J Nakamura

Gunma University, Maebashi, Gunma Prefecture, Japan

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Publications (20)35.52 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Spontaneous rupture of the esophagus is a relatively uncommon event, and recurrent rupture is extremely rare. We present a patient who experienced and survived 2 spontaneous perforations of the esophagus, occurring 6 years apart. A 43-year-old man was admitted to our hospital with upper abdominal pain after vomiting. Esophagoscopy, esophagogram, and computed tomography were suggestive of esophageal rupture. Emergency left thoracolaparotomy revealed a 20-mm perforation of the left lower esophageal wall that had been previously repaired. After the perforation was repaired with a single-layer closure, the mediastinum and pleural cavity were drained. The patient recovered well and was discharged from the hospital on postoperative day 29. To the best of our knowledge, only 7 previous cases of recurrent spontaneous esophageal perforation have been reported in the literature.
    Clinical Journal of Gastroenterology 02/2013; 6(1). DOI:10.1007/s12328-012-0356-8
  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 01/2013; 74(11):3022-3027. DOI:10.3919/jjsa.74.3022
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    ABSTRACT: Extramammary Paget's disease (EPD) is rare. We report a case of double anal canal cancers in a patient with a long history of perianal Paget's disease. The patient, a 68-year-old Japanese woman, refused surgery initially and was treated with electron beam therapy, which achieved remission. However, 6 years later, Paget's disease was found to be progressing again and double anal canal tumors were also detected in the proctos and external skin area. We performed abdominoperineal resection (Miles' operation) and lymph node dissection for the Paget's disease with double anal canal tumors. Immunohistochemical staining revealed cytokeratin (CK)-20 expression in the adenocarcinomas and Paget's disease lesion, but not CK-7 or gross cystic disease fluid protein-15 expression. The lesion was joined to the carcinoma by a stalk. The immunohistochemistry results suggested secondary EPD, although it was originally considered to be Paget's carcinoma (primary EPD) based on the clinical history.
    Surgery Today 04/2012; 42(7):697-702. DOI:10.1007/s00595-012-0178-9 · 1.53 Impact Factor
  • Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 01/2011; 72(6):1598-1601. DOI:10.3919/jjsa.72.1598
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    ABSTRACT: Entero-related fistulae are often intractable. Recently, growth factors were generally in sight with the development of regenerative medicine. Basic fibroblast growth factor (bFGF) possesses potent angiogenic activity. In Japan, recombinant bFGF, also known as Trafermin, has been administered for intractable skin ulcer for its strong effect on tissue granulation. Here, we report the effect of bFGF for entero-related fistulae. Two intractable cases were treated by applying bFGF in the fistulae after performing the enterostomy. Case 1: Postoperative intractable vesicorectal fistula was treated by bFGF. 82 days later, fistula was closed. Case 2: Colonic perforation due to ischemic colitis was treated. 37 days after treatment, fistula was closed. In conclusion, in the treatment of the intractable entero-related fistulae, Trafermin was useful for healing the fistulae.
    Hepato-gastroenterology 01/2007; 54(75):803-5. · 0.93 Impact Factor
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    ABSTRACT: Both paclitaxel and S-1 are effective against gastric cancer, but the optimal regimen for combined chemotherapy with these drugs remains unclear. This phase I/II study was designed to determine the maximum tolerated dose (MTD), recommended dose (RD), dose-limiting toxicity (DLT), and objective response rate of paclitaxel in combination with S-1. S-1 was administered orally at a fixed dose of 80 mg m-2 day-1 from days 1 to 14 of a 28-day cycle. Paclitaxel was given intravenously on days 1, 8, and 15, starting with a dose of 40 mg m-2 day-1. The dose was increased in a stepwise manner to 70 mg m-2. Treatment was repeated every 4 weeks unless disease progression was confirmed. In the phase I portion, 17 patients were enrolled. The MTD of paclitaxel was estimated to be 70 mg m-2 because 40% of the patients given this dose level (two of five) had DLT. The RD was determined to be 60 mg m-2. In the phase II portion, 24 patients, including five with assessable disease who received the RD in the phase I portion, were evaluated. The median number of treatment courses was six (range: 1-17). The incidence of the worst-grade toxicity in patients given the RD was 28 and 8%, respectively. All toxic effects were manageable. The response rate was 54.1%, and the median survival time was 15.5 months. Our phase I/II trial showed that S-1 combined with paclitaxel is effective and well tolerated in patients with advanced gastric cancer.
