complication of a catheter port system. A 67-year-old male who had undergone left hemicolorectomy and partial hepatectomy for liver metastases from colon cancer underwent hepatic arterial infusion (HAI) of chemotherapy by a percutaneously implanted catheter port system to prevent recurrence. Eighteen months after the implantation of a port system he complained of intermittent claudication. Intravenous digital subtraction angiography (IV-DSA) showed occlusion of the left superficial femoral artery. The catheter was removed and a femoro-popliteal bypass with an artificial graft was constructed. Thrombus was found around the indwelling catheter at the insertion site. After the operation his complaint disappeared and has been alive without recurrence for 6 years.
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Affiliation(s)
- Reiko Imai
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Maebashi, Japan.
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22
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Oba N, Fujimoto Y, Hirata K, Ando N, Saida K. [A case of Gerstmann-Sträussler-Scheinker disease with severe muscular atrophy and vertical gaze palsy]. Rinsho Shinkeigaku 2000; 40:726-31. [PMID: 11186913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Here we report a case of 56-year-old man with Gerstmann-Sträussler-Scheinker disease (GSS). He had gait disturbance, limb and truncal ataxia, dysarthria and dysphagia at the age of 53. When he developed vertical gaze palsy and dystonic posture of the neck, subcortical dementia, progressive supuranuclear palsy was suspected. Thereafter dementia rapidly progessed, and CT scan showed severe atrophy of the brain. Since severe muscular atrophy and fasciculation also appeared, and abnormality in the codon 102 of prion protein gene was found, he was diagnosed to have the classical type of GSS. GSS with vertical gaze palsy has never been reported, and involvement of the lower motor neuron is also very rare. Therefore, the present case is an atypical type of GSS.
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Affiliation(s)
- N Oba
- Department of Neurology, Nishinara National Hospital
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23
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Oba N, Horikawa H. [A case of midbrain infarction with acute bilateral cerebellar ataxia]. Rinsho Shinkeigaku 2000; 40:614-6. [PMID: 11086404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
An 81-year-old man was suffered from acute dysarthria and gait disturbance. Bilateral cerebellar ataxia and ataxic dysarthria were the only neurological findings. MRI images revealed an infarction in the lower and medial part of the midbrain. We consider that bilateral ataxia of the present case was caused by the lesion at the decussation of the superior cerebellar peduncle.
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Affiliation(s)
- N Oba
- Department of Neurology, Gojo Hospital
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24
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Abstract
A case of adrenal rest tumor arising in the liver of a 62-year-old male with chronic hepatitis type C is reported. The tumor was clinically non-functioning and required distinction from hepatocellular carcinoma. The yellowish-brown tumor measured 25 x 18 x 15 mm and was located in the subcapsular portion of the right hepatic lobe. Histologically, the tumor presented features similar to those of the adrenal cortex and was predominantly composed of pale cells. Electron micrograph revealed lipid droplets and mitochondria with tubulo-vesicular cristae, consistent with the characteristics of steroid-producing cells. Immunohistochemically, the tumor expressed the adrenal 4 binding protein and a number of enzymes involved in the synthesis of adrenocortical steroids. At surgery, the right adrenal gland was present independently from the liver. This hepatic tumor was considered to be an adrenal rest tumor with steroidogenic capability.
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Affiliation(s)
- K Arai
- Departments of Pathology, Shizuoka General Hospital, Shizuoka, Japan
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25
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Shibayama M, Oba N, Senda Y, Nishibu M, Hashimoto T. [Clinical evaluation of serum 1,5AG levels in patients with liver cirrhosis]. Rinsho Byori 1997; 45:1187-90. [PMID: 9437902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We measured serum 1,5 anhydroglucitol (1,5AG) levels by HPLC in 32 patients with liver cirrhosis, 32 with diabetes mellitus and 61 normal subjects. Serum 1,5AG was significantly lower in patients with diabetes mellitus and liver cirrhosis compared with that in normal subjects. Serum levels of type IV collagen were higher in patients with liver cirrhosis than in those without liver cirrhosis. A negative correlation was observed between serum 1,5AG and type IV collagen in patients with liver cirrhosis (r = -0.37, p < 0.05), but not in patients with diabetes mellitus. These data suggest that serum 1,5AG levels reflect the degree of liver cirrhosis.
