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Yamazaki K, Iguchi T, Kanoh Y, Takayasu K, Ngo TTT, Onuki A, Kawaji H, Oshima S, Kanda T, Masai H, Sasanuma H. Homologous recombination contributes to the repair of acetaldehyde-induced DNA damage. Cell Cycle 2024:1-16. [PMID: 38571319 DOI: 10.1080/15384101.2024.2335028] [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: 11/04/2023] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
Acetaldehyde, a chemical that can cause DNA damage and contribute to cancer, is prevalently present in our environment, e.g. in alcohol, tobacco, and food. Although aldehyde potentially promotes crosslinking reactions among biological substances including DNA, RNA, and protein, it remains unclear what types of DNA damage are caused by acetaldehyde and how they are repaired. In this study, we explored mechanisms involved in the repair of acetaldehyde-induced DNA damage by examining the cellular sensitivity to acetaldehyde in the collection of human TK6 mutant deficient in each genome maintenance system. Among the mutants, mismatch repair mutants did not show hypersensitivity to acetaldehyde, while mutants deficient in base and nucleotide excision repair pathways or homologous recombination (HR) exhibited higher sensitivity to acetaldehyde than did wild-type cells. We found that acetaldehyde-induced RAD51 foci representing HR intermediates were prolonged in HR-deficient cells. These results indicate a pivotal role of HR in the repair of acetaldehyde-induced DNA damage. These results suggest that acetaldehyde causes complex DNA damages that require various types of repair pathways. Mutants deficient in the removal of protein adducts from DNA ends such as TDP1-/- and TDP2-/- cells exhibited hypersensitivity to acetaldehyde. Strikingly, the double mutant deficient in both TDP1 and RAD54 showed similar sensitivity to each single mutant. This epistatic relationship between TDP1-/- and RAD54-/- suggests that the protein-DNA adducts generated by acetaldehyde need to be removed for efficient repair by HR. Our study would help understand the molecular mechanism of the genotoxic and mutagenic effects of acetaldehyde.
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Affiliation(s)
- Kosuke Yamazaki
- Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan
| | - Tomohiro Iguchi
- Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Yutaka Kanoh
- Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kazuto Takayasu
- Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Trinh Thi To Ngo
- Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Ayaka Onuki
- Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hideya Kawaji
- Research Center for Genome and Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shunji Oshima
- Sustainable Technology Laboratories, Asahi Quality & Innovations Ltd, Ibaraki, Japan
| | | | - Hisao Masai
- Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan
| | - Hiroyuki Sasanuma
- Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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Iguchi T, Mita J, Iseda N, Sasaki S, Harada N, Ninomiya M, Sugimachi K, Honboh T, Sadanaga N, Matsuura H. Development of predictive score for postoperative dysphagia after emergency abdominal surgery in patients of advanced age. Ann Gastroenterol Surg 2024; 8:172-181. [PMID: 38250679 PMCID: PMC10797835 DOI: 10.1002/ags3.12716] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/10/2023] [Accepted: 07/03/2023] [Indexed: 01/23/2024] Open
Abstract
Aim Postoperative dysphagia after emergency abdominal surgery (EAS) in patients of advanced age has become problematic, and appropriate dysphagia management is needed. This study was performed to identify predictive factors of dysphagia after EAS and to explore the usefulness of swallowing screening tools (SSTs). Methods This retrospective study included 267 patients of advanced age who underwent EAS from 2012 to 2022. They were assigned to a dysphagia group and non-dysphagia group using the Food Intake Level Scale (FILS) (dysphagia was defined as a FILS level of <7 on postoperative day 10). From 2018, original SSTs including a modified water swallowing test were performed by nurses. Results The incidence of postoperative dysphagia was 22.8% (61/267). Patients were significantly older in the dysphagia than non-dysphagia group. The proportions of patients who had poor nutrition, cerebrovascular disorder, Parkinson's disease, dementia, nursing-care service, high intramuscular adipose tissue content (IMAC), and postoperative ventilator management were much higher in the dysphagia than non-dysphagia group. Using logistic regression analysis, high IMAC, postoperative ventilator management, cerebrovascular disorder, and dementia were correlated with postoperative dysphagia and were assigned 10, 4, 3, and 3 points, respectively, according to each odds ratio. The optimal cut-off value was 7 according to a receiver operating characteristics curve. Using 1:1 propensity score matching for high-risk patients, the incidence of postoperative dysphagia was reduced by SSTs. Conclusions The new prediction score obtained from this study can identify older patients at high risk for dysphagia after EAS, and SSTs may improve these patients' short-term outcomes.
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Affiliation(s)
- Tomohiro Iguchi
- Department of SurgerySaiseikai Fukuoka General HospitalFukuokaJapan
| | - Junya Mita
- Department of SurgeryOita Red Cross HospitalOitaJapan
| | - Norifumi Iseda
- Department of SurgerySaiseikai Fukuoka General HospitalFukuokaJapan
| | - Shun Sasaki
- Department of SurgerySaiseikai Fukuoka General HospitalFukuokaJapan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | | | - Keishi Sugimachi
- Department of Hepato‐Biliary Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Takuya Honboh
- Department of SurgerySaiseikai Fukuoka General HospitalFukuokaJapan
| | - Noriaki Sadanaga
- Department of SurgerySaiseikai Fukuoka General HospitalFukuokaJapan
| | - Hiroshi Matsuura
- Department of SurgerySaiseikai Fukuoka General HospitalFukuokaJapan
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Iseda N, Iguchi T, Hirose K, Itoh S, Honboh T, Sadanaga N, Matsuura H. Prognostic Impact of Lymphocyte-to-C-Reactive Protein Ratio in Patients Who Underwent Surgical Resection for Pancreatic Cancer. Am Surg 2023; 89:4452-4458. [PMID: 35920820 DOI: 10.1177/00031348221117034] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Increasing evidence indicates that increased systemic inflammation is correlated with poorer cancer-specific survival in various cancer types. This study aimed to evaluate the prognostic value of various combinations of inflammatory factors in patients who underwent surgical resection for pancreatic cancer (PC). METHODS We retrospectively analyzed 97 consecutive patients with PC who underwent pancreatectomy. We assessed the predictive impact for recurrence using a combination of 5 inflammatory markers and focused on the lymphocyte-C-reactive protein ratio (LCR) to elucidate its prognostic and predictive value for recurrence-free survival (RFS) and overall survival (OS) in univariate and multivariate analyses using the Cox proportional hazards model. RESULTS Low preoperative LCR was correlated with low serum hemoglobin, low serum albumin concentration, high frequency of microscopic vascular invasion, and high frequency of microscopic perineural invasion. The low LCR group had significantly worse RFS and OS. Lower preoperative LCR was an independent predictor of shorter RFS and OS in this cohort. DISCUSSION Preoperative LCR is a novel and convenient prognostic marker for patients with PC. Patients with low LCR may require more favorable intensive therapy.
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Affiliation(s)
- Norifumi Iseda
- Department of Surgery, Saiseikai Fukuoka General Hospital, Japan
| | - Tomohiro Iguchi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Japan
| | - Kosuke Hirose
- Department of Surgery, Saiseikai Fukuoka General Hospital, Japan
| | - Shinji Itoh
- Departments of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Takuya Honboh
- Department of Surgery, Saiseikai Fukuoka General Hospital, Japan
| | - Noriaki Sadanaga
- Department of Surgery, Saiseikai Fukuoka General Hospital, Japan
| | - Hiroshi Matsuura
- Department of Surgery, Saiseikai Fukuoka General Hospital, Japan
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Shimagaki T, Sugimachi K, Mano Y, Onishi E, Iguchi T, Nakashima Y, Sugiyama M, Yamamoto M, Morita M, Toh Y. Cachexia index as a prognostic predictor after resection of pancreatic ductal adenocarcinoma. Ann Gastroenterol Surg 2023; 7:977-986. [PMID: 37927935 PMCID: PMC10623946 DOI: 10.1002/ags3.12686] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/09/2023] [Accepted: 04/13/2023] [Indexed: 11/07/2023] Open
Abstract
Aim This study was performed to investigate the relationship between the preoperative cachexia index (CXI) and long-term outcomes in patients who have undergone radical resection of pancreatic ductal adenocarcinoma (PDAC). Methods In total, 144 patients who underwent pancreatic resection for treatment of PDAC were retrospectively analyzed. The relationship between the CXI and the patients' long-term outcomes after PDAC resection was investigated. The CXI was calculated based on the preoperative skeletal muscle index, serum albumin level, and neutrophil-to-lymphocyte ratio. After propensity-score matching, we compared clinicopathological features and outcomes. Results The multivariate analysis showed that lymph node metastasis (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.16-3.23; P = 0.0118), R1 resection (HR, 57.20; 95% CI, 9.39-348.30; P < 0.0001), and a low CXI (HR, 2.10; 95% CI, 1.27-3.46; P = 0.0038) were independent and significant predictors of disease-free survival (DFS) after PDAC resection. Moreover, a low CXI (HR, 3.14; 95% CI, 1.71-5.75; P = 0.0002) was an independent and significant predictor of overall survival (OS) after PDAC resection. After propensity-score matching, the low CXI group had a significantly worse prognosis than the high CXI group for both DFS and OS. Conclusion The CXI can be a useful prognostic factor for DFS and OS after pancreatic resection for treatment of PDAC.
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Affiliation(s)
- Tomonari Shimagaki
- Department of Hepatobiliary and Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Keishi Sugimachi
- Department of Hepatobiliary and Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Yohei Mano
- Department of Hepatobiliary and Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Emi Onishi
- Department of Hepatobiliary and Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Tomohiro Iguchi
- Department of Hepatobiliary and Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Yuichiro Nakashima
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Masahiko Sugiyama
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Manabu Yamamoto
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Masaru Morita
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Yasushi Toh
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
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Tomino T, Harada N, Toshida K, Tomiyama T, Kosai Y, Kurihara T, Yoshiya S, Takeishi K, Toshima T, Nagao Y, Morita K, Iguchi T, Itoh S, Yoshizumi T. Effect of Early Enteral Nutrition on Graft Loss After Living Donor Liver Transplantation: A Propensity Score Matching Analysis. Transplant Proc 2023; 55:2164-2170. [PMID: 37778930 DOI: 10.1016/j.transproceed.2023.07.029] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 07/21/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND This study aimed to elucidate the effect of early enteral nutrition on graft loss within 12 h after living-donor liver transplantation (LDLT) using propensity score-matching analysis and subsequently examine the risk factors for graft loss after LDLT. METHODS We retrospectively reviewed the data of 467 LDLT patients who were assigned to the early and non-early groups based on the optimal cutoff value of 12 h for the starting time of early enteral nutrition after LDLT to predict graft loss. RESULTS The 1-year graft survival rate of the early group before propensity score-matching was 92.1%, whereas the 1-year graft survival rate of the non-early group was 86.2%. There was no significant difference between the 2 groups (P = .067). The incidences of early allograft dysfunction (EAD), small-for-size graft (SFSG) syndrome, acute cellular rejection (ACR), and sepsis were not statistically different between the 2 groups (P = .12, .91, .46, and .056, respectively). After propensity score-matching, the 1-year graft survival rate of the early group was 94.4%, whereas the 1-year graft survival rate of the non-early group was 85.4% (P = .034). The incidences of EAD, SFSG syndrome, and ACR were not statistically different between the 2 groups (P = .43, .81, and .24, respectively). However, the incidence of sepsis was statistically different between the 2 groups (non-early: 10.7% vs early: 3.6%, P = .038). CONCLUSION Early enteral nutrition within 12 h after LDLT may contribute to better graft survival in LDLT patients by preventing sepsis.
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Affiliation(s)
- Takahiro Tomino
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Katsuya Toshida
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takahiro Tomiyama
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukiko Kosai
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeshi Kurihara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shohei Yoshiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuki Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeo Toshima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Nagao
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazutoyo Morita
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Iguchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinji Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Iseda N, Iguchi T, Itoh S, Sasaki S, Honboh T, Yoshizumi T, Sadanaga N, Matsuura H. Textbook outcome in the laparoscopic cholecystectomy of acute cholecystitis. Asian J Endosc Surg 2023; 16:741-746. [PMID: 37525942 DOI: 10.1111/ases.13238] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/19/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE Textbook outcome (TO) is a novel composite measure of clinical outcomes that can be used to measure the quality of surgical outcomes. The aim of this cohort study was to propose TO criteria for laparoscopic cholecystectomy for acute cholecystitis and to identify reasons for TO failure and individual patient factors that predispose to failure. METHODS We retrospectively analyzed data for 189 patients with acute cholecystitis who underwent laparoscopic cholecystectomy. TO was defined as laparoscopic cholecystectomy without conversion to open cholecystectomy, intraoperative complications, postoperative complications (Clavien-Dindo classification ≥2), prolonged length of stay (≥10 days), readmission within 30 days, or mortality. RESULTS TO was achieved in 154 of 189 patients who underwent laparoscopic cholecystectomy for acute cholecystitis. Medical costs were lower in the TO-achieved group than in the TO-failure group. Factors associated with TO failure on multivariate analysis were age > 70 years, hemoglobin <11.9 g/dL, and white blood cells >18 000 / μL (all P < .05). CONCLUSIONS Applying TO to patients with acute cholecystitis allowed us to evaluate the overall quality of care related to hospitalization. TO may provide better assessment of the quality of care and help determine the treatment choice and reduce costs.
