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Namba Y, Kobayashi T, Hashimoto M, Onoe T, Mashima H, Oishi K, Honmyo N, Abe T, Kuroda S, Ohdan H. The efficacy and safety of pure laparoscopic liver resection for hepatocellular carcinoma in super-elderly patients over 80 years: A multicenter propensity analysis. J Hepatobiliary Pancreat Sci 2024; 31:234-242. [PMID: 38009434 DOI: 10.1002/jhbp.1395] [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] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Very few reports have evaluated the safety of laparoscopic liver resection in super-elderly patients. We assessed the short-term outcomes of laparoscopic liver resection in patients with hepatocellular carcinoma aged ≥80 years, using propensity score matching. METHODS We retrospectively analyzed the data of 287 patients (aged ≥80 years) who underwent liver resection for hepatocellular carcinoma at eight hospitals belonging to Hiroshima Surgical study group of Clinical Oncology, between January 2012 and December 2021. The perioperative outcomes were compared between laparoscopic and open liver resection, using propensity score matching. RESULTS Of the 287 patients, 83 and 204 were included in the laparoscopic and open liver resection groups, respectively. Propensity score matching was performed, and 52 patients were included in each group. The operation (p = .68) and pringle maneuver (p = .11) time were not different between the groups. There were no significant differences in the incidences of bile leakage or organ failure. The laparoscopic liver resection group had significantly less intraoperative bleeding and a lower incidence of cardiopulmonary complications (both p < .01). CONCLUSIONS Laparoscopic liver resection can be safely performed in elderly patients aged ≥80 years.
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Affiliation(s)
- Yosuke Namba
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masakazu Hashimoto
- Department of Gastroenterological-Breast and Transplant Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Takashi Onoe
- Department of Surgery, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Hiroaki Mashima
- Department of Surgery and Endoscopic Surgery, JA Onomichi General Hospital, Hiroshima, Japan
| | - Koichi Oishi
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Naruhiko Honmyo
- Department of Surgery, Hiroshima City North Medical Center, Asa Citizens Hospital, Hiroshima, Japan
| | - Tomoyuki Abe
- Department of Surgery and Gastroenterological Surgery, East Hiroshima Medical Hospital, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Namba Y, Kobayashi T, Kuroda S, Hashimoto M, Takei D, Fukuhara S, Oshita K, Matsubara K, Honmyo N, Nakano R, Sakai H, Tahara H, Ohira M, Ide K, Ohdan H. Protocol to evaluate the efficacy and safety of tolvaptan in patients with refractory ascites after liver resection: an open-label, single-arm phase I/II study. Int J Surg Protoc 2024; 28:1-5. [PMID: 38433869 PMCID: PMC10905494 DOI: 10.1097/sp9.0000000000000015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/23/2023] [Indexed: 03/05/2024] Open
Abstract
Background In patients with chronic liver diseases such as cirrhosis, massive ascites after hepatic resection is the cause of prolonged hospitalization and worsening prognosis. Recently, the efficacy of tolvaptan in refractory ascites has been reported; however, there are no reports on the efficacy or safety of tolvaptan for refractory ascites after hepatic resection. This study aims to evaluate the efficacy of early administration of tolvaptan in patients with refractory ascites after hepatic resection. Materials and methods This is an open-label, single-arm phase I/II study. This study subject will comprise patients scheduled for hepatic resection of a liver tumor. Patients with refractory ascites after hepatic resection (drainage volume on postoperative day 1 ≥5 ml/body weight 1 kg/day) will be treated with tolvaptan. The primary endpoint will include the maximum change in body weight after hepatic resection relative to the preoperative baseline. The secondary endpoints will include drainage volume, abdominal circumference, urine output, postoperative complication rate (heart failure and respiratory failure), number of days required for postoperative weight gain because of ascites to decrease to preoperative weight, change in improvement of postoperative pleural effusion, total amount of albumin or fresh frozen plasma transfusion, type and amount of diuretics used, and postoperative hospitalization days. Conclusion This trial will evaluate the efficacy and safety of tolvaptan prophylaxis for refractory ascites after hepatic resection. As there are no reports demonstrating the efficacy of tolvaptan prophylaxis for refractory ascites after hepatic resection, the authors expect that these findings will lead to future phase III trials and provide valuable indications for the selection of treatments for refractory postoperative ascites.
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Affiliation(s)
- Yosuke Namba
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Masakazu Hashimoto
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
- Department of Gastroenterological-Breast and Transplant Surgery, Hiroshima Prefectural Hospital
| | - Daisuke Takei
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
- Department of Surgery and Endoscopic Surgery, JA Onomichi General Hospital, Hiroshima, Japan
| | - Sotaro Fukuhara
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Ko Oshita
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Keiso Matsubara
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Naruhiko Honmyo
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Hiroshi Sakai
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University
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Oshita KO, Kobayashi T, Tadokoro T, Namba Y, Fukuhara S, Matsubara K, Takei D, Honmyo N, Kuroda S, Kawaoka T, Aikata H, Ohdan H. Outcomes and Prognostic Analysis of Surgical Resection for Oligometastasis from Hepatocellular Carcinoma. Anticancer Res 2023; 43:5189-5196. [PMID: 37909959 DOI: 10.21873/anticanres.16720] [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] [Received: 09/08/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND/AIM This study aimed to evaluate the outcomes of patients who underwent resection for oligometastasis from hepatocellular carcinoma (HCC) and identify the prognostic factors associated with poor survival. PATIENTS AND METHODS Patients who underwent resection for oligometastasis from HCC between January 2000 and April 2021 were retrospectively investigated. Oligometastasis was defined as 1-5 single organ metastases that were detected preoperatively in this study. Clinical characteristics and treatment outcomes were analyzed, and independent risk factors for poor prognosis were identified using cox proportional hazards model. RESULTS A total of 33 patients were included in this study. Eleven oligometastases were located in the intraabdominal lymph node, 8 in the adrenal gland, 5 in the lung, 4 in the peritoneum, 3 in the pleura, and 1 each in the supraclavicular lymph node and abdominal wall. No re-operation or operative death occurred in this study. The median OS was 44.6 months (range=5.1-150.6 months), and the median survival after primary HCC diagnosis was 116.5 months (range=7.1-253.6 months). The median cumulative incidence of recurrent HCC was 7.2 months (range=0.3-94.7 months). The multivariate analysis showed that an alpha-fetoprotein level ≥20 ng/ml and multiple primary HCC tumors were independent poor prognostic factors. CONCLUSION Clinical characteristics and treatment outcomes of patients who underwent resection for oligometastasis from HCC were demonstrated. A high alpha-fetoprotein level and multiple primary HCC tumors were independent poor prognostic factors. Surgical resection can be one of the treatment options for oligometastasis from HCC.
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Affiliation(s)
- K O Oshita
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan;
| | - Takeshi Tadokoro
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yosuke Namba
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sotaro Fukuhara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keiso Matsubara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Daisuke Takei
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naruhiko Honmyo
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomokazu Kawaoka
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
- Department of Gastroenterology and Metabolisms, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Aikata
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
- Department of Gastroenterology and Metabolisms, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Fukuhara S, Kuroda S, Kobayashi T, Takei D, Namba Y, Oshita K, Matsubara K, Honmyo N, Nakano R, Sakai H, Tahara H, Ohira M, Kawaoka T, Tsuge M, Chosa K, Awai K, Ohdan H. Preoperative percutaneous or transvascular marking for curative resection of small liver tumours with potential for missing during hepatectomy: a study protocol for an open-label, single-arm phase II study. BMJ Open 2023; 13:e075891. [PMID: 37890974 PMCID: PMC10619086 DOI: 10.1136/bmjopen-2023-075891] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Small liver tumours are difficult to identify during hepatectomy, which prevents curative tumour excision. Preoperative marking is a standard practice for small, deep-seated tumours in other solid organs; however, its effectiveness for liver tumours has not been validated. The objective of this study is to evaluate the effectiveness of preoperative markings for curative resection of small liver tumours. METHODS AND ANALYSIS This is an open-label, single-arm, single-centre, phase II study. Patients with liver tumours of ≤15 mm requiring hepatectomy will be enrolled and will undergo preoperative marking by placing a microcoil near the tumour using either the percutaneous or transvascular approach. The tumours, including the indwelling markers, will be excised. The primary endpoint will be the successful resection rate of liver tumours, defined as achieving a surgical margin of ≥5 mm and ≤15 mm. Secondary endpoints will include the results of preoperative marking and hepatectomy. ETHICS AND DISSEMINATION Ethical approval for this trial was obtained from the Ethical Committee for Clinical Research of Hiroshima University, Japan. The results will be published at an academic conference or by submitting a paper to a peer-reviewed journal. TRIAL REGISTRATION NUMBER jRCTs062220088.