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Affiliation(s)
- M Shibayama
- Department of Clinical Laboratory, Kanazawa University Hospital
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26
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Iemura J, Aoshima M, Ishigami N, Kaneda T, Oba N. Surgery for hepatocellular carcinoma with tumor thrombus in the right atrium. Hepatogastroenterology 1997; 44:824-5. [PMID: 9222699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Three cases of tumor thrombus that originated from a hepatocellular carcinoma in the liver and extended into the right atrium are described. All patients had received both resection of the tumor thrombus and lobectomy of the liver either simultaneously or independently within a short interval. Surgical order and extracorporeal circulation system were varied depending on the thrombus extension. Two of the patients died within 4 months of surgery due to different reasons and the other is doing well at 24 months after surgery.
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Affiliation(s)
- J Iemura
- Cardiovascular Surgical Unit, Shizuoka General Hospital, Japan
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27
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Saegusa T, Ito K, Oba N, Matsuda M, Kojima K, Tohyama K, Matsumoto M, Miura K, Suzuki H. Enlargement of multiple cavernous hemangioma of the liver in association with pregnancy. Intern Med 1995; 34:207-11. [PMID: 7787330 DOI: 10.2169/internalmedicine.34.207] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Four cavernous hemangiomas were found in a 34-year-old woman after the first delivery. All four hemangiomas became enlarged after the second delivery. Due to complaints of symptoms of compression, and to rule out malignancy, surgical intervention was employed. Histologically, the tumors were typical cavernous hemangiomas. Although a relationship between enlargement of hemangiomas and estrogen was suggested, estrogen receptors were not detected in the tumors.
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Affiliation(s)
- T Saegusa
- Department of Hepato-gastroenterology, Shizuoka General Hospital
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28
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Umehara Y, Kimura T, Yoshida M, Oba N, Harada Y. Comparison of doubling times of serum carcinoembryonic antigen produced by various metastatic lesions in recurrent gastric and colorectal carcinomas. Cancer 1993; 71:4055-9. [PMID: 8508370 DOI: 10.1002/1097-0142(19930615)71:12<4055::aid-cncr2820711241>3.0.co;2-q] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The authors measured the serial serum carcinoembryonic antigen (CEA) levels in patients with recurrent gastric or colorectal carcinoma. Among the 45 patients with recurrent gastric carcinomas, those with lung metastases showed the most prolonged CEA doubling time (CEA-DT), followed by those with liver and peritoneal metastases, respectively. Of the 31 patients with recurrent colorectal carcinomas, those with local recurrence showed the most prolonged CEA-DT, followed by those with lung, liver, and peritoneal metastases, respectively. A positive correlation was observed for gastric and colorectal carcinomas between CEA-DT in patients with metastatic lesions and outcome (R = 0.84 and 0.93, respectively). The results of the current study suggest that postoperative measurement of CEA-DT is useful in the determination of region of recurrence of carcinoma, which would permit early surgery and chemotherapy. Measurement of CEA-DT also may be helpful for the accurate determination of prognosis.
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Affiliation(s)
- Y Umehara
- First Department of Surgery, Hamamatsu University School of Medicine, Japan
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29
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Abstract
We investigated 230 systematically sampled fresh specimens from 12 early and 26 advanced gastric cancer patients by DNA flow cytometry for heterogeneity in DNA content. Fifty-eight percent of the 12 early gastric cancers were uniformly diploid and 42% were uniformly aneuploid. Fifty-four percent of advanced cancers were uniformly diploid in superficial layers and 42% were uniformly diploid in deep layers, whereas 46% were uniformly aneuploid in superficial layers, and 50% were uniformly aneuploid and 8% were heterogeneously aneuploid and diploid in deep layers. Both diploid and aneuploid samples were obtained from 15% for advanced cancers, but ploidy heterogeneity did not occur in early cancers. Heterogeneity for DNA index (more than one aneuploid DNA index) occurred in 46% of whole thickness of advanced cancers, in 19% of superficial layers of advanced cancers, and in 8% of early cancers. We concluded that DNA ploidy determination using superficial layer specimens may be reliable in early gastric cancer but must be interpreted with care in advanced cancer.