    British Journal of Cancer 01/2007; 95(12):1642-7. DOI:10.1038/sj.bjc.6603497 · 4.84 Impact Factor
  • T Asao · H Kuwano · M Ide · I Hirayama · J Nakamura · K Endo
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    ABSTRACT: The location of a small lesion must be precisely identified during laparoscopic surgery. A gamma probe that is usually used for navigating sentinel lymph nodes was evaluated for its usefulness in locating small gastrointestinal lesions (14 gastric and 10 colonic). A total of 2 mCi of a Tc(99m)-labeled rhenium colloid was injected endoscopically around a tumor 16 h prior to surgery. During operation, the abdominal cavity was scanned using a handheld gamma probe (Navigator GPS, Tyco HealthCare, Norwalk, CT, USA). In all cases, the injection site was identified as the highest spot in the abdominal cavity, with 2585 counts per second on average (range, 910-8800 counts per second). The highest count in a lymph node was 637 per second on average. The gamma probe is a useful tool for identifying small gastrointestinal lesions during open and laparoscopic operations.
    Surgical Endoscopy 09/2003; 17(8):1216-7. DOI:10.1007/s00464-002-8596-1 · 3.26 Impact Factor
  • T Asao · H Kuwano · E Mochiki · J Nakamura · H Shoji · T Shimura · K Fujita
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    ABSTRACT: To extend the usefulness of laparoscopic operations, a secure and easy method for the ligation of large vessels is needed. Herein we describe a novel ligation forceps that can be used as a ligature carrier and knot pusher. A 2-0 suture thread with a knot already tied near one end is hooked in the upper jaw of a novel ligation forceps. After the lower jaw is passed under the vessel or cystic duct, the forceps is closed. When one end of the thread is withdrawn, the knot is trapped in the indentation built into the lower jaw; the ligature is then passed under the pedicle. An extracorporeal ligation can then be performed continuously by the same forceps. The origins of large vessels were ligated safely and easily with this device during 65 laparoscopic procedures (four total colectomies, 12 colectomies, and 49 gastrectomies). Following temporary hemostasis of accidental bleeding with clamping forceps, ligation hemostasis can also be performed using this instrument. This novel ligation forceps permits the secure ligation of vessels or a cystic duct without the need for another device. The proposed method is both easy and inexpensive.
    Surgical Endoscopy 06/2001; 15(5):524-7. DOI:10.1007/s004640080058 · 3.26 Impact Factor
  • Surgical Endoscopy 02/1999; 13(1):91. DOI:10.1007/s004649900908 · 3.26 Impact Factor
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    ABSTRACT: Levels of fucosylated antigens in sera from patients with liver diseases were examined by a newly developed sandwich-type enzyme immuno assay with the aid of anti-fucosylated antigen antibody, YB-2 which reacts simultaneously with Y, Leb and H type 2 antigens. When the cut-off value was set arbitrarily at mean +3 SD values of normal, 30 (69.8%) of the 43 patients with HCC, 14 (53.8%) of the 26 patients with liver cirrhosis (LC) and 24 (45.3%) of the 53 patients with chronic hepatitis (CH) were found to be positive, whereas all of the 30 samples from healthy controls were negative. The levels of alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) in HCC were not correlated with those of YB-2 antigens. The positive rates of the combination YB-2 and AFP assay and YB-2 and PIVKA-II assay in HCC were significantly higher (83.7 and 86.0%, respectively) than that of the AFP and PIVKA-II combination (65.1%) which had been reported to be the best combination up to this time.