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Affiliation(s)
- Sotaro Fukuhara
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Daisuke Takei
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Yosuke Namba
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Ko Oshita
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Keiso Matsubara
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Naruhiko Honmyo
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Nakano
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Sakai
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
| | - Tomokazu Kawaoka
- Gastroenterology and Metabolism, Hiroshima University, Hiroshima, Japan
| | - Masataka Tsuge
- Gastroenterology and Metabolism, Hiroshima University, Hiroshima, Japan
| | - Keigo Chosa
- Diagnostic Radiology, Hiroshima University, Hiroshima, Japan
| | - Kazuo Awai
- Diagnostic Radiology, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan
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Oshita K, Kobayashi T, Namba Y, Fukuhara S, Matsubara K, Takei D, Nakano R, Okamoto W, Sakai H, Tanimine N, Nakahara T, Kuroda S, Tahara H, Ohira M, Kawaoka T, Ide K, Imamura M, Aikata H, Ohdan H. Efficacy and safety of lenvatinib-transcatheter arterial chemoembolisation sequential therapy followed by surgical resection for intermediate-stage hepatocellular carcinoma beyond Up-to-7 criteria: a study protocol for a multicentre, single-arm, prospective study. BMJ Open 2023; 13:e073797. [PMID: 37798025 PMCID: PMC10565137 DOI: 10.1136/bmjopen-2023-073797] [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: 03/17/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION The feasibility and efficacy of surgical resection following systemic therapy for intermediate-stage hepatocellular carcinoma (HCC) beyond the Up-to-7 criteria is unclear. The combination of lenvatinib (LEN) and transcatheter arterial chemoembolisation (TACE), termed LEN-TACE sequential therapy, has shown a high response rate and survival benefit in patients with intermediate-stage HCC. This trial aims to evaluate the efficacy and safety of LEN-TACE sequential therapy and the feasibility of surgical resection for intermediate-stage HCC beyond the Up-to-7 criteria. METHODS AND ANALYSIS This is a multicentre, single-arm, prospective clinical trial. Thirty patients with intermediate-stage HCC beyond the Up-to-7 criteria will be enrolled. Patients eligible for this study will undergo LEN-TACE sequential therapy in which LEN is administered for 4 weeks, followed by TACE, and then further LEN for another 4 weeks. Patients will be assessed for efficacy of LEN-TACE sequential therapy and resectability, and surgical resection will be performed if the HCC is considered radically resectable. The primary outcome of this study is the resection rate after LEN-TACE sequential therapy. The secondary outcomes are the objective response rate of LEN-TACE sequential therapy, safety, curative resection rate, overall survival and recurrence-free survival. ETHICS AND DISSEMINATION This trial was approved by the Institutional Review Board of Hiroshima University, Japan (approval no. CRB210003), and has been registered with the Japan Registry of Clinical Trials (jRCTs061220007). The results of this study will be submitted for publication in a peer-reviewed journal and shared with the scientific community at international conferences. TRIAL REGISTRATION NUMBER jRCTs061220007 (https://jrct.niph.go.jp/latest-detail/jRCTs061220007).
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Affiliation(s)
- Ko Oshita
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tsuyoshi Kobayashi
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yosuke Namba
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sotaro Fukuhara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keiso Matsubara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Daisuke Takei
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryosuke Nakano
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Wataru Okamoto
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
- Cancer Treatment Center, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Sakai
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Naoki Tanimine
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takashi Nakahara
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Shintaro Kuroda
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Tahara
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Ohira
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomokazu Kawaoka
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Kentaro Ide
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Michio Imamura
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Hiroshi Aikata
- Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
- Research Center for Hepatology and Gastroenterology, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Kaneda H, Hazama D, Kodama H, Miyazaki A, Azuma K, Kawashima Y, Sato Y, Ito K, Shiraishi Y, Miura K, Takahama T, Oizumi S, Namba Y, Ikeda S, Miura S, Tachihara M. 333P Efficacy and safety of immune checkpoint inhibitors alone or combined with chemotherapy in pulmonary sarcomatoid carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.371] [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: 12/07/2022] Open
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Tadokoro T, Oishi K, Namba Y, Bekki T, Okimoto S, Mukai S, Saito Y, Fujisaki S, Takahashi M, Mouri T, Nishida T, Fukuda T. Duodenal diverticula perforation caused by an impacted bezoar successfully treated by endoscopic drainage and lithotripsy: A case report and literature review. Clin Case Rep 2022; 10:e6619. [PMID: 36419578 PMCID: PMC9676119 DOI: 10.1002/ccr3.6619] [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] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/29/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022] Open
Abstract
Duodenal diverticula perforation due to an impacted bezoar is a rare disease. Surgical treatment is associated with high rates of complications and mortality; therefore, treatment strategies must be carefully decided. Endoscopic treatment offers significant benefits to patients over surgery. Duodenal diverticula perforation due to an impacted bezoar was performed endoscopic treatment. Endoscopic treatment offers significant benefits to patients over surgery.
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Affiliation(s)
- Takeshi Tadokoro
- Department of Surgery Chugoku Rosai Hospital Kure, Hiroshima Japan
| | - Koichi Oishi
- Department of Surgery Chugoku Rosai Hospital Kure, Hiroshima Japan
| | - Yosuke Namba
- Department of Surgery Chugoku Rosai Hospital Kure, Hiroshima Japan
| | - Tomoaki Bekki
- Department of Surgery Chugoku Rosai Hospital Kure, Hiroshima Japan
| | - Sho Okimoto
- Department of Surgery Chugoku Rosai Hospital Kure, Hiroshima Japan
| | - Shoichiro Mukai
- Department of Surgery Chugoku Rosai Hospital Kure, Hiroshima Japan
| | - Yasufumi Saito
- Department of Surgery Chugoku Rosai Hospital Kure, Hiroshima Japan
| | - Seiji Fujisaki
- Department of Surgery Chugoku Rosai Hospital Kure, Hiroshima Japan
| | - Mamoru Takahashi
- Department of Surgery Chugoku Rosai Hospital Kure, Hiroshima Japan
| | - Teruo Mouri
- Department of Gastroenterology Chugoku Rosai Hospital Hiroshima Japan
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Bekki T, Abe T, Namba Y, Okimoto S, Mukai S, Saito Y, Oishi K, Fujisaki S, Ohdan H, Fukuda T. Validation of appendiceal stump invagination in laparoscopic appendectomy. Asian J Endosc Surg 2022; 16:203-209. [PMID: 36300645 DOI: 10.1111/ases.13137] [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: 09/03/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There are various methods for appendiceal stump dissection, but the necessity for stump invagination remains unclear. This study aimed to assess the efficacy of appendiceal stump invagination in patients with acute appendicitis after laparoscopic appendectomy (LA). METHODS We enrolled 327 patients with acute appendicitis who underwent LA between 2012 and 2020. Perioperative variables and surgical outcomes were analyzed between the invagination of the appendiceal stump and noninvagination groups. Propensity score-matched analysis (PSM) was performed. RESULTS More patients experienced severe inflammation and severe intra-abdominal contamination in the noninvagination group than in the invagination group. Patients in the noninvagination group had an older age, higher body mass index, and poorer American Society of Anesthesiologists physical status than the invagination group. Severe inflammation in the noninvagination group was associated with longer hospital stays and poorer postoperative complications than in the invagination group. PSM analysis was performed to minimize bias in the two groups. After PSM analysis, there were no significant differences in surgical site infection, postoperative intra-abdominal abscess, Clavien-Dindo class ≥IIIa, or postoperative stay between the two groups. During the follow-up period, the postoperative adhesive ileus was not significantly different between the invagination and noninvagination groups. CONCLUSION Invagination of the appendiceal stump during LA is not necessary to prevent short- and long-term complications. Even in cases dissected using a laparoscopic endostapler, the appendiceal stump per se is not related to postoperative adhesive ileus.
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Affiliation(s)
- Tomoaki Bekki
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Tomoyuki Abe
- Department of Surgery, National Hospital Organization Higashihiroshima Medical Center, Hiroshima, Japan
| | - Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Sho Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Shoichiro Mukai
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Yasufumi Saito
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Koichi Oishi
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Seiji Fujisaki
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshikatsu Fukuda
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan.,Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Harigai A, Saito AI, Inoue T, Suzuki M, Namba Y, Suzuki Y, Makino F, Nagashima O, Sasaki S, Sasai K. The prognostic value of 18F-FDG PET/CT taken immediately after completion of radiotherapy for lung cancer treated with concurrent chemoradiotherapy: A pilot study. Cancer Radiother 2022; 26:711-716. [PMID: 35715357 DOI: 10.1016/j.canrad.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 12/10/2021] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The prognostic value of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) taken immediately after completion of radiotherapy in lung cancer patients is not well known. The purpose of this study is to assess the prognostic value of PET/CT taken immediately after completion of radiotherapy in lung cancer patients. MATERIALS AND METHODS Patients with primary lung cancer planned to undergo concurrent chemoradiotherapy were enrolled. Patients underwent PET/CT scans at 3 time points: before radiotherapy, within 24hours of completing radiotherapy (im-PET/CT), and 2-9 months after radiotherapy (post-PET/CT). Maximum standardized uptake value (SUVmax) was obtained. A post-PET/CT-SUVmax cut-off of 2.5 was determined as radiotherapy success. RESULTS Nineteen patients were enrolled. im-PET/CT-SUVmax for patients in the high post-PET/CT-SUVmax group was significantly higher than that of the low group (P=0.004). Receiver operator curve analysis indicated that im-PET/CT-SUVmax of 4.35 was an optimal cut-off value to discriminate between the two groups. Multivariable analysis showed that a high im-PET/CT-SUVmax was significantly associated with a high post-PET/CT-SUVmax (P=0.003). CONCLUSION PET/CT-SUVmax taken immediately following radiotherapy was associated with that evaluated 2-9 months after radiotherapy.
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Affiliation(s)
- A Harigai
- Clinical training center, Juntendo university, Urayasu hospital, 2-1-1 Tomioka Urayasushi, Chiba, Japan
| | - A I Saito
- Department of radiation oncology, Juntendo university, faculty of medicine, Tokyo, Japan.
| | - T Inoue
- Department of radiation oncology, Juntendo university, faculty of medicine, Tokyo, Japan
| | - M Suzuki
- Department of radiology, Juntendo Tokyo Koto geriatric medical center, Tokyo, Japan
| | - Y Namba
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - Y Suzuki
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - F Makino
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - O Nagashima
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - S Sasaki
- Department of respiratory medicine, Juntendo university, Urayasu hospital, Chiba, Japan
| | - K Sasai
- Department of radiation oncology, Juntendo university, faculty of medicine, Tokyo, Japan
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10
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Bekki T, Oishi K, Tadokoro T, Namba Y, Okimoto S, Mukai S, Saito Y, Fujisaki S, Nishida T, Ohdan H, Fukuda T. Laparoscopic resection of schwannoma in the hepatoduodenal ligament: a case report. Surg Case Rep 2021; 7:187. [PMID: 34410526 PMCID: PMC8377106 DOI: 10.1186/s40792-021-01271-y] [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: 05/21/2021] [Accepted: 08/12/2021] [Indexed: 01/16/2023] Open
Abstract
Background The occurrence of schwannomas in the hepatoduodenal ligament is rare, and its preoperative accurate diagnosis is difficult. Only few cases have been treated with laparoscopic surgery. Case presentation A 54-year-old man visited our hospital following abnormal abdominal computed tomography findings. He had no complaints, and his laboratory investigations were normal. Abdominal contrast-enhanced computed tomography revealed a tumor with enhancement at the margin of the hepatoduodenal ligament. The abdominal magnetic resonance imaging findings of the tumor showed hypointensity on the T1-weighted images and mixed hypointensity and hyperintensity on the T2-weighted fat-suppression images. Positron emission tomography showed localized accumulation of fludeoxyglucose only in the hepatoduodenal ligament tumor. The patient underwent laparoscopic tumor resection for accurate diagnosis. Histopathologically, the tumor was mainly composed of spindle cells, which were strongly positive for S-100 protein on immunohistochemical staining. The patient was discharged without any postoperative complications on day 5. Conclusions Complete tumor resection is essential for schwannomas to avoid recurrence. Laparoscopic surgery is useful for schwannomas occurring in the hepatoduodenal ligament and can be performed safely by devising an appropriate surgical method.