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Affiliation(s)
- Y Umehara
- First Department of Surgery, Hamamatsu University School of Medicine, Japan
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Oba N, Sugimura H, Umehara Y, Yoshida M, Kimura T, Yamaguchi T. Evaluation of an oleic acid water-in-oil-in-water-type multiple emulsion as potential drug carrier via the enteral route. Lipids 1992; 27:701-5. [PMID: 1487968 DOI: 10.1007/bf02536028] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A water-in-oil-in-water (W/O/W) emulsion composed of oleic acid was used as a carrier of carboxyfluorescein (CF) via the enteral route, as a model for future drug transport. The absorption of CF in the small intestine of rats given the emulsion (W/O/W group) was compared with the absorption in a group administered CF alone (CF group), and a group administered a mixed micelle of oleic acid and a surface-active agent in CF solution (MM group). Higher amounts of CF were absorbed in the W/O/W and MM groups than in the CF group. At 120 min, the amount of CF remaining in the intestinal tract was smaller in the MM group than in the W/O/W group. In the early period, CF excretion into bile was higher in the MM group than in the W/O/W group, but from 120 to 360 min, CF excretion in the W/O/W group was higher than in the MM group (non-specific). The blood CF level was significantly higher at 240 and 360 min in the W/O/W group than in the other two groups. The highest concentration in lymph was found in the W/O/W group. The W/O/W emulsion was considered superior to the micelles because it maintained a higher blood level of CF over long periods and transferred it to the lymph. This suggests that the W/O/W emulsion is applicable as a drug carrier via the enteral route.
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Affiliation(s)
- N Oba
- First Department of Surgery, Hamamatsu University School of Medicine, Japan
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Abstract
Nuclear DNA contents were comparatively determined by flow cytometry in primary and metastatic lesions from 112 cases with stomach cancer. Aneuploidy frequency and mean DNA index were higher in lymph node metastatic lesions than in primary lesions, both resected synchronously. In these lymph node metastatic lesions, DNA ploidy patterns did not change in 79% (89/112 cases), and did change in 21% (23/112 cases). Concordance of the DNA index between primary lesions and synchronous liver metastatic lesions was seen in 63% (5/8 cases), but the concordance rate was only 25% (4/16 cases) for primary lesions and metachronous liver metastatic lesions and 0% (0/8) for primary lesions and lung metastases. DNA ploidy changes in metastatic lesions were marked in distal metastatic lesions, or more marked in metachronous metastases than in synchronous ones. The results of the present study suggested the possibility of detecting changes in biological characteristics of metastatic lesions by flow cytometric DNA analysis.
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Affiliation(s)
- Y Umehara
- First Department of Surgery, Hamamatsu University School of Medicine, Japan
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Umehara Y, Kimura T, Yoshida M, Oba N, Harada Y. Metastatic mode of gastric carcinoma by flow cytometric and clinicopathologic parameters. Clin Exp Metastasis 1992; 10:19-24. [PMID: 1733643 DOI: 10.1007/bf00163572] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We used flow cytometric and conventional clinicopathologic parameters to analyse the metastatic mode of cancer in 113 stomach cancer patients. Liver metastasis was frequent in cases with intestinal-type cancer, cancer located in the distal stomach, positive venous invasion and aneuploid cancer. Lung and pleural metastasis (excluding nodular lung metastasis), however, were frequent in cases with serosal invasion and diploid cancer. Peritoneal metastasis was frequently seen with tumors located in the proximal or whole stomach, diffuse-type cancer and cancer with serosal invasion. All cases developing bone metastasis were positive for lymph node metastasis. DNA ploidy was partially related to the metastatic mode of stomach cancer, but this was not the sole parameter for predicting metastasis. However, prediction may be possible if based on both DNA ploidy and clinicopathologic parameters, suggesting the possibility of the prophylaxis of recurrence by appropriate postoperative adjuvant therapy.
