The effect of roughness on the wettability is studied. The rough surface is constructed with phot... more The effect of roughness on the wettability is studied. The rough surface is constructed with photoresist micropatterns which are formed by photolithography. The aspect ratio is defined as the length ratio between the pattern space and its height. Contact angles of three kinds of liquids, pure water, diiodomethane and ethylene glycol, increase and saturate with the increase of the aspect ratio. The wetting behavior of pure water of which higher surface energy is extremely complex.
Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons), 2014
A 35-year-old female patient receiving gynecological treatment for endometriosis was diagnosed as... more A 35-year-old female patient receiving gynecological treatment for endometriosis was diagnosed as having small bowel obstruction due to an ileal tumor. Laparoscopic ileo-cecal resection with D3 lymph node dissection was performed, because preoperative diagnosis was not confirmed. The intraoperative observation showed that there were a lot of blueberry spots in the pelvic space and all such spots were cauterized using power device. Although pathological diagnosis showed a heterotopic endometriosis of the terminal ileum along with a dissected lymph node, there were no malignant findings in the resected specimen including dissected lymph nodes. Laparoscopic surgery would be adequate for such disease, because both curative surgery for small bowel obstruction due to an ileal endometriosis and cauterization for all blueberry spots could be performed at the same time.
We herein report five cases of ulcerative colitis-associated cancer/dysplasia. Although clinical ... more We herein report five cases of ulcerative colitis-associated cancer/dysplasia. Although clinical remission had been achieved in all patients, mucosal inflammation had been resolved in only one patient. Thus, in order to prevent cancer from developing, appropriate medical therapy aiming not only to relieve the clinical symptoms, but also to suppress chronic inflammation appears to be necessary. Moreover, cancer occurred as early as 4 years after the diagnosis in one patient. In patients without complete resolution of mucosal inflammation, careful surveillance colonoscopy should be initiated in the early phase.
To compare the time interval from insertion until development of central venous catheter related ... more To compare the time interval from insertion until development of central venous catheter related bloodstream infection (CVC-RBSI) between patients who received non-routine dressing change group (Group 1) and patients who received routine dressing change group (Group 2). Between March 2006 and July 2008, patients who underwent CVC were randomly divided into Groups 1 and 2. Comparative study between the two groups was performed by reference to the incidences of CVC-RBSI from the prospectively obtained database. One hundred-eighty nine patients underwent 530 CVC insertions. Group 1 had 254 CVCs and Group 2 had 276 CVCs. There were no significant inter-group differences in patient background factors, except for gender. In addition, Group 1 had a shorter duration of catheter insertion than Group 2. Nevertheless, Group 1 had not only a significantly shorter period from insertion until the development of CVC-RBSI but also a higher frequency of fever than Group 2. The results of our compari...
for their study reporting the results of a single-institution phase II study of adjuvant cisplati... more for their study reporting the results of a single-institution phase II study of adjuvant cisplatin, fluorouracil (5-FU), and interferon-͓alpha͔based chemoradiation followed by gemcitabine for patients with resected pancreatic adenocarcinoma. 1 With a median follow-up of 38 months, the authors report a median overall survival of 25 months and actuarial 1-, 2-, and 3-year overall survival rates of 75%, 56%, and 41%, respectively. The authors report in this study that 36 patients (68%) received grade 3 or 4 chemoradiation associated toxicities and 30% (17 patients) required hospitalization for treatment-related toxicities, primarily gastrointestinal toxicity. Our group and others have shown that interferon (IFN) mediate apoptosis pancreatic cancer cell lines through IFN receptors and the caspase cascade. 2,3 In addition, IFNs enhanced cytotoxicity occurred when IFNs were combined with 5-FU and gemcitabine. 2 We also showed that the IFN alpha/beta receptors was expressed in only 25% of patients in the pancreatic cancer tissue. 4 Interestingly, those patients' survival was more favorable, compared with the patients who did not express the IFN alpha/beta receptor. 4 Furthermore, expression of this receptor did not correlate lymphovascular or perineural invasion, lymph node metastases or size, or stage of neoplasm. 4 In addition, expression of this receptor was associated with improved survival for patients with resectable pancreatic cancer who received adjuvant therapy. 5 As IFN-based chemoradiation has been associated with significant toxicity in Linehan 1 and in another study by Virginia Mason group, 6 it is crucial to identify the subset of patient who will benefit from this study. Linehan et al 1 mentioned that they analyzed the tumor specimen from the patients in their trial for expression of interferon receptors and did not find any correlation with expression of these receptors and outcome. Unfortunately, no data was provided. We have several questions in this regard 1 : what type of interferon receptors did they looked for, 2 what technique was used to look for expression of these receptors?
Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional ... more Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional Japanese herbal medicine, improves gastrointestinal (GI) motility in patients undergoing abdominal surgery, few studies have investigated the efficacy of perioperative DKT administration for relief of postoperative ileus (PI) in patients undergoing surgery for GI cancer. Therefore, the aim of this study was to investigate whether perioperative administration of DKT relieves PI in patients with GI cancer. We performed a comprehensive electronic search of the literature (Cochrane Library, PubMed, the Web of Science and ICHUSHI) up to December 2016 to identify studies that had shown the efficacy of perioperative DKT administration for relief of PI in patients with GI cancer. To integrate the individual effect of DKT, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I statistics. ...
It is well known that intersigmoid hernia (ISH) is a rare condition. Here we describe our experie... more It is well known that intersigmoid hernia (ISH) is a rare condition. Here we describe our experience of laparoscopic surgery for small-bowel obstruction (SBO) due to ISH after sufficient decompression involving long-tube insertion. A 45-year-old woman with no history of abdominal surgery visited our hospital with epigastric pain. She was diagnosed as having SBO and underwent long-tube insertion as conservative therapy. However, her symptoms did not improve. Gastrografin contrast enema via the long-tube demonstrated a beak sign in the lower left abdomen and CT showed incarcerated small bowel was successively covered by sigmoid mesocolon, suggesting that the SBO was due to ISH, and she underwent laparoscopic surgery after sufficient decompression of the dilated small bowel. Intraoperative examination demonstrated incarceration of a loop of the small bowel in the intersigmoid fossa without strangulation. Because the incarcerated portion of the small bowel was not necrotized, herniation repair was performed by removing the incarcerated small bowel from the intersigmoid fossa without closure of the hernia orifice. The postoperative course was uneventful, and the patient is now free of symptoms and recurrence 12 months after surgery. Laparoscopic surgery after sufficient decompression is a useful treatment for SBO due to ISH.
α-taxilin is a binding partner of syntaxins, which are the central coordinators of membrane traff... more α-taxilin is a binding partner of syntaxins, which are the central coordinators of membrane traffic. Expression of α-taxilin has been implicated in the development of human glioblastoma, hepatocellular carcinoma and renal cell carcinoma. In the present study, the clinical significance of α-taxilin expression in colorectal cancer (CRC) was investigated. A total of 20 cases of colorectal intramucosal adenocarcinoma (IMA) with adenoma were analyzed using immunohistochemical analysis. The results demonstrated that α-taxilin expression was significantly associated with Ki-67 indices in adenoma and IMA. The patients expressed equally high levels of α-taxilin in the upper third of the intramucosal glands. These results suggest that α-taxilin expression is significantly associated with the proliferative activity of CRC, but that its overexpression alone is not a biomarker of malignancy. Next, α-taxilin expression was investigated in 57 advanced CRCs and its association with prognosis was determined. Well-differentiated and/or moderately differentiated adenocarcinomas in the left-sided colon with anatomic stage II and/or III were analyzed. α-taxilin expression levels were high on the surface of nearly all tumors, but variable at the deep advancing edge. α-taxilin levels at the advancing edge were not significantly associated with local invasiveness or prognosis. In conclusion, α-taxilin is a cell proliferation marker in colorectal epithelial neoplasms but cannot be a marker of malignancy or prognosis of CRCs.
Background How systemic inflammation-based prognostic scores such as the modified Glasgow Prognos... more Background How systemic inflammation-based prognostic scores such as the modified Glasgow Prognostic Score (mGPS) and neutrophil:lymphocyte ratio (NLR) differ across populations of patients with colorectal cancer (CRC) remains unknown. The present study examined the mGPS and NLR in patients from United Kingdom (UK) and Japan. Methods Patients undergoing resection of TNM I-III CRC in two centres in the UK and Japan were included. Differences in clinicopathological characteristics and mGPS (0-CRP≤10mg/L, 1-CRP>10mg/L, 2-CRP>10mg/L, albumin<35g/L) and NLR (≤5/>5) were examined. Results Patients from UK (n=581) were more likely to be female, high ASA and BMI, present as an emergency (all P<0.01) and have higher T stage compared to those from Japan (n=559).