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Affiliation(s)
- Tomoaki Bekki
- Department of Surgery, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima, Japan
| | - Koichi Oishi
- Department of Surgery, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima, Japan.
| | - Takeshi Tadokoro
- Department of Surgery, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima, Japan
| | - Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima, Japan
| | - Sho Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima, Japan
| | - Shoichiro Mukai
- Department of Surgery, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima, Japan
| | - Yasufumi Saito
- Department of Surgery, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima, Japan
| | - Seiji Fujisaki
- Department of Surgery, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima, Japan
| | | | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima, Japan
| | - Toshikatsu Fukuda
- Department of Surgery, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima, Japan.,Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3 Minami-ku, Hiroshima, Japan
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11
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Sugawara S, Lee JS, Kang JH, Kim HR, Inui N, Hida T, Lee KH, Yoshida T, Tanaka H, Yang CT, Nishio M, Ohe Y, Tamura T, Yamamoto N, Yu CJ, Akamatsu H, Namba Y, Sumiyoshi N, Nakagawa K. Nivolumab with carboplatin, paclitaxel, and bevacizumab for first-line treatment of advanced nonsquamous non-small-cell lung cancer. Ann Oncol 2021; 32:1137-1147. [PMID: 34139272 DOI: 10.1016/j.annonc.2021.06.004] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [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] [Received: 02/13/2021] [Revised: 05/26/2021] [Accepted: 06/10/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This international, randomized, double-blind phase III study (ONO-4538-52/TASUKI-52) evaluated nivolumab with bevacizumab and cytotoxic chemotherapy as first-line treatment for nonsquamous non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Between June 2017 and July 2019, this study enrolled treatment-naïve patients with stage IIIB/IV or recurrent nonsquamous NSCLC without sensitizing EGFR, ALK, or ROS1 alterations. They were randomly assigned in a 1 : 1 ratio to receive nivolumab or placebo in combination with carboplatin, paclitaxel, and bevacizumab every 3 weeks for up to six cycles, followed by nivolumab/placebo with bevacizumab until progressive disease or unacceptable toxicity. The primary endpoint was progression-free survival (PFS) assessed by an independent radiology review committee (IRRC). RESULTS Overall, 550 patients from Japan, Korea, and Taiwan were randomized; of these patients, 273 and 275 received the nivolumab and placebo combinations, respectively. In the present preplanned interim analysis with a median follow up of 13.7 months, the IRRC-assessed median PFS was significantly longer in the nivolumab arm than in the placebo arm (12.1 versus 8.1 months; hazard ratio 0.56; 96.4% confidence interval 0.43-0.71; P < 0.0001). The PFS benefit was observed across all patients with any programmed death-ligand 1 (PD-L1) expression levels including PD-L1-negative patients. The IRRC-assessed objective response rates were 61.5% and 50.5% in the nivolumab and placebo arms, respectively. The incidence of treatment-related adverse events of grade 3 or 4 was comparable between the two arms; treatment-related adverse events leading to death were observed in five and four patients in the nivolumab and placebo arms, respectively. CONCLUSION The TASUKI-52 regimen should be considered a viable new treatment strategy for treatment-naïve patients with advanced nonsquamous NSCLC.
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Affiliation(s)
- S Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - J-S Lee
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - J-H Kang
- Department of Medical Oncology, The Catholic University of Korea Seoul St. Mary's Hospital, Seoul, Korea
| | - H R Kim
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - N Inui
- Department of Pulmonary Medicine, Hamamatsu University Hospital, Shizuoka, Japan
| | - T Hida
- Department of Thoracic Oncology, Aichi Cancer Center, Aichi, Japan
| | - K H Lee
- Department of Internal Medicine, Chungbuk National University Hospital, Chungcheongbuk-do, Korea
| | - T Yoshida
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - H Tanaka
- Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan
| | - C-T Yang
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - M Nishio
- Department of Thoracic Medical Oncology, Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - Y Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - T Tamura
- Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - N Yamamoto
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - C-J Yu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - H Akamatsu
- Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Y Namba
- Clinical Science, Ono Pharmaceutical Co., Ltd., Osaka, Japan
| | - N Sumiyoshi
- Oncology Clinical Development Planning 1, Ono Pharmaceutical Co., Ltd., Osaka, Japan
| | - K Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan.
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12
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Namba Y, Oishi K, Okimoto S, Moriuchi T, Bekki T, Mukai S, Saito Y, Fujisaki S, Takahashi M, Fukuda T, Ohdan H. Imaging diagnosis of aberrant proper hepatic and gastroduodenal arteries prior to pancreaticoduodenectomy: A case report. Radiol Case Rep 2021; 16:1650-1654. [PMID: 34007377 PMCID: PMC8111473 DOI: 10.1016/j.radcr.2021.03.062] [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: 03/27/2021] [Accepted: 03/28/2021] [Indexed: 12/29/2022] Open
Abstract
In hepatobiliary and pancreatic surgery, an understanding of hepatic artery anomalies is of great importance to surgeons. Cases of the proper hepatic artery originating from the superior mesenteric artery and the gastroduodenal artery originating from the celiac trunk are extremely rare. To our knowledge, there are no reports of these arterial variants being diagnosed before hepatobiliary and pancreatic surgery. A 73-year-old woman underwent subtotal stomach-preserving pancreaticoduodenectomy and lymphadenectomy for duodenal carcinoma. Preoperative vascular construction with 3-dimensional computed tomography showed variants of the proper hepatic artery and gastroduodenal artery. The proper hepatic artery originated from the superior mesenteric artery, and the gastroduodenal artery originated from the celiac trunk. Intraoperative findings and preoperative vascular construction from 3-dimensional computed tomography were found to be matched exactly; both the proper hepatic artery and gastroduodenal artery were preserved. By diagnosing a rare arterial variant preoperatively, we were able to perform the surgery safely. In hepatobiliary and pancreatic surgery, understanding any potential variation of the hepatic artery before surgery is crucial to ensure the best patient outcomes.
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Affiliation(s)
- Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Koichi Oishi
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
- Corresponding author.
| | - Sho Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | | | - Tomoaki Bekki
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Shoichiro Mukai
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Yasufumi Saito
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Seiji Fujisaki
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | | | | | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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13
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Namba Y, Mukai S, Saito Y, Moriuchi T, Bekki T, Okimoto S, Oishi K, Fujisaki S, Takahashi M, Fukuda T, Egi H, Ohdan H. Risk Factors for Anastomotic Leakage after Colorectal Surgery with Double-staple Technique Anastomosis: Impact of the Agatston Score. J Anus Rectum Colon 2021; 5:181-187. [PMID: 33937559 PMCID: PMC8084537 DOI: 10.23922/jarc.2020-099] [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] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/03/2021] [Indexed: 01/23/2023]
Abstract
Objectives Anastomotic leakage is associated with severe morbidity, mortality, and functional defects. Its risk factors remain unclear. However, blood perfusion may be a potential major risk factor. It has been reported that the Agatston score is an index for blood flow perfusion evaluation. Therefore, we evaluated the clinical indicators associated with anastomotic leakage, including the Agatston score, in patients who underwent colorectal surgery. Methods We retrospectively analyzed 147 patients who underwent elective colorectal surgery with the double-staple technique anastomosis for colorectal cancer between April 2015 and March 2020. The primary outcome was the presence or absence of anastomotic leakage. Univariate and multivariate analyses were employed to identify pre- and intraoperative risk factors. Results Of the 147 patients analyzed, anastomotic leakage occurred in 12 (8.16%). Male gender, history of angina and myocardial infarction, preoperative white blood cell count, the Agatston score, extent of bleeding, operation time, and intraoperative fluid volume were significantly related to a higher incidence of anastomotic leakage in univariate analysis. Multivariate analysis demonstrated that the incidence of anastomotic leakage was high in patients with a high Agatston score. Conclusions The Agatston score can predict the incidence of anastomotic leakage in patients following colorectal surgery. Thus, perioperative measures to prevent anastomotic leakage are recommended when a high Agatston score is observed. A prospective trial is required to demonstrate, with a high level of evidence, that the Agatston score can be useful as a risk score for anastomotic leakage following colorectal surgery.
