-
Kengo Kanetaka,
Akihito Enjoji, Junichiro Furui,
Yasuhiro Nagata,
Hikaru Fujioka,
Toshiaki Shiogama,
Akimi Miyata,
Hiroki Kishikawa,
Shigetoshi Matsuo,
Toru Iwata,
Takashi Kanematsu,
Susumu Eguchi
[show abstract]
[hide abstract]
ABSTRACT: Although combination therapy consisting of 5-fluorouracil (5-FU) and cisplatin for the treatment of gastric cancer has been reported, no consistent regimen has been established. Our aim was to determine the optimal treatment schedule of this therapy, for patients with advanced or recurrent gastric cancer.
We conducted a phase II study to evaluate the efficacy and safety of combination therapy consisting of intermittent 5-FU and low-dose cisplatin in 26 patients with advanced or recurrent gastric cancer. The treatment cycle consisted of intravenous cisplatin at 3.3 mg/m(2)/day for 5 consecutive days. 5-FU was administered as a continuous intravenous infusion at 300-500 mg/body every other day (days 1, 3, 5) for 4 weeks.
The partial response rate was 34.6%. The median survival duration was 12.8 months and the one-year survival was 53.1%. There were a few adverse effects.
Our results suggest that this mode of combination therapy led to a fairly favorable outcome for patients with advanced or recurrent gastric cancer.
Anticancer research 08/2012; 32(8):3495-9. · 1.73 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Hepatocellular carcinoma accompanied by portal hypertension and hypersplenism is difficult to treat medically and surgically due to pancytopenia and the development of collateral circulation. In this study, we were able to safely and simultaneously perform a laparoscopically-assisted splenectomy and partial hepatectomy. The characteristics of this procedure include: (1) the shared use of a medial wound made through laparoscopically-assisted surgery; (2) improved safety for manipulating areas that were difficult to observe with a camera in a case of splenomegaly; (3) a preventive ligation of the splenic artery; (4) improved hemostatic function using LigaSure Impact; and (5) hemorrhage control through manual manipulations and the Pringle maneuver during liver parenchymal transection. The surgery was safely performed using the above points.
Surgery Today 03/2011; 41(3):444-7. · 1.22 Impact Factor
-
Yujo Kawashita,
Akira Ohtsuru,
Hikaru Fujioka,
Yukio Kamohara,
Yasushi Kawazoe,
Nozomu Sugiyama,
Susumu Eguchi,
Hiroaki Kuroda, Junichiro Furui,
Shunichi Yamashita,
Yasufumi Kaneda,
Takashi Kanematsu
[show abstract]
[hide abstract]
ABSTRACT: Establishment of a bioartificial liver support system using genetically modified hepatocytes is a potential approach to improve the treatment of severe liver failure. We describe the development of an efficient ex vivo method of gene transfer into a large number of porcine hepatocytes using hemagglutinating virus of Japan (HVJ)-liposome. The transfection efficiency of HVJ-liposome into isolated porcine hepatocytes attached to microcarrier beads was evaluated by β-galactosidase (β-gal) staining, fluorescence activated cell sorting analysis for β-gal and luciferase assay, respectively. To examine the function and cellular damage of transduced hepatocytes, we used enzyme-linked immunosorbent assay for porcine albumin synthesis, lidocaine clearance test (P-450 activity), aspartate aminotransferase, and lactic dehydrogenase release assays. The optimal conditions for gene transfer into the beads-attached hepatocytes using HVJ-liposome included 4 μg of deoxyribonucleic acid with 200 μg of lipid/2 × 105 cells and exposure duration of 90 min. Under these conditions, β-gal and luciferase genes were transduced to 2.5 × 108 isolated porcine hepatocytes following attachment to the beads. Positive β-gal staining was observed in more than 30% of the beads-attached hepatocytes. The gene transfer activity of HVJ-liposome method determined by luciferase activities was about 100-fold of that of the lipofection method. Transfected porcine hepatocytes remained functional without any significant cell damage. Our results demonstrated that HVJ-liposome mediated gene transfer into microcarrier-attached porcine hepatocytes is an efficient and nontoxic method suitable for a bioartificial liver support sytem.
Artificial Organs 07/2008; 24(12):932 - 938. · 2.00 Impact Factor
-
Pancreas 05/2008; 36(3):324-7. · 2.39 Impact Factor
-
European Journal of Emergency Medicine 05/2007; 14(2):118-9. · 0.90 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Rectal carcinoids comprise only about 1% of all anorectal neoplasms. In addition, ganglioneuroma of the gastrointestinal tract is a rare tumor composed ganglion cells, nerve fibers, and supporting cells. Multiple carcinoid tumors with diffuse ganglioneuromatosis limited to the rectum are quite unusual.
A 69-year-old man was referred to us because of about 100 small submucosal rectal tumors. He underwent abdominoperineal resection. Pathology revealed carcinoid tumors for about 30 submucosal nodules and diffuse ganglioneuromotosis. To date (6 months later) he remains well with no recurrence.