Background The use of a transnasal fine gastrointestinal fiberscope (TNF-GIF) has been rapidly di... more Background The use of a transnasal fine gastrointestinal fiberscope (TNF-GIF) has been rapidly disseminating in Japan. However, there has been no trial of long tube insertion (LTI) using the TNF-GIF for patients with small bowel obstruction (SBO). Purpose To examine whether TNF-GIF-guided LTI is superior to conventional LTI for patients with clinically diagnosed SBO. Methods The time required for LTI was determined prospectively in each group of patients who underwent the conventional method (group 1, n=10) and the TNF-GIF-guided method (group 2, n=10) between March 2007 and November 2007. Insertion time was compared between groups 1 and 2. Results Insertion time in group 2 was significantly shorter than that in group 1 (group 1, 22±16 min versus group 2, 9.2± 5.4 min; P=0.03). Conclusions Novel TNF-GIF-guided LTI is useful and superior to the conventional method. Keywords Long tube insertion. Small bowel obstruction. Transnasal fine gastrointestinal fiberscope Abbreviations BFS bronchofiberscope LTI long tube insertion NG tube nasogastric tube STI short tube insertion TNF-GIF transnasal fine gastrointestinal fiberscope SBO small bowel obstruction
In the present study, we evaluated the safety and long-term outcome of liver resection for metast... more In the present study, we evaluated the safety and long-term outcome of liver resection for metastatic liver tumor in patients with liver dysfunction. Sixty-one patients, who underwent liver resection for metastatic liver tumor, were retrospectively divided into two groups, based on the retention rate of indocyanine green at 15 minutes (ICGR15). Group 1: ICGR15 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 10% (n = 34), Group 2: ICG R15 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 10% (n = 27). Patient background, perioperative data (operation time, blood loss, duration of Pringle&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s maneuver, volume of resected liver), duration of postoperative hospital stay, and three-year survival rate were compared between the two groups. All data were expressed as median values. There were no differences in patient backgrounds between the two groups. No significant differences were observed betweens Group 1 and 2 for operation time (383.5 vs. 345.0 min), blood loss (390 vs. 296mL), duration of Pringle&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s maneuver (55 vs. 42 min), volume of resected liver (402.5 vs. 110.0 mL), or duration of postoperative hospital stay (26 vs. 26 days). The three-year survival rates in Groups 1 and 2 were 72.9% and 87.8%, respectively (p = 0.937). Liver resection for metastatic liver tumor in patients with liver dysfunction can be performed safely, and the long-term outcome is comparable to that in patients with normal function.
Few studies have examined the relationship between systemic inflammatory response (SIR) and dista... more Few studies have examined the relationship between systemic inflammatory response (SIR) and distant metastasis in patients with T3 colorectal cancer (T3 CRC). Uni-and multivariate analyses were performed in order to evaluate the influence of SIR on distant metastasis in patients with T3 CRC using collected clinical data. Between January 2000 and August 2009, 335 patients with pathologically diagnosed T3CRC were enrolled. Univariate analysis revealed that tumor differentiation, lymphatic invasion, venous invasion, lymph node metastasis, serum carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA 19-9) level, C-reactive protein (CRP) level and the Glasgow Prognostic Score (GPS) were associated with distant metastasis. Multivariate analysis using these selected characteristics disclosed that the CRP level was associated with distant metastasis of T3 CRC, as well as with lymph node metastasis, and CEA and CA19-9 levels. The level of CRP is one of the important clinical characteristics associated with distant metastasis of T3 CRC. Patients and Methods We retrospectively reviewed a database of 335 patients (male:female=222:113) who had undergone elective surgery for T3 CRC, performed by the same trained surgical team at the
We report a case of bleeding in the small intestine of a 59-year-old man that was successfully di... more We report a case of bleeding in the small intestine of a 59-year-old man that was successfully diagnosed and treated by total intraoperative enteroscopy. The patient was admitted to our hospital because of gastrointestinal bleeding. Gastroscopy, colonoscopy and mesenteric arteriography could not identify the bleeding point. Technetium-99m-labeled red blood cell scintigraphy suggested bleeding from the small intestine but could not reveal the precise lesion. As the patient presented melena and went into a state of shock, we performed emergency laparotomy with total intraoperative enteroscopy using a colonoscope. A small ulceration was found at the jejunum, and subsequently partial resection of the jejunum was performed. The lesion was diagnosed histopathologically as angiodysplasia. The patient recovered uneventfully and was discharged on the 24th postoperative day. Bleeding in the small intestine is rare and difficult to diagnose but it sometimes induces a severe condition. Total intraoperative enteroscopy using a colonoscope is effective for detecting the bleeding point in the small intestine and can be performed at most centers without special fiberscopes and techniques.