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Affiliation(s)
- Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Shoichiro Mukai
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Yasufumi Saito
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | | | - Tomoaki Bekki
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Sho Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Koichi Oishi
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Seiji Fujisaki
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | | | | | - Hiroyuki Egi
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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14
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Bekki T, Fukuda T, Moriuchi T, Namba Y, Okimoto S, Mukai S, Saito Y, Oishi K, Nishida T, Ohdan H. Appendicitis with submucosal fecalith mimicking a submucosal tumor: a case report. Surg Case Rep 2021; 7:105. [PMID: 33905033 PMCID: PMC8079595 DOI: 10.1186/s40792-021-01169-9] [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: 03/03/2021] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Submucosal fecalith(s) mimicking submucosal tumors of the gastrointestinal lumen are rare. Moreover, accurate preoperative diagnosis of these entities is exceedingly difficult, and the mechanism(s) of their formation remains unclear. Case presentation A 40-year-old woman visited the authors’ hospital due to lower abdominal pain and diarrhea. She had previously been treated for endometriosis. Laboratory investigation revealed increased C-reactive protein levels. Abdominal contrast-enhanced computed tomography revealed thickening of the appendix wall and dilation of the small intestine. The patient was diagnosed with paralytic ileus caused by appendicitis, and interval appendectomy was scheduled. She underwent laparoscopic-assisted appendectomy after conservative treatment. Partial cecal resection was selected due to the presence of an elastic mass in the cecum. The final pathological diagnosis was submucosal fecalith, not submucosal tumor. On day 5, the patient was discharged without any postoperative complications. Conclusions In cases of appendicitis with fecalith(s) that appear as submucosal tumor(s) on colonoscopy, submucosal fecalith mimicking submucosal tumor should be considered in the differential diagnosis.
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Affiliation(s)
- Tomoaki Bekki
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Toshikatsu Fukuda
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan. .,Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | | | - Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Sho Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Shoichiro Mukai
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Yasufumi Saito
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Koichi Oishi
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | | | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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15
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Namba Y, Fujisaki S, Fukuda T. Kocuria kristinae infection associated with short bowel syndrome: A case report. Int J Surg Case Rep 2020; 77:276-278. [PMID: 33189010 PMCID: PMC7672243 DOI: 10.1016/j.ijscr.2020.11.006] [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: 08/29/2020] [Revised: 11/02/2020] [Accepted: 11/02/2020] [Indexed: 11/21/2022] Open
Abstract
Only a few cases of K. kristinae infection have been reported in the literature. Patients with short bowel syndrome (SBS) have a risk of opportunistic infections. We report a rare case of K. kristinae infection associated with SBS. Patients with SBS require careful follow-up for opportunistic infections such as K. kristinae.
Introduction Only a few cases of K. kristinae infection have been reported in the literature. Patients with short bowel syndrome have an increased risk of opportunistic infections due to decreased bowel immunity and the long-term central venous catheter placement. We report a rare case of K. kristinae infection associated with SBS requiring long-term central venous access port placement. Presentation of case A 70-year-old woman presented with fever of approximately 39 °C to our hospital for examination. She has undergone total hysterectomy and radiation therapy for cervical cancer 36 years ago. Five years ago, she developed multiple small bowel perforations, and a jejunostomy was constructed at the oral end of the perforation and approximately 110 cm from the ligament of Treitz because of the difficulty in dissecting the adhesion. She developed short bowel syndrome, and the central venous port was constructed four years ago due to poor enteral nutrition. K. kristinae was detected in the central venous catheter tip and in two blood cultures. We administered intravenous vancomycin. After seven days of antibiotic treatment, both fever and inflammatory reaction improved, and the blood culture was negative. After 16 days of antibiotic treatment, we performed central venous port construction on the side opposite to the previous site. Conclusion Patients with short bowel syndrome have an increased risk of K. kristinae infections due to decreased bowel immunity and the long-term central venous port, and therefore, these patients should be followed up carefully.
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Affiliation(s)
- Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Japan
| | - Seiji Fujisaki
- Department of Surgery, Chugoku Rosai Hospital, Japan; Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Toshikatsu Fukuda
- Department of Surgery, Chugoku Rosai Hospital, Japan; Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan
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16
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Lee JS, Sugawara S, Kang J, Kim H, Inui N, Hida T, Lee K, Yoshida T, Tanaka H, Yang C, Nishio M, Ohe Y, Tamura T, Yamamoto N, Yu CJ, Akamatsu H, Namba Y, Sumiyoshi N, Nakagawa K. LBA54 Randomized phase III trial of nivolumab in combination with carboplatin, paclitaxel, and bevacizumab as first-line treatment for patients with advanced or recurrent non-squamous NSCLC. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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17
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Hayashi H, Okada M, Kijima T, Aoe K, Kato T, Fujimoto N, Nakagawa K, Takeda Y, Hida T, Kanai K, Hirano J, Namba Y, Ohe Y. 1895MO Three-year follow-up results of the MERIT trial: A Japanese phase II study of nivolumab in malignant pleural mesothelioma. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Kohata A, Hirata Y, Ishikawa S, Kai A, Namba Y, Okimoto S, Mukai S, Fujisaki S, Takahashi M, Fukuda T, Nishida T. Large hydrocele of the canal of Nuck diagnosed and treated using conventional and laparoscopic methods. J Surg Case Rep 2020; 2020:rjaa222. [PMID: 32864093 PMCID: PMC7446026 DOI: 10.1093/jscr/rjaa222] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/08/2020] [Indexed: 11/14/2022] Open
Abstract
A 49-year-old woman presented to the hospital with a right inguinal swelling. On examination, we suspected hydrocele of the canal of Nuck (HCN) or an appendiceal or retroperitoneal tumor. Surgery for diagnosis and removal of the mass revealed that it was large and located in the preperitoneal cavity, extending into the inguinal ring; so, it was difficult to observe the entire outline of the mass solely using the laparoscopic approach. Therefore, we added the conventional approach with an inguinal incision. This combination of conventional and laparoscopic approaches helped in safe removal of the tumor. The HCN is an unusual developmental condition in women among whom it might cause an inguinal swelling infrequently. In a case with a large HCN, a combined approach using conventional and laparoscopic methods is suggested for better observation of the abdomen and successful resection without perforation of the mass than when using a single approach.
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Affiliation(s)
- Akihiro Kohata
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuzo Hirata
- Department of Surgery, Saiseikai Hiroshima Hospital, Hiroshima, Japan
| | - Sho Ishikawa
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University Hospital, Hiroshima, Japan
| | - Azusa Kai
- Department of Surgical Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Sho Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Shoichiro Mukai
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | - Seiji Fujisaki
- Department of Surgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | | | | | - Toshihiro Nishida
- Department of Diagnostic Pathology, Chugoku Rosai Hospital, Hiroshima, Japan
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19
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Namba Y, Hirata Y, Mukai S, Nishida T, Ishikawa S, Kai A, Kohata A, Okimoto S, Fujisaki S, Fukuda S, Takahashi M, Fukuda T. Multiple peritoneal dissemination of T2 colorectal cancer without lymph node metastases: a case report. J Surg Case Rep 2020; 2020:rjaa118. [PMID: 32760481 PMCID: PMC7394141 DOI: 10.1093/jscr/rjaa118] [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] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/29/2020] [Accepted: 06/15/2020] [Indexed: 11/24/2022] Open
Abstract
Most cases of peritoneal dissemination of colorectal cancers are from T3 or T4 tumors. A 61-year-old woman was admitted for examination of a positive fecal occult blood test. Colonoscopy showed an ascending colon tumor that was diagnosed as an adenocarcinoma with massive submucosal invasion. Imaging modality revealed numerous nodules throughout the abdominal cavity. Peritoneal dissemination of the ascending colon or ovarian cancer and pseudomyxoma peritonei were considered in the preoperative differential diagnoses, and laparoscopic ileocecal resection was performed. Intraperitoneal observation revealed numerous white nodules in the peritoneum, omentum and Douglas fossa. Both the nodules and tumor were diagnosed as mucinous carcinoma based on a pathology report. The tumor invasion depth was limited to muscularis propria, and no regional lymph node metastasis was detected. Peritoneal dissemination of the ascending colon cancer was considered. We report a rare case of multiple peritoneal dissemination of T2 colorectal cancer without lymph node metastases.
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Affiliation(s)
- Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Yuzo Hirata
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan.,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shoichiro Mukai
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan.,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshihiro Nishida
- Department of Pathology Clinical Laboratory, Chugoku Rosai Hospital, Kure, Japan
| | - Syo Ishikawa
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Azusa Kai
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Akihiro Kohata
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Syo Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan.,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Seiji Fujisaki
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan.,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Saburo Fukuda
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan.,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mamoru Takahashi
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan.,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshikatsu Fukuda
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan.,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Namba Y, Matsugu Y, Furukawa M, Namba M, Sasaki T, Itamoto T. Step-up approach combined with negative pressure wound therapy for the treatment of severe necrotizing pancreatitis: a case report. Clin J Gastroenterol 2020; 13:1331-1337. [PMID: 32712840 DOI: 10.1007/s12328-020-01190-9] [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: 05/13/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
Abstract
A step-up approach and continuous drainage using NPWT was an effective strategy for the treatment of severe necrotizing pancreatitis. A 62-year-old woman developed severe necrotizing pancreatitis after endoscopic retrograde cholangiopancreatography, extending from the left anterior pararenal space to the interior renal pole. Endoscopic transluminal drainage and percutaneous catheter drainage were unsuccessful in controlling the disease. We proceeded with video-assisted retroperitoneal necrosectomy, at the pancreas and splenic hilum, and drainage, with two additional surgical drains located at the left inferior renal pole and, subcutaneously, at the incision wound. NPWT enhanced fluid drainage and facilitated surgical wound closure, which was infected and opened. Four subsequent endoscopic necrosectomy procedures were required, at the site of the draining fistula, to achieve complete resolution of fluid collection and wound closure.
