Akihito Abe

Dokkyo Medical University, Totigi, Tochigi, Japan

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Publications (15)29.76 Total impact

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    ABSTRACT: To investigate the clinical utility of the Combination of Platelet count and Neutrophil to Lymphocyte Ratio (COP-NLR) for predicting the postoperative survival of patients undergoing surgery for gastric cancer (GC).
    Journal of Surgical Oncology 08/2014; · 2.64 Impact Factor
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    ABSTRACT: Background: There have been no studies reporting about hepcidin and its relation with stress due to train-ing 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. Introduction Maintaining adequate oxygen-carrying capacity is essential for elite athletes to achieve optimum performance. However, many athletes have low serum iron levels that negatively in-fluence oxygen-carrying capacity. There have been reports that anemia in athletes is related to iron deficiency, but the cause of such iron deficiency remains unknown
    08/2014;
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    ABSTRACT: To investigate the influence of clinical characteristics including nutritional markers on postoperative survival in patients undergoing total gastrectomy (TG) for gastric cancer (GC).
    Anticancer research 08/2014; 34(8):4223-9. · 1.71 Impact Factor
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    ABSTRACT: We propose that needlescopic surgery (NS) should be considered as a way of improving the esthetic result and post-operative quality of life of patients and of reducing costs and stress on surgeons, and we have evaluated the results of NS. We used NS in 157 patients between May 1998 and December 2010: cholecystectomy in 150 patients, marsupialization of splenic and hepatic cysts in 4 and splenectomy in 3, respectively. Under general anesthesia, one 12-mm and two or three 2- or 3-mm ports were introduced into the operative field. The specimen was retrieved from the 12-mm wound using a plastic bag. The procedures were successfully completed in all patients without conversion to an open procedure. In eight (5.3%) of 150 cholecystectomies a change to 5-mm instruments was required. The mean operation times and postoperative hospital stays for cholecystectomy, splenectomy, and marsupialization of splenic and hepatic cysts were 80.2 min and 3.2 days, 167 min and 5.6 days, 170 min and 7 days, and 120 min and 7 days, respectively. There were a few perioperative complications. The most important factor for reducing operation time and achieving a low conversion rate is the use of at least one 3- or 5-mm port for the grasping instruments in cholecystectomy. We recognized a residual cyst requiring splenectomy 62 months after marsupialization in one case. Technical points for performing safe procedures on solid organs were: no direct organ mobilization to avoid organ injuries, the rotation of the operating table and the utilization of organ gravity to create a better operative field, the minimum use of the needlescope to perform a safe maneuver and the improvement of bi-manual technique. NS is a safe and feasible procedure for achieving minimal invasive surgery. We should consider NS as a first choice to treat operable diseases in this laparoscopic era.
    Journal of hepato-biliary-pancreatic sciences. 07/2011; 18(4):516-24.
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    ABSTRACT: We reported a novel technique of sentinel lymph node (SLN) identification using fluorescence imaging of indocyanine green injection. Furthermore, to obtain safe and accurate identification of SLN during surgery, we introduce the image overlay navigation surgery and evaluate its efficacy. This study enrolled 50 patients with a tumors <2 cm in diameter. Initially, we obtained three-dimensional (3-D) imaging from multidetector-row computed tomography (MD-CT) by volume rendering. It was projected on the patient's operative field with the clear visualization of lymph node (LN) through projector. Then, the dye of indocyanine green (ICG) was injected subdermally in the areola. Subcutaneous lymphatic channels draining from the areola to the axilla were visible by fluorescence imaging immediately. Lymphatic flow was reached after LN revealed on 3-D imaging. After incising the axillary skin on the point of LN mapping, SLN was then dissected under the guidance of fluorescence imaging with adequate adjustment of sensitivity and 3-D imaging. Lymphatic channels and SLN were successfully identified by Photodynamic eye (PDE) in all patients. And the sites of skin incision also were identical with the LN being demonstrated by 3-D imaging in all patients. The mean number of SLN was 3.7. The image overlay navigation surgery was visually easy to identify the location of SLN from the axillary skin. There were no intra- or postoperative complications associated with SLN identification. This combined navigations of fluorescence and 3-D imaging revealed more easy and effective to detect SLN intraoperatively than fluorescence imaging alone.
