Papers by Mitsugi Shimoda
Archives of Clinical and Experimental Surgery (ACES), 2012
The effects of Edaravone (Edr) on hepatic ischemia-reperfusion (I/R) injury and liver regeneratio... more The effects of Edaravone (Edr) on hepatic ischemia-reperfusion (I/R) injury and liver regeneration were examined in a pig hepatectomy model.
International Journal of Scientific Research, 2012
Background: There have been no studies reporting about hepcidin and its relation with stress due ... more Background: There have been no studies reporting about hepcidin and its relation with stress due to training or competition in contact sports such as rugby. There are also no studies reporting about the relation of hepcidin with iron, ferritin, or hemoglobin. Research question: The aim of this study was to investigate the dynamics of serum iron and hepcidin in rugby players. Type of study: Observational parallel-group study. Methods: Forty Eight male rugby players were accrued from the top domestic league for this study. Laboratory data were analyzed on an annual basis. The players were divided into two groups according to the duration of participation in top league games (total competition time 300min for group A and <300min for group B), and these two groups were compared. Results: The levels of glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), creatine phosphokinase (CPK), blood urea nitrogen, ferritin, and hepcidin were increased significantly in all of the players after training or competition. In contrast, the total protein, albumin, alkaline phosphatase, creatinine, red blood cell count, hemoglobin, haematocrit, and platelet count showed a significant decrease. Comparison of the two groups showed that the levels of GOT, GPT, LDH, CPK, creatinine, uric acid, hepcidin, and ferritin were higher in group A than in group B. Conclusions: These findings suggest that the yearly variations of iron, hemoglobin, ferritin, and hepcidin levels were demonstrated to be associated with biochemical parameters. In addition, starting players have a higher work load than substitute players despite undergoing the same training.
The Open Transplantation Journal, 2008
Journal of Clinical & Experimental Dermatology, 2010
Aim: PDS-II for peritoneal and subcuticular sutures, followed by Dermabond for skin dressing was ... more Aim: PDS-II for peritoneal and subcuticular sutures, followed by Dermabond for skin dressing was commonly used in minimal surgical field, it is still unclear whether subcuticular closure and skin dressing are effective for the major abdominal surgical incision. The purpose was to investigate SSI of PDS-II and Dermabond versus Vicryl and silk in major abdominal surgery using the pig liver resection mode.
Asian journal of surgery / Asian Surgical Association, Jan 26, 2015
Recurrence of hepatocellular carcinoma (HCC) after surgery is frequent, and is an important facto... more Recurrence of hepatocellular carcinoma (HCC) after surgery is frequent, and is an important factor adversely influencing the long-term survival of patients. This prospective study evaluated whether adjuvant chemotherapy with oral tegafur/uracil (UFT) reduces the recurrence rate of HCC. In addition, expression of thymidylate synthase (TS) and dihydropyrimidine dehydrogenase (DPD) were investigated in resected tumors and nontumorous tissues, and the relationship between their expression and the effectiveness of UFT was examined. A total of 117 patients who underwent curative hepatic resection for HCC were randomly allocated to UFT 400 mg/d (n = 24, UFT group) or surgery alone (n = 56, control group). The primary endpoint was the recurrence-free survival rate, and the secondary endpoint was the overall survival rate. Expression of the DPD and TS genes were quantified with TaqMan reverse transcription-polymerase chain reaction assay using β-actin as an internal standard. The cut-off val...
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Background: he efects of Edaravone (Edr) on hepatic ischemia-reperfusion (I/R) injury and liver r... more Background: he efects of Edaravone (Edr) on hepatic ischemia-reperfusion (I/R) injury and liver regeneration were examined in a pig hepatectomy model.
The extraction of a liver from CT images is es-sential for oncologic surgery planning. This artic... more The extraction of a liver from CT images is es-sential for oncologic surgery planning. This article presents an accurate and automatic approach to extract a liver from CT images. Our algorithm exploits three types of liver structure models: intensity model, shape model, and blood vessel model. First, the region including the liver is roughly extracted based on intensity histogram analysis. Second, the extracted regions are segmented using a shape feature called â ˘ AIJlocal thicknessâ ˘ A ˙ I based on the observation that the liver is thicker than other organs. Finally, the segmented regions including blood vessels in the liver are merged into a single liver region. Experimental results show that the average error of the volume extraction is 61.25 cc, and this result is much superior to the conventional one.
This article presents an automatic approach to estimate optimal resected-liver regions for oncolo... more This article presents an automatic approach to estimate optimal resected-liver regions for oncologic surgery planning. Usually, resected liver regions are determined by selecting cut points on the portal vessels on 3D simulation software. Since the liver has complex vessel structure, it is difficult for human to find optimal resected liver regions. To solve this problem, a tumor domination ratio is proposed to find all portal vessels related to tumors. The tumor domination ratio allows us to compute the ideal resected region, that is, all the perfusion territories related to the tumor. Moreover, some types of conditions such as the size of vessels are considered for practical surgical use. The experimental results demonstrate that the resected liver regions of the proposed approach are much smaller than those of the conventional approach in most cases.
