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World Journal of Gastrointestinal Surgery 2013年第7期5卷 224-228页

作者： Hideki Suzuki Yasuo Hosouchi Shigeru sasaki Kenichiro Araki Norio Kubo akira Watanabe Hiroyuki Kuwano Department of General Surgical Science (SurgeryⅠ) Gunma University Graduate School of MedicineMaebashi 371-8511 Japan

Despite the advance of diagnostic modalities, carcinoma in the body and tail of the pancreas are commonly presented at a late stage. With unresectable lesions, long-term survival is extremely rare, and surgery remains the only curative option for pancreatic cancer. An aggressive approach by applying extended distal pancreatectomy with the resection of the celiac axis may increase the resectability and analgesic effect but great care must be taken with the arterial blood supply to the liver and stomach. Sometimes, accidental injury to the pancreatoduodenal artery compromises collateral blood flow and leads to fatal complications. Therefore, knowledge of any alternative restoration of the compromised collateral flow before surgery is essential. The present case report shows a patient with a pancreatic body cancer in whom the splenic, celiac, and common hepatic arteries were involved with the tumor, which extended almost to the root of the gastroduodenal artery. We modified the procedure by reanastomosis between the proper hepatic artery and middle colic artery without vascular graft. The postoperative course was uneventful, and the patient was discharged on post-operative day 19. The patient was immediately free of epigastric and back pain.

关键词： Pancreatic body-tail cancer Celiac artery resection Arterial reconstruction

Argon plasma coagulation for superficial esophageal squamous-cell carcinoma in high-risk patients

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World Journal of Gastroenterology 2012年第38期18卷 5412-5417页

作者： Kumiko Tahara Satoshi Tanabe Kenji Ishido Katsuhiko Higuchi Tohru sasaki Chikatoshi Katada Mizutomo Azuma Kento Nakatani akira Naruke Myungchul Kim Wasaburo Koizumi Department of Gastroenterology Kitasato University East Hospital Kanagawa 252-0380 Japan

AIM: To evaluate the usefulness and safety of argon plasma coagulation (APC) for superficial esophageal squamous-cell carcinoma (SESC) in high-risk patients. METHODS: We studied 17 patients (15 men and 2 women, 21 lesions) with SESC in whom endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), and open surgery were contraindicated from March 1999 through February 2009. None of the patients could tolerate prolonged EMR/ESD or open surgery because of severe concomitant disease (e.g., liver cirrhosis, cerebral infarction, or ischemic heart disease) or scar formation after EMR/ESD and chemoradiotherapy. After conventional endoscopy, an iodine stain was sprayed on the esophageal mucosa to determine the lesion margins. The lesion was then ablated by APC. We retrospectively studied the treatment time, number of APC sessions per site, complications, presence or absence of recurrence, and time to ***: The median duration of follow-up was 36 mo (range: 6-120 mo). All of the tumors were macroscopically classified as superficial and slightly depressed type (0-Ⅱc). The preoperative depth of invasion was clinical T1a (mucosal cancer) for 19 lesions and clinical T1b (submucosal cancer) for 2. The median treatment time was 15 min (range: 10-36 min). The median number of treatment sessions per site was 2 (range: 1-4). The median hospital stay was 14 d (range: 5-68 d). Among the 17 patients (21 lesions), 2 (9.5%) had recurrence and underwent additional APC with no subsequent evidence of recurrence. There were no treatment-related complications, such as bleeding or perforation. CONCLUSION: APC is considered to be safe and effective for the management of SESC that cannot be resected endoscopically because of underlying disease, as well as for the control of recurrence after EMR and local recurrence after chemoradiotherapy.

关键词： Argon plasma coagulation Superficial esophageal cancer Squamous-cell carcinoma High-risk patient Endoscopic therapy

Osteoinduction and Osteoconduction with Porous Beta-Tricalcium Phosphate Implanted after Fibular Resection in Humans

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Journal of Biomaterials and Nanobiotechnology 2019年第3期10卷 159-173页

作者： Takashi Ariizumi Hiroyuki Kawashima Hiroshi Hatano Tetsuro Yamagishi Naoki Oike Taro sasaki Hajime Umezu Yongjun Xu Naoto Endo akira Ogose Division of Orthopedic Surgery Niigata University Graduate School of Medical and Dental Sciences Niigata Japan Department of Orthopedic Surgery Niigata Cancer Center Hospital Niigata Japan Division of Pathology Niigata University Hospital Niigata Japan Department of Orthopedic Surgery Harbin Medical University Hospital Harbin China Department of Orthopedic Surgery Uonuma Kikan Hospital Niigata Japan