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Affiliation(s)
- Norifumi Iseda
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Iguchi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Shinji Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shun Sasaki
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Takuya Honboh
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noriaki Sadanaga
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Hiroshi Matsuura
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
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Hori K, Yamazaki S, Ohtaka-Maruyama C, Ono T, Iguchi T, Masai H. Cdc7 kinase is required for postnatal brain development. Genes Cells 2023; 28:679-693. [PMID: 37584256 DOI: 10.1111/gtc.13059] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 07/20/2023] [Accepted: 08/06/2023] [Indexed: 08/17/2023]
Abstract
The evolutionally conserved Cdc7 kinase plays crucial roles in initiation of DNA replication as well as in other chromosomal events. To examine the roles of Cdc7 in brain development, we have generated mice carrying Cdc7 knockout in neural stem cells by using Nestin-Cre. The Cdc7Fl/Fl NestinCre mice were born, but exhibited severe growth retardation and impaired postnatal brain development. These mice exhibited motor dysfunction within 9 days after birth and did not survive for more than 19 days. The cerebral cortical layer formation was impaired, although the cortical cell numbers were not altered in the mutant. In the cerebellum undergoing hypoplasia, granule cells (CGC) decreased in number in Cdc7Fl/F l NestinCre mice compared to the control at E15-18, suggesting that Cdc7 is required for DNA replication and cell proliferation of CGC at mid embryonic stage (before embryonic day 15). On the other hand, the Purkinje cell numbers were not altered but its layer formation was impaired in the mutant. These results indicate differential roles of Cdc7 in DNA replication/cell proliferation in brain. Furthermore, the defects of layer formation suggest a possibility that Cdc7 may play an additional role in cell migration during neural development.
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Affiliation(s)
- Karin Hori
- Genome Dynamics Project, Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan
| | - Satoshi Yamazaki
- Genome Dynamics Project, Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Chiaki Ohtaka-Maruyama
- Developmental Neuroscience Project, Department of Brain and Neurosciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Tomio Ono
- Laboratory for Transgenic Technology, Center for Basic Technology Research, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Tomohiro Iguchi
- Genome Dynamics Project, Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Hisao Masai
- Genome Dynamics Project, Department of Basic Medical Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Chiba, Japan
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Matsuda M, Iguchi T, Iseda N, Sasaki S, Honbo T, Emi Y, Sadanaga N, Naito Y, Kato S, Matsuura H. [A 30-Month Survival Case of Undifferentiated Carcinoma of the Duodenum Treated by Pancreaticoduodenectomy]. Gan To Kagaku Ryoho 2023; 50:1001-1004. [PMID: 37800297] [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: 10/07/2023]
Abstract
The patient was an elderly man in his early 80s who was admitted to our hospital due to anemia and tarry stools. An upper gastrointestinal endoscopy revealed a type 2 tumor in the second portion of the duodenum. An endoscopic biopsy revealed poorly differentiated adenocarcinoma. We performed a pancreaticoduodenectomy because neither lymphadenopathy nor distant metastases were found. Macroscopic findings revealed that the lesion was mainly in the second portion of the duodenum, and there was no evidence of invasion of the main pancreatic duct, the bile duct, or the ampulla of Vater. Histologically, the tumor was composed of atypical cells with polymorphic or spindle-shaped nuclei proliferating in a scattered fashion, and immunohistological examinations showed weakly positive results for cytokeratin(CK)AE1/AE3 and CK20 and positive results for vimentin but negative results for CK7. The tumor was diagnosed as undifferentiated carcinoma of the duodenum(pT4N0M0, pStage ⅡB). The patient recovered enough to be discharged and was followed up without postoperative adjuvant chemotherapy. He maintained recurrence-free survival for 27 months, after which lymph node and lung metastases reoccurred. This is a rare case of undifferentiated carcinoma of the duodenum treated by curative resection with a relatively favorable prognosis.
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Iguchi T, Iseda N, Hirose K, Itoh S, Harada N, Ninomiya M, Sugimachi K, Honboh T, Maeda T, Sadanaga N, Matsuura H. Prognostic Impact of the Preoperative Systemic Inflammation Score in Patients With Pancreatic Ductal Adenocarcinoma. Am Surg 2023; 89:2213-2219. [PMID: 35392670 DOI: 10.1177/00031348221086782] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUD The systemic inflammation score (SIS), which is based on the preoperative lymphocyte-to-monocyte ratio (LMR) and serum albumin (Alb) level, is a prognostic indicator for several cancer types. However, the prognostic significance of the SIS in pancreatic ductal adenocarcinoma (PDAC) remains unknown. METHODS Seventy-eight patients who underwent radical surgery for PDAC were categorized as follows: SIS 0 (LMR ≥3.51 and Alb ≥4.0 g/dl), n = 26; SIS 1 (LMR <3.51 or Alb <4.0 g/dl), n = 29 and SIS 2 (LMR <3.51 and Alb <4.0 g/dl), n=23. RESULTS The tumour size sequentially increased in SIS 0, 1 and 2 groups. A higher SIS was associated with increased vascular invasion, perineural invasion and surgical margin positivity rate. Recurrence-free survival (RFS) rates between the SIS 1 and 2 groups showed no significant difference However, patients of the SIS 1 and 2 groups had poorer outcomes than those of the SIS 0 group for RFS. Overall survival (OS) rates between the SIS 1 and 2 groups also showed no significant difference. However, patients of the SIS 1 and 2 groups had poorer outcomes than those of the SIS 0 group for OS. The SIS was an independent prognostic factor for RFS and OS. DISCUSSION The SIS is a simplified prognostic factor for patients with PDAC.
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Affiliation(s)
- Tomohiro Iguchi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Norifumi Iseda
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Kosuke Hirose
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Shinji Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mizuki Ninomiya
- Department of Surgery, Fukuoka City Hospital, Fukuoka, Japan
| | - Keishi Sugimachi
- Depatment of Hepato-Biliary Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Takuya Honboh
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Takashi Maeda
- Department of Surgery, Hirosima Red Cross Hospital and Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Noriaki Sadanaga
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Hiroshi Matsuura
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
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Inaba D, Iguchi T, Iseda N, Sasaki S, Honboh T, Okura A, Sadanaga N, Matsuura H. Safety of laparoscopic cholecystectomy in patients with a cerebrospinal fluid shunt in the peritoneal cavity. Asian J Endosc Surg 2023. [PMID: 37062535 DOI: 10.1111/ases.13190] [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: 03/01/2023] [Revised: 03/24/2023] [Accepted: 03/31/2023] [Indexed: 04/18/2023]
Abstract
INTRODUCTION The management of patients with a cerebrospinal fluid (CSF) shunt located in the peritoneal cavity undergoing laparoscopic surgery is an issue that has not yet been settled. These patients are at risk of increased intracranial pressure caused by peritoneal insufflation, shunt dysfunction, and shunt infection/retrograde meningitis. This study aimed to determine the need for perioperative shunt intervention in CSF shunt patients undergoing laparoscopic cholecystectomy. METHODS We reviewed and analyzed five shunt patients who underwent laparoscopic cholecystectomy in our institution between 2012 and 2022, as well as 17 patients described in previous reports. RESULTS Among the 22 patients, shunt type was ventriculoperitoneal in 14 and lumboperitoneal in eight. The most common indication for CSF shunt was hydrocephalus caused by cerebral vascular accident (50.0%). Laparoscopic cholecystectomy was performed for cholecystolithiasis in 13 patients (59.1%), acute cholecystitis in eight (36.4%), and gallbladder polyp in one (4.5%). Shunt clamping or externalization was performed in six patients. Two patients in the group that did not undergo shunt clamping or externalization experienced complications (intra abdominal abscess and subcutaneous emphysema). However, the incidence of short-term complications (both overall and shunt-related) and median length of hospital stay did not significantly differ between the two groups. CONCLUSION Routine shunt clamping, externalization, or removal might not be necessarily required in patients with a ventriculoperitoneal or lumboperitoneal shunt undergoing laparoscopic cholecystectomy.
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Affiliation(s)
- Daichi Inaba
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Tomohiro Iguchi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Norifumi Iseda
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Shun Sasaki
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Takuya Honboh
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Akira Okura
- Department of Neurosurgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Noriaki Sadanaga
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Hiroshi Matsuura
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
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11
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Yano YI, Iguchi T, Sato S, Iseda N, Sasaki S, Abe Y, Nakayama T, Honboh T, Kato S, Sadanaga N, Matsuura H. Successful laparoscopic cholecystectomy for gallbladder hemorrhage from a Dieulafoy lesion in a patient on hemodialysis: a case report. Surg Case Rep 2023; 9:46. [PMID: 36961559 PMCID: PMC10039168 DOI: 10.1186/s40792-023-01628-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 03/19/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Patients on long-term dialysis are prone to hemorrhagic complications, particularly uremic bleeding, but gallbladder hemorrhage is rare, even in patients on dialysis. There have been occasional reports of a Dieulafoy lesion being a cause of gastrointestinal hemorrhage, but its occurrence within the gallbladder is quite rare. This report describes a case of gallbladder hemorrhage from a Dieulafoy lesion in a patient on hemodialysis that was diagnosed early and successfully treated by laparoscopic cholecystectomy. CASE PRESENTATION The patient was a 68-year-old woman on long-term hemodialysis with end-stage renal failure who presented with epigastralgia and back pain. There was no history of trauma or oral administration of antiplatelet or anticoagulant agents. There were no signs of an inflammatory reaction or hyperbilirubinemia. Contrast-enhanced computed tomography revealed a slightly hyperdense area in the distended gallbladder and extravasation within the gallbladder lumen but no gallstones. A severe atherosclerotic lesion was also found. She was diagnosed to have gallbladder hemorrhage and emergency laparoscopic cholecystectomy was performed. Although the postoperative course was complicated by drug fever, she was discharged on postoperative day 10 in a satisfactory condition. Histology revealed hemorrhagic ulceration with an exposed blood vessel accompanied by abnormal arteries in the submucosa. Arteriosclerosis with eccentric intimal hyperplasia in a small-sized artery was also seen. The diagnosis was gallbladder hemorrhage from a Dieulafoy lesion. CONCLUSIONS A Dieulafoy lesion should be kept in mind as a cause of gallbladder hemorrhage in a patient with severe arteriosclerosis and a bleeding diathesis, particularly if on dialysis, and treated as early as possible.
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Affiliation(s)
- Yuu-Ichi Yano
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan
| | - Tomohiro Iguchi
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan.
| | - Shota Sato
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan
| | - Norifumi Iseda
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan
| | - Shun Sasaki
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan
| | - Yasuhiro Abe
- Department of Internal Medicine, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan
| | - Tomohiro Nakayama
- Department of Radiology, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan
| | - Takuya Honboh
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan
| | - Seiya Kato
- Division of Pathology, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin Chuo-Ku, Fukuoka, Japan
| | - Noriaki Sadanaga
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan
| | - Hiroshi Matsuura
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-Ku, Fukuoka, 810-0001, Japan
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12
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Yoshida Y, Iguchi T, Iseda N, Hirose K, Honboh T, Iwasaki N, Kato S, Sadanaga N, Matsuura H. Delayed laparoscopic cholecystectomy for a patient with coronavirus disease 2019 who developed gangrenous cholecystitis: a case report. Surg Case Rep 2022; 8:134. [PMID: 35843961 PMCID: PMC9288926 DOI: 10.1186/s40792-022-01494-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/12/2022] [Indexed: 01/08/2023] Open
Abstract
Abstract
Background
Gangrenous cholecystitis has a high risk of perforation and sepsis; therefore, cholecystectomy in the early stage of the disease is recommended. However, during the novel coronavirus disease 2019 (COVID-19) pandemic, the management of emergent surgeries changed to avoid contagion exposure among medical workers and poor postoperative outcomes.
Case presentation
A 56-year-old man presented to our hospital with abdominal pain. Computed tomography revealed intraluminal membranes, an irregular or absent wall, and an abscess of the gallbladder, indicating acute gangrenous cholecystitis. Early laparoscopic cholecystectomy seemed to be indicated; however, a COVID-19 antigen test was positive despite no obvious pneumonia on chest computed tomography and no symptoms. After discussion among the multidisciplinary team, antibiotic therapy was started and percutaneous transhepatic gallbladder drainage (PTGBD) was planned for the following day because the patient’s vital signs were stable and his abdominal pain was localized. Fortunately, the antibiotic therapy was very effective, and PTGBD was not needed. The cholecystitis improved and the patient was discharged from the hospital on day 10. One month later, laparoscopic delayed cholecystectomy was performed after confirming a negative COVID-19 polymerase chain reaction test result. The postoperative course was uneventful, and the patient was discharged on postoperative day 2 in satisfactory condition.
