[Show abstract][Hide abstract] ABSTRACT: We present the case of patient whose splenic cyst was resected using a laparoscopic-assisted approach. A 37-year-old man was admitted to hospital aware of a mass in the left hypochondrium. A cyst, approximately 13 cm long, was found at the lower pole of the spleen. Surgery was selected because of the tumor size, and its associated symptoms. Laparoscopic-assisted partial splenectomy was carried out with a soft coagulation and ultrasonically activated scalpel (harmonic). The patient recovered well and was discharged from the hospital on postoperative day 8. Laparoscopic-assisted surgery using soft coagulation and an ultrasonically activated scalpel was thought to be a useful alternative for splenic cyst.
Preview · Article · Jan 2014 · Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
[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.
No preview · Article · Feb 2013 · Clinical Journal of Gastroenterology
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] 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.
No preview · Article · Apr 2007 · Hepato-gastroenterology
[Show abstract][Hide abstract] 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.
Full-text · Article · Jan 2007 · British Journal of Cancer
[Show abstract][Hide abstract] 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.
No preview · Article · Sep 2003 · Surgical Endoscopy
[Show abstract][Hide abstract] 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.
No preview · Article · Jun 2001 · Surgical Endoscopy
[Show abstract][Hide abstract] ABSTRACT: Based on the results described, the mini-retractor reduces the number of ports required for instruments during video-assisted surgery, thus improving the cost performance and minimal invasiveness of endolaparoscopic surgery.
No preview · Article · Feb 1999 · Surgical Endoscopy
[Show abstract][Hide abstract] 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.
Preview · Article · Jan 1997 · Annals of Cancer Research and Therapy
[Show abstract][Hide abstract] 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.
No preview · Article · Jan 1995 · Anticancer research
[Show abstract][Hide abstract] 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.
No preview · Article · Sep 1994 · Oncology Reports
[Show abstract][Hide abstract] 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.
No preview · Article · Jul 1994 · Oncology Reports
[Show abstract][Hide abstract] 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.
[Show abstract][Hide abstract] 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.