检索结果-南通市图书馆

Erythropoietin ameliorates early ischemia-reperfusion injury following the Pringle maneuver

World Journal of Gastroenterology 2010年第38期16卷 4838-4845页

作者： Masato Kato Tokihiko Sawada junji kita Mitsugi Shimoda Keiichi Kubota Second Department of Surgery Dokkyo Medical UniversityKitakobayash 880

AIM:To investigate the protective effect of erythropoietin (Epo) against ischemia-reperfusion injury (IR/I) following the Pringle maneuver (PM),in comparison with conventional steroid administration in a prospective randomized trial. METHODS:Patients were randomized by age, sex, diagnosis, and surgical method, and assigned to three groups:(1) A steroid group (STRD, n= 9) who received 100 mg of hydrocortisone before PM, and on postoperative days 1, 2 and 3, followed by tapering until postoperative day 7; (2) An EPO1 group (n=10) who received 30 000 U of Epo before the PM and at the end of surgery; and (3) An EPO2 group (n=8) who received 60 000 U of Epo before the PM. Hemoglobin (Hb), hematocrit (Ht), aspartate aminotransferase (AST), alanine transaminase (ALT),lactate dehydrogenase (LDH), lactate, interleukin-6 (IL-6),and tumor necrosis factor(TNF)-α were measured before and just after (Day 0) surgery, and on postoperative days 1, 3, 7 and 14. RESULTS: There were no increases in Hb and Ht in the EPO1 and EPO2 groups. AST was signif icantly lower in EPO1 than in STRD on Day 0 (P=0.041), and lower in EPO1 than in STRD and EPO2 on Day 1 (P=0.018). ALT was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.020) and Day 1 (P=0.004). There were no signif icant inter-group differences in the levels of LDH and lactate. IL-6 was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.0036) and Day 1 (P=0.0451). TNF-α was signif icantly lower in EPO1 than in STRD and EPO2 on Day 0 (P=0.0006) and Day 1 (P<0.0001). Furthermore, hospitalization was signif icantly shorter in EPO1 and EPO2 than in ***:Epo has greater potential than steroids to ameliorate IR/I after the PM. Epo at a dose of 30000 U, administered before PM and just after surgery, yields better results.

关键词： Erythropoietin Hepatic resection Pringle maneuver Steroid Prospective randomized study

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Hepatocellular carcinoma with chronic B-type hepatitis complicated by autoimmune hemolytic anemia:A case report

引用

World Journal of Gastroenterology 2007年第32期13卷 4401-4404页

作者： Toshie Okada Keiichi Kubota junji kita Masato Kato Tokihiko Sawada Department of Gastro-enterological Surgery Dokkyo University School of MedicineTochigiJapan

A 57-year-old man consulted a local hospital because of a persistent slight fever. At the age of 37 years he was diagnosed having B-type hepatitis, but left the liver dysfunction untreated. Twenty years later, he was diagnosed having chronic hepatitis B, hepatocellular carcinoma （HCC） and macrocytic anemia, and referred to our hospital for further investigation. A HCC with a maximum diameter of 5.2 cm was detected in segment 8. Results of blood tests included 1.8 mg/dL serum total bilirubin, 0.9 mg/dL bilirubin, less than 10 mg/dL haptoglobin, 7.9 g/dL hemoglobin, 130 fL MCV, and 14.5% reticuloo/tes. A bone marrow sample showed erythroid hyperplasia. The direct Coombs test gave a positive result. We diagnosed the anemia as autoimmmune hemolytic anemia （AIHA）, for which prednisolone could not be administered due to positivity for HBsAg and HBeAg. After preparation of washed blood cells for later transfusion, the patient underwent systematic resection of segment 8. The cut surface of the resected specimen demonstrated an encapsulated yellow-brownish tumor measuring 52 mmx 40 mm which was diagnosed pathologicaly as moderately differentiated HCC. On the 9th postoperative day, the patient＇s temperature rose to 38℃, and exacerbated hemolysis was observed. The maximum total bilirubin value was 5.8 mg/dL and minimum hemoglobin level was 4.6 g/dL. He tolerated this period without blood transfusion. Currently he is being followed up as an outpatient, and shows no signs of HCC recurrence or symptoms of anemia. AIHA associated with HBV infection has been described in only three previous cases, and the present case is the first in which surgery was performed for accompanying HCC.