    World Journal of Surgery 10/2010; 35(1):154-8. · 2.23 Impact Factor
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    ABSTRACT: Background: Recently, sentinel lymph node biopsy (SLNB) has been carried out routinely in patients with early breast cancer. Avoidance of axillary lymph node dissection is considerably desirable items of maximizing the quality of life of postoperative patients Here we report non-invasive identification of SLN using indocyanine green (ICG) fluorescence imaging, which provides a high detection rate and a low false-negativity rate. Patients and Methods: One hundred and fifty breast cancer patients with tumors less than 3 cm in diameter were enrolled in this study. ICG dye and indigo carmine were injected subdermally at the same time into the areola. Subcutaneous lymphatic channels draining from the areola to the axilla were immediately rendered visible by fluorescence imagings using a Photodynamic Eye (PDE). After incising the axillary skin over the location of the LN identified by ultrasonography, the SLN was dissected under fluorescence imaging guidance with adequate adjustment of sensitivity. Results: Lymphatic channels and SLN were successfully identified in all patients. The mean number of SLN and the operation time for SLNB were 3.2 and 15.2 min, respectively. Twenty-six patients (17.3%) were found to have lymph node metastases pathologically. Adjustment of the sensitivity of PDE facilitated a reduction in the operation time. There were no intra-or postoperative complications associated with SLN identification. Conclusions: This method is feasible, safe, and only minimally invasive for intraoperative detection of SLN, allowing real-time observation without any need for training.
    The Open Surgical Oncology Journal 01/2010; 2(2).
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    ABSTRACT: We evaluated the usefulness of intraoperative exploration of the biliary anatomy using fluorescence imaging with indocyanine green (ICG) in experimental and clinical cholecystectomies. The experimental study was done using two 40-kg pigs and the clinical study was done in 12 patients for whom cholecystectomy was planned from January 2009 to June 2009. Initially we used a laparoscopic approach for the evaluation of fluorescence imaging of the biliary system in the two pigs. Then the clinical study was started on the basis of these experimental results. ICG (1.0 ml/body of 2.5 mg/ml ICG) was infused 1-2 h before surgery. With the subjects under general anesthesia we observed in real time the condition of the biliary tract under the guidance of fluorescence imaging employing an infrared camera or a prototype laparoscope. ICG was added intravenously to observe the location or flow condition of the cystic artery. We obtained a clear view of the biliary tract and the location of the cystic duct in the two pigs. Local compression with a transparent hemispherical plastic device was effective for offering a clearer view. The biliary tract, except for the gallbladder, was clearly recognized in all clinical subjects. Local compression with a transparent hemispherical plastic device for open cholecystectomy and a flat plastic device for laparoscopy provided clearer visualization of the confluence between the cystic duct and common bile duct or common hepatic duct. The location of the cystic artery was revealed after division of the connective tissues, and the flow condition of the cystic artery was confirmed 7-10 s after intravenous re-infusion of ICG. There were no adverse events related to the intraoperative procedure or the ICG itself. This method is safe and easy for the identification of the biliary anatomy, without requiring cannulation into the cystic duct, X-ray equipment, or the use of radioactive materials. Although fluorescence imaging is still at an early stage of application in comparison with ordinary intraoperative cholangiography, we expect that this method will become routine, offering a lower degree of invasiveness that will help avoid bile duct injury.
    Journal of hepato-biliary-pancreatic sciences. 10/2009; 17(5):595-600.
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    ABSTRACT: Necl-5 is an immunoglobulin-like molecule that was originally identified as a poliovirus receptor. Although Necl-5 expression is often up-regulated in cancer cells, its pathophysiological significance in the development of cancer remains unclear. We investigated the roles of Necl-5 in the development of colitis-associated neoplasia. Necl-5-deficient mice were generated and treated with dimethylhydrazine (DMH) and/or dextran sodium sulphate (DSS) to induce colitis and its associated neoplasias. Colon tissues were examined for histology, Ki-67 expression by immunohistochemistry and K-ras gene mutation. Colon tumours occurred significantly less frequently in heterozygous (Necl-5(+/-)) or homozygous Necl-5-deficient (Necl-5(-/-)) mice than in wild-type (WT) mice with DMH/DSS treatment. Total ulcer index and inflammatory cell infiltration were significantly lower in Necl-5(-/-) mice than in WT mice with DSS alone or DMH/DSS treatment. Colon tumours in both WT and Necl-5(-/-) mice showed high cell proliferation ability but lacked K-ras mutation. The total Ki-67 labelling index in non-neoplastic colon epithelium was significantly higher in WT (45.9 +/- 0.94) than in Necl-5(+/-) (34.3 +/- 1.40) or Necl-5(-/-) (27.7 +/- 1.15) mice with DMH/DSS treatment (p < 0.001). Necl-5 plays a role in the development of colitis-associated cancer by up-regulating colonic mucosal cell proliferation.