Conclusion
We have reported a case of acute gangrenous cholecystitis in a patient with asymptomatic COVID-19 disease. This report can help to determine treatment strategies for patients with gangrenous cholecystitis during future pandemics.
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13
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Sugimachi K, Araki H, Saito H, Masuda T, Miura F, Inoue K, Shimagaki T, Mano Y, Iguchi T, Morita M, Toh Y, Yoshizumi T, Ito T, Mimori K. Persistent epigenetic alterations in transcription factors after a sustained virological response in hepatocellular carcinoma. JGH Open 2022; 6:854-863. [PMID: 36514506 PMCID: PMC9730721 DOI: 10.1002/jgh3.12833] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/03/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
Background and Aim The risk of hepatocellular carcinoma (HCC) persists in a condition of sustained virologic response (SVR) after hepatitis C virus (HCV) eradication. Comprehensive molecular analyses were performed to test the hypothesis that epigenetic abnormalities present after an SVR play a role in hepatocarcinogenesis. Methods Whole-genome methylome and RNA sequencing were performed on HCV, SVR, and healthy liver tissue. Integrated analysis of the sequencing data focused on expression changes in transcription factors and their target genes, commonly found in HCV and SVR. Identified expression changes were validated in demethylated cultured HCC cell lines and an independent validation cohort. Results The coincidence rates of the differentially methylated regions between the HCV and SVR groups were 91% in the hypomethylated and 71% in the hypermethylated regions in tumorous tissues, and 37% in the hypomethylated and 36% in the hypermethylated regions in non-tumorous tissues. These results indicate that many epigenomic abnormalities persist even after an SVR was achieved. Integrated analysis identified 61 transcription factors and 379 other genes that had methylation abnormalities and gene expression changes in both groups. Validation cohort specified gene expression changes for 14 genes, and gene ontology pathway analysis revealed apoptotic signaling and inflammatory response were associated with these genes. Conclusion This study demonstrates that DNA methylation abnormalities, retained after HCV eradication, affect the expression of transcription factors and their target genes. These findings suggest that DNA methylation in SVR patients may be functionally important in carcinogenesis, and could serve as biomarkers to predict HCC occurrence.
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Affiliation(s)
- Keishi Sugimachi
- Department of Hepatobiliary‐Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Hiromitsu Araki
- Department of Biochemistry, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan,Department of Business and Technology Management, Faculty of EconomicsKyushu UniversityFukuokaJapan
| | - Hideyuki Saito
- Department of SurgeryKyushu University Beppu HospitalBeppuJapan
| | - Takaaki Masuda
- Department of SurgeryKyushu University Beppu HospitalBeppuJapan
| | - Fumihito Miura
- Department of Biochemistry, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Kentaro Inoue
- Department of Biochemistry, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan,Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Tomonari Shimagaki
- Department of Hepatobiliary‐Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Yohei Mano
- Department of Hepatobiliary‐Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Tomohiro Iguchi
- Department of Hepatobiliary‐Pancreatic SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Masaru Morita
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Yasushi Toh
- Department of Gastroenterological SurgeryNational Hospital Organization Kyushu Cancer CenterFukuokaJapan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Takashi Ito
- Department of Biochemistry, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
| | - Koshi Mimori
- Department of SurgeryKyushu University Beppu HospitalBeppuJapan
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14
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Komatsuya K, Iguchi T, Fukuyama M, Kawashima I, Ogura K, Kikuchi N, Shimoda Y, Takeda Y, Shimonaka M, Yamamoto N, Sugiura N, Maeda N, Kasahara K. Phosphacan acts as a repulsive cue for cerebellar granule cells in a TAG-1/GD3 raft-dependent manner. J Neurochem 2022; 163:375-390. [PMID: 36227633 DOI: 10.1111/jnc.15709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 07/28/2022] [Revised: 09/19/2022] [Accepted: 10/10/2022] [Indexed: 11/29/2022]
Abstract
Phosphacan, a chondroitin sulfate proteoglycan, is a repulsive cue of cerebellar granule cells. This study aims to explore the molecular mechanism. The glycosylphosphatidylinositol-anchored neural adhesion molecule TAG-1 is a binding partner of phosphacan, suggesting that the repulsive effect of phosphacan is possibly due to its interaction with TAG-1. The repulsive effect was greatly reduced on primary cerebellar granule cells of TAG-1-deficient mice. Surface plasmon resonance analysis confirmed the direct interaction of TAG-1 with chondroitin sulfate C. On postnatal days 1, 4, 7, 11, 15, and 20 and in adulthood, phosphacan was present in the molecular layer and internal granular layer, but not in the external granular layer. In contrast, transient TAG-1 expression was observed exclusively within the premigratory zone of the external granular layer on postnatal days 1, 4, 7, and 11. Boyden chamber cell migration assay demonstrated that phosphacan exerted its repulsive effect on the spontaneous and brain-derived neurotrophic factor (BDNF)-induced migration of cerebellar granule cells. The BDNF-induced migration was inhibited by MK-2206, an Akt inhibitor. The pretreatment with a raft-disrupting agent, methyl-β-cyclodextrin, also inhibited the BDNF-induced migration, suggesting that lipid rafts are involved in the migration of cerebellar granule cells. In primary cerebellar granule cells obtained on postnatal day 7 and cultured for 7 days, the ganglioside GD3 and TAG-1 preferentially localized in the cell body, whereas the ganglioside GD1b and NB-3 localized in not only the cell body but also neurites. Pretreatment with the anti-GD3 antibody R24, but not the anti-GD1b antibody GGR12, inhibited the spontaneous and BDNF-induced migration, and attenuated BDNF-induced Akt activation. These findings suggest that phosphacan is responsible for the repulsion of TAG-1-expressing cerebellar granule cells via GD3 rafts to attenuate BDNF-induced migration signaling.
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Affiliation(s)
- Keisuke Komatsuya
- Laboratory of Biomembrane, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Tomohiro Iguchi
- Laboratory of Biomembrane, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Michiko Fukuyama
- Laboratory of Biomembrane, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Chemistry, Tokyo University of Science, Tokyo, Japan
| | - Ikuo Kawashima
- Laboratory of Biomembrane, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kiyoshi Ogura
- Laboratory of Biomembrane, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Norihito Kikuchi
- Laboratory of Biomembrane, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Yasushi Shimoda
- Department of Bioengineering, Nagaoka University of Technology, Niigata, Japan
| | - Yasuo Takeda
- Department of Clinical Pharmacy and Pharmacology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | | | - Naomasa Yamamoto
- Laboratory of Biomembrane, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Nobuo Sugiura
- Institute for Molecular Science of Medicine, Aichi Medical University, Aichi, Japan
| | - Nobuaki Maeda
- Neural Network Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kohji Kasahara
- Laboratory of Biomembrane, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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15
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Petrylak D, Azad A, Szmulewitz R, Iguchi T, Shore N, Holzbeierlein J, Alekseev B, El-Chaar N, Rosbrook B, Ma J, Zohren F, Haas G, Stenzl A, Armstrong A. 1398P Overall survival (OS) in patients (pts) with metastatic hormone-sensitive prostate cancer (mHSPC) who received prior androgen deprivation therapy (ADT) and reached low prostate-specific antigen (PSA) levels treated further with enzalutamide (ENZA): Post hoc analyses of ARCHES. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1884] [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: 11/01/2022] Open
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16
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Shimagaki T, Sugimachi K, Mano Y, Onishi E, Iguchi T, Uehara H, Sugiyama M, Yamamoto M, Morita M, Toh Y. Simple systemic index associated with oxaliplatin‐induced liver damage can be a novel biomarker to predict prognosis after resection of colorectal liver metastasis. Ann Gastroenterol Surg 2022; 6:813-822. [PMID: 36338597 PMCID: PMC9628223 DOI: 10.1002/ags3.12580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/02/2022] [Indexed: 12/01/2022] Open
Abstract
Aim Oxaliplatin, an anticancer drug for advanced colorectal cancer, causes liver sinusoidal damage, sometimes with portal hypertension. We conducted a retrospective comparative study of the relationship of liver sinusoidal disorders and liver function with the prognosis in patients who underwent hepatectomy for colorectal liver metastasis (CRLM). Methods In total, 158 patients who underwent hepatectomy for CRLM were included in the study, and the effect of chemotherapy‐associated liver damage on the prognosis was examined. Results Preoperative oxaliplatin was used in 75 of 158 patients; of these 75 patients, 26 had intraoperative blue liver (BL). In a comparison of the BL group (n = 26) and non‐BL group (n = 132), patients in the BL group had a significantly lower serum albumin concentration and a significantly higher indocyanine green test result, aspartate aminotransferase‐to‐platelet ratio index (APRI), and FIB‐4 score. Operative morbidities were not significantly different between the two groups. The overall survival rate after hepatectomy was significantly worse in the BL group than in the non‐BL group. In the univariate analysis, the serum albumin concentration, indocyanine green test, a high tumor burden score (TBS), and the APRI were statistically significant poor prognostic factors. In the multivariate analysis, the APRI and a high TBS were independent poor prognostic factors. Conclusion The APRI and TBS in patients with CRLM are prognostic predictors after hepatectomy for metastatic liver cancer. This study indicated that liver damage in patients treated with preoperative oxaliplatin has an effect on the prognosis.
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Affiliation(s)
- Tomonari Shimagaki
- Department of Hepatobiliary and Pancreatic Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Keishi Sugimachi
- Department of Hepatobiliary and Pancreatic Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Yohei Mano
- Department of Hepatobiliary and Pancreatic Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Emi Onishi
- Department of Hepatobiliary and Pancreatic Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Tomohiro Iguchi
- Department of Hepatobiliary and Pancreatic Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Hideo Uehara
- Department of Gastroenterological Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Masahiko Sugiyama
- Department of Gastroenterological Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Manabu Yamamoto
- Department of Gastroenterological Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Yasushi Toh
- Department of Gastroenterological Surgery National Hospital Organization Kyushu Cancer Center Fukuoka Japan
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17
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Mita J, Iguchi T, Iseda N, Takada K, Hirose K, Miura N, Honboh T, Emi Y, Akashi T, Kato S, Sadanaga N, Matsuura H. A case of successful conversion surgery for locally advanced pancreatic cancer with synchronous triple cancer of the lung and esophagus: a case report. Surg Case Rep 2022; 8:19. [PMID: 35067787 PMCID: PMC8784582 DOI: 10.1186/s40792-022-01377-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/20/2022] [Indexed: 11/11/2022] Open
Abstract
Background The number of reports of multiple primary cancer (MPC) is increasing because of the advancement in diagnostic imaging technology. However, the treatment strategy for MPCs involving pancreatic cancer is controversial because of the extremely poor prognosis. We herein report a patient with synchronous triple cancer involving the pancreas, esophagus, and lung who underwent conversion surgery after intensive chemotherapy for unresectable locally advanced pancreatic cancer. Case presentation A 59-year-old man was admitted to our hospital with epigastric pain, anorexia, and weight loss. Computed tomography and upper gastrointestinal endoscopy revealed that the patient had synchronous triple cancer of the pancreas, esophagus, and lung. While the esophageal and lung cancer were relatively non-progressive, the pancreatic tail cancer had invaded the aorta, celiac axis, and left kidney, and the patient was diagnosed with unresectable locally advanced disease. Because the described lesion could have been the prognostic determinant for this patient, we initiated intensive chemotherapy (gemcitabine plus nab-paclitaxel) for pancreatic cancer. After six courses of chemotherapy, the tumor size shrank remarkably and no invasion to the aorta or celiac axis was observed. No significant changes were observed in the esophageal and lung cancers; endoscopic submucosal dissection could be still a curative treatment for the esophageal cancer. Therefore, we performed curative resection for pancreatic cancer (distal pancreatomy, splenectomy, and left nephrectomy; ypT3N0cM0, ypStage IIA, UICC 8th). Pathologically, complete resection was achieved. The patient then underwent endoscopic submucosal dissection for early esophageal cancer (pT1a[M]-LPM) and video-assisted thoracoscopic right upper lobectomy in combination with right lower partial resection for early lung cancer (pT2aN0M0, pStage IB, UICC 8th). Eight months after pancreatic cancer surgery, the patient is alive and has no sign of recurrence; as a result of the successful treatment, the patient has a good quality of life. Conclusions Treatment of MPC is challenging, especially for cases with unresectable tumors. Although synchronous triple cancer can involve unresectable pancreatic cancer, radical resection may be possible after careful assessment of the appropriate treatment strategy and downstaging of unresectable tumors.