Although the optimal treatment for the multiple rectal carcinoids remains to be clearly established, it is believed that not all patients with multiple rectal carcinoids (measuring less than 1 cm in diameter) need to have a radical operation. However, the treatment plan for each case should be individualized and a careful follow-up is mandatory.
World Journal of Surgical Oncology 02/2007; 5:19. · 1.12 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A 71-year old woman who underwent a modified radical mastectomy for invasive ductal carcinoma of the left breast, developed postoperative chylous leakage. Though conservative management was uneffective, a direct surgical repair led to good results. Because the morbidity of a reoperation to the superficial chest wall is low, timely surgical treatment is therefore strongly recommended in cases of high output chylous leakage following a mastectomy.
The Breast 11/2006; 15(5):677-9. · 2.49 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We herein report the case of an idiopathic liver cystic mass which aggressively infiltrated the thoraco-abdominal wall. A 74-year-old woman who had a huge cystic lesion in her right hepatic lobe was transferred to our hospital for further examinations. Imaging studies revealed a simple liver cyst, and the cytological findings of intracystic fluid were negative. She was followed up periodically by computed tomography (CT) scans. Seven years later, she complained of a prominence and dull pain in her right thoraco-abdominal region. CT revealed an enlargement of the cystic lesion and infiltration into the intercostal subcutaneous tissue. We suspected the development of a malignancy inside the liver cyst such as cystadenocarcinoma, and she therefore underwent surgery. A tumor extirpation was performed, including the chest wall, from the 7th to the 10th rib, as well as a right hepatic lobectomy. Pathologically, the lesion consisted of severe inflammatory change with epithelioid cell granuloma and bone destruction without any malignant neoplasm. No specific pathogens were evident based on further histological and molecular examinations. Therefore the lesion was diagnosed to be a destructive granuloma associated with a long-standing hepatic cyst. Since undergoing surgery, the patient has been doing well without any signs of recurrence.
World Journal of Gastroenterology 04/2006; 12(11):1798-801. · 2.47 Impact Factor
-
The Journal of trauma 05/2005; 58(4):863-6. · 2.48 Impact Factor
-
Gastrointestinal Endoscopy 02/2005; 61(1):109-10. · 4.88 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A 56-year-old man diagnosed a having multiple hepatocellular carcinoma (HCC) with liver cirrhosis underwent transcatheter arterial embolization (TAE). Five months later, recurrent HCC was detected in the liver as well as in the left adrenal gland. A second TAE was performed to treat the intrahepatic recurrence, which was followed by hand-assisted laparoscopic surgery (HALS) for the metastatic tumor in the left adrenal gland. The combination of the two procedures successfully controlled HCC. To our knowledge, this is the first report describing an adrenalectomy by HALS for adrenal metastasis from an HCC.
Surgery Today 02/2005; 35(2):172-4. · 1.22 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Parapapillary choledochoduodenal fistula is a rare disorder. We herein report a case of parapapillary choledochoduodenal fistula associated with cholangiocarcinoma. A 61-year-old woman was admitted to our hospital for further examination of a liver tumor. She had no clinical symptoms, but computed tomography scans showed an irregularly contoured liver tumor which was histologically confirmed to be adenocarcinoma, by a needle biopsy examination. Duodenal fiberscopy revealed a fistula orifice 1.0 cm proximal to the orifice of the papilla of Vater, and endoscopic retrograde cholangiography through the fistula showed a communication to the common bile duct. Hypotonic duodenography demonstrated reflux of contrast material into the choledochoduodenal fistula. The bile sample collected from the common bile duct showed extremely high levels of pancreatic enzymes, including amylase, phospholipase-A2, and elastase-I. Furthermore, Helicobacter DNA was detected in bile by polymerase chain reaction (PCR) analysis. This experience suggests to us that parapapillary choledochoduodenal fistula may be a risk factor for biliary tract carcinoma, and surgical management is the treatment of choice for this rare condition, even when the patient has no significant clinical symptoms.
Journal of Hepato-Biliary-Pancreatic Surgery 02/2005; 12(2):143-6. · 1.60 Impact Factor
-
Gastrointestinal Endoscopy 10/2004; 60(3):463-7. · 4.88 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We attempt to quantify the amount of peritoneal irrigation required to significantly decrease the intraperitoneal bacteria in children with perforated appendicitis, as no ideal volume of peritoneal lavage has yet been determined. A series of 11 children who were operated on for peritonitis caused by perforated appendicitis were reviewed retrospectively. All children were treated with our treatment protocol that included intraoperative peritoneal lavage using a large volume of saline. Peritoneal fluid samples were taken before and after peritoneal lavage and then were cultured to determine the colony counts. Twenty of 24 bacteria were available for evaluation of the changes in the flora counts. We found 85% of species to be resistant to peritoneal lavage when 3-5 l of saline per square meter of body surface area (l/m2) were used. In contrast, 5.8+/-1.54 l/m2 of peritoneal lavage fluid was necessary to completely eradicate the intraperitoneal bacterial flora. The residual bacteria showed a greater decrease when lavage fluid in excess of 6 l/m2 was used. Although this is only a preliminary report, these findings could be used to justify a true prospective randomized trial in the future.