    The Journal of Pathology 08/2008; 217(1):42-53. · 7.59 Impact Factor
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    ABSTRACT: We present a novel method for sentinel lymph node (SLN) identification by fluorescence imaging that provides a high detection rate and a low false-negativity rate. Twenty-five breast cancer patients with tumors less than 3 cm in diameter were enrolled. A combination of indocyanine green and indigo carmine was injected subdermally in the areola. Subcutaneous lymphatic channels draining from the areola to the axilla were immediately showed by fluorescence imaging. After incising the axillary skin near the point of disappearance of the fluorescence, the SLN was dissected under fluorescence guidance. In all patients, the lymphatic channels and SLN were successfully visualized. The mean number of fluorescent SLN and blue-dyed SLN were 5.5 and 2.3. Eight patients were found to have lymph node metastases pathologically. All of them were recognized by fluorescence imaging. This method is feasible and safe for intraoperative detection of SLN allowing real-time observation without any need for training.
    American journal of surgery 07/2008; 195(6):850-3. · 2.36 Impact Factor
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    ABSTRACT: Non-steroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors are representative agents for the chemoprevention of sporadic colorectal neoplasia. However, few reports have described the chemopreventive effects of such agents on colitis-associated tumorigenesis. To clarify whether treatment with the COX-2 inhibitor may reduce the risk of colitis-associated neoplasia, we investigated the effect of one such agent, etodolac, on tumorigenesis in the colitis-associated neoplasia model using p53-deficient mice treated with dextran sulfate sodium (DSS). The p53-/- mice were divided into four groups: i) treatment with DSS + etodolac, then after two cycles of DSS, the mice were given distilled water for 84 days. In addition, etodolac was administered three times a week at a dose of 10 mg/kg body weight throughout the experiment. ii) Treatment with two cycles of DSS only, followed by distilled water for 84 days. iii) Treatment with etodolac alone. iv) Distilled water alone was administered to the control group. The incidence of mice with neoplasia was 82.4% in the DSS + etodolac group and 100% in the DSS-alone group. No neoplasia was observed in the etodolac-alone and control groups. The mean (+/- SEM) number of total neoplasias per mouse was 1.29+/-0.2 in the DSS + etodolac group and 3.0+/-0.52 in the DSS-alone group, the inter-group difference being significant (p<0.01). There was no significant difference in the inflammation score between these two groups. These results showed that treatment with etodolac significantly reduced the occurrence of neoplasia, suggesting that this COX-2 inhibitor has chemopreventive activity against colitis-associated tumorigenesis.
    Oncology Reports 03/2008; 19(2):393-9. · 2.30 Impact Factor
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    ABSTRACT: The relationship between the prognosis and the extent of colorectal carcinoma (CRC) is still unclear. As a simple parameter of the local invasion of CRC, we assessed the extent of tumor invasion beyond the outer border of the muscularis propria (MP). We examined 147 cases of CRC using a slight modification of the procedure established by the Japanese Society for Cancer of the Colon and Rectum. For the statistical analysis, the patients were divided into two groups, namely, a "shallow" group and a "deep" group, using a specific cut-off value (COV). A multivariate analysis to identify independent prognostic factors was performed. Significant differences in the 5-year survival rate were observed between the "shallow" and "deep" groups in 39 cases of rectal carcinoma (COV 4 mm; 72.4% vs. 30.0%, hazard ratio = 3.204), but not observed in 147 cases of CRC. In addition, the outcome for patients with "deep" cancer in the lower rectum was markedly worse than that for patients with "shallow" cancer (COV 4 mm; 81.8% vs. 12.5%, hazard ratio = 5.371). The depth of tumor invasion beyond the MP is thus considered to be an important prognostic factor for patients with T3/T4 rectal carcinoma, especially in the lower rectum. A careful follow-up is required for the patients with rectal carcinoma that has invaded more than 4 mm beyond the MP.
    Surgery Today 02/2008; 38(2):115-22. · 0.96 Impact Factor