    Glycoconjugate Journal 02/1997; 14(1):81-7. DOI:10.1023/A:1018517116368 · 2.52 Impact Factor
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    ABSTRACT: Recent findings regarding abnormalities of the TGF-β receptor and loss of its responsiveness to TGF-β in tumor cells have suggested that this receptor is one of the tumor suppressor genes. Abnormalities of the intracellular signal transduction pathway for TGF-β in tumor cells have also been reported, to which the TGF-β receptor contributes. In order to clarify the tumor suppression mechanism involving the TGF-β receptor, it has become necessary to gain a comprehensive understanding of the series of abnormalities in the signal transduction pathway. In this paper, we discuss the TGF-β receptor and the relationship of cancer to these abnormalities in the signal transduction pathway.
    Annals of Cancer Research and Therapy 01/1997; 6(1):33-37. DOI:10.4993/acrt1992.6.33
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    ABSTRACT: In this study we examined the efficacy of the measurement of IAP (serum ancl peritoneal washings) during the treatment of colorectal cancers, and determined the possible benefits of using the IAP measurements from both serum and peritoneal washings. One hundred and six patients (peritoneal washings: 58, peritoneal fluid: 67) were investigated. Serum IAP levels were significantly higher in patients who underwent complicated surgical procedures which involved greater time and blood loss compared to those patients who underwent less involved surgical procedures with little loss of blood and time. In peritoneal washings, up to 66. 7% of cases with peritoneal dissemination showed elevated levels of IAP in the peritoneal cavity, while 37% of cases with no dissemination at surgery macroscopically had positive IAP levels (8 mg/g protein). The results suggest the value of IAP in determining the need for combined immunochemotherapy for patients in an immunosuppressive environment.
    Anticancer research 07/1996; 16(4B):2269-72. · 1.83 Impact Factor
  • Cancer 01/1996; 77:1694-1700. · 4.89 Impact Factor
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    ABSTRACT: Immunoscintigraphy by 99mTc labeled mouse CEA antibody, BW 431/26, was done for 14 patients with colorectal cancer. All patients underwent body scan 6 and 24 hours after administration of 99mTc antibody, 30 mCi/1mg. In 13 out of 14 cases (92.9%) with colorectal cancer, the specific accumulation of 99mTc was shown. The count ratio between the lesion and normal tissue indicating the accumulation of labeled antibody was calculated as 2.6 to 12.8. The hepatic metastasis could be demonstrated as cold spots in one case and as hot spots in the other case. No adverse reaction was noticed in any of patients examined. These results indicate that immunoscintigraphy by 99mTc-CEA antibody detects carcinoma of the colon excellently, and is quite useful clinically. With SPECT, it is possible to localize the site of the lesion more distinctly and to predict the accumulation of the antibody in the tumor as a treatment application.
    Anticancer research 01/1995; 15(2):471-5. · 1.83 Impact Factor
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    ABSTRACT: In surgery for colorectal cancer, a tendency of immune suppression was noted as seen in surgery for other types of gastro-intestinal cancer. This tendency was also found in the biological response, and it was related to the operative procedures and insults for rectal cancer. The degree of immunosuppression was milder in patients who underwent procedures that preserve the natural sphincter than in those who underwent colostomy. It is important for surgeons to avoid postoperative immunosuppression in order to prevent recurrence and improve prognosis. Given similar degrees of operative insult and stage of cancer, an operative procedure which causes as little immunosuppression as possible should be selected.
    Oncology Reports 09/1994; 1(5):1029-33. DOI:10.3892/or.1.5.1029 · 2.30 Impact Factor
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    ABSTRACT: In this study we investigated the effect of combined administration of UFT and Krestin (PSK) on the growth of intraperitoneal metastasis and temporal changes in the immune-endocrine system under this immunochemotherapy. At 7 days, Plasma ACTH levels of the PSK group were significantly lower than that of the control group (p<0.01). At 14 days, the tumor weight in the combined and the PSK alone group was significantly decreased, compared to the control group (p<0.05). Serum IAP levels of the UFT group were significantly lower than that of the control group (p<0.05). Serum cortisol levels of the combined group were lower than that of the other groups.