, under the care of the same trained surgical team and nursing staff. Because all patients underg... more , under the care of the same trained surgical team and nursing staff. Because all patients undergoing CRC surgery received the same treatment, based on a defined clinical path, they also received the same PN regimen via the CVC. Basically, the clinical path stipulated CVC insertion on the day before surgery in patients who had sufficient oral intake. However, most patients for whom oral intake was not 4045
The Groshong catheter (GC) is considered to have a lower risk of central venous catheter-related ... more The Groshong catheter (GC) is considered to have a lower risk of central venous catheter-related bloodstream infection (CVC-RBSI) than conventional catheters because of its valve system (closed-end) for preventing blood reflux. However, few studies have compared the GC with conventional (open-end) catheters in terms of catheter-related complications. To compare the incidence of catheter-related complications including CVC-RBSI between the GC and the Argyle catheter (AC). The GC and the AC were inserted in the same way from the internal jugular vein. Catheter-related complications were evaluated from the database retrospectively. Two hundred seventy GCs were inserted in 123 patients, and 251 ACs were inserted in 135 patients. There were no significant differences in patient background factors between GC and AC use, except for the following two parameters. Use of GC was associated with a longer catheter insertion length and a younger patient age. Univariate analysis revealed that neither type of catheter reduced the incidence of CVC-RBSI. Kaplan-Meier analysis and log rank test revealed no significant difference between the GC and the AC in the period from insertion to development of complications. The GC has no superiority over the conventional AC for preventing CVC-RBSI.
This study was designed to estimate the clinical significance of the C-reactive protein (CRP)/alb... more This study was designed to estimate the clinical significance of the C-reactive protein (CRP)/albumin ratio (CAR) for prediction of postoperative survival in patients with colorectal cancer (CRC). The Glasgow Prognostic Score (GPS), calculated from the serum levels of CRP and albumin, is well known to be a valuable inflammation-based prognostic system for several types of cancer. A recent study has demonstrated that the CAR is also useful for prediction of treatment outcome in patients with hepatocellular carcinoma. Uni- and multivariate analyses using the Cox proportional hazards model were performed to detect the clinical characteristics that were most closely associated with overall survival (OS). All recommended cutoff values were defined using receiver operating characteristic curve analyses. Kaplan-Meier analysis was used to compare OS curves between the two groups. A total of 627 patients who had undergone elective CRC surgery were enrolled. Multivariate analysis using the results of univariate analyses demonstrated that CAR (&amp;amp;amp;amp;gt;0.038/≤0.038) was associated with OS (hazard ratio 2.596; 95 % confidence interval 1.603-4.204; P &amp;amp;amp;amp;lt; 0.001) along with pathological differentiation (others/well or moderately), carcinoembryonic antigen level (&amp;amp;amp;amp;gt;8.7/≤8.7, ng/ml), stage (III, IV/0, I, II), neutrophil to lymphocyte ratio (NLR) (&amp;amp;amp;amp;gt;2.9/≤2.9), and GPS (2/0, 1). Kaplan-Meier analysis and log rank test demonstrated a significant difference in OS curves between patients with low CAR (≤0.038) and those with high CAR (&amp;amp;amp;amp;gt;0.038; P &amp;amp;amp;amp;lt; 0.001). CAR is as useful for predicting the postoperative survival of patients with CRC as previously reported inflammation-based prognostic systems, such as GPS and NLR.