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Iguchi T, Iseda N, Hirose K, Ninomiya M, Honboh T, Maeda T, Sawada F, Tachibana YI, Akashi T, Sekiguchi N, Sadanaga N, Matsuura H. Indocyanine green fluorescence to ensure perfusion in middle segment-preserving pancreatectomy: a case report. Surg Case Rep 2021; 7:262. [PMID: 34928447 PMCID: PMC8688606 DOI: 10.1186/s40792-021-01344-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/04/2021] [Indexed: 12/02/2022] Open
Abstract
Background Middle segment-preserving pancreatectomy (MSPP) is an alternative to total pancreatectomy that allows for the preservation of the endocrine and exocrine functions of the pancreas. However, maintaining perfusion to the pancreatic remnant is of critical importance. We describe the first case to our knowledge in which indocyanine green (ICG) fluorescence was used to confirm perfusion to the pancreatic remnant during MSPP. Case presentation A 79-year-old man with diabetes mellitus was referred to our hospital for treatment of a pancreatic tumor. Computed tomography revealed a hypovascular mass in the uncus of the pancreas and dilatation of the main pancreatic duct, measuring 13 mm in the tail of the pancreas. He was diagnosed with cancer of the pancreatic uncus via endoscopic ultrasound and fine-needle aspiration revealed a mixed-type intraductal papillary mucinous neoplasm (IPMN), along with high-risk stigmata in the tail of the pancreas. We performed MSPP and the length of the pancreatic remnant was 4.6 cm. The dorsal pancreatic artery was preserved and perfusion to the pancreatic remnant was confirmed by ICG fluorescence. Histopathological examination showed a pancreatic ductal adenocarcinoma in the uncus (pT1cN1M0, pStage 2B) and IPMN in the tail of the pancreas. The postoperative course was complicated by a grade B pancreatic fistula, but this was successfully treated with conservative management. The patient was transferred to a hospital 33 days after surgery. Insulin administration was necessary, but C-peptide was detectable and blood glucose was relatively well-controlled. He did not exhibit any exocrine dysfunction when pancreatic enzyme supplementation was administered. Conclusion ICG fluorescence can be used to evaluate perfusion to the pancreatic remnant during MSPP.
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Affiliation(s)
- Tomohiro Iguchi
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan.
| | - Norifumi Iseda
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
| | - Kosuke Hirose
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
| | - Mizuki Ninomiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higasi-ku, Fukuoka, 812-8582, Japan
| | - Takuya Honboh
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
| | - Takashi Maeda
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higasi-ku, Fukuoka, 812-8582, Japan
| | - Fumi Sawada
- Department of Internal Medicine, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
| | - Yu-Ichi Tachibana
- Department of Internal Medicine, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
| | - Tetsuro Akashi
- Department of Internal Medicine, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
| | - Naotaka Sekiguchi
- Department of Internal Medicine, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
| | - Noriaki Sadanaga
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
| | - Hiroshi Matsuura
- Department of Surgery, Saiseikai Fukuoka General Hospital, 1-3-46 Tenjin, Chuo-ku, Fukuoka, 810-0001, Japan
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Iguchi T, Motomura T, Uchiyama H, Iseda N, Yoshida R, Kayashima H, Harada N, Ninomiya M, Sugimachi K, Honboh T, Maeda T, Sadanaga N, Matsuura H. Impact of a 7.5-Fr Pancreatic Stent for Preventing Pancreatic Fistula after Pancreaticoduodenectomy. Dig Surg 2021; 38:361-367. [PMID: 34784601 DOI: 10.1159/000520462] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/24/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Pancreatic duct stents are widely used to reduce the incidence of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD); however, small stents may cause adverse effects, such as occlusion. Recently, we have tried placing a 7.5-Fr pancreatic duct stent to achieve more effective exocrine output from the pancreas; however, the association between pancreatic duct stent size and POPF remains unknown. METHODS Sixty-five patients with soft pancreatic texture who underwent PD were retrospectively analyzed. After dividing the pancreas, a pancreatic duct stent (stent size 4.0 in 29 patients, 5.0 in 18, and 7.5 Fr in 18) was placed in the main pancreatic duct. RESULTS Twenty-five of 65 patients with soft pancreatic texture (38.5%) developed POPF. POPF became less frequent as the pancreatic duct stent size increased (p = 0.003). The factors associated with POPF development were a 7.5-Fr pancreatic duct stent (p = 0.005), 5.0-Fr pancreatic duct stent (p = 0.031), and male sex (p = 0.008). Pancreatic duct stent size and pancreatic duct diameter did not differ between the POPF and non-POPF groups. DISCUSSION/CONCLUSIONS In patients with a soft pancreas, the placement of a 7.5-Fr pancreatic duct stent may reduce the incidence of POPF.
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Affiliation(s)
- Tomohiro Iguchi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Takashi Motomura
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Hideaki Uchiyama
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Norifumi Iseda
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Rintaro Yoshida
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Hiroto Kayashima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mizuki Ninomiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keishi Sugimachi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takuya Honboh
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Takashi Maeda
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noriaki Sadanaga
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Hiroshi Matsuura
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
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Armstrong A, Iguchi T, Azad A, Szmulewitz R, Holzbeierlein J, Villers A, Alcaraz A, Alekseev B, Shore N, Petrylak D, Rosbrook B, Zohren F, Yamada S, Haas G, Stenzl A. LBA25 Final overall survival (OS) analysis from ARCHES: A phase III, randomized, double-blind, placebo (PBO)-controlled study of enzalutamide (ENZA) + androgen deprivation therapy (ADT) in men with metastatic hormone-sensitive prostate cancer (mHSPC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Uchiyama H, Kuma S, Ishida M, Tsujita E, Nobuto Y, Kasagi Y, Natsugoe K, Aoyagi T, Iguchi T, Itoh H. Resection and reconstruction of pancreatic artery aneurysms caused by the compression of the celiac trunk by the median arcuate ligament: a report of two cases. Surg Case Rep 2021; 7:167. [PMID: 34268612 PMCID: PMC8282884 DOI: 10.1186/s40792-021-01247-y] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background Some patients with the compression of the celiac trunk by the median arcuate ligament (MAL) suffer pancreatic artery aneurysms (PAAs) due to excessive blood flow from the superior mesenteric artery. These aneurysms are in peril because they are prone to rupture irrespective of size. Here, we present two cases of resection and reconstruction of PAAs caused by the compression of the celiac trunk by the MAL.
Case presentation Patient 1 was a 44-year-old man who was first diagnosed to have a visceral artery aneurysm with a diameter of 4 cm accidentally found by ultrasound examination at a regular medical check-up. Contrast-enhanced CT revealed the compression of the celiac trunk by the MAL and a PAA originating from the first jejunal artery. First, laparoscopic excision of the MAL followed by a stent placement into the celiac trunk was performed. Although the stent was patent, the PAA still grew. The patient underwent resection and reconstruction of the PAA. Reconstruction of the pancreatic arterial arcade was needed because clamping of the inferior pancreaticoduodenal artery (IPDA) resulted in disappearance of the hepatic arterial blood flow. The follow-up CT 2 years and 9 months after the operation revealed no recurrence of aneurysms and the patent anastomosis. Patient 2 was a 68-year-old man who presented with an epigastric pain. Contrast-enhanced CT revealed the compression of the celiac trunk by the MAL and a PAA approximately 6 cm in diameter originating from the IPDA. The PAA was surrounded by a relatively low-intensity area, suggesting impending rupture of the PAA. The patient underwent resection and reconstruction of the PAA under an emergency situation. Reconstruction of the pancreatic arterial arcade was needed because clamping of the inflow IPDA resulted in disappearance of the hepatic blood flow. The follow-up CT 1 year and 8 months after the operation revealed no recurrence of aneurysms and the patent anastomosis. Conclusions Although long-term follow-up is needed, resection and reconstruction is one of the therapeutic choices for PAAs caused by the compression of the celiac trunk by the MAL in order to prevent catastrophic aneurysm rupture.
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Affiliation(s)
- Hideaki Uchiyama
- Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan.
| | - Sosei Kuma
- Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan
| | - Mayumi Ishida
- Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan
| | - Eiji Tsujita
- Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan
| | - Yoshinari Nobuto
- Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan
| | - Yuta Kasagi
- Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan
| | - Keita Natsugoe
- Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan
| | - Takehiko Aoyagi
- Department of Surgery, National Hospital Organization Fukuokahigashi Medical Center, Koga, 811-3195, Japan
| | - Tomohiro Iguchi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, 810-0001, Japan
| | - Hiroyuki Itoh
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, 810-0001, Japan
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Sugimoto R, Inada H, Tanaka Y, Senju T, Aratake Y, Nakanishi A, Miki M, Lee L, Hisano T, Matsumoto Y, Mano Y, Iguchi T, Sugimachi K, Okumura Y, Taguchi K, Furukawa M. Improved indocyanine green retention after short-term lenvatinib withdrawal in three patients with hepatocellular carcinoma. Clin J Gastroenterol 2021; 14:1484-1490. [PMID: 34176067 PMCID: PMC8437917 DOI: 10.1007/s12328-021-01470-y] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/21/2021] [Indexed: 11/27/2022]
Abstract
Use of lenvatinib, which has a high response rate in advanced hepatocellular carcinoma, sometimes results in tumor shrinkage and resectability of previously unresectable liver cancers. In Asia, including Japan, liver reserve, one of the determinants of resectability, is mainly determined by the indocyanine green (ICG) retention rate. Three patients with advanced liver cancer treated at our institution had very poor ICG retention rates during treatment with lenvatinib. Lenvatinib may reduce blood flow in both cancerous and non-cancerous regions by inhibiting vascular endothelial growth factor. Therefore, accurate determination of liver function likely requires withdrawal of this treatment several days before ICG retention testing.
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Affiliation(s)
- Rie Sugimoto
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan.
| | - Hiroki Inada
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Yuki Tanaka
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Takeshi Senju
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Yoshifusa Aratake
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Akira Nakanishi
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Masami Miki
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Lingaku Lee
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Terumasa Hisano
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Yoshihiro Matsumoto
- Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Yohei Mano
- Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Tomohiro Iguchi
- Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Keishi Sugimachi
- Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Yukihiko Okumura
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Kenichi Taguchi
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
| | - Masayuki Furukawa
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka City Fukuoka Prefecture, 811-1395, Japan
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23
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Yoshiya S, Harada N, Tomiyama T, Takeishi K, Toshima T, Iguchi T, Itoh S, Ninomiya M, Yoshizumi T, Mori M. The Significant Prognostic Factors in Prolonged Intensive/High Care Unit Stay After Living Donor Liver Transplantation. Transplant Proc 2021; 53:1630-1638. [PMID: 33934913 DOI: 10.1016/j.transproceed.2021.02.020] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 01/09/2021] [Accepted: 02/25/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prolonged stay in an intensive/high care unit (ICU/HCU) after living donor liver transplantation (LDLT) is a significant event with possible mortality. METHODS Adult-to-adult LDLTs (n = 283) were included in this study. Univariate and multivariate analyses were performed for the factors attributed to the prolonged ICU/HCU stay after LDLT. RESULTS Recipients who stayed in the ICU/HCU 9 days or longer were defined as the prolonged group. The prolonged group was older (P = .0010), had a higher model for end-stage liver disease scores (P < .0001), and had higher proportions of patients with preoperative hospitalization (P < .0001). Delirium (P < .0001), pulmonary complications (P < .0001), sepsis (P < .0001), reintubation or tracheostomy (P < .0001), relaparotomy due to bleeding (P = .0015) or other causes (P < .0001), and graft dysfunction (P < .0001) were associated with prolonged ICU/HCU stay. Only sepsis (P = .015) and graft dysfunction (P = .019) were associated with in-hospital mortality among patients with prolonged ICU/HCU stay or graft loss within 9 days of surgery. Among these patients, grafts from donors aged <42 years and with a graft-to-recipient weight ratio of >0.76% had significantly higher graft survival than grafts from others (P = .0013 and P < .0001, respectively). CONCLUSION Prolonged ICU/HCU stay after LDLT was associated with worse short-term outcomes. The use of grafts of sufficient volume from younger donors might improve graft survival.