    Oncology Reports 07/1994; 1(4):727-30. DOI:10.3892/or.1.4.727 · 2.30 Impact Factor
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    ABSTRACT: A novel monoclonal antibody, YB-2 was obtained after immunization of mice with fucosylated antigens isolated from human saliva. The antibody was demonstrated to react with Y (Fuc alpha 1-->2Gal-beta 1-->4[Fuc alpha 1-->3]GlcNAc beta),Leb (Fuc alpha 1-->2Gal beta 1-->3[Fuc alpha 1-->4]GlcNAc beta) and H type 2 (Fuc alpha 1-->2Gal-beta 1-->4GlcNAc beta) antigens, but not with H type 1 (Fuc alpha 1-->2Gal beta 1-->3GlcNAc beta), Lea (Gal beta 1-->3[Fuc alpha 1-->4]GlcNAc beta), X (Gal beta 1-->4[Fuc alpha 1-->3]GlcNAc beta) or with non-fucosylated antigens. Inhibition assays of YB-2 antibody with such reactive antigens showed that YB-2 antibody preferentially reacted with Y antigen. Formalin-fixed and paraffin-embedded sections prepared from normal and malignant colorectal tissues were examined immunohistochemically with YB-2. The positive rates of staining with YB-2 antibody were 88.6% in malignant and 12.0% in normal tissues. The expression of fucosylated antigens detected by YB-2 antibody seemed to be correlated with survival among patients with primary colorectal cancer. Therefore, YB-2 antibody could be useful as an immunochemical tool for diagnosis and evaluation of the prognosis of colorectal cancer.
    Japanese journal of cancer research: Gann 07/1993; 84(6):641-8.
  • J. Nakamura · T. Asao · S. Takanoshita · Y. Nagamachi
    Nippon Daicho Komonbyo Gakkai Zasshi 01/1993; 46(7):925-929. DOI:10.3862/jcoloproctology.46.925
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    ABSTRACT: The purpose of this study was to evaluate the effect of adjuvant radiotherapy for advanced rectal cancers on the human neuro-immuno-endocrine system. Fifty-seven patients with rectal cancer were investigated. Abdominoperineal resection (APR) was carried out on all of them. The levels of serum IAP in 4-12 weeks after operation were significantly higher in the preoperative radiotherapy group compared with those of non-preoperatively irradiated (p < 0.05). With preoperative radiotherapy, serum IAP levels in patients with postoperative intracavitary cone irradiation returned to normal values within three months of operation; however, those with postoperative external pelvic irradiation continued to be significantly elevated until six months after operation. We conclude that preoperative radiotherapy combined with post-operative external pelvic irradiation is likely to exert unfavorable effects on the human immuno-endocrine system.
    Anticancer research 14(3B):1257-64. · 1.83 Impact Factor
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    ABSTRACT: In this study we investigated temporal changes in both the endocrine system and immunity in rats under immunochemotherapy with 5-FU and Krestine (PSK). This immunochemotherapy was performed on two types of groups, non-cancer-bearing rats and cancer-bearing rats. As hosts, inbred strain WKA/HA 5-week-old male rats and as tumors, transplantable ascitic liver cancer KDH-8 cells were used. Our results indicated that 1) in the non-cancer-bearing rats, 5-FU administration led to an increase in serum cortisol and IAP, however, PSK concurrent administration clearly lowered the levels of cortisol and IAP; 2) in the cancer-bearing rats, the levels of ACTH, cortisol and IAP increased as the cancer progressed, but in the immunothemotherapy administration groups these levels were lower; 3) the immunothemotherapy administration group had greater effects on both tumor growth and liver metastasis.
    In vivo (Athens, Greece) 7(2):131-4. · 0.97 Impact Factor