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Affiliation(s)
- Yosuke Namba
- Department of Gastroenterological-Breast and Transplant Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Yasuhiro Matsugu
- Department of Gastroenterological-Breast and Transplant Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-kanda, Minami-ku, Hiroshima, 734-8530, Japan. .,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Masaru Furukawa
- Department of Gastroenterology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Maiko Namba
- Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tamito Sasaki
- Department of Gastroenterology, Hiroshima Prefectural Hospital, Hiroshima, Japan.,Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Toshiyuki Itamoto
- Department of Gastroenterological-Breast and Transplant Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-kanda, Minami-ku, Hiroshima, 734-8530, Japan.,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Ishikawa S, Mukai S, Hirata Y, Kohata A, Kai A, Namba Y, Okimoto S, Fujisaki S, Fukuda S, Takahashi M, Fukuda T, Ohdan H. Rectal Arteriovenous Malformation Treated by Transcatheter Arterial Embolization. Case Rep Gastroenterol 2020; 14:7-14. [PMID: 32095120 PMCID: PMC7011768 DOI: 10.1159/000505090] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/27/2019] [Indexed: 11/25/2022] Open
Abstract
An 86-year-old man who presented with frequent hematochezia with mild anemia on blood tests was admitted to our hospital. Colonoscopy exhibited a submucosal tumor-like lesion in the lower rectum. CT and MRI showed blood flow into the lesion, but not tumor component. Angiography of the superior rectal artery and left internal iliac artery showed vascular hyperplasia and nidus. Thus, rectal arteriovenous malformation was diagnosed. If bleeding from arteriovenous malformation was out of control, surgical resection was necessary. However, due to the age of the patient, we performed transcatheter arterial embolization and abdominoperineal resection was not needed. Embolization from the left superior rectal artery, middle rectal artery and inferior rectal artery was performed to control the bleeding and to avoid surgery. After embolization, he was followed up for 10 months in our hospital without recurrence.
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Affiliation(s)
- Sho Ishikawa
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | | | - Yuzo Hirata
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Akihiro Kohata
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Azusa Kai
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Sho Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Seiji Fujisaki
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | - Saburo Fukuda
- Department of Surgery, Chugoku Rosai Hospital, Kure, Japan
| | | | | | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Namba Y, Fukuda T, Ishikawa S, Kai A, Kohata A, Okimoto S, Mukai S, Fujisaki S, Hirata Y, Fukuda S, Takahashi M. Inguinal bladder hernia treated using transabdominal preperitoneal approach: A case report. Int J Surg Case Rep 2019; 67:165-168. [PMID: 32062126 PMCID: PMC7021531 DOI: 10.1016/j.ijscr.2019.11.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/24/2019] [Revised: 11/08/2019] [Accepted: 11/15/2019] [Indexed: 01/17/2023] Open
Abstract
Inguinal bladder hernia (IBH) is a rare condition that is difficult to diagnose preoperatively. 16% of IBHs are diagnosed postoperatively due to bladder injury and leakage. Preoperative diagnosis of IBHs is important to lessen postoperative complications. Transabdominal preperitoneal approach can significantly reduce the risk of bladder damage.
Introduction Inguinal bladder hernia (IBH) is a rare condition that is difficult to diagnose preoperatively based only on physical examination; 16% of IBHs are diagnosed postoperatively due to complications. Presentation of case We report the case of a 56-year-old man who presented with left inguinal swelling and increased frequency of urination since eight years. Physical examination demonstrated a 6 × 4 cm non-reducible left inguinal bulge with mild tenderness on palpation. Computed tomography revealed a left inguinal hernia containing a portion of the urinary bladder. He was diagnosed with IBH and transabdominal preperitoneal (TAPP) repair was performed. We confirmed a left internal inguinal hernia and incised the peritoneum from the outside of the left inguinal ring. The preperitoneal space was dissected toward the Retzius space, and the prolapsed bladder was examined. The adhesion with the surroundings was carefully dissected and the bladder was reduced into the abdomen. Indigo carmine was injected through a urinary catheter, which confirmed that no bladder damage had occurred. After the mesh was positioned to cover the myopectineal orifice, it was fixed to the Cooper’s ligaments, interior side, lateral side, and ventral side. The postoperative course was uneventful, and the patient is now free of symptoms and recurrence two months after surgery. Conclusion TAPP repair is a useful treatment for IBH. Preoperative diagnosis of IBH is important to lessen postoperative complications.
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Affiliation(s)
- Yosuke Namba
- Department of Surgery, Chugoku Rosai Hospital, Japan
| | - Toshikatsu Fukuda
- Department of Surgery, Chugoku Rosai Hospital, Japan; Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan.
| | - Syo Ishikawa
- Department of Surgery, Chugoku Rosai Hospital, Japan
| | - Azusa Kai
- Department of Surgery, Chugoku Rosai Hospital, Japan
| | | | - Syo Okimoto
- Department of Surgery, Chugoku Rosai Hospital, Japan; Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Shoichiro Mukai
- Department of Surgery, Chugoku Rosai Hospital, Japan; Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Seiji Fujisaki
- Department of Surgery, Chugoku Rosai Hospital, Japan; Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Yuzo Hirata
- Department of Surgery, Chugoku Rosai Hospital, Japan; Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Saburo Fukuda
- Department of Surgery, Chugoku Rosai Hospital, Japan; Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Mamoru Takahashi
- Department of Surgery, Chugoku Rosai Hospital, Japan; Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Japan
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Namba Y, Urushihara T, Nakahara H, Itamoto T. Single-incision totally extraperitoneal hernia repair with intraperitoneal inspection of strangulated femoral hernia at risk for intestinal ischemia after repositioning: a case report. J Med Case Rep 2019; 13:229. [PMID: 31307534 PMCID: PMC6631552 DOI: 10.1186/s13256-019-2134-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/07/2019] [Accepted: 05/27/2019] [Indexed: 11/18/2022] Open
Abstract
Background Totally extraperitoneal hernia repair and the transabdominal preperitoneal approach have advantages and disadvantages. We used the advantages of totally extraperitoneal hernia repair and the transabdominal preperitoneal approach and performed single-incision totally extraperitoneal hernia repair with intraperitoneal inspection for the treatment of strangulated femoral hernia in a patient at risk for intestinal ischemia. Case presentation We report a case of a 75-year-old Japanese woman who presented with black vomiting of 5 days’ duration. Physical examination revealed a right inguinal bulge and sharp pain. Computed tomography revealed a right strangulated femoral hernia with no intestinal ischemia. We were able to reposition the hernia; however, we performed the operation with consideration of the possibility of intestinal ischemia by incarceration of the intestine because the onset was 5 days previously. Intraperitoneal observation revealed a right femoral hernia and confirmed that the intestinal tract was not ischemic. However, the intestinal tract was expanded because of ileus, and securing a clear field of vision was difficult. Hence, we switched to totally extraperitoneal hernia repair at the same incision and performed single-incision totally extraperitoneal hernia repair with intraperitoneal inspection. The hernia sac was observed at the femoral rings and obturator foramen. The mesh was inserted through the incision, and after it was positioned to cover the Hesselbach triangle, femoral rings, inguinal ring, and obturator foramen, it was fixed with SECURESTRAP®. Observation of the abdominal cavity confirmed complete repair. After the operation, there was no recurrence or other complications. Conclusion We report a case of successful single-incision totally extraperitoneal hernia repair with intraperitoneal inspection for the treatment of strangulated femoral hernia in a patient at risk for intestinal ischemia after repositioning.
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Affiliation(s)
- Yosuke Namba
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Takashi Urushihara
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-kanda, Minami-ku, Hiroshima, 734-8530, Japan. .,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
| | - Hideki Nakahara
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-kanda, Minami-ku, Hiroshima, 734-8530, Japan
| | - Toshiyuki Itamoto
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, 1-5-54 Ujina-kanda, Minami-ku, Hiroshima, 734-8530, Japan.,Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Namba Y, Oshita A, Nishisaka T, Namba M, Sasaki T, Matsugu Y, Itamoto T. Lymphoepithelial cyst of the pancreas: A case report and summary of imaging features of pancreatic cysts. Int J Surg Case Rep 2019; 55:192-195. [PMID: 30763861 PMCID: PMC6374521 DOI: 10.1016/j.ijscr.2019.01.022] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/15/2019] [Accepted: 01/22/2019] [Indexed: 01/03/2023] Open
Abstract
A lymphoepithelial cyst (LEC) of the pancreas is a benign and rare lesion. A pancreatic LEC is difficult to be diagnosed and differentiate from the malignancy preoperatively. We summarized the imaging features of pancreatic cysts to differentiate from the malignancy.
Introduction A lymphoepithelial cyst (LEC) of the pancreas is a benign and rare lesion that is difficult to diagnose preoperatively based on imaging studies. Presentation of case We report a case of a 49-year-old man who presented with weight loss and diarrhea. The serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels were slightly elevated to 6.7 ng/mL (reference value <5.0 ng/mL) and 45 U/mL (reference value <37 U/mL), respectively. Computed tomography showed a large cystic mass with internal septa in the pancreatic tail. The cystic wall and the septa showed enhancement while the cystic contents remained unenhanced. Magnetic resonance imaging (MRI) demonstrated a multiple-ball-like lesion with low signal intensity on T1-weighted image and high signal intensity on T2-weighted image. Diffusion-weighted MRI showed high signal intensity in the central and iso-signal intensity in the peripheral portions of the cystic lesion. The cystic wall and septa showed high signal intensity, and the cystic contents showed low signal intensity on an enhanced MRI. Endoscopic ultrasonography showed a cyst with multiple high-echoic lesions in the pancreatic tail. A mucinous cystic neoplasm and branch duct intraductal papillary mucinous neoplasm were considered among the differential diagnoses, and we performed distal pancreatectomy with concomitant splenectomy and lymphadenectomy for both diagnostic and therapeutic purposes. Histopathological findings revealed that the cystic wall was lined by stratified squamous epithelium, and several lymphoid follicles and a few sebaceous glands were observed within the cystic wall without hair follicles, leading to the final diagnosis of an LEC. Conclusion We report a rare case of a pancreatic LEC, which was difficult to be diagnosed and summarize the imaging features of pancreatic cysts to differentiate from the malignancy preoperatively.