Hepato-gastroenterology
We investigated, for the first time, the protective effect of erythropoietin (EPO) against liver ... more We investigated, for the first time, the protective effect of erythropoietin (EPO) against liver ischemia-reperfusion (I-R) injury in a pig model. Partial hepatic ischemia was maintained for 60 min in a pig. Pigs were allocated to 4 groups (n=5 each): (1) Control group with I-R injury (Vehicle); (2) EPO group with I-R injury, given three injections of EPO at 5000 IU/kg (EPO5000x3); (3) EPO group with I-R injury, given a single injection of EPO at 5000 IU/kg (EPO5000x1); and (4) EPO group with I-R injury, given three injections of EPO at 500 IU/kg (EPO500x3). Liver function tests (AST, ALT, LDH), and TUNEL assay were performed. Three hours after I-R injury, AST levels in the Vehicle, EPO5000x3, EPO5000x1, and EPO500 x3 groups were 1494.2 +/- 711.3 U/L, 307.3 +/- 127.6 UL, 296.5 +/- 9.2 U/L, and 474.6 +/- 242.0 UL, respectively (one-factor ANOVA, p = 0.020). At 3h the ALT and LDH levels in the Vehicle group were significantly higher than those in the EPO5000x3 and EPO5000x1 groups. Ap...
Hepato-gastroenterology, 2007
A 54-year-old man who had undergone Miles' operation for rectal cancer in 1999 was found to h... more A 54-year-old man who had undergone Miles' operation for rectal cancer in 1999 was found to have four brain metastases, which were treated by partial resection and gamma knife therapy in February 2003. During follow-up, ultrasound (US) showed a hypoechoic lesion in the head of the pancreas, and computed tomography (CT) demonstrated low-density tumors in the pancreatic head and left adrenal gland. Endoscopic retrograde pancreatography revealed severe stenosis of the main pancreatic duct, and endoscopic ultrasonography showed a hypoechoic lesion in the pancreas head. This patient was also found to have a coin lesion in the middle of the right lung by chest CT. All lesions were considered resectable. The patient underwent pancreato-duodenectomy and left adrenectomy. Histologically, these tumors were diagnosed as metastases from the rectal cancer. Although the patient's postoperative course was uneventful, CT showed multiple metastases in the both lungs. These were not resectabl...
The British journal of surgery, Jan 2, 2015
Randomized studies of adjuvant chemotherapy using gemcitabine suggest a survival benefit after re... more Randomized studies of adjuvant chemotherapy using gemcitabine suggest a survival benefit after resection of pancreatic cancer. S-1 has also been shown to prolong survival in patients with unresectable pancreatic cancer. This study compared the effects of adjuvant chemotherapy with S-1 or gemcitabine after resection of pancreatic cancer in a randomized trial. Patients who had undergone resection of pancreatic cancer were registered in this randomized clinical trial. The primary endpoint was disease-free survival (DFS). Expression levels of thymidylate synthase (TS) and dihydropyrimidine dehydrogenase (DPD) mRNAs in cancer tissues were measured as indicators of fluoropyrimidine sensitivity. Of 57 patients registered, 29 were allocated to the S-1 group and 28 to gemcitabine. DFS tended to be better with S-1 (median 14·6 (90 per cent c.i. 8·8 to 28·4) months versus 10·5 (7·0 to 28·4) months in the gemcitabine group; P = 0·188), with a similar pattern for overall survival: 21·5 (95 per c...
Digestive surgery, Jan 17, 2015
Surgical resection continues to be the current standard treatment for distal bile duct carcinoma ... more Surgical resection continues to be the current standard treatment for distal bile duct carcinoma (DBC), as no effective alternative treatment exists. However, even after resection, the long-term prognosis is poor. Simple biomarkers that can predict response or toxicity, and which are applicable to all community oncology settings worldwide, have not been identified. Differential white-cell counts, such as the neutrophil-to-lymphocyte ratio (NLR), as markers of inflammation, may be simple and readily available biomarkers. This study aimed to determine whether the NLR can be used as a predictor of surgical outcome in patients with DBC. We enrolled 91 DBC patients who had undergone pancreatoduodenectomy (PD) at a single institution between April 2000 and December 2013. Blood was sampled on admission for determination of NLR. An NLR of ≥5 was selected as the cut-off value for validation. Seventeen patients had an NLR of ≥5 (Group 1; 18.7%), while 74 had an NLR of <5 (Group 2; 81.3%). ...