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Affiliation(s)
- Shohei Yoshiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takahiro Tomiyama
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuki Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takeo Toshima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Iguchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shinji Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mizuki Ninomiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Sugimachi K, Mano Y, Matsumoto Y, Iguchi T, Taguchi K, Hisano T, Sugimoto R, Morita M, Toh Y. Adenomyomatous hyperplasia of the extrahepatic bile duct: a systematic review of a rare lesion mimicking bile duct carcinoma. Clin J Gastroenterol 2021; 14:393-401. [PMID: 33400191 DOI: 10.1007/s12328-020-01327-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/17/2020] [Indexed: 01/17/2023]
Abstract
Adenomyomatous hyperplasia (AH) is a tumor-like inflammatory hyperplastic lesion. In the biliary system, AH commonly arises in the gallbladder, but AH of the extrahepatic bile duct is extremely rare. AH usually develops and is found with symptoms related to biliary stenosis or obstruction, but there are few disease-specific manifestations. It is difficult to make a definitive diagnosis by imaging or cytopathological examination; thus, surgical resections were performed in all past reported cases. The pathophysiological etiology of AH is unknown, but it is considered to be associated with chronic inflammation. According to the epidemiological findings of cases reported to date, the possibility of malignant transformation is considered to be negative. However, the symptoms and imaging findings of AH are difficult to distinguish from those of early-stage bile duct carcinoma. In the current review, we discuss the epidemiology, pathophysiology, diagnosis, and management of AH of the bile duct.
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Affiliation(s)
- Keishi Sugimachi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
| | - Yohei Mano
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Yoshihiro Matsumoto
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Tomohiro Iguchi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Kenichi Taguchi
- Department of Cancer Pathology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Terumasa Hisano
- Department of Gastroenterology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Rie Sugimoto
- Department of Gastroenterology, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Yasushi Toh
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
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25
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Motomura T, Uchiyama H, Iguchi T, Ninomiya M, Yoshida R, Honboh T, Sadanaga N, Akashi T, Matsuura H. Impact of Osteopenia on Oncologic Outcomes After Curative Resection for Pancreatic Cancer. In Vivo 2020; 34:3551-3557. [PMID: 33144467 DOI: 10.21873/invivo.12198] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 08/25/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND/AIM We evaluated the relationship between low bone mineral density (BMD), also called osteopenia, and prognosis in patients who underwent resection for pancreatic cancer (PC). PATIENTS AND METHODS We enrolled 91 consecutive patients who underwent curative resections for PC between May 2009 and January 2019. Their BMDs were measured at the Th11 vertebra using computed tomography. Patients were then divided by age-adjusted standard BMD values into the osteopenia group (n=34) and the non-osteopenia group (n=57). Their overall survival (OS) and recurrence-free survival (RFS) were compared (log-rank test). RESULTS The two groups did not differ in age, BMI, tumor marker, operation time, blood loss, postoperative complications or stage. The osteopenia group had significantly worse 3-year rates for OS (46% vs. 30%, p=0.04) and RFS (41% vs. 26%, p=0.01). In multivariate analysis, osteopenia was an independent prognostic factor for RFS (HR=2.16, p=0.01). CONCLUSION Osteopenia is an adverse prognostic factor for patients with resected PC.
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Affiliation(s)
- Takashi Motomura
- Department of Surgery, Saiseikai Fukuoka, General Hospital, Fukuoka, Japan
| | - Hideaki Uchiyama
- Department of Surgery, Saiseikai Fukuoka, General Hospital, Fukuoka, Japan
| | - Tomohiro Iguchi
- Department of Surgery, Saiseikai Fukuoka, General Hospital, Fukuoka, Japan
| | - Mizuki Ninomiya
- Department of Surgery, Saiseikai Fukuoka, General Hospital, Fukuoka, Japan
| | - Rintaro Yoshida
- Department of Surgery, Saiseikai Fukuoka, General Hospital, Fukuoka, Japan
| | - Takuya Honboh
- Department of Surgery, Saiseikai Fukuoka, General Hospital, Fukuoka, Japan
| | - Noriaki Sadanaga
- Department of Surgery, Saiseikai Fukuoka, General Hospital, Fukuoka, Japan
| | - Tetsuro Akashi
- Department of Internal Medicine, Saiseikai Fukuoka, General Hospital, Fukuoka, Japan
| | - Hiroshi Matsuura
- Department of Surgery, Saiseikai Fukuoka, General Hospital, Fukuoka, Japan
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26
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Maeda T, Imai D, Wang H, Yugawa K, Kinjo N, Kawata K, Ikeda S, Edahiro K, Takeishi K, Iguchi T, Kayashima H, Harada N, Ninomiya M, Yamaguchi S, Konishi K, Tsutsui S, Matsuda H. Hepatic resection for recurrent hepatocellular carcinoma during pregnancy: a case report. Surg Case Rep 2020; 6:229. [PMID: 32990785 PMCID: PMC7524929 DOI: 10.1186/s40792-020-00985-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/18/2020] [Indexed: 11/10/2022] Open
Abstract
Background Hepatocellular carcinoma (HCC) during pregnancy is extremely rare. Treatment strategies for cancers detected during pregnancy have been controversial. We herein report a case of recurrent HCC detected at 20 weeks of pregnancy, which subsequently prompted hepatic resection after abortion. Case presentation A 36-year-old woman underwent laparoscopic partial hepatectomy for HCC (20 mm in diameter) in segment 5 of the liver during follow-up after being determined as a hepatitis B virus carrier two and a half years ago. Post-surgery follow-up abdominal ultrasonography revealed a 36-mm tumor in segment 7 of the liver. Abdominal contrast-enhanced computed tomography revealed a well-enhanced tumor with a 40-mm diameter in segment 7 adjacent to the inferior vena cava and right hepatic vein, suggesting HCC recurrence. Laboratory data revealed total bilirubin (0.4 mg/dL), aspartate aminotransferase (28 IU/L), alanine aminotransferase (30 IU/L), glutamyltransferase (16 IU/L), prothrombin time (115.3%), and indocyanine green retention rate at 15 min (7.0%). α-Fetoprotein (AFP) (12,371.5 ng/mL; normal range < 10 ng/mL) and PIVKA-II (208 mAU/mL; normal range < 40 mAU/mL) were both significantly elevated. After discussions with a cancer board consisting of experts from the departments of gastroenterology, obstetrics and gynecology, and surgery, as well as obtaining appropriate informed consent from the patient and her family, we decided to perform a hepatic resection after abortion. Subsequently, abortion surgery was performed at 21 weeks and 2 days of pregnancy. After 6 days, subsegmentectomy of liver segment 7 was performed under general and epidural anesthesia, with a pathological diagnosis which was moderately differentiated HCC being established. Given the good postoperative course, without particular complications, the patient was subsequently discharged 10 days after the operation. Approximately 2 years after the surgery, the patient remains alive without recurrence, while both AFP and PIVKA-II were within normal limits. Conclusions Treatment strategies for HCC detected during pregnancy remain controversial. As such, decisions should be made based on HCC growth and fetal maturity after thorough multidisciplinary team discussions and obtaining appropriate informed consent from the patient and her family.
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Affiliation(s)
- Takashi Maeda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan.
| | - Daisuke Imai
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Huanlin Wang
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Kyohei Yugawa
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Nao Kinjo
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Koto Kawata
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Shinichiro Ikeda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Keitaro Edahiro
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Kazuki Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 810-8582, Japan
| | - Tomohiro Iguchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 810-8582, Japan
| | - Hiroto Kayashima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 810-8582, Japan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 810-8582, Japan
| | - Mizuki Ninomiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 810-8582, Japan
| | - Shohei Yamaguchi
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Kozo Konishi
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Shinichi Tsutsui
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Hiroyuki Matsuda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
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27
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Iseda N, Itoh S, Tomiyama T, Morinaga A, Wang H, Shimagaki T, Kurihara T, Nagao Y, Toshima T, Harada N, Iguchi T, Yoshizumi T, Mori M. [Immune Response on Outcomes in Hepatocellular Carcinoma]. Gan To Kagaku Ryoho 2020; 47:1303-1306. [PMID: 33130688] [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: 06/11/2023]
Abstract
Recently, immune checkpoint inhibitors(ICI)has been developed considerably. ICI has already been approved for malignant melanoma, lung cancer and renal cancer. We expected ICI to be taken for many cancers in the future. Therefore, the development of biomarker for them are needed. The recent large phase Ⅲ study IMbrave 150 evaluated atezolizumab plus bevacizumab vs sorafenib as the first treatment for patients with unresectable hepatocellular carcinoma(HCC). IMbrave 150 demonstrated statistically significant and clinically meaningful improvements in both OS and RFS for atezolizumab plus bevacizumab compared with sorafenib in HCC patients. A paradigm shift in the treatment of unresectable HCC is about to occur. In this article, we discussed the significance and biomarkers of tumor immunity in HCC microenvironment.
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Affiliation(s)
- Norifumi Iseda
- Dept. of Surgery and Science, Graduate School of Medical Sciences, Kyushu University
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28
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Inokuchi S, Itoh S, Yoshizumi T, Yugawa K, Yoshiya S, Toshima T, Takeishi K, Iguchi T, Sanefuji K, Harada N, Sugimachi K, Ikegami T, Kohashi K, Taguchi K, Yonemasu H, Fukuzawa K, Oda Y, Mori M. Mitochondrial expression of the DNA repair enzyme OGG1 improves the prognosis of pancreatic ductal adenocarcinoma. Pancreatology 2020; 20:1175-1182. [PMID: 32741713 DOI: 10.1016/j.pan.2020.07.011] [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: 02/29/2020] [Revised: 07/05/2020] [Accepted: 07/17/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES 8-Hydroxydeoxyguanosine (8-OHdG) is an indicator of oxidative stress and causes transversion mutations and carcinogenesis. 8-OHdG is excision repaired by 8-OHdG DNA glycosylase 1 (OGG1), which is classified as nuclear and mitochondrial subtypes. We aimed to clarify the role of OGG1 in pancreatic ductal adenocarcinoma (PDAC). METHODS Ninety-two patients with PDAC who had undergone surgical resection at multiple institutions were immunohistochemically analyzed. The OGG1 and 8-OHdG expression levels were scored using the Germann Immunoreactive Score. The cutoff values of OGG1, as well as that of 8-OHdG, were determined. RESULTS The low nuclear OGG1 expression group (n = 41) showed significantly higher carbohydrate antigen (CA)19-9 (p = 0.026), and higher s-pancreas antigen (SPAN)-1 (p = 0.017) than the high expression group (n = 51). Nuclear OGG1 expression has no effect on the prognosis. The low mitochondrial OGG1 expression group (n = 40) showed higher CA19-9 (p = 0.041), higher SPAN-1 (p = 0.032), and more histological perineural invasion (p = 0.037) than the high expression group (n = 52). The low mitochondrial OGG1 expression group had a significantly shorter recurrence-free survival (p = 0.0080) and overall survival (p = 0.0073) rates. The Cox proportional hazards model revealed that low mitochondrial OGG1 expression is an independent risk factor of the PDAC prognosis. OGG1 expression was negatively correlated with 8-OHdG expression (p = 0.0004), and high 8-OHdG expression shortened the recurrence-free survival of patients with PDAC. CONCLUSIONS Low mitochondrial OGG1 expression might aggravate the PDAC prognosis.
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Affiliation(s)
- Shoichi Inokuchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan
| | - Shinji Itoh
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan.
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan
| | - Kyohei Yugawa
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan; Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 812-8582, Japan
| | - Shohei Yoshiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan
| | - Takeo Toshima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan
| | - Kazuki Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan
| | - Tomohiro Iguchi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, 811-1395, Japan
| | - Kensaku Sanefuji
- Department of Surgery, Oita Red Cross Hospital, 870-0033, Oita, Japan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan
| | - Keishi Sugimachi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, 811-1395, Japan
| | - Toru Ikegami
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 812-8582, Japan
| | - Kenichi Taguchi
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka, 811-1395, Japan
| | - Hirotoshi Yonemasu
- Department of Anatomic Pathology, Oita Red Cross Hospital, 870-0033, Oita, Japan
| | - Kengo Fukuzawa
- Department of Surgery, Oita Red Cross Hospital, 870-0033, Oita, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, 812-8582, Japan
| | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 812-8582, Fukuoka, Japan
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29
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Iguchi T, Sugimachi K, Mano Y, Motomura T, Sugiyama M, Ota M, Ikebe M, Esaki T, Yoshizumi T, Morita M, Mori M, Toh Y. Prognostic Impact of Geriatric Nutritional Risk Index in Patients With Synchronous Colorectal Liver Metastasis. Anticancer Res 2020; 40:4165-4171. [PMID: 32620666 DOI: 10.21873/anticanres.14416] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 05/26/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The Geriatric Nutritional Risk Index (GNRI) is a prognostic indicator for several cancers; however, the association between the GNRI and colorectal liver metastasis (CRLM) remains unknown. PATIENTS AND METHODS Eighty patients who underwent hepatectomy for synchronous CRLM were divided into two groups based on the GNRI. RESULTS The preoperative CA19-9 levels were significantly higher in the low (GNRI ≤98; n=30) than the normal GNRI group (GNRI >98; n=50). Patients in the low GNRI group had poorer outcomes than those in the normal GNRI group. A low GNRI was an independent prognostic factor for recurrence-free survival and overall survival. Among 50 patients who experienced recurrence, only 16 of 22 patients (72.7%) in the low GNRI group could receive intensive treatment and 27 of 28 patients (96.4%) in the normal GNRI group. CONCLUSION The GNRI is a simplified prognostic factor for patients with CRLM.