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Affiliation(s)
- Yosuke Namba
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Japan
| | - Akihiko Oshita
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Japan.
| | - Takashi Nishisaka
- Department of Pathology Clinical Laboratory, Hiroshima Prefectural Hospital, Japan
| | - Maiko Namba
- Department of Gastroenterology, Hiroshima Prefectural Hospital, Japan
| | - Tamito Sasaki
- Department of Gastroenterology, Hiroshima Prefectural Hospital, Japan
| | - Yasuhiro Matsugu
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Japan
| | - Toshiyuki Itamoto
- Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical & Health Sciences, Hiroshima University, Japan
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Motomura H, Watanabe J, Togo S, Sumiyoshi I, Namba Y, Suina K, Mizuno T, Kadoya K, Iwai M, Nagaoka T, Sasaki S, Hayashi T, Uekusa T, Abe K, Urata Y, Sakurai F, Mizuguchi H, Kato S, Takahashi K. P1.03-006 Clinicopathological Features and Poor Outcome for ALK Inhibitors of Squamous Cell Lung Cancer with ALK-Rearrangement. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.810] [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: 11/28/2022]
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Hasegawa Y, Kiyota N, Takahashi S, Yokota T, Yen CJ, Iwae S, Shimizu Y, Hong RL, Goto M, Namba Y, Ferris R, Monga M, Lynch M, Hagihara S, Tahara M. 360O_PR Efficacy and safety of nivolumab for recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) in Asia: CheckMate 141 subgroup analysis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw587.002] [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: 11/12/2022] Open
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27
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Hasegawa Y, Kiyota N, Takahashi S, Yokota T, Yen CJ, Iwae S, Shimizu Y, Hong RL, Goto M, Namba Y, Ferris R, Monga M, Lynch M, Hagihara S, Tahara M. 360O_PR Efficacy and safety of nivolumab for recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) in Asia: CheckMate 141 subgroup analysis. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00518-4] [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: 11/30/2022] Open
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Katayama S, Uchino S, Uji M, Ohnuma T, Namba Y, Kawarazaki H, Toki N, Takeda K, Yasuda H, Izawa J, Tokuhira N, Nagata I. Factors Predicting Successful Discontinuation of Continuous Renal Replacement Therapy. Anaesth Intensive Care 2016; 44:453-7. [DOI: 10.1177/0310057x1604400401] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This multicentre, retrospective observational study was conducted from January 2010 to December 2010 to determine the optimal time for discontinuing continuous renal replacement therapy (CRRT) by evaluating factors predictive of successful discontinuation in patients with acute kidney injury. Analysis was performed for patients after CRRT was discontinued because of renal function recovery. Patients were divided into two groups according to the success or failure of CRRT discontinuation. In multivariate logistic regression analysis, urine output at discontinuation, creatinine level and CRRT duration were found to be significant variables (area under the receiver operating characteristic curve for urine output, 0.814). In conclusion, we found that higher urine output, lower creatinine and shorter CRRT duration were significant factors to predict successful discontinuation of CRRT.
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Affiliation(s)
- S. Katayama
- Intensive Care, Tokyo Women's Medical University, Department of Emergency Medicine, Asahi General Hospital, Chiba, Japan
| | - S. Uchino
- Intensive Care, Tokyo Women's Medical University, Department of Emergency Medicine, Asahi General Hospital, Chiba, Japan
| | - M. Uji
- Intensive Care Unit, Osaka University Hospital, Osaka, Japan
| | - T. Ohnuma
- Intensive Care Unit, Department of Anesthesiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Y. Namba
- Department of Emergency and Critical Care, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - H. Kawarazaki
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kanagawa, Japan
| | - N. Toki
- Department of Internal Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - K. Takeda
- Division of Intensive Care Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - H. Yasuda
- Intensive Care Unit, Department of Emergency and Critical Care Medicine, Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | - J. Izawa
- Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan
| | - N. Tokuhira
- Division of Intensive Care, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - I. Nagata
- Department of Emergency, Kanto Rosai Hospital, Kanagawa, Japan
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Namba S, Hayashi K, Hirayama T, Hirayama T, Namba Y, Terado M, Easton P, Ujike Y. Sleep monitoring in ICU patients. Crit Care 2015. [PMCID: PMC4471815 DOI: 10.1186/cc14631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sato T, Kashihara Y, Namba Y, Tanaka M, Fuke S, Saito H. In-hospital and long-term clinical outcomes of left main coronary artery disease in patients with acute myocardial infarction. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Namba Y, Nakazawa Y, Niinaka M, Yano Y, Yoneda T, Kimura H, Mori M, Okada T, Yamaguchi T, Yokota S. Characteristics of Non-Small Cell Lung Cancer with Rare Epidermal Growth Factor Receptor Gene Mutations. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt459.59] [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: 11/12/2022] Open
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Yuh N, Komuta K, Yokoi T, Yamamoto S, Minami S, Shiroyama T, Hirashima T, Namba Y, Kijima T, Tachibana I. Phase II Study of Tailored Dose S-1 Plus Carboplatin Followed by S-1 for Advanced Squamous Cell Lung Cancer. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt459.141] [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: 11/14/2022] Open
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Nakatsuji N, Nishizawa M, Namba Y, Nakata I, Yokota S. Effort of Patient Support Team for Chemotherapy in NHO National Toneyama Hospital. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt460.107] [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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Nishino K, Imamura F, Morita S, Mori M, Komuta K, Kijima T, Namba Y, Kumagai T, Yamamoto S, Tachibana I, Nakazawa Y, Uchida J, Minami S, Takahashi R, Yano Y, Okuyama T, Kumanogoh A. A retrospective analysis of 335 Japanese lung cancer patients who responded to initial gefitinib treatment. Lung Cancer 2013; 82:299-304. [PMID: 24018023 DOI: 10.1016/j.lungcan.2013.08.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [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: 05/23/2013] [Revised: 08/05/2013] [Accepted: 08/07/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Gefitinib treatment results in considerably better progression-free survival compared with that of platinum doublets in the first line treatment of nonsmall-cell lung cancer (NSCLC) carrying an activating epidermal growth factor receptor (EGFR) mutation. Some patients who respond to gefitinib have an overall survival (OS) of more than 5 years, whereas other initial responders do less well. Although there has been considerable effort made to elucidate the mechanisms of acquired resistance, there have only been a few studies that addressed the effect of clinical backgrounds and treatment histories on the survival of the patients who had responded to an EGFR-tyrosine kinase inhibitor (TKI). In this study, we especially focused on the clinical benefit of EGFR-TKI administration after progression. PATIENTS AND METHODS We retrospectively analyzed consecutive patients with advanced NSCLC who were diagnosed before October 2010, treated with gefitinib after July 2002, and responded to it. The primary objective of this study was to evaluate how clinical backgrounds and treatment histories influence survival of the patients who respond to gefitinib. The secondary objectives were to evaluate the safety of long-term gefitinib use and to establish the optimal treatment sequence using a dynamic treatment regimen analysis (DTRA). RESULTS A total of 335 patients were recruited. Twenty-eight (8.4%) patients survived more than 5 years. Sixty-five and 93 patients received gefitinib as rechallenge and beyond progressive disease (BPD), respectively. A statistically significant difference in OS was observed between the patients who underwent gefitinib rechallenge and those who did not rechallenge (median: 1272 days vs. 774 days; p < 0.001), a result supported by a DTRA. Patients treated with gefitinib BPD also showed a tendency of longer survival. CONCLUSIONS Gefitinib rechallenge and BPD played a central role in long term survival of the patients who initially responded to gefitinib.
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Affiliation(s)
- K Nishino
- Department of Thoracic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
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Namba Y, Suzuki R, Sasaki J, Takayasu M, Watanabe K, Kenji D, Hayashi M, Kitamura Y, Kawamo M, Masaki H, Kyuuno E, Hayashi M, Yamaguchi M, Maeda A. Thallium group poisoning incident in Japan 2011. Crit Care 2013. [PMCID: PMC3642765 DOI: 10.1186/cc12207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Takahashi R, Imamura F, Morita S, Mori M, Komuta K, Kijima T, Namba Y, Nishino K, Yamamoto S, Hirata H, Tachibana I, Kumanogoh A. What Factors Affect Long-Term Survival After Responding to Gefitinib in Advanced Non-Small-Cell Lung Cancer? Real World Evidence. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32405-4] [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: 11/25/2022] Open
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Ko R, Sasaki S, Namba Y, Ishimori A, Yoshioka M, Yoshioka Y, Tominaga S, Takahashi K. Efficacy of Fexofenadine in Preventing Tyrosine Kinase Inhibitor (TKI)-Induced Interstitial Lung Disease. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32271-7] [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] Open
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Namba Y, Hattori Y, Edagawa M, Yoshioka H, Iwasaku M, Shimada T, Satouchi M, Katagami N, Fujita S, Mori M, Imamura F, Kotani Y, Nishimura T, Morita S, Negoro S. A Phase II Study of Pemetrexed in Chemotherapy-Naive Elderly Patients with Advanced Non-Squamous Non-Small-Cell Lung Cancer: Hanshin Oncology Group 003. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)32202-x] [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] Open
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Yamazaki Y, Mikami Y, Yuguchi M, Namba Y, Isokawa K. Development of collagen fibres and lysyl oxidase expression in the presumptive dermis of chick limb bud. Anat Histol Embryol 2011; 41:68-74. [PMID: 21919949 DOI: 10.1111/j.1439-0264.2011.01103.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Lysyl oxidase (LOX) plays a critical role in the formation of cross-linkages in extracellular matrix molecules. Thus, it is essential for the biogenesis and homeostasis of the connective tissue matrix. During development, collagen fibres and elastic system fibres emerge and accumulate in a temporospatial manner in the presumptive dermis of chicks. In this study, we investigated LOX mRNA expression by laser capture microdissection and RT-qPCR and LOX protein localization by immunohistochemistry. The picrosirius polarization method was used to investigate a relation between collagen accumulation and LOX expression. PCR analysis showed that the expression of LOX mRNA in the presumptive dermis became apparent at embryonic day 13 and increased considerably by ED17. Immunohistochemical staining for LOX in the dermis was very low at all stages of development. Accumulation of collagen fibres was seen in the dermis on ED10, and higher wavelengths of birefringence became evident by ED13. Our findings suggest that the temporal pattern of LOX mRNA expression correlates with collagen fibre accumulation in the dermis of the developing chick limb bud, whereas LOX expression was relatively constant at the protein level.