World journal of gastroenterology : WJG, Jan 14, 2014
We report a case of intraductal papillary neoplasm of the bile duct (IPNB) that developed in a pa... more We report a case of intraductal papillary neoplasm of the bile duct (IPNB) that developed in a patient with primary sclerosing cholangitis. A 46-year-old woman was admitted to our hospital with obstructive jaundice. The liver function tests demonstrated increased serum liver enzyme levels. Computed tomography showed dilatation of the intrahepatic bile ducts. Abdominal ultrasonography revealed a highly echoic protruding lesion in the posterior bile duct near the right lobe of the liver. The lesion was suspected to be IPNB, but we were unable to confirm whether it was a carcinoma. A right hepatectomy was performed, and this showed that the dilated bile duct was filled with mucin and contained several yellowish papillary tumors. Histologically, the neoplastic biliary epithelium showed papillary growth in the dilated lumen. The tumor was diagnosed as IPNB, high-grade intraepithelial neoplasia secreting abundant mucin. No recurrence has been detected 3 years after surgery.
International surgery
We evaluated the efficacy of TachoComb (TC) collagen fleece and Harmonic Focus (HF) shears in a p... more We evaluated the efficacy of TachoComb (TC) collagen fleece and Harmonic Focus (HF) shears in a pig liver resection model. Pigs were divided into 3 groups of 7, in which vessels were tied with silk and TC was applied to the cut surfaces (Silk+TC group), sealed and sheared with HF and TC (HF+TC group), or sealed using HF alone (HF-TC group). After 1 month, we conducted a histologic evaluation and recorded the incidence of bile leakage with infected collections at the liver cut surface. Six pigs were evaluated in each group. In the Silk+TC group, 4 of the 6 pigs had infected collections at the cut surface. Histologically, the silk had remained under the fibrotic tissue, which contained remnants of TC fragments. In the HF+TC group, 5 of the 6 pigs also had infected collections, and histologically, TC had remained in the hard fibrotic tissues. In the HF-TC group, none of the 6 pigs had infected collections, and the histologic findings were normal. Use of the HF alone may be an effective...
Hepato-gastroenterology
It is known that portal vein (PV) or superior mesenteric vein (SMV) is easily invaded by locally ... more It is known that portal vein (PV) or superior mesenteric vein (SMV) is easily invaded by locally advanced pancreatic head cancer due to anatomical characteristics. Few studies have investigated the results of PD with PV or SMV resection (PVR) for pancreatic head cancer. We retrospectively reviewed a database of 83 patients who had undergone PD for pancreatic head cancer (PC). We divided them into two groups, a group with PD and PVR (PD +PVR G) and a group with PD and no PVR (PD -PVR G). The clinicopathological findings and mortality were analyzed. Twenty-nine of the 83 patients (34.9%) needed PD with PVR. Median survival and disease free survival were 20.4 months and 10.6 months, respectively. The 5-year overall survival rate was 8.1% in PD +PVR G and 7.4% in PD -PVR G, respectively. There was no difference between the two groups (p = 0.091, HR: 1.576; 95% CI: 0.9299-2.670). The 5-year disease free survival rate was 9.6% in PD +PVR G and 10.2% in PD -PVR G, respectively. Also, there...
Case reports in surgery, 2012
A 54-year-old man with chronic hepatitis C was admitted to our hospital because of a disturbance ... more A 54-year-old man with chronic hepatitis C was admitted to our hospital because of a disturbance of consciousness and hyperammonemia. Abdominal angiography revealed a portosystemic shunt between the superior mesenteric vein and inferior vena cava. Endoscopic examination showed no varix. As interventional treatment was unsuccessful, surgical ligation of the shunt was performed. After surgery, portography revealed a huge shunt. Before ligation, the portal pressure, portal flow speed, and volume at the umbilical portion were 24 H(2)O. 5.6 cm/s and 203 ml/min, respectively. Finally the shunt was ligated. The portal flow speed and volume increased for 14 days following surgery and then stabilized. No varices were observed postoperatively. Doppler ultrasound, portography, and portal pressure monitoring can be used to reveal haemodynamic changes in the portal system and justify surgical ligation of portosystemic shunt.
The American surgeon, 2012
Pancreatic fistula (PF) after pancreaticoduodenectomy (PD) is still a severe complication and a c... more Pancreatic fistula (PF) after pancreaticoduodenectomy (PD) is still a severe complication and a challenging problem. The common risk factors are the soft pancreas and small pancreatic duct of the remnant pancreas. Those two risk factors were recognized during surgery. On the other hand, a preoperatively determined risk factor of PF is unclarified. We conducted a retrospective analysis of 203 patients consecutively treated by PD from April 2000 to October 2010. PF was defined according to the criteria of the International Study Group of Pancreatic Fistula. Clinical and pre- and intraoperative data were compared between PF and non-PF patients. The recommended cutoff value of body mass index (BMI) as 20 kg/m(2) was defined by receiver operating characteristic curve analysis. PF occurred in 53 (26.1%) of 203 patients. In univariate analysis, BMI and soft remnant pancreas were found to be risk factors of PF (P = 0.027, P = 0.005). In multivariate analysis, BMI and soft pancreas were also...
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Papers by Mitsugi Shimoda