关键词： Hepatocellular carcinoma B-type hepatitis Auto-immune hemolytic anemia

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Intraductal papillary neoplasm of the bile duct developing in a patient with primary sclerosing cholangitis: A case report

引用

World Journal of Gastroenterology 2014年第42期20卷 15925-15930页

作者： Hiroyuki Hachiya junji kita Takayuki Shiraki Yukihiro Iso Mitsugi Shimoda Keiichi Kubota Second Department of Surgery Dokkyo Medical University

We report a case of intraductal papillary neoplasm of the bile duct(IPNB) that developed in a patient with primary sclerosing cholangitis. A 46-year-old woman was admitted to our hospital with obstructive jaundice. The liver function tests demonstrated increased serum liver enzyme levels. Computed tomography showed dilatation of the intrahepatic bile ducts. Abdominal ultrasonography revealed a highly echoic protruding lesion in the posterior bile duct near the right lobe of the liver. The lesion was suspected to be IPNB, but we were unable to confirm whether it was a carcinoma. A right hepatectomy was performed, and this showed that the dilated bile duct was filled with mucin and contained several yellowish papillary tumors. Histologically, the neoplastic biliary epithelium showed papillary growth in the dilated lumen. The tumor was diagnosed as IPNB, high-grade intraepithelial neoplasia secreting abundant mucin. No recurrence has been detected 3 years after surgery.

关键词： Intraductal papillary neoplasm of the bile duct Primary sclerosing cholangitis Cholangiocarcinoma High-grade intraepithelial neoplasia Premalignant lesion

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Ectopic hepatocellular carcinoma arising from pancreas: A case report and review of the literature

引用

World Journal of Gastroenterology 2007年第31期13卷 4270-4273页

作者： Keiichi Kubota junji kita Kyu Rokkaku Yoshimi Iwasaki Tokihiko Sawada Johji Imura Takahiro Fujimori Second Department of Surgery Dokkyo University Hospital 880 Kitakobayashi Mibu Tochigi Japan Department of Surgical and Molecular Pathology Dokkyo University Hospital 880 Kitakobayashi Mibu Tochigi Japan

A 56-year-old man was found to have a pancreatic tail tumor. His blood chemistry showed no infection with hepatitis B or C virus and no elevations of tumor markers or pancreatic hormones. Abdominal ultrasound showed an encapsulated, rather heterogeneous, hypoechoic tumor, 6.5 cm in maximum diameter, with a beak sign. Helical dynamic CT revealed an irregularly enhanced tumor with pooling of contrast medium in the delayed phase. Abdominal angiography showed a hypervascular tumor. With a tentative diagnosis of non-functional islet-cell tumor, the patient underwent resection of the pancreatic body and tail with splenectomy. The contour of the liver and its surface were normal. In microscopic examination, tumor cells arranged in a trabecular pattern with focal bile pigment resembling hepatocellular carcinoma (HCC). Immunohistochemically, these tumor cells were positivefor HEPPAR-1, CAM5.2, cytokeratin 18 and COX-2, but negative for MUC-1, and cytokeratins 7, 20 and 8. These results supported a diagnosis of HCC without any adenocarcinoma component. The patient is currently doing well without any signs of recurrence in either the remaining pancreas or liver three years after surgery. We report the rare case with ectopic HCC in the pancreas with a review of the literature.

关键词： Hepatocellular carcinoma Ectopic liver Ectopic hepatocellular carcinoma Pancreas Pancreatictumor Islet-cell tumor

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Gastrectomy for patients with gastric cancer and non-uremic renal failure

引用

World Journal of Gastroenterology 2007年第34期13卷 4589-4592页

作者： Shozo Mori Tokihiko Sawada Kiyoshige Hamada junji kita Mitsugi Shimoda Nobumi Tagaya Keiichi Kubota Second Department of Surgery Dokkyo University School of Medicine Kitakobayashi 880 Mibu Shimotsuga Tochigi 321-0293 Japan

AIM： To investigate the safety and outcome of gastrectomy for patients with gastric cancer and nonuremic renal failure （NURF）.METHODS： One hundred forty-seven patients who underwent gastrectomy for carcinoma were retrospectively divided into two groups： a group with Ccr values of ≥ 50 mL/min （Group 1, n = 110）, and one with Ccr values of ≥ 20 to 〈 50 mL/min （Group 2, n = 37）. Preoperative patient characteristics, intraoperative parameters （including operation time and blood loss）, and postoperative management and complications were evaluated.RESULTS： There were no statistically significant differences between the two groups in operation time （297.9 rnin vs 272.6 rnin, P = 0.137） or blood loss （435 rnL vs 428 rnL, P = 0.078）. The differences in postoperative complications and hospital stay between the groups were not statistically significant. None of the patients in Group 2 required dialysis therapy, and no patients died due to gastrectorny or gastrectorny-related causes. The overall 4-year survival rates in Groups 1 and 2 were 86.6% and 81.8%, respectively （P = 0.48）, and the corresponding 4-year disease-free survival rates for stage I, I, and Ⅲ patients were 88.7% and 83.5%, respectively （P = 0.65）.CONCLUSION： Gastrectomy can be performed as safely in patients with NURF similar to patients with normal renal function.