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Affiliation(s)
- Y Yamazaki
- Department of Anatomy, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo, Japan.
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Sasaki S, Yoshioka Y, Ko R, Katsura Y, Namba Y, Koike K, Yoshioka M, Tominaga S. Diagnostic and therapeutic significance of the cerebrospinal fluid (CSF) EGFR mutation analysis for the patients with NSCLC suffering meningitis carcinomatosa harboring active EGFR mutation, after gefitinib therapy failure. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10608] [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: 11/20/2022] Open
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Oka K, Namba Y, Ichimaru N, Moriyama T, Kyo M, Kokado Y, Imai E, Takahara S. Clinicopathological study of expression of lymphatic vessels in renal allograft biopsy after treatment for acute rejection. Transplant Proc 2010; 41:4154-8. [PMID: 20005358 DOI: 10.1016/j.transproceed.2009.09.067] [Citation(s) in RCA: 4] [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: 11/02/2008] [Revised: 03/10/2009] [Accepted: 09/15/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Lymph vessel expression is related to inflammatory cell infiltration, around renal tubules in acute rejection episodes (ARE) of transplanted kidneys. However, there is little information on the lymph vessels after treatment of an ARE, particularly in relation to renal function and histological findings. PATIENTS AND METHODS We investigated 13 cases of ARE diagnosed by kidney transplant biopsy performed from 1997 to 2005 within 3 years of transplantation. Treatment of the ARE lead to an improved serum creatinine level in all cases. There was neither an ABO-incompatible nor an acute humoral rejection case. Lymphatic vessels in re-biopsies were examined using immunohistochemical staining with D2-40 antibody that detected lymphatic endothelium. Re-biopsy cases in which the baseline creatinine had increased by more than 20% despite treatment were considered the severe group; the others, as the stable group. The relation between lymphatic vessel density (LVD) and renal function was examined using Banff scores. RESULTS LVD was significantly higher in the severe than the stable group. The expression of lymph vessels versus the Banff score showed a direct relation: greater Banff scores showed higher expressions of lymph vessels. CONCLUSIONS The expression of lymph vessels in renal allograft specimens after treatment of an ARE was related to deterioration of renal function and inflammatory cell invasion. We plan a further examination of the relationship between the expression of lymph vessels and long-term prognosis.
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Affiliation(s)
- K Oka
- Osaka Kaisei Hospital, 1-6-10 Miyahara, Yodogawaku, Osaka 532-0003, Japan.
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Namba Y. 241. Minimum Dose of Hypobaric Bupivacaine Solution During Spinal Anesthesia for Nongeriatric Patients. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00061] [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: 11/03/2022]
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Nishimura K, Arichi N, Tokugawa S, Yoshioka I, Namba Y, Kishikawa H, Takahara S, Ichikawa Y. Hepatocyte growth factor and interleukin-6 in combination with prostate volume are possible prostate cancer tumor markers in patients with gray-zone PSA levels. Prostate Cancer Prostatic Dis 2007; 11:258-63. [PMID: 17876341 DOI: 10.1038/sj.pcan.4501006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim was to assess whether hepatocyte growth factor (HGF) and interleukin (IL)-6 in combination with prostate volume are able to accurately detect prostate cancer in patients with gray-zone prostate-specific antigen (PSA) levels. A total of 159 patients with PSA levels of <10 ng ml(-1) were enrolled. Forty-two (35.3%) were diagnosed with prostate cancer, whereas 117 (64.7%) had no cancer and were used as benign group. HGF and IL-6 density (HGFD and IL-6D, respectively) values were calculated by dividing serum HGF and IL-6 levels with prostate volume. Median IL-6 (2.3 pg ml(-1)) levels for the prostate cancer group were significantly higher than those for the benign group before adjustment for age (1.7 pg ml(-1)) (P=0.0098). After age adjustments, median IL-6 (2.17 pg ml(-1)), HGFD (0.00972 ng ml(-1) cm(-3)), and IL-6D (0.0848 pg ml(-1) cm(-3)) values for the prostate cancer group were significantly higher than those for the benign group (IL-6, 1.78 pg ml(-1); HGFD, 0.00732 ng/ml/cc; and IL-6D, 0.049 pg/ml/cc; P=0.0416, 0.007 and 0.0005, respectively). In receiver operating characteristic analyses, the areas under the curves for HGFD (0.64) and IL-6D (0.68) were significantly greater than those for HGF (0.52) and IL-6 (0.61) (P=0.0006 and 0.019, respectively). With an HGFD cutoff value of 0.00392 ng ml(-1) cm(-3) (sensitivity=100%, specificity=11%), 11.1% of the benign group were able to avoid unnecessary biopsies without missing prostate cancer. HGF and IL-6 levels in combination with prostate volume were shown to be useful parameters for prostate cancer screening in patients with gray-zone PSA levels.
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Affiliation(s)
- K Nishimura
- Department of Urology, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan.
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Kameyama K, Sakoda Y, Tamai K, Igarashi H, Tajima M, Mochizuki T, Namba Y, Kida H. Development of an immunochromatographic test kit for rapid detection of bovine viral diarrhea virus antigen. J Virol Methods 2006; 138:140-6. [PMID: 17046073 DOI: 10.1016/j.jviromet.2006.08.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [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: 11/01/2005] [Revised: 08/07/2006] [Accepted: 08/29/2006] [Indexed: 10/24/2022]
Abstract
An immunochromatographic test was developed for rapid diagnosis of bovine viral diarrhea virus (BVDV) infections using monoclonal antibodies against the nonstructural protein, NS3, of the virus. The kit detected specifically the NS3 of various BVDV strains. Using the kit, leukocyte extracts of cattle infected persistently with BVDV were found positive while those of healthy cattle were negative. The sensitivity and specificity of this kit in compared with virus isolation were 100% and 97.2%, respectively. Furthermore, the test also gave positive results for calves infected acutely with BVDV in experimental infection. The BVDV antigen was detected in 1 ml of blood using a relatively simple procedure. This test kit should be useful for rapid diagnosis of BVD.
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Affiliation(s)
- K Kameyama
- Laboratory of Microbiology, Department of Disease Control, Graduate School of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Sapporo 060-0818, Japan
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Oka K, Moriyama T, Takahara S, Naruse M, Namba Y, Ichimaru N, Kyo M, Kokado Y, Okuyama A, Ito T, Imai E, Aozasa K. Increased Expression of Renin in Chronic Allograft Nephropathy. Transplant Proc 2005; 37:2131-4. [PMID: 15964360 DOI: 10.1016/j.transproceed.2005.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chronic allograft nephropathy (CAN) is the main cause of renal transplant failure in the first decade posttransplant. The precise pathogenetic mechanism for CAN is not completely understood. A possible role of renin-angiotensin system for CAN has been suggested through clinical observations that angiotensin-converting enzyme inhibition and angiotensin II receptor blockers prevent CAN. METHODS Distribution of renin-positive cells in allograft biopsy specimens was examined immunohistochemically in 23 renal transplant recipients diagnosed with CAN Biopsy specimens obtained from seven recipients with stable renal function were examined as controls. Histologic evaluation was performed based on the Banff 97 classification. RESULTS Renin-positive cells were found in the juxtaglomerular apparatus (JGA) adjoining the afferent arterioles in both groups. When the number of renin-positive cells in JGA was defined as a renin index, it was significantly higher in the CAN than the control group (P = .007). There was no significant difference in age, interval between transplantation and biopsy, and blood pressure between groups. Only a significantly higher serum creatinine was found in the CAN group. CONCLUSIONS The increased renin-positive cells in JGA suggest a significant role of the intrarenal renin-angiotensin system activation in the development of CAN.
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Affiliation(s)
- K Oka
- Department of Pathology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
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Kodama T, Miyazaki T, Kitamura I, Suzuki Y, Namba Y, Sakurai J, Torikai Y, Inoue S. Effects of single and long-term administration of wheat albumin on blood glucose control: randomized controlled clinical trials. Eur J Clin Nutr 2004; 59:384-92. [PMID: 15674303 DOI: 10.1038/sj.ejcn.1602085] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the effects of single and long-term administration of wheat albumin (WA) on blood glucose levels and blood glucose control, respectively. DESIGN Randomly arranged crossover trial for single administration in healthy subjects and double-blinded randomized controlled trial for long-term administration (3 months) in diabetic patients. In vitro alpha-amylase inhibitory activity of WA was also determined. SETTING Central Research Laboratories of Nisshin Flour Milling Co. Ltd. (Saitama, Japan) for single administration and Aiwa Clinic (Saitama, Japan) for long-term administration. SUBJECTS A total of 12 healthy adult male volunteers for the single administration and 24 type II outpatient diabetics with mild hyperglycemia for the long-term administration. INTERVENTIONS Subjects took soups containing 0, 0.25, 0.5, and 1.0 g WA before test meals for single administration, and patients took soups with or without 0.5 g WA before every meal for the long-term (3 months) administration. RESULTS In vitro alpha-amylase inhibitory activity of WA was 150 times that of wheat flour. In the single administration experiment, WA suppressed peak postprandial blood glucose levels in a dose-dependent manner: 31, 47, and 50% reduction after 0.25, 0.5, and 1.0 g administrations, respectively. In the long-term administration, 0.5 g of WA did not affect fasting blood glucose levels, whereas it reduced hemoglobin A1c levels. No significant adverse effects such as hypoglycemia or gastrointestinal disturbances were observed in the two experiments. CONCLUSION In the treatment of type II diabetic patients, WA might be a useful functional food, which, with diet and exercise, could help to improve blood glucose control without any critical adverse effects.