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Affiliation(s)
- Tomohiro Iguchi
- Department of Hepato-Biliary Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan .,Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keishi Sugimachi
- Department of Hepato-Biliary Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yohei Mano
- Department of Hepato-Biliary Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Takashi Motomura
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahiko Sugiyama
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Mitsuhiko Ota
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masahiko Ikebe
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Taito Esaki
- Department of Gastrointestinal and Medical Oncology National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Tomoharu Yoshizumi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasushi Toh
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
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30
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Maeda T, Yugawa K, Kinjo N, Imai D, Sanefuji K, Kawata K, Ikeda S, Edahiro K, Takeishi K, Iguchi T, Harada N, Ninomiya M, Yamaguchi S, Konishi K, Tsutsui S, Matsuda H. Large surgically resected leiomyosarcoma of the liver: a case report. Surg Case Rep 2020; 6:168. [PMID: 32648231 PMCID: PMC7347740 DOI: 10.1186/s40792-020-00934-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/02/2020] [Indexed: 12/26/2022] Open
Abstract
Background Primary hepatic leiomyosarcoma (PHL) is an extremely rare type of tumor. We herein report a case of a large surgically resected leiomyosarcoma of the liver. Case presentation A 69-year-old man with a feeling of epigastric compression was referred for examination of an abdominal mass. He had no history of liver disease or alcohol abuse. Liver function tests indicated Child-Pugh class A. Tumor markers were negative. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a relatively well-contrasted 12 × 11 × 8 cm tumor with well-defined boundary replacing the lateral segment of the liver alongside multiple intrahepatic metastases. Several nodules up to 12 mm were found in both lungs, suggestive of metastasis. SUVmax of the liver mass and lung tumor in positron emission tomography were 10.4 and 1.5, respectively. Hepatocellular carcinoma was primarily suspected. Lateral segmentectomy of the liver was performed to confirm diagnosis and prevent tumor rupture. Macroscopically, the lateral segment of the liver had been replaced by a lobular or multinodular tumor with a maximum diameter of 15 cm. In pathological findings, the tumor consisted of bundle-like proliferation of complicated banding spindle-like cells with clear cytoplasm, accompanied by storiform pattern and compressed blood vessels. Nuclear fission images were observed in 8/10 HPF. Partial necrosis was present, with associated venous invasion and intrahepatic metastasis. Immunohistochemical staining for tumor cells revealed desmin, α-smooth muscle actin (αSMA), and h-caldesmon were all positive, informing a final diagnosis of PHL. The postoperative course was uneventful, and he was discharged on the 12th postoperative day. Conclusions PHL is a rare malignant disease with relatively poor prognosis. To confirm a diagnosis of PHL, immunohistochemical analysis as well as histopathological findings is important. The preferred treatment is surgical resection, sometimes in combination with adjuvant chemotherapy and radiotherapy. Further studies are needed to elucidate and better understand this uncommon clinical entity.
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Affiliation(s)
- Takashi Maeda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan.
| | - Kyohei Yugawa
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Nao Kinjo
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Daisuke Imai
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Kensaku Sanefuji
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Koto Kawata
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Shinichiro Ikeda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Keitaro Edahiro
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Kazuki Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tomohiro Iguchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Mizuki Ninomiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Shohei Yamaguchi
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Kozo Konishi
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Shinichi Tsutsui
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
| | - Hiroyuki Matsuda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan
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31
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Maeda T, Yugawa K, Kinjo N, Kayashima H, Imai D, Kawata K, Ikeda S, Edahiro K, Takeishi K, Iguchi T, Harada N, Ninomiya M, Yamaguchi S, Konishi K, Tsutsui S, Matsuda H. Mixed adenoneuroendocrine carcinoma of the distal bile duct: a case report. Surg Case Rep 2020; 6:160. [PMID: 32632765 PMCID: PMC7338298 DOI: 10.1186/s40792-020-00921-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mixed adenoneuroendocrine carcinoma (MANEC) of the common bile duct (CBD) is very rare, with only 10 reported cases. Here, we report a case of MANEC of the distal bile duct (DBD) that was surgically resected under a diagnosis of cholangiocarcinoma (CCA). CASE PRESENTATION A 60-year-old male had epigastric pain and was admitted to our hospital for the treatment of a suspected CBD stone. Upon admission, laboratory findings revealed elevated hepatobiliary enzymes including serum aspartate aminotransferase, serum alanine aminotransferase, serum glutamyltransferase, and serum alkaline phosphatase. Both carcinoembryonic antigen and carbohydrate antigen 19-9 were negative. Computed tomography (CT) showed dilation of the CBD. Endoscopic retrograde cholangiopancreatography (ERCP) showed circumferential stenosis and a 5-mm elevated lesion in the DBD. Brush cytology showed atypical ductal cells, indicating adenocarcinoma (AC) of the DBD. Under a diagnosis of CCA of the DBD, a subtotal stomach-preserving pancreaticoduodenectomy was performed. Neither peritoneal dissemination nor lymph node metastasis was found. Microscopically, the lesion was seen to be composed of predominantly well-differentiated tubular AC in the superficial layer of the tumor, admixed with neuroendocrine carcinoma (NEC) in the deeper portion, indicating a diagnosis of MANEC of the DBD. After immunohistochemical staining, NEC components were positive for synaptophysin and CD56 and were for SSTR2, SSTR5, and mammalian target of rapamycin (mTOR). Three months postsurgery, postoperative adjuvant chemotherapy with S-1 was started. More than 3 years postsurgery, he is alive without recurrence. CONCLUSIONS MANEC is highly malignant, progresses rapidly, and has a poor prognosis. Preoperative diagnosis is difficult; therefore, identifying NEC components by immunohistochemical staining using resected specimens is important.
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Affiliation(s)
- Takashi Maeda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan.
| | - Kyohei Yugawa
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Nao Kinjo
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Hiroto Kayashima
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Daisuke Imai
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Koto Kawata
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Shinichiro Ikeda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Keitaro Edahiro
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Kazuki Takeishi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tomohiro Iguchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Noboru Harada
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Mizuki Ninomiya
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shohei Yamaguchi
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Kozo Konishi
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Shinichi Tsutsui
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
| | - Hiroyuki Matsuda
- Department of Surgery, Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima, 730-8619, Japan
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32
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Ota M, Ikebe M, Shin Y, Kagawa M, Mano Y, Nakanoko T, Nakashima Y, Uehara H, Sugiyama M, Iguchi T, Sugimachi K, Yamamoto M, Morita M, Toh Y. Laparoscopic Total Gastrectomy for Remnant Gastric Cancer: A Single-institution Experience and Systematic Literature Review. In Vivo 2020; 34:1987-1992. [PMID: 32606171 DOI: 10.21873/invivo.11996] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/06/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND/AIM The safety and efficacy of laparoscopic total gastrectomy (LTG) for remnant gastric cancer (RGC) remains unclear. The purpose of this study was to compare the clinical outcomes of LTG with open total gastrectomy (OTG) for RGC. PATIENTS AND METHODS Twenty-two patients who underwent total gastrectomy for RGC were enrolled in this study. RESULTS LTG was carried out in seven patients, and OTG was performed in the remaining 15 patients. The mean operation time in the LTG group was longer than that in the OTG group. The estimated blood loss in the LTG group was less than that in the OTG group. No cases in the LTG group required open conversion. Postoperatively, the first meal and defecation were earlier in the LTG group than in the OTG group. The overall survival rates of the two groups were comparable. CONCLUSION Laparoscopic total gastrectomy is a feasible surgical option for RGC.
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Affiliation(s)
- Mitsuhiko Ota
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Masahiko Ikebe
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Yuki Shin
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Masaki Kagawa
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Yohei Mano
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Tomonori Nakanoko
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Yuichiro Nakashima
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Hideo Uehara
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Masahiko Sugiyama
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Tomohiro Iguchi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Keishi Sugimachi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Manabu Yamamoto
- Department of Surgery, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Masaru Morita
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
| | - Yasushi Toh
- Department of Gastrointestinal Surgery, National Hospital Organization, Kyushu Cancer Center, Fukuoka, Japan
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33
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Kohjimoto Y, Higuchi M, Ueda Y, Iguchi T, Koike H, Wakamiya T, Yamashita S, Kikkawa K, Hara I. Intraoperative measurements of urethral length and bladder neck diameter as predictors of urinary continence after robot-assisted radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33779-4] [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: 11/27/2022] Open
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34
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Kidogami S, Iguchi T, Sato K, Yoshikawa Y, Hu Q, Nambara S, Komatsu H, Ueda M, Kuroda Y, Masuda T, Mori M, Doki Y, Mimori K. SF3B4 Plays an Oncogenic Role in Esophageal Squamous Cell Carcinoma. Anticancer Res 2020; 40:2941-2946. [PMID: 32366446 DOI: 10.21873/anticanres.14272] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 03/23/2020] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The spliceosome pathway, including Splicing Factor 3b Subunit 4 (SF3B4), plays an important role in carcinogenesis and progression in various cancers; however, the clinical relevance of SF3B4 in esophageal squamous cell carcinoma (ESCC) remains unknown. PATIENTS AND METHODS SF3B4 expression was evaluated by real-time reverse transcription polymerase chain reaction in 80 ESCC patients. In order to explore the mechanism of SF3B4 in ESCC, the mRNA expression and copy number of SF3B4 were obtained from TCGA and we also implemented gene set enrichment analysis (GSEA). RESULTS The high SF3B4 expression group (n=33) showed significantly more lymphatic permeation and poorer prognosis than the low SF3B4 expression group (n=47). GSEA revealed that high SF3B4 expression was correlated with genes associated with the transcription factor E2F and the G2/M checkpoint. SF3B4 expression was positively correlated with SF3B4 DNA copy number. CONCLUSION Over-expression of SF3B4 may play a crucial role in the lymphatic progression of ESCC.
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Affiliation(s)
- Shinya Kidogami
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan.,Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Tomohiro Iguchi
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Kuniaki Sato
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Yukihiro Yoshikawa
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan.,Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Quingjang Hu
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Sho Nambara
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Hisateru Komatsu
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan.,Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Masami Ueda
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan.,Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yosuke Kuroda
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Takaaki Masuda
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
| | - Masaki Mori
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Koshi Mimori
- Department of Surgery, Kyushu University Beppu Hospital, Oita, Japan
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35
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Iguchi T, Sugimachi K, Mano Y, Kono M, Kagawa M, Nakanoko T, Uehara H, Sugiyama M, Ota M, Ikebe M, Morita M, Toh Y. The Preoperative Prognostic Nutritional Index Predicts the Development of Deep Venous Thrombosis After Pancreatic Surgery. Anticancer Res 2020; 40:2297-2301. [PMID: 32234929 DOI: 10.21873/anticanres.14195] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 02/05/2020] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND/AIM Pancreatic surgery is associated with a high risk of developing deep venous thrombosis (DVT) and malnutrition. We aimed to evaluate the factors predicting the development of DVT, focusing on nutrition assessment tools. PATIENTS AND METHODS One hundred patients who underwent pancreatic surgery were postoperatively examined for DVT. We assessed the risk factors for the development of DVT after surgery. RESULTS Postoperative DVT was detected in 11 patients (11%). Patients who developed DVT after surgery were significantly older (p=0.016) and had higher preoperative D-dimer levels (p=0.005) than those who did not. The preoperative prognostic nutritional index (PNI) was mostly associated with the development of DVT (p=0.079). Furthermore, PNI ≤44.3, BUN >20 mg/dl, D-dimer ≥1.9 μg/ml were independent predictors for the development of DVT after surgery. CONCLUSION A poor nutrition status and dehydration should be preoperatively improved for patients who are identified, as having a high risk of developing DVT after pancreatic surgery.