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Affiliation(s)
- Y Umehara
- First Department of Surgery, Hamamatsu University School of Medicine, Japan
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Abstract
We studied the amounts of nuclear DNA in gastric cancer metastases histologically and cytochemically by flow cytometry, which was performed retrospectively on paraffin-embedded specimens from 95 patients. At surgery, all cases of aneuploid cancer were positive for lymph node metastases. Liver metastases were frequently seen in aneuploid cancer (63%, P < 0.01), while lung metastases were the most common in diploid cancer (50%, P < 0.05). The incidence of peritoneal metastasis was high in undifferentiated diploid cancer (72%, P < 0.01). Local lymph node recurrence after surgery was more common in aneuploid than in diploid cancer (P < 0.01). The incidence of bone and distant lymph node metastasis was found to be strongly dependent on tissue differentiation. The DNA ploidy pattern is thus considered to be closely linked to lymph node, liver, and lung metastases in gastric cancer.
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Affiliation(s)
- Y Umehara
- First Department of Surgery, Hamamatsu University School of Medicine, Japan
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Abstract
The antigen levels of plasminogen activators (PAs), tissue-type PA (t-PA) and urokinase-type PA (u-PA), were measured in extracts from 30 gastric carcinomas and corresponding normal gastric mucosa. The t-PA level was significantly higher in normal mucosa than in cancer tissue, while the u-PA level was significantly higher in cancer tissue. The u-PA level increased with increasing tumor stage, and there was a significant difference between early and advanced cancer. The u-PA level also increased with the degree of nodal involvement, and it was higher in undifferentiated tumors than in well-differentiated ones. It was higher in cases with venous invasion, liver metastasis or peritoneal dissemination than in cases without these features.
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Affiliation(s)
- Y Umehara
- First Department of Surgery, Hamamatsu University School of Medicine, Japan
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Umehara Y, Miyahara T, Yoshida M, Oba N, Matsuda T, Gotou H, Harada Y. [An analysis of the cellular DNA contents in lung-metastasized stomach cancers]. Gan No Rinsho 1990; 36:469-72. [PMID: 2319690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
A study has been conducted of the cellular DNA contents in the primary and metastatic lesions of 30 cases of lung-metastasized stomach cancers, in which each DNA Index (DI) was calculated and analysed comparatively. As a consequence, the rate of the diploid type in the nodular lung metastases was found to be higher than the rate of the others. Further, the DI's of 22 out of 30 (73%) metastatic lymph nodes corresponded with those of the primary lesions. Four lung metastatic lesions out of five differed from their primary lesions, but all five lesions simulated their metastatic lymph nodes. Thus understanding of the properties of the metastatic lymph nodes, rather than their primary lesions, would seen to be helpful in planning the therapy to combat recurrent cancers.
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Affiliation(s)
- Y Umehara
- 1st Dept. of Surgery, Hamamatsu Univ. School of Med
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Oba N, Mori S, Nakagomi A, Iwama S, Harada Y, Yoshimura K. [A case of rupture of a posterior pancreaticoduodenal artery aneurysm]. Nihon Geka Gakkai Zasshi 1988; 89:133-6. [PMID: 3283520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A 75 year old man complaining of right upper abdominal pain was admitted to our hospital. He became shocked with hypotension and cold sweat, and immediately underwent operation. Laparotomy revealed massive hemorrhage in the retroperitoneal region, particularly in the right upper space. It was derived from the rupture of the posterior pancreaticoduodenal artery aneurysm. The arterial trunk was ligated above and below the aneurysm and the aneurysmectomy was carried out. The patient recovered and was discharged from the hospital 56 days after operation. There was no other visceral artery aneurysm and the etiology of this aneurysm was unknown. Four cases of pancreaticoduodenal artery aneurysm have been reported in Japan and three of them were operated, but this is the first surgically resected case for the rupture of pancreaticoduodenal artery aneurysm with success.