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Affiliation(s)
- T Kodama
- Nisshin Pharma Inc., Tokyo, Japan
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Namba Y, Moriyama T, Kyo M, Oka K, Kokado Y, Shi Y, Imamura R, Ichimaru N, Okuyama A, Takahara S. Comparison of histopathological characteristics of allograft biopsy between responder and non-responder to antiproteinuric effect of angiotensin-converting enzyme inhibitor (ACEI). Clin Transplant 2004; 18 Suppl 11:29-33. [PMID: 15191370 DOI: 10.1111/j.1399-0012.2004.00244.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Angiotensin-converting enzyme inhibitor (ACEI) has become recognized as agents that have renoprotective effects in the treatment of progressive renal diseases including post-transplant kidneys. Previously we demonstrated the safety and effectiveness of ACEI treatment on the hypertensive proteinuric post-transplant patients (N = 10) who had been followed up for 12 months. However, not all patients show good response in urinary protein reduction. We aimed to analyse the histopathological factor(s) affecting the responsiveness of proteinuria to ACEI treatment. Fourteen post-transplant patients with proteinuria who were treated with ACEI and underwent allograft biopsy were analysed. Eight patients showed 50% or more reduction in proteinuria (responder). The other 6 patients showed less (< 50%) reduction in proteinuria (non-responder). There was no difference in clinical characteristics (BP, renal function, donor age, recipient body mass index), dietary sodium or protein intake, and diuretic use between the two groups. As a histopathological characteristic, glomerular size in responder group was significantly larger than that in non-responder group. This suggests that the large glomerular size at least partly contributes to the responsiveness in urinary protein reduction to ACEI treatment in kidney allograft recipients with proteinuria.
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Affiliation(s)
- Y Namba
- Department of Urology, Osaka University Graduate School of Medicine, Toyonaka, Osaka, Japan
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Namba Y, Oka K, Moriyama T, Ichimaru N, Kyo M, Kokado Y, Ito T, Imai E, Aozasa K, Okuyama A, Takahara S. Risk factors for graft loss in patients with recurrent IGA nephropathy after renal transplantation. Transplant Proc 2004; 36:1314-6. [PMID: 15251321 DOI: 10.1016/j.transproceed.2004.05.044] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The recurrence rate of IgA nephropathy (IgAN) in transplanted kidneys has been reported to be >50%. Although recurrent IgAN has a benign clinical course, recent data suggest that it leads to graft loss in a substantial number of patients. METHODS We performed a retrospective single-center analysis of 34 renal transplant recipients, with biopsy-proven IgAN as the cause of end-stage renal failure. RESULTS Renal allograft biopsies were performed in 30 patients, of whom 24 did and 6 did not have biopsy-confirmed recurrent transplant IgAN. Recurrent transplant IgAN was more often detected in men and at later timepoints after post-transplantation. Four patients with recurrent transplant IgAN progressed to graft failure. Progression to graft failure was associated with worsened renal function, higher systolic blood pressure, and the lack of presenation of angiotensin-converting enzyme inhibitors (ACEs) at the time of allograft biopsy. Immunologic factors such as frequency of acute rejection, HLA typing, and immunosuppression did not show a relation to recurrence or graft loss. CONCLUSIONS Recurrent transplant IgAN increased with long-term graft survival and risk factors for graft loss due to recurrent IgAN were similar to those among IgAN in native kidneys.
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Affiliation(s)
- Y Namba
- Department of Pathology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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Takahara S, Ichimaru N, Kojima Y, Namba Y, Toki K, Shi Y, Yoshimura K, Matsumiya K, Nonomura N, Okuyama A. Investigation of the pharmacokinetics of cyclosporine in patients following long-term administration after a kidney transplant: comparison of neoral and sandimmune. Transplant Proc 2004; 36:456S-460S. [PMID: 15041387 DOI: 10.1016/j.transproceed.2004.01.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A crossover administration of Neoral and Sandimmune was performed in 43 renal allograft recipients who had been on cyclosporine maintenance therapy for 2 to 19 years posttransplant to investigate the pharmacokinetics of cyclosporine. Although there was no difference in C0 values (trough values) when Neoral and Sandimmune were administered at the same doses, AUC(0-4) and AUC(0-12) values of Neoral were 1.57- and 1.36-fold greater than those of Sandimmune, respectively. For both Neoral and Sandimmune, there was a high correlation between the C2 value and AUC(0-4). The Pearson's product-moment coefficient for the correlation between the C2 value and AUC(0-4) was R=0.91642. On the other hand, the correlation with the C0 value (trough value) was low (R=0.53181). During the period of the study, there was no acute rejection episode, onset of adverse drug reaction symptoms, or marked change in laboratory test values.
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Affiliation(s)
- S Takahara
- Osaka University, Graduate School of Medicine, Faculty of Medicine, Urology Department, Suita, Japan.
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Littger R, Alke A, Tewes B, Gropp F, Asai T, Watanabe K, Kuromi K, Kurohane K, Ogino K, Taki T, Tsukada H, Nakayama J, Oku N, Babai I, Matyas G, Baranji L, Milosevits J, Alving CR, Bendas G, Rothe U, Scherphof GL, Kamps JAAM, Kessner S, Rothe U, Bendas G, Carafa M, Di Stefano A, Sozio P, Cacciatore I, Mosciatti B, Santucci E, Choice E, Harvie P, Galbraith T, Zunder E, Dutzar B, Anklesaria P, Paul R, Cocquyt J, De Cuyper M, Van der Meeren P, Cruz MEM, Gaspar MM, Silva MT, Dathe M, Nikolenko H, Wessolowski A, Schmieder P, Beyermann M, Bienert M, Santos ND, Cox KA, Allen C, Gallagher RC, Ickenstein L, Mayer LD, Bally MB, Fischer S, Margalit R, Freisleben HJ, Garidel P, Chen HC, Moore D, Mendelsohn R, Garidel P, Keller M, Hildebrand A, Blume A, Girão da Cruz MT, Simões S, Pedroso de Lima MC, Graser A, Nahde T, Fahr A, Müller R, Müller-Brüsselbach S, Harvie P, Dutzar B, Choice E, Cudmore S, O'Mahony D, Anklesaria P, Paul R, Hoving S, van Tiel ST, Seynhaeve ALB, Ambagtsheer G, Eggermont AMM, ten Hagen TLM, Høyrup P, Jensen SS, Jørgensen K, Iden D, Kuang H, Mullen P, Jacobs C, Roben P, Stevens T, Lollo C, Ishida T, Maeda R, Masuda K, Ichihara M, Kiwada H, Jung K, Reszka R, Kaiser N, Ohloff I, Linser-Haar S, Massing U, Schubert R, Kan P, Tsao CW, Chen WK, Wang AJ, Kimpfler A, Gerber C, Wieschollek A, Bruchelt G, Schubert R, Kobayashi T, Okada Y, Ishida T, Sone S, Harashima H, Maruyama K, Kiwada H, Kondo M, Lee CM, Tanaka T, Su W, Kitagawa T, Ito T, Matsuda H, Murai T, Miyasaka M, Junji K, Kondo M, Asai T, Ogino K, Taki T, Tsukada H, Baba K, Oku N, Koning GA, Wauben MHM, ten Hagen TLM, Vestweber D, Everts M, Kok RJ, Schraa AJ, Molema G, Schiffelers RM, Storm G, Kristl J, Šentjurc M, Abramović Z, Landry S, Perron S, Bestman-Smith J, Désormeaux A, Tremblay MJ, Bergeron MG, Madeira C, Loura LMS, Fedorov A, Prieto M, Aires-Barros MR, Marques CM, Simões SI, Cruz ME, Cevc G, Martins MB, Moreira JN, Gaspar R, Allen TM, Esposito C, Ortaggi G, Bianco A, Bonadies F, Malizia D, Napolitano R, Cametti C, Mossa G, Endert G, Essler F, Lutz S, Panzner S, Pastorino F, Brignole C, Pagnan G, Moase EH, Allen TM, Ponzoni M, Pavelic Z, Škalko-Basnet N, Jalšenjak I, Penacho N, Simões S, Pedroso de Lima MC, Pisano C, Bucci F, Serafini S, Martinelli R, Cupelli A, Marconi A, Ferrara FF, Santaniello M, Critelli L, Tinti O, Luisi P, Carminati P, Santaniello M, Bucci F, Tinti O, Pisano C, Critelli L, Galletti B, Luisi P, Carminati P, Sauer I, Nikolenko H, Dathe M, Schleef M, Voß C, Schmidt T, Flaschel E, König S, Wenger T, Dumond J, Bogetto N, Reboud-Ravaux M, Schramm HJ, Schramm W, Sheynis T, Rozner S, Kolusheva S, Satchell D, Jelnik R, Shigeta Y, Imanaka H, Ando H, Makino T, Kurohane K, Oku N, Baba N, Shimizu K, Asai T, Takada M, Baba K, Namba Y, Oku N, Simberg D, Danino D, Talmon Y, Minsky A, Ferrari ME, Wheeler CJ, Barenholz Y, Takada M, Shimizu K, Kuromi K, Asai T, Baba K, Oku N, Takeuchi Y, Kurohane K, North JR, Namba Y, Nango M, Oku N, Tewes B, Köchling T, Deissler M, Kühl C, Marx U, Strote G, Gropp F, Qualls MM, Kim JM, Thompson DH, Zhang ZY, Shum P, Collier JH, Hu BH, Ruberti JW, Messersmith PB, Thompson DH, Tsuruda T, Nakade A, Sadzuka Y, Hirota S, Sonobe T, Vorauer-Uhl K, Wagner A, Katinger H, Wagner A, Vorauer-Uhl K, Katinger H, Weeke-Klimp AH, Bartsch M, Meijer DKF, Scherphof GL, Kamps JAAM, Zeisig R, Walther W, Reß A, Fichtner I, Zschörnig O, Schiller J, Süß M, Bergmeier C, Arnold K, Nchinda G, Überla K, Zschörnig O. Poster Abstracts. J Liposome Res 2003. [DOI: 10.1081/lpr-120017490] [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: 11/03/2022]
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