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Affiliation(s)
- Tomohiro Iguchi
- Department of Hepato-Biliary Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Keishi Sugimachi
- Department of Hepato-Biliary Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yohei Mano
- Department of Hepato-Biliary Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Mihoko Kono
- Department of Cardiovascular Medicine, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masaki Kagawa
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Tomonori Nakanoko
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Hideo Uehara
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masahiko Sugiyama
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Mitsuhiko Ota
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masahiko Ikebe
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yasushi Toh
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
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36
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Sonnenschein V, Tsuji Y, Kokuryu S, Kubo W, Suzuki S, Tomita H, Kiyanagi Y, Iguchi T, Matsushita T, Wada N, Kitaguchi M, Shimizu HM, Hirota K, Shinohara T, Hiroi K, Hayashida H, Guo W, Ito D, Saito Y. An experimental setup for creating and imaging 4He 2 * excimer cluster tracers in superfluid helium-4 via neutron- 3He absorption reaction. Rev Sci Instrum 2020; 91:033318. [PMID: 32259963 DOI: 10.1063/1.5130919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 02/29/2020] [Indexed: 06/11/2023]
Abstract
For the purpose of future visualization of the flow field in superfluid helium-4, clusters of the triplet state excimer 4He2 * are generated along the micro-scale recoil tracks of the neutron-absorption reaction n + 3He → 3T + p. This reaction is induced by neutron irradiation of the 3He fraction contained in natural isotopic abundance liquid helium with neutron beams either from the Japan Proton Accelerator Research Complex, Materials and Life Science Experimental Facility (JPARC)/Materials and Life Science Experimental Facility or from the Kyoto University Institute for Integrated Radiation and Nuclear Science. These 4He2 * clusters are expected to be ideal tracers of the normal-fluid component in superfluid helium with several advantageous properties. Evidence of the excimer generation is inferred by detection of laser induced fluorescence emitted from the 4He2 * clusters excited by a purpose-built short pulse gain-switched titanium:sapphire (Ti:sa) laser operating at a wavelength of 905 nm. The setup and performance characteristics of the laser system including the Ti:sa and two continuous wave re-pumping lasers are described. Detection at the fluorescence wavelength of 640 nm is performed by using optical bandpass filtered photomultiplier tubes (PMT). Electrical noise in the PMT acquisition traces could successfully be suppressed by post-processing with a simple algorithm. Despite other laser-related backgrounds, the excimer was clearly identified by its fluorescence decay characteristics. Production of the excimer was found to be proportional to the neutron flux, adjusted via insertion of different collimators into the neutron beam. These observations suggest that the apparatus we constructed does function in the expected manner and, therefore, has the potential for groundbreaking turbulence research with superfluid helium.
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Affiliation(s)
- V Sonnenschein
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - Y Tsuji
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - S Kokuryu
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - W Kubo
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - S Suzuki
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - H Tomita
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - Y Kiyanagi
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - T Iguchi
- Department of Energy Engineering, Nagoya University, Nagoya, Aichi 464-8603, Japan
| | - T Matsushita
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - N Wada
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - M Kitaguchi
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - H M Shimizu
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - K Hirota
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - T Shinohara
- Department of Physics, Nagoya University, Nagoya, Aichi 464-8602, Japan
| | - K Hiroi
- J-PARC Center, Japan Atomic Energy Agency, Tokai, Ibaraki 319-1195, Japan
| | - H Hayashida
- Comprehensive Research Organization for Science and Society, Tokai, Ibaraki 319-1106, Japan
| | - W Guo
- National High Magnetic Field Laboratory, Tallahassee, Florida 32310, USA
| | - D Ito
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Kumatori, Osaka 590-0494, Japan
| | - Y Saito
- Institute for Integrated Radiation and Nuclear Science, Kyoto University, Kumatori, Osaka 590-0494, Japan
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Sugimachi K, Iguchi T, Ohta M, Mano Y, Hisano T, Yokoyama R, Taguchi K, Ikebe M, Morita M, Toh Y. Laparoscopic spleen-preserving distal pancreatectomy for a solid-cystic intraabdominal desmoid tumor at a gastro-pancreatic lesion: a case report. BMC Surg 2020; 20:24. [PMID: 32013941 PMCID: PMC6998096 DOI: 10.1186/s12893-020-0691-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/29/2020] [Indexed: 11/12/2022] Open
Abstract
Background We report a case of an intraabdominal desmoid tumor that occurred at a gastro-pancreatic lesion with spontaneous cystic features, and present the successful laparoscopic resection of the tumor. Case presentation A 20-mm retroperitoneal cystic mass with a solid component was found adjacent to the stomach and pancreatic body in a 52-year-old woman with no history of familial adenomatous polyposis. Laparoscopic spleen-preserving distal pancreatectomy with wedge resection of the stomach was performed, and complete resection was achieved without intraoperative and postoperative complications. Histopathological examination by immunohistochemistry enabled diagnosis of a desmoid tumor that had originated from the stomach and invaded the pancreatic parenchyma with a spontaneous cystic change. We herein report an extremely rare case of an intraabdominal desmoid tumor with a spontaneous cystic change. Conclusion Regardless of its rarity, desmoid tumor should be included in the preoperative differential diagnosis of a cystic intraabdominal mass, and laparoscopic function-preserving surgery may be an optimal treatment option.
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Affiliation(s)
- Keishi Sugimachi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
| | - Tomohiro Iguchi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Mitsuhiko Ohta
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yohei Mano
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Terumasa Hisano
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Ryohei Yokoyama
- Department of Orthopedic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Kenichi Taguchi
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masahiko Ikebe
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yasushi Toh
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
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Sugimachi K, Iguchi T, Mano Y, Morita M, Mori M, Toh Y. Significance of bile culture surveillance for postoperative management of pancreatoduodenectomy. World J Surg Oncol 2019; 17:232. [PMID: 31888657 PMCID: PMC6937703 DOI: 10.1186/s12957-019-1773-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 12/19/2019] [Indexed: 02/07/2023] Open
Abstract
Background The management of infectious complications is important in pancreatoduodenectomy (PD). We sought to determine the significance of preoperative surveillance bile culture in perioperative management of PD. Methods This study enrolled 69 patients who underwent PD for malignant tumors at a single institute between 2014 and 2017. Surveillance bile culture was performed before or during surgery. Correlations between the incidence of infectious postoperative complications and clinicopathological parameters, including bile cultures, were evaluated. Results Preoperative positive bile culture was confirmed in 28 of 51 patients (55%). Bile culture was positive in 27 of 30 cases (90%) with preoperative biliary drainage, and 1 of 21 cases (5%) without drainage (p < 0.01). Preoperative isolated microorganisms in bile were consistent with those detected in surgical sites in 11 of 27 cases (41%). Cases with positive multi-drug-resistant bacteria in preoperative bile culture showed significantly higher incisional SSI after PD (p = 0.01). The risk factors for the incidence of organ/space SSI were soft pancreatic texture (p = 0.01) and smoking history (p = 0.02) by multivariate analysis. Preoperative positive bile culture was neither associated with organ/space SSI nor overall postoperative complications. Conclusions Preoperative surveillance bile culture is useful for the management of wound infection, prediction of causative pathogens for infectious complications, and the selection of perioperative antibiotic prophylaxis.
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Affiliation(s)
- Keishi Sugimachi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
| | - Tomohiro Iguchi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Yohei Mano
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
| | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yasushi Toh
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan
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Sugimachi K, Iguchi T, Mano Y, Nishijima T, Nakanoko T, Uehara H, Sugiyama M, Ohta M, Ikebe M, Morita M, Toh Y. The Impact of Immunonutritional and Physical Status on Surgical Outcome After Pancreaticoduodenectomy in Elderly Patients. Anticancer Res 2019; 39:6347-6353. [PMID: 31704866 DOI: 10.21873/anticanres.13846] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 09/20/2019] [Revised: 09/30/2019] [Accepted: 10/01/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The aim of this study was to determine the significance of immunonutritional and physical index in the assessment of risk associated with pancreaticoduodenectomy (PD) in the elderly. PATIENTS AND METHODS This study enrolled 92 patients who underwent PD. They were divided into 2 groups: Group A included patients 79 years and younger (n=79) and Group B patients 80 years and older (n=13). Among 37 patients, physical function and body composition were also evaluated. RESULTS Significantly higher neutrophil-lymphocyte ratio, lower prognostic nutritional index (PNI), and controlling nutritional score were observed in Group B. Muscle strength and walking ability were significantly impaired in Group B, although there was no significant difference in body composition. Age was not correlated with the incidence of postoperative complications, overall survival or recurrence-free survival by univariate and multivariate analysis. CONCLUSION PD is justified for the elderly, with acceptable morbidity and prognosis. However, immunonutritional status and physical function are significantly impaired; thus, appropriate case selection and active nutritional support are required for the elderly.
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Affiliation(s)
- Keishi Sugimachi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Tomohiro Iguchi
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yohei Mano
- Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Tomohiro Nishijima
- Department of Geriatric Oncology Service, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Tomonori Nakanoko
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Hideo Uehara
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masahiko Sugiyama
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Mitsuhiko Ohta
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masahiko Ikebe
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yasushi Toh
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
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Stenzl A, Szmulewitz R, Petrylak D, Holzbeierlein J, Villers A, Azad A, Alcaraz A, Alekseev B, Iguchi T, Shore N, Rosbrook B, Baron B, Kunieda F, Morlock R, Ramaswamy K, Armstrong A. ARCHES–efficacité du traitement par suppression androgénique en association avec l’enzalutamide ou placebo dans le cancer de la prostate hormono-sensible métastatique : résultats de l’antigène spécifique de la prostate (PSA). Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.141] [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: 10/25/2022]
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Matsui Y, Hiraki T, Gobara H, Iguchi T, Tomita K, Uka M, Araki M, Nasu Y, Furuya M, Kanazawa S. Percutaneous thermal ablation for renal cell carcinoma in patients with Birt–Hogg–Dubé syndrome. Diagn Interv Imaging 2019; 100:671-677. [DOI: 10.1016/j.diii.2019.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/16/2019] [Accepted: 06/20/2019] [Indexed: 01/29/2023]
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42
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Stenzl A, Szmulewitz R, Petrylak D, Holzbeierlein J, Villers A, Azad A, Alcaraz A, Alekseev B, Iguchi T, Shore N, Rosbrook B, Baron B, Haas G, Morlock R, Ramaswamy K, Armstrong A. ARCHES - The role of androgen deprivation therapy (ADT) with enzalutamide (ENZA) or placebo (PBO) in metastatic hormone-sensitive prostate cancer (mHSPC): Post hoc analyses of high and low disease volume and risk groups. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.010] [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: 11/13/2022] Open
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Fukumoto K, Takemoto Y, Yoshikawa J, Norioka N, Iguchi T, Yoshiyama M, Shuto T. P6205Increase in EPA/AA Ratio Predicts Improvement in Endothelial Function in Purified Eicosapentaenoic Acid-Treated Patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are well-known for preventing cardiovascular disease. Among n-3 PUFAs, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play key roles in preventing cardiovascular diseases. However, the effects of n-3 PUFAs have been examined under conditions of simultaneous administration of EPA and DHA in the majority of clinical investigations and the effect of purified EPA is still controversial. EPA has been reported to improve endothelial dysfunction. Although several mechanisms underlying the effects of EPA on endothelial function have been demonstrated such as the modulation of lipid metabolism including increases in high-density lipoprotein (HDL) and/or decreases in triglyceride (TG) levels, decreases in cytokine production, and inhibition of inflammatory processes, the main mechanisms ameliorating endothelial function have not been fully determined.
Purpose
We sought to clarify the main factors associated with EPA administration that led to improved endothelial function.
Methods
Fifty-one consecutive patients with hypertriglyceridemia (mean ± SD age, 60±13 years) with no evidence of coronary artery disease (CAD) were prospectively enrolled and administered purified EPA (1800 mg/day). Forty-eight patients who were not administered EPA were enrolled as age- and sex-matched controls. Clinical variables such as body mass index, HbA1c, fasting glucose level, HDL, low-density lipoprotein, TG, systolic blood pressure, diastolic blood pressure, heart rate, interleukin-6, baseline diameter of the brachial artery, intima-media thickness of the brachial artery, and flow-mediated dilation (FMD) were examined before and after 6 months of treatment. Univariate and multivariate regression analyses were performed to examine the associations between FMD changes and clinical variables.
Results
FMD was significantly improved from 4.16% ± 1.88% to 6.30% ± 2.24% (p<0.0001) in the EPA group. The change in FMD was positively correlated with the change in EPA/arachidonic acid (AA) ratio (r=0.34, p=0.014). The multivariate regression analysis showed that the change in EPA/AA ratio alone was significantly associated with the change in FMD (p=0.010).
Conclusions
EPA treatment improves endothelial dysfunction in patients with hypertriglyceridemia without evidence of CAD. The change in FMD was associated with the change in EPA/AA ratio alone. These finding suggest that a direct effect of EPA on the endothelium may be the predominant factor ameliorating endothelial function.
Acknowledgement/Funding
This study was supported, in part, by a Grant-in-Aid for Scientific Research from the Ministry of Education, Science and Culture of Japan (15K08649).