The effect of roughness on the wettability is studied. The rough surface is constructed with phot... more The effect of roughness on the wettability is studied. The rough surface is constructed with photoresist micropatterns which are formed by photolithography. The aspect ratio is defined as the length ratio between the pattern space and its height. Contact angles of three kinds of liquids, pure water, diiodomethane and ethylene glycol, increase and saturate with the increase of the aspect ratio. The wetting behavior of pure water of which higher surface energy is extremely complex.
Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons), 2014
A 35-year-old female patient receiving gynecological treatment for endometriosis was diagnosed as... more A 35-year-old female patient receiving gynecological treatment for endometriosis was diagnosed as having small bowel obstruction due to an ileal tumor. Laparoscopic ileo-cecal resection with D3 lymph node dissection was performed, because preoperative diagnosis was not confirmed. The intraoperative observation showed that there were a lot of blueberry spots in the pelvic space and all such spots were cauterized using power device. Although pathological diagnosis showed a heterotopic endometriosis of the terminal ileum along with a dissected lymph node, there were no malignant findings in the resected specimen including dissected lymph nodes. Laparoscopic surgery would be adequate for such disease, because both curative surgery for small bowel obstruction due to an ileal endometriosis and cauterization for all blueberry spots could be performed at the same time.
We herein report five cases of ulcerative colitis-associated cancer/dysplasia. Although clinical ... more We herein report five cases of ulcerative colitis-associated cancer/dysplasia. Although clinical remission had been achieved in all patients, mucosal inflammation had been resolved in only one patient. Thus, in order to prevent cancer from developing, appropriate medical therapy aiming not only to relieve the clinical symptoms, but also to suppress chronic inflammation appears to be necessary. Moreover, cancer occurred as early as 4 years after the diagnosis in one patient. In patients without complete resolution of mucosal inflammation, careful surveillance colonoscopy should be initiated in the early phase.
To compare the time interval from insertion until development of central venous catheter related ... more To compare the time interval from insertion until development of central venous catheter related bloodstream infection (CVC-RBSI) between patients who received non-routine dressing change group (Group 1) and patients who received routine dressing change group (Group 2). Between March 2006 and July 2008, patients who underwent CVC were randomly divided into Groups 1 and 2. Comparative study between the two groups was performed by reference to the incidences of CVC-RBSI from the prospectively obtained database. One hundred-eighty nine patients underwent 530 CVC insertions. Group 1 had 254 CVCs and Group 2 had 276 CVCs. There were no significant inter-group differences in patient background factors, except for gender. In addition, Group 1 had a shorter duration of catheter insertion than Group 2. Nevertheless, Group 1 had not only a significantly shorter period from insertion until the development of CVC-RBSI but also a higher frequency of fever than Group 2. The results of our compari...
for their study reporting the results of a single-institution phase II study of adjuvant cisplati... more for their study reporting the results of a single-institution phase II study of adjuvant cisplatin, fluorouracil (5-FU), and interferon-͓alpha͔based chemoradiation followed by gemcitabine for patients with resected pancreatic adenocarcinoma. 1 With a median follow-up of 38 months, the authors report a median overall survival of 25 months and actuarial 1-, 2-, and 3-year overall survival rates of 75%, 56%, and 41%, respectively. The authors report in this study that 36 patients (68%) received grade 3 or 4 chemoradiation associated toxicities and 30% (17 patients) required hospitalization for treatment-related toxicities, primarily gastrointestinal toxicity. Our group and others have shown that interferon (IFN) mediate apoptosis pancreatic cancer cell lines through IFN receptors and the caspase cascade. 2,3 In addition, IFNs enhanced cytotoxicity occurred when IFNs were combined with 5-FU and gemcitabine. 2 We also showed that the IFN alpha/beta receptors was expressed in only 25% of patients in the pancreatic cancer tissue. 4 Interestingly, those patients' survival was more favorable, compared with the patients who did not express the IFN alpha/beta receptor. 4 Furthermore, expression of this receptor did not correlate lymphovascular or perineural invasion, lymph node metastases or size, or stage of neoplasm. 4 In addition, expression of this receptor was associated with improved survival for patients with resectable pancreatic cancer who received adjuvant therapy. 5 As IFN-based chemoradiation has been associated with significant toxicity in Linehan 1 and in another study by Virginia Mason group, 6 it is crucial to identify the subset of patient who will benefit from this study. Linehan et al 1 mentioned that they analyzed the tumor specimen from the patients in their trial for expression of interferon receptors and did not find any correlation with expression of these receptors and outcome. Unfortunately, no data was provided. We have several questions in this regard 1 : what type of interferon receptors did they looked for, 2 what technique was used to look for expression of these receptors?
Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional ... more Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional Japanese herbal medicine, improves gastrointestinal (GI) motility in patients undergoing abdominal surgery, few studies have investigated the efficacy of perioperative DKT administration for relief of postoperative ileus (PI) in patients undergoing surgery for GI cancer. Therefore, the aim of this study was to investigate whether perioperative administration of DKT relieves PI in patients with GI cancer. We performed a comprehensive electronic search of the literature (Cochrane Library, PubMed, the Web of Science and ICHUSHI) up to December 2016 to identify studies that had shown the efficacy of perioperative DKT administration for relief of PI in patients with GI cancer. To integrate the individual effect of DKT, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I statistics. ...
It is well known that intersigmoid hernia (ISH) is a rare condition. Here we describe our experie... more It is well known that intersigmoid hernia (ISH) is a rare condition. Here we describe our experience of laparoscopic surgery for small-bowel obstruction (SBO) due to ISH after sufficient decompression involving long-tube insertion. A 45-year-old woman with no history of abdominal surgery visited our hospital with epigastric pain. She was diagnosed as having SBO and underwent long-tube insertion as conservative therapy. However, her symptoms did not improve. Gastrografin contrast enema via the long-tube demonstrated a beak sign in the lower left abdomen and CT showed incarcerated small bowel was successively covered by sigmoid mesocolon, suggesting that the SBO was due to ISH, and she underwent laparoscopic surgery after sufficient decompression of the dilated small bowel. Intraoperative examination demonstrated incarceration of a loop of the small bowel in the intersigmoid fossa without strangulation. Because the incarcerated portion of the small bowel was not necrotized, herniation repair was performed by removing the incarcerated small bowel from the intersigmoid fossa without closure of the hernia orifice. The postoperative course was uneventful, and the patient is now free of symptoms and recurrence 12 months after surgery. Laparoscopic surgery after sufficient decompression is a useful treatment for SBO due to ISH.
α-taxilin is a binding partner of syntaxins, which are the central coordinators of membrane traff... more α-taxilin is a binding partner of syntaxins, which are the central coordinators of membrane traffic. Expression of α-taxilin has been implicated in the development of human glioblastoma, hepatocellular carcinoma and renal cell carcinoma. In the present study, the clinical significance of α-taxilin expression in colorectal cancer (CRC) was investigated. A total of 20 cases of colorectal intramucosal adenocarcinoma (IMA) with adenoma were analyzed using immunohistochemical analysis. The results demonstrated that α-taxilin expression was significantly associated with Ki-67 indices in adenoma and IMA. The patients expressed equally high levels of α-taxilin in the upper third of the intramucosal glands. These results suggest that α-taxilin expression is significantly associated with the proliferative activity of CRC, but that its overexpression alone is not a biomarker of malignancy. Next, α-taxilin expression was investigated in 57 advanced CRCs and its association with prognosis was determined. Well-differentiated and/or moderately differentiated adenocarcinomas in the left-sided colon with anatomic stage II and/or III were analyzed. α-taxilin expression levels were high on the surface of nearly all tumors, but variable at the deep advancing edge. α-taxilin levels at the advancing edge were not significantly associated with local invasiveness or prognosis. In conclusion, α-taxilin is a cell proliferation marker in colorectal epithelial neoplasms but cannot be a marker of malignancy or prognosis of CRCs.
Background How systemic inflammation-based prognostic scores such as the modified Glasgow Prognos... more Background How systemic inflammation-based prognostic scores such as the modified Glasgow Prognostic Score (mGPS) and neutrophil:lymphocyte ratio (NLR) differ across populations of patients with colorectal cancer (CRC) remains unknown. The present study examined the mGPS and NLR in patients from United Kingdom (UK) and Japan. Methods Patients undergoing resection of TNM I-III CRC in two centres in the UK and Japan were included. Differences in clinicopathological characteristics and mGPS (0-CRP≤10mg/L, 1-CRP>10mg/L, 2-CRP>10mg/L, albumin<35g/L) and NLR (≤5/>5) were examined. Results Patients from UK (n=581) were more likely to be female, high ASA and BMI, present as an emergency (all P<0.01) and have higher T stage compared to those from Japan (n=559).