Osteoinductive properties of β-TCP remain unknown in humans. It is important to improve the bone grafts which have been the standard treatment for bone defect due to their biocompatibility and bone-healing properties. The purpose of this study was to radiologically clarify the bone forming property of β-TCP by evaluating the replacement of β-TCP by newly formed bone in the defect after fibular resection and to examine the histological features of a β-TCP specimen three months after grafting. Radiographs of 17 patients who underwent β-TCP grafting were evaluated. Osteoinductive and osteoconductive properties were assessed by examining bone formation from the remnant fibula, periosteum, and β-TCP alone. In one case, β-TCP was removed later because of postoperative complications and was evaluated histologically. Twenty two of 34 sites between the remnant fibula and β-TCP had achieved good bone regeneration. Five of 14 sites between the periosteum and β-TCP had achieved good bone regeneration. We found immature but evident bone formation in three cases with no osseous and periosteal sites. Histological analysis revealed bone formation on the outer macropore surface of β-TCP. Some blood vessels formed in the macropores expressed CD31 and CD34, while a few lymphatic vessels expressed CD34 and podoplanin. Thus, the osteoinductive ability of β-TCP alone was demonstrated in humans radiographically for the first time. The histological morphology of β-TCP was demonstrated at an early stage after grafting in humans.

关键词： Osteoinduction Osteoconduction Beta-Tricalcium Phosphate Bioactive

Analysis of a Questionnaire Survey regarding Current Conditions against Exposure to Anticancer Drugs and Reports of Cancer Chemotherapy at Outpatient Departments in Japan

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Pharmacology & Pharmacy 2017年第5期8卷 140-152页

作者： Tsuyoshi Shirakawa Tomoko Hara Kojiro Hata Kojiro Hata Kimitaka Suetsugu Hideki Kakimoto Kentaro Ogata Yousuke Ikari Hidenori sasaki Makoto Takahashi Masaru Fukahori Miyuki Uoi Taito Esaki Mikako Hiraike Toshinobu Hayashi akira Tokunaga Norio Ureshino Tsuneo Kuwamura Hitoshi Kusaba Kenji Mitsugi Eishi Baba Department of Pharmacy National Hospital Organization Kyushu Medical Center Fukuoka Japan Department of Oncology Miyazaki Prefectural Miyazaki Hospital Miyazaki Japan Department of Internal Medicine Fukuoka Wajiro Hospital Fukuoka Japan Department of Pharmacy Hamanomachi Hospital Fukuoka Japan Department of Pharmacy Kyushu University Hospital Fukuoka Japan Department of Pharmacy Fukuoka University Hospital Fukuoka Japan Department of Practical Pharmaceutical Science Faculty of Pharmaceutical Sciences Fukuoka University Fukuoka Japan Division of Medical Oncology Hematology and Infection Diseases Fukuoka University Hospital Fukuoka Japan Department of Pharmacy Kurume University Hospital Fukuoka Japan Division of Gastroenterology Kurume University Department of Medicine Fukuoka Japan Department of Pharmacy National Kyushu Cancer Center Fukuoka Japan Department of Gastrointestinal and Medical Oncology National Kyushu Cancer Center Fukuoka Japan Department of Pharmacy National Hospital Organization Kyushu Medical Center Fukuoka Japan Department of Pharmacy Saga-Ken Medical Centre Koseikan Saga Japan Department of Medical Oncology Saga-Ken Medical Centre Koseikan Saga Japan Department of Pharmacy Japan Community Healthcare Organization Kyushu Hospital Fukuoka Japan Department of Medicine and Comprehensive Biosystemic Science Kyushu University Graduate School of Medical Sciences Fukuoka Japan Department of Medical Oncology Hamanomachi Hospital Fukuoka Japan Department of Comprehensive Clinical Oncology Faculty of Medical Sciences Kyushu University Fukuoka Japan

[Background] Medical staff have many occasions to be exposed to anticancer drugs (ACDs) in the process of performing cancer chemotherapy. Although guidelines for the safe handling of ACDs have been published, actual measures against exposure to ACDs differ between hospitals, and no surveillance data regarding the conditions of each hospital in relation to performing chemotherapy in Japan are available. [Methods] To understand current measures against exposure to ACDs and problems related to cancer chemotherapy at outpatient departments, we conducted a questionnaire survey on doctors, pharmacists, and nurses in 10 leading hospitals for cancer chemotherapy in Japan. [Results] Responses were received from all 10 institutions. The hospital pharmacists prepared all ACDs for outpatients in each institution. All hospitals took basic measures against ACD exposure, such as using personal protective equipment and penetration-resistant waste containers. Conditions against exposure to ACDs generally improved between 2012 and 2015, especially in terms of conveyance of ACDs and use of a closed-system drug transfer device. However, no measures linking ACDs with administration routes or injection sites were commonly taken in any of the hospitals in 2015. [Conclusions] Conditions against ACD exposure improved between 2012 and 2015, possibly because new guidelines were issued. To improve measures for ACD exposure in Japan, preparing more appropriate manuals and offering more opportunities to medical staff for continuing education are considered important.

关键词： Exposure Anticancer Drugs Measurement Personal Protective Equipment Outpatient Service