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    ABSTRACT: Life-threatening gastrointestinal bleeding due to arterio-venous malformation around the pancreatic head is a rare clinical entity. Herein we report a 60-year-old male patient with uncontrolled bleeding from varices of the duodenum due to pancreatic arterio-venous malformation, who was treated by emergency surgery. Upper GI endoscopy revealed bleeding from juxta-ampullary duodenal varices. While contrast-enhanced CT demonstrated a hypervascular mosaic lesion in the region of the pancreatic head, subsequent selective angiography confirmed the presence of the malformation. The patient underwent selective transcatheter arterial embolization, but despite successful embolization of the gastroduodenal artery, bleeding continued and the patient became hemodynamically unstable, at which point he was referred to our department. He underwent an emergency pancreatoduodenectomy with exteriorization of pancreatic juice. During surgery the superior mesenteric vein was very thin (3mm) and was misdiagnosed as a right colic vein, and subsequently divided in this situation. After accomplishing pancreatoduodenectomy, the superior mesenteric vein was reconstructed. During reconstruction of the vein, small bowel congestion became apparent and a temporary porto-systemic bypass was created. Reconstruction was performed by the standard modified Child procedure except for exteriorization of the pancreatic juice. The patient made an uneventful postoperative recovery. Pancreatojejunostomy (2nd stage) was carried out three months after the emergency surgery. Emergency pancreatoduodenectomy is a definitive life-saving procedure when other forms of management such as transcatheter arterial embolization have been exhausted. In this rare situation, the superior mesenteric vein is extremely thin and therefore care should be taken not to damage it.
    Hepato-gastroenterology 01/2008; 55(86-87):1553-6. · 0.77 Impact Factor
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    Journal of Gastroenterology and Hepatology 01/2008; 23(3):498-498. · 3.33 Impact Factor
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    ABSTRACT: Although patients with early colorectal cancer invading the submucosa (CRC-sm) may be treated with endoscopic mucosal resection alone, they generally undergo additional surgery because of the risk of lymph node metastasis. The aims of the present study were to examine the roles of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in tumor vascularization and to investigate whether COX-2 and VEGF expression and tumor vascularity are useful markers for predicting lymph node metastasis in CRC-sm. Twenty-seven resected specimens of CRC-sm with lymph node dissection were examined, and expression of COX-2 and VEGF was evaluated immunohistochemically and scored. Microvessel density (MVD) in CRC-sm tissues was estimated using a Macscope system after CD34 immunostaining. The relationships among clinicopathological parameters, COX-2 and VEGF expression, and MVD in CRC-sm tissues were then analyzed. Scores for COX-2, VEGF and MVD were all significantly higher in patients with CRC-sm with lymphatic invasion or lymph node metastasis. COX-2 score (P < 0.0001) and VEGF score (P = 0.035) were significantly correlated with MVD in CRC-sm tissues. In addition, COX-2 score was significantly correlated with VEGF score in the CRC-sm specimens examined. Both COX-2 and VEGF are involved in tumor vascularization in CRC-sm. COX-2 expression, VEGF expression, and MVD are possible markers for predicting lymph node metastasis in patients with CRC-sm, and use of COX-2 expression may be clinically practical.
    Journal of Gastroenterology and Hepatology 08/2007; 22(7):1071-7. · 3.33 Impact Factor
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    ABSTRACT: Angiolipoma is a common benign tumor with a characteristic vascular component that usually occurs in subcutaneous tissue. Although lipomas are frequently encountered at colonoscopy as submucosal tumors, angiolipomas are rarely found in the gastrointestinal tract including the large intestine. Here we report a 77-year old Japanese man who underwent transanal resection of a tumor that was diagnosed tentatively as a leiomyoma. Histologically, the tumor consisted of mature fat cells and blood vessels. Immunohistochemically, the tumor cells were negative for c-kit and HMB-45, which are consistently expressed in tumors such as gastrointestinal stromal tumor and angiomyolipoma. The tumor was therefore diagnosed as an angiolipoma. This is thought to be the first case report of a surgically resected angiolipoma of the rectum.
    World Journal of Gastroenterology 02/2007; 13(3):467-9. · 2.55 Impact Factor

Publication Stats

144 Citations
29.76 Total Impact Points

Institutions

  • 2007–2014
    • Dokkyo Medical University
      • • Division of Surgical Gastroenterology
      • • Department of Surgery II
      • • Department of Surgical and Molecular Pathology
      Totigi, Tochigi, Japan