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Affiliation(s)
- K Fukumoto
- Osaka City University Graduate School of Medicine, Department of Medical Education and General Practice, Osaka, Japan
| | - Y Takemoto
- Osaka City University Graduate School of Medicine, Department of Medical Education and General Practice, Osaka, Japan
| | - J Yoshikawa
- Osaka City University Graduate School of Medicine, Department of Medical Education and General Practice, Osaka, Japan
| | - N Norioka
- Osaka City University Graduate School of Medicine, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Iguchi
- Bell land General Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Yoshiyama
- Osaka City University Graduate School of Medicine, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Shuto
- Osaka City University Graduate School of Medicine, Department of Medical Education and General Practice, Osaka, Japan
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Tao WK, Iguchi T, Lang S. Expanding the Goddard CSH Algorithm for GPM: New Extratropical Retrievals. J Appl Meteorol Climatol 2019; 58:921-946. [PMID: 32636716 PMCID: PMC7340152 DOI: 10.1175/jamc-d-18-0215.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Goddard Convective-Stratiform Heating (CSH) algorithm has been used to retrieve latent heating (LH) associated with clouds and cloud systems in support of the Tropical Rainfall Measuring Mission (TRMM) and Global Precipitation Measurement (GPM) mission. The CSH algorithm required the use of a cloud-resolving model (CRM) to simulate LH profiles to build look-up tables (LUTs). However, the current LUTs in the CSH algorithm are not suitable for retrieving LH profiles at high latitudes or winter conditions that are needed for GPM. The NASA Unified-Weather Research and Forecasting (NU-WRF) model is used to simulate three eastern continental US (CONUS) synoptic winter and three western coastal/offshore events. The relationship between LH structures (or profiles) and other precipitation properties (radar reflectivity, freezing level height, echo-top height, maximum radar reflectivity height and surface precipitation rate) is examined, and a new classification system is adopted with varying ranges for each of these precipitation properties to create LUTs representing high latitude/winter conditions. The performance of the new LUTs is examined using a self-consistency check for one CONUS and one West Coast offshore event by comparing LH profiles retrieved from the LUTs using model-simulated precipitation properties with those originally simulated by the model. The results of the self-consistency check validate the new classification and LUTs. High latitude retrievals from the new LUTs are merged with those from the CSH algorithm to retrieve LH profiles over the GPM domain using precipitation properties retrieved from the GPM combined algorithm.
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Affiliation(s)
- W-K Tao
- Mesoscale Atmospheric Processes Laboratory NASA/Goddard Space Flight Center Greenbelt, MD 20771
| | - T Iguchi
- Mesoscale Atmospheric Processes Laboratory NASA/Goddard Space Flight Center Greenbelt, MD 20771
- Earth System Science Interdisciplinary Center University of Maryland College Park, MD
| | - S Lang
- Mesoscale Atmospheric Processes Laboratory NASA/Goddard Space Flight Center Greenbelt, MD 20771
- Science Systems and Applications, Inc. Lanham, MD 20706
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Tanaka T, Inai R, Iguchi T, Yanai H, Kanazawa S. Dermoid cyst presenting as an intramuscular mass: CT and MRI features. Diagn Interv Imaging 2018; 100:195-196. [PMID: 30579768 DOI: 10.1016/j.diii.2018.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/30/2018] [Accepted: 12/05/2018] [Indexed: 11/25/2022]
Affiliation(s)
- T Tanaka
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan.
| | - R Inai
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan
| | - T Iguchi
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan
| | - H Yanai
- Department of Pathology, Okayama University Hospital, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan
| | - S Kanazawa
- Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho kita-ku, Okayama, 700-8558, Japan
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Iguchi T, Miyauchi E, Watanabe S, Masai H, Miyatake S. A BTB-ZF protein, ZNF131, is required for early B cell development. Biochem Biophys Res Commun 2018; 501:570-575. [PMID: 29750959 DOI: 10.1016/j.bbrc.2018.05.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 04/27/2018] [Accepted: 05/07/2018] [Indexed: 10/16/2022]
Abstract
Members of the BTB-ZF transcription factor family play important roles in lymphocyte development. During T cell development, ZNF131, a BTB-ZF protein, is critical for the double-negative (DN) to double-positive (DP) transition and is also involved in cell proliferation. Here, we report that knockout of Znf131 at the pre-pro-B cell stage in mb1-Cre knock-in mouse resulted in defect of pro-B to pre-B cell transition. ZNF131 was shown to be required for efficient pro-B cell proliferation as well as for immunoglobulin heavy chain gene rearrangement that occurs in the proliferating pro-B cells. We speculate that inefficient gene rearrangement may be due to loss of cell proliferation, since cell cycle progression and immunoglobulin gene rearrangement, which would occur in a mutually exclusive manner, may be interconnected or coupled to avoid occurrence of genomic instability. ZNF131 suppresses expression of Cdk inhibitor, p21cip1, and that of pro-apoptotic factors, Bax and Puma, targets of p53, to facilitate cell cycle progression and suppress unnecessary apoptosis, respectively, of pro-B cells. There results demonstrate the essential roles of ZNF131 in coordinating the B cell differentiation and proliferation.
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Affiliation(s)
- Tomohiro Iguchi
- Department of Genome Medicine, Tokyo Metropolitan Institute of Medical Science, 4-6-1 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Emako Miyauchi
- Department of Genome Medicine, Tokyo Metropolitan Institute of Medical Science, 4-6-1 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Sumiko Watanabe
- Division of Molecular and Developmental Biology, Institute of Medical Science, University of Tokyo, Shirokane-dai 4-6-1, Minatoku-ku, Tokyo 108-8639, Japan
| | - Hisao Masai
- Department of Genome Medicine, Tokyo Metropolitan Institute of Medical Science, 4-6-1 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Shoichiro Miyatake
- Department of Genome Medicine, Tokyo Metropolitan Institute of Medical Science, 4-6-1 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan; Graduate School of Environmental Health Sciences, Azabu University, 1-17-71 Chuo-ku, Fuchinobe, Sagamihara, Kanagawa 252-5201, Japan.
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Iguchi T, Hiraki T, Matsui Y, Fujiwara H, Masaoka Y, Uka M, Gobara H, Toyooka S, Kanazawa S. Short hookwire placement under imaging guidance before thoracic surgery: A review. Diagn Interv Imaging 2018; 99:591-597. [DOI: 10.1016/j.diii.2018.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/20/2018] [Accepted: 04/03/2018] [Indexed: 10/17/2022]
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Shimizu D, Masuda T, Takano Y, Imamura H, Yamaguchi R, Sato K, Tobo T, Hirata H, Kuroda Y, Nambara S, Hayashi N, Iguchi T, Ito S, Eguchi H, Ochiya T, Yanaga K, Miyano S, Mimori K. Abstract 502: Circulating exosomal miR-203 is associated with metastasis via inducing tumor-associated macrophages in colorectal cancer. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Distant metastasis is the leading cause of mortality in patients with malignant tumor including colorectal cancer (CRC). A primary tumor can create a premetastatic niche in distant organs to facilitate the development of metastasis by communicating with host cells. However, little is known about the communicating mechanism is known. Understanding this mechanism should uncover a new field of cancer therapy through the targeting of the interaction between tumor and host. In this study, we focused on circulating microRNAs (miRs) as the communication tool between host and tumor cells that were mainly carried by exosomes in circulation. As a result of gene expression microarray and gene set enrichment analysis, we identified miR-203 as a putative signaling molecule between tumors and monocytes in metastatic CRC patients. The level of miR-203 expression was significantly upregulated in a TNM stage-dependent manner. High exosomal miR-203 expression in serum was significantly associated with poor DFS and OS (P < 0.01), and was an independent poor prognostic factor. Additionally, high exosomal miR-203 was associated with distant metastasis (P < 0.01). We also found that exosomes carrying miR-203 from CRC cells were incorporated into monocytes and miR-203 promoted the expression of M2 markers such as CD163 and STAT3 in vitro. It suggested that serum exosomal miR-203 released from CRC cells promoted the differentiation of monocytes to M2-tumor-associated macrophages (TAMs) which facilitated premetastatic niche and distant metastasis. Co-injection of miR-203-transfected CRC cells and monocyte increased a ratio of liver metastasis in vivo compared with only control CRC cells or only miR-203-transfected CRC cells injection. On the other hand, overexpression of miR-203 did not increase the proliferation, invasion and migration capacity of CRC cells. This results indicated that serum exosomal miR-203 might create a premetastatic niche whereas did not affect to malignant phenotype of CRC cells. Our study indicated that serum exosomal miR-203 expression could be a novel and feasible biomarker for predicting metastasis, possibly via promoting the differentiation of monocytes to M2-TAMs in CRC.
Citation Format: Dai Shimizu, Takaaki Masuda, Yuki Takano, Hisae Imamura, Rui Yamaguchi, Kuniaki Sato, Taro Tobo, Hidenari Hirata, Yosuke Kuroda, Sho Nambara, Naoki Hayashi, Tomohiro Iguchi, Shuhei Ito, Hidetoshi Eguchi, Takahiro Ochiya, Katsuhiko Yanaga, Satoru Miyano, Koshi Mimori. Circulating exosomal miR-203 is associated with metastasis via inducing tumor-associated macrophages in colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 502.
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Affiliation(s)
- Dai Shimizu
- 1Kyushu University Beppu Hospital, Beppu, Japan
| | | | - Yuki Takano
- 1Kyushu University Beppu Hospital, Beppu, Japan
| | | | | | | | - Taro Tobo
- 1Kyushu University Beppu Hospital, Beppu, Japan
| | | | | | - Sho Nambara
- 1Kyushu University Beppu Hospital, Beppu, Japan
| | | | | | - Shuhei Ito
- 1Kyushu University Beppu Hospital, Beppu, Japan
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49
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Iguchi T, Ueda M, Masuda T, Nambara S, Kidogami S, Komatsu H, Sato K, Tobo T, Ogawa Y, Hu Q, Saito T, Hirata H, Sakimura S, Uchi R, Hayashi N, Ito S, Eguchi H, Sugimachi K, Maehara Y, Mimori K. Identification of UHRF2 as a Negative Regulator of Epithelial-Mesenchymal Transition and Its Clinical Significance in Esophageal Squamous Cell Carcinoma. Oncology 2018; 95:179-187. [PMID: 29909415 DOI: 10.1159/000488860] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 01/19/2018] [Accepted: 03/26/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The involvement of epithelial-mesenchymal transition (EMT) in esophageal squamous cell carcinoma (ESCC) has not been fully elucidated. Here, we aimed to identify EMT-related genes associated with TGF-β in ESCC and to clarify the role of these genes in the progression of ESCC. METHODS EMT-related genes associated with TGF-β expression were identified in patients with ESCC using microarray analysis and public datasets. The effects of ubiquitin-like with PHD and ring finger domains 2 (UHRF2) expression were analyzed in ESCC cell lines. Cell proliferation and invasion were measured using MTT and invasion assays, respectively. UHRF2 mRNA expression was also analyzed in 75 ESCC specimens to determine the clinical significance of UHRF2 in ESCC. RESULTS Treatment of ESCC cell lines with TGF-β increased UHRF2 expression. UHRF2 overexpression increased CDH1 (E-cadherin) expression and decreased invasive capacity. The 75 ESCC specimens were divided into the UHRF2 high-expression group (n = 61) and the UHRF2 low-expression group (n = 14). Low UHRF2 expression was significantly correlated with vascular invasion (p = 0.034) and was an independent prognostic factor for poor prognosis (p = 0.005). CONCLUSION UHRF2 may be a negative regulator of EMT and a novel prognostic biomarker for ESCC.
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Affiliation(s)
- Tomohiro Iguchi
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Masami Ueda
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Takaaki Masuda
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Sho Nambara
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Shinya Kidogami
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Hisateru Komatsu
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Kuniaki Sato
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Taro Tobo
- Department of Pathology, Kyushu University Beppu Hospital, Beppu, Japan
| | - Yushi Ogawa
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Qingjiang Hu
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Tomoko Saito
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Hidenari Hirata
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Shotaro Sakimura
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Ryutaro Uchi
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Naoki Hayashi
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Shuhei Ito
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Hidetoshi Eguchi
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Keishi Sugimachi
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
| | - Yoshihiko Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koshi Mimori
- Department of Surgery, Kyushu University Beppu Hospital, Beppu, Japan
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50
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Iguchi T, Ohkubo M, Sugiyama T, Hori K, Ono T, Ishida R. Effects of water viscosity and tongue ingestion site on tongue pressure during food bolus propulsion. J Oral Rehabil 2018. [DOI: 10.1111/joor.12623] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T. Iguchi
- Department of Oral Health & Clinical Science; Division of Dysphagia Rehabilitation; Tokyo Dental College; Tokyo Japan
| | - M. Ohkubo
- Department of Oral Health & Clinical Science; Division of Dysphagia Rehabilitation; Tokyo Dental College; Tokyo Japan
| | - T. Sugiyama
- Department of Oral Health & Clinical Science; Division of Dysphagia Rehabilitation; Tokyo Dental College; Tokyo Japan
| | - K. Hori
- Divisions of Comprehensive Prosthodontics; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - T. Ono
- Divisions of Comprehensive Prosthodontics; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - R. Ishida
- Department of Oral Health & Clinical Science; Division of Dysphagia Rehabilitation; Tokyo Dental College; Tokyo Japan
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