Background The use of a transnasal fine gastrointestinal fiberscope (TNF-GIF) has been rapidly di... more Background The use of a transnasal fine gastrointestinal fiberscope (TNF-GIF) has been rapidly disseminating in Japan. However, there has been no trial of long tube insertion (LTI) using the TNF-GIF for patients with small bowel obstruction (SBO). Purpose To examine whether TNF-GIF-guided LTI is superior to conventional LTI for patients with clinically diagnosed SBO. Methods The time required for LTI was determined prospectively in each group of patients who underwent the conventional method (group 1, n=10) and the TNF-GIF-guided method (group 2, n=10) between March 2007 and November 2007. Insertion time was compared between groups 1 and 2. Results Insertion time in group 2 was significantly shorter than that in group 1 (group 1, 22±16 min versus group 2, 9.2± 5.4 min; P=0.03). Conclusions Novel TNF-GIF-guided LTI is useful and superior to the conventional method. Keywords Long tube insertion. Small bowel obstruction. Transnasal fine gastrointestinal fiberscope Abbreviations BFS bronchofiberscope LTI long tube insertion NG tube nasogastric tube STI short tube insertion TNF-GIF transnasal fine gastrointestinal fiberscope SBO small bowel obstruction
In the present study, we evaluated the safety and long-term outcome of liver resection for metast... more In the present study, we evaluated the safety and long-term outcome of liver resection for metastatic liver tumor in patients with liver dysfunction. Sixty-one patients, who underwent liver resection for metastatic liver tumor, were retrospectively divided into two groups, based on the retention rate of indocyanine green at 15 minutes (ICGR15). Group 1: ICGR15 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 10% (n = 34), Group 2: ICG R15 &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 10% (n = 27). Patient background, perioperative data (operation time, blood loss, duration of Pringle&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s maneuver, volume of resected liver), duration of postoperative hospital stay, and three-year survival rate were compared between the two groups. All data were expressed as median values. There were no differences in patient backgrounds between the two groups. No significant differences were observed betweens Group 1 and 2 for operation time (383.5 vs. 345.0 min), blood loss (390 vs. 296mL), duration of Pringle&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s maneuver (55 vs. 42 min), volume of resected liver (402.5 vs. 110.0 mL), or duration of postoperative hospital stay (26 vs. 26 days). The three-year survival rates in Groups 1 and 2 were 72.9% and 87.8%, respectively (p = 0.937). Liver resection for metastatic liver tumor in patients with liver dysfunction can be performed safely, and the long-term outcome is comparable to that in patients with normal function.
Few studies have examined the relationship between systemic inflammatory response (SIR) and dista... more Few studies have examined the relationship between systemic inflammatory response (SIR) and distant metastasis in patients with T3 colorectal cancer (T3 CRC). Uni-and multivariate analyses were performed in order to evaluate the influence of SIR on distant metastasis in patients with T3 CRC using collected clinical data. Between January 2000 and August 2009, 335 patients with pathologically diagnosed T3CRC were enrolled. Univariate analysis revealed that tumor differentiation, lymphatic invasion, venous invasion, lymph node metastasis, serum carcinoembryonic antigen (CEA) level, carbohydrate antigen 19-9 (CA 19-9) level, C-reactive protein (CRP) level and the Glasgow Prognostic Score (GPS) were associated with distant metastasis. Multivariate analysis using these selected characteristics disclosed that the CRP level was associated with distant metastasis of T3 CRC, as well as with lymph node metastasis, and CEA and CA19-9 levels. The level of CRP is one of the important clinical characteristics associated with distant metastasis of T3 CRC. Patients and Methods We retrospectively reviewed a database of 335 patients (male:female=222:113) who had undergone elective surgery for T3 CRC, performed by the same trained surgical team at the
We report a case of bleeding in the small intestine of a 59-year-old man that was successfully di... more We report a case of bleeding in the small intestine of a 59-year-old man that was successfully diagnosed and treated by total intraoperative enteroscopy. The patient was admitted to our hospital because of gastrointestinal bleeding. Gastroscopy, colonoscopy and mesenteric arteriography could not identify the bleeding point. Technetium-99m-labeled red blood cell scintigraphy suggested bleeding from the small intestine but could not reveal the precise lesion. As the patient presented melena and went into a state of shock, we performed emergency laparotomy with total intraoperative enteroscopy using a colonoscope. A small ulceration was found at the jejunum, and subsequently partial resection of the jejunum was performed. The lesion was diagnosed histopathologically as angiodysplasia. The patient recovered uneventfully and was discharged on the 24th postoperative day. Bleeding in the small intestine is rare and difficult to diagnose but it sometimes induces a severe condition. Total intraoperative enteroscopy using a colonoscope is effective for detecting the bleeding point in the small intestine and can be performed at most centers without special fiberscopes and techniques.