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Affiliation(s)
- N Oba
- Kikugawa Hospital, Shizuoka, Japan
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Ishizaki T, Hashizume K, Kometani M, Tanaki T, Oba N, Numata T, Matsubara F, Shiobara S, Tejima H, Odaka K, Tsukuda K, Hattori K. [Two cases of leukemia associated with disseminated intravascular coagulation (DIC) and hypocomplementemia--with special reference to the relationship between DIC and complement (author's transl)]. Rinsho Ketsueki 1980; 21:1146-55. [PMID: 6934324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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38
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Ishizaki T, Hashizume K, Kometani M, Tanaki T, Numata T, Oba N, Matsubara F, Tsukuda K, Hattori K. [Serum complement components in patients with leukemia with special reference to disseminated intravascular coagulation (DIC) (author's transl)]. Rinsho Ketsueki 1980; 21:169-78. [PMID: 7411863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Abstract
Relation of the intimal change in aging of various arteries to progression of atherosclerosis and the morphology of regression of atherosclerotic lesion were discussed. The course of regression of experimental atherosclerosis in rabbits and its histological findings were described.
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Oba N. [Choroideremia: study of two Japanese families (author's transl)]. Nippon Ganka Gakkai Zasshi 1974; 78:116-47. [PMID: 4858639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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41
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Oba N. [The effect of adaptation on pupil light reflex]. Nippon Ganka Gakkai Zasshi 1972; 76:1240-1. [PMID: 4675729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Abstract
1. The dark-adaptation curves of two subjects with essential night blindness revealed no evidence for functioning rod vision. Cone vision was normal.2. The photopupillomotor dark adaptation, and flash intensity response amplitude curves on one of these subjects confirmed the absence of rod function.3. However, there is the normal amount of rhodopsin in their rods with normal kinetics.4. Cone pigment kinetics are also nearly normal. After a full bleach, log threshold elevation of the foveal cones is linearly related to pigment regeneration. The constant of proportionality is about 3.0 as it is in the normal retina.5. After a full rhodopsin bleach, the contralateral pupil size recovered its full dark value along a curve which followed the regeneration of rhodopsin.6. The results in (5) are identical to those previously found on normal subjects.7. With the exception of a very small response attributed to the contribution of cones, no significant changes in pupil size were evoked by uniform ganzfeld steady backgrounds until the intensity of retinal illuminance was so high that appreciable rhodopsin was bleached. This contrast to the changes evoked by weak steady backgrounds in the normal eye.8. Therefore, rod bleaching signals are normal in such retinas but rod signals evoked by real lights are not functional. This supports Rushton's concept as to how bleaching signals influence retinal sensitivity as opposed to the view of Barlow.9. The defect in essential night blindness very probably involves the rod automatic gain control, but because of (4) the cone gain control must be normal.10. Therefore, rod and cone gain control mechanisms must be independent in these night blind retinas and, by analogy, in the normal retina as well.
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Oba N. [A case report of a family of Rieger's anomaly]. Nippon Ganka Gakkai Zasshi 1971; 75:326-31. [PMID: 5103190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Oba N. Effect of the intensity of light adaptatoon on the rate of recovery of maximum pupil size in the dark. Nippon Ganka Gakkai Zasshi 1971; 75:773-6. [PMID: 5103231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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46
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Oba N, Hiyamuta E. [A case of sarcoidosis with involvement of nervous system]. Nippon Ganka Gakkai Zasshi 1971; 75:941-50. [PMID: 4324709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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47
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Oba N. [Contributions of scotopic system on the human visual evoked potential]. Nippon Ganka Gakkai Zasshi 1969; 73:627-33. [PMID: 5389087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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48
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Totsuka K, Oba N. [Emergency treatment of eye injuries]. Geka Chiryo 1968; 19:589-97. [PMID: 5756227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Imoto M, Minoura Y, Goto K, Harada H, Nishihira K, Fujita H, Fujimoto K, Izuta T, Kono G, Fujioka K, Shiota A, Oba N, Oshita H, Usamoto T, Kubo T. EFFECTS OF QUINONE DIOXIME ON THE PEROXIDE CURE OF ETHYLENE PROPYLENE RUBBER. ACTA ACUST UNITED AC 1968. [DOI: 10.2324/gomu.41.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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50
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Oba N. [Visual evoked potential by localized retinal stimulation]. Nippon Ganka Gakkai Zasshi 1967; 71:1540-51. [PMID: 5627056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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