Pediatric Surgery International 08/2004; 20(7):534-7. · 1.25 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We report a case of toxic megacolon associated with fulminant pseudomembranous colitis. A 72-year-old woman was admitted with severe dehydration and shock. Computed tomography showed evidence of diffuse thickening of the colonic wall, colonic dilatation and ascites. She underwent transverse colostomy and received postoperative vancomycin, both orally and by administration from the stoma. Her clinical situation improved dramatically following surgery. When a patient is unable to tolerate subtotal colectomy and ileostomy because of a severe overall condition, temporary colostomy followed by administration of vancomycin through the stoma is recommended.
Asian Journal of Surgery 08/2004; 27(3):236-7. · 0.57 Impact Factor
-
Yoshitsugu Tajima,
Kenzo Fukuda,
Noritsugu Tsuneoka,
Ryuji Tsutsumi,
Tamotsu Kuroki,
Shinya Onizuka, Junichiro Furui,
Shizuo Yamanaka,
Yasushi Makimoto,
Ryoichi Tsuchiya,
Takashi Kanematsu
The American Journal of Surgery 07/2004; 187(6):741-2. · 2.78 Impact Factor
-
Transplantation 06/2004; 77(9):1477-8. · 4.00 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: At present, little information is available on the outcome of medical therapy for patients with acute right colonic diverticulitis, and this has meant a gap in constructing guidelines for its treatment.
The records of patients with acute right colonic diverticulitis at Nagasaki University Graduate School and affiliated hospitals were reviewed and analyzed with the goal of establishing therapeutic guidelines. The time frame of the data analyzed was from 1984 to 2002.
Of the 81 patients included in the data, 80 patients who were suffering a first attack were successfully treated with bowel rest and antibiotics. Two of these 80 patients underwent an elective operation at the surgeon's discretion during the original hospitalization and 1 (1.2%) needed an urgent operation. Of the 78 patients who responded to medical therapy, 16 (20.5%) developed recurrent right colonic diverticulitis. All 16 patients who had a second attack were successfully treated with medical therapy. Three of the 16 patients underwent an elective operation during this rehospitalization period. Of the 13 patients who had had a second attack and had responded to medical therapy, there was a third attack in 2 patients (15.4%). Both of these patients were again successfully treated with medical therapy. There has been no morbidity and no mortality related to recurrence to date. The average time from the first attack to us contacting the patient was 35.2 months.
Unlike acute uncomplicated left colonic diverticulitis, our findings indicate that after two documented episodes, medical treatment alone rather than elective surgery may be considered as an effective guideline for the treatment of acute uncomplicated right colonic diverticulitis.
The American Journal of Surgery 03/2004; 187(2):233-7. · 2.78 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The authors report on an 11-month-old girl who presented with a hepatoblastoma. The tumor was located in Couinaud's segments IV, V, VII, and VIII. She received adjuvant chemotherapy in accordance with the Japanese Study Group for Pediatric Liver Tumor Protocol-2, and the tumor thereafter showed a partial response, involving segments IV and VIII. She thereafter underwent a modified central bisegmentectomy (segments IV, VIII, and a part of V). The postoperative course was uneventful, and the patient is now doing well 22 months after the operation. The authors consider the central bisegmentectomy to be a volume-saving operation, and, based on a volumetric analysis, the estimated preserved volume of the functioning liver parenchyma was determined to be 87%. However, if using a right trisegmentectomy, the preserved volume was estimated to only be 44%. The authors consider a central bisegmentectomy to be a useful alternative operation for patients with centrally located hepatoblastoma to minimize both morbidity and mortality.
Journal of Pediatric Surgery 02/2004; 39(1):E13-6. · 1.45 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Changes in the serum concentration of hepatocyte growth factor (HGF), a potent mitogen for hepatocytes, were investigated in adult-to-adult living-donor liver transplantation (LDLT) in which liver regeneration is involved. Between August 2000 and November 2002, 15 consecutive adult-to-adult LDLTs were performed using the right lobe graft. The recipients were divided into two groups: acute liver failure (n=6) and chronic liver failure (n=9). In addition, right lobe donors (n=12) were evaluated. Measurement of HGF was performed on preoperative and postoperative days 1, 3, 7, and 14 after LDLT. The pretransplant levels of serum HGF were higher in the acute liver failure group than in the chronic liver failure group (P<0.05). After liver replacement, serum HGF levels normalized rapidly in both groups and remained rather low. Despite vigorous liver regeneration in all groups, serum HGF levels did not change significantly after adult-to-adult LDLT with right lobe graft.
Transplantation 01/2004; 76(12):1769-70. · 4.00 Impact Factor