, under the care of the same trained surgical team and nursing staff. Because all patients underg... more , under the care of the same trained surgical team and nursing staff. Because all patients undergoing CRC surgery received the same treatment, based on a defined clinical path, they also received the same PN regimen via the CVC. Basically, the clinical path stipulated CVC insertion on the day before surgery in patients who had sufficient oral intake. However, most patients for whom oral intake was not 4045
The Groshong catheter (GC) is considered to have a lower risk of central venous catheter-related ... more The Groshong catheter (GC) is considered to have a lower risk of central venous catheter-related bloodstream infection (CVC-RBSI) than conventional catheters because of its valve system (closed-end) for preventing blood reflux. However, few studies have compared the GC with conventional (open-end) catheters in terms of catheter-related complications. To compare the incidence of catheter-related complications including CVC-RBSI between the GC and the Argyle catheter (AC). The GC and the AC were inserted in the same way from the internal jugular vein. Catheter-related complications were evaluated from the database retrospectively. Two hundred seventy GCs were inserted in 123 patients, and 251 ACs were inserted in 135 patients. There were no significant differences in patient background factors between GC and AC use, except for the following two parameters. Use of GC was associated with a longer catheter insertion length and a younger patient age. Univariate analysis revealed that neither type of catheter reduced the incidence of CVC-RBSI. Kaplan-Meier analysis and log rank test revealed no significant difference between the GC and the AC in the period from insertion to development of complications. The GC has no superiority over the conventional AC for preventing CVC-RBSI.
This study was designed to estimate the clinical significance of the C-reactive protein (CRP)/alb... more This study was designed to estimate the clinical significance of the C-reactive protein (CRP)/albumin ratio (CAR) for prediction of postoperative survival in patients with colorectal cancer (CRC). The Glasgow Prognostic Score (GPS), calculated from the serum levels of CRP and albumin, is well known to be a valuable inflammation-based prognostic system for several types of cancer. A recent study has demonstrated that the CAR is also useful for prediction of treatment outcome in patients with hepatocellular carcinoma. Uni- and multivariate analyses using the Cox proportional hazards model were performed to detect the clinical characteristics that were most closely associated with overall survival (OS). All recommended cutoff values were defined using receiver operating characteristic curve analyses. Kaplan-Meier analysis was used to compare OS curves between the two groups. A total of 627 patients who had undergone elective CRC surgery were enrolled. Multivariate analysis using the results of univariate analyses demonstrated that CAR (&amp;amp;amp;amp;gt;0.038/≤0.038) was associated with OS (hazard ratio 2.596; 95 % confidence interval 1.603-4.204; P &amp;amp;amp;amp;lt; 0.001) along with pathological differentiation (others/well or moderately), carcinoembryonic antigen level (&amp;amp;amp;amp;gt;8.7/≤8.7, ng/ml), stage (III, IV/0, I, II), neutrophil to lymphocyte ratio (NLR) (&amp;amp;amp;amp;gt;2.9/≤2.9), and GPS (2/0, 1). Kaplan-Meier analysis and log rank test demonstrated a significant difference in OS curves between patients with low CAR (≤0.038) and those with high CAR (&amp;amp;amp;amp;gt;0.038; P &amp;amp;amp;amp;lt; 0.001). CAR is as useful for predicting the postoperative survival of patients with CRC as previously reported inflammation-based prognostic systems, such as GPS and NLR.
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