关键词： Gastric cancer Non-uremic renal failure Gastrectomy Chronic kidney disease

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

eGFR is a reliable preoperative renal function parameter in patients with gastric cancer

引用

World Journal of Gastroenterology 2010年第19期16卷 2417-2420页

作者： Takayuki Kosuge Tokihiko Sawada Yoshimi Iwasaki junji kita Mitsugi Shimoda Nobumi Tagaya Keiichi Kubota Sec-ond Department of Surgery Dokkyo Medical University Kitako-bayashi 880 Mibu Shimotsuga Tochigi 321-0293 Japan

AIM: To evaluate the validity of the estimated glomerular filtration rate (eGFR) as a preoperative renal function parameter in patients with gastric cancer. METHODS: A retrospective study was conducted in 147 patients with gastric cancer. Preoperative creatinine clearance (Ccr), eGFR, and preand postoperative serum creatinine (sCr) data were examined. Preoperative Ccr and eGFR were then compared for their reliability in predicting postoperative renal dysfunction. RESULTS: Among 110 patients with normal preoperative Ccr values, 7 (6.3%) had abnormal postoperative sCr values, and among 112 patients with normal preoperative eGFR values, postoperative sCr was abnormal in 5 (4.5%) (P = 0.53). Among 37 patients with abnormal preoperative Ccr values, 30 (81.1%) had normal postoperative sCr values, and of 35 patients with abnormal preoperative eGFR values, postoperative sCr was normal in 25 (71.4%) (P = 0.34). PreoperativeCcr was signifi cantly correlated with eGFR (r = 0.514), and postoperative sCr was significantly correlated with preoperative Ccr (r = -0.334) and eGFR (r = -0.02). CONCLUSION: Preoperative eGFR is as effective as Ccr for predicting postoperative renal dysfunction. eGFR should therefore be used as an indicator of preoperative renal function in place of Ccr since it is a cheaper and easier to perform test.

关键词： Estimated glomerular filtration rate Creatinine clearance test Gastric cancer

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy

引用

World Journal of Gastroenterology 2009年第18期15卷 2252-2257页

作者： Yoshimi Iwasaki Tokihiko Sawada Shozo Mori Yukihiro Iso Masato Katoh Kyu Rokkaku junji kita Mitsugi Shimoda Keiichi Kubota Department of Gastroenterological Surgery Dokkyo Medical University880 KitakobayashiMibuTochigi321-0293Japan

AIM:To compare creatinine clearance(Ccr) with estimated glomerular filtration rate(eGFR) in preoperative renal function tests in patients undergoing ***:The records of 197 patients undergoing hepatectomy between August 2006 and August 2008 were studied,and preoperative Ccr,a three-variable equation for eGFR(eGFR3) and a five-variable equation for eGFR(eGFR5) were *** values were defined as Ccr < 50 mL/min,eGFR3 and eGFR5 < 60 mL/min per 1.73 *** maximum increases in the postoperative serum creatinine(post Cr) level and postoperative rate of increase in the serum Cr level(post Cr rate) were ***:There were 37 patients(18.8%) with abnormal Ccr,31(15.7%) with abnormal eGFR3,and 40(20.3%) with abnormal *** there were no significant differences in the post Cr rate between patients with normal and abnormal Ccr,eGFR3 and eGFR5 values,the post Cr level was significantly higher in patients with eGFR3 and eGFR5 abnormality than in normal patients(P < 0.0001).Post Cr level tended to be higher in patients with Ccr abnormality(P = 0.0936 and P = 0.0875,respectively).CONCLUSION:eGFR5 and the simpler eGFR3,rather than Ccr,are recommended as a preoperative renal function test in patients undergoing hepatectomy.

关键词： Estimated glomerular filtration rate Creatinine clearance test Hepatectomy Renal functiontest

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Primary hepatic leiomyosarcoma:Case report and literature review

引用

World Journal of Gastrointestinal Oncology 2011年第10期3卷 148-152页

作者： Nairuthya Shivathirthan junji kita Yukihiro Iso Hiroyuki Hachiya Park KyungHwa Tokihiko Sawada Keiichi Kubota Second Department of Surgery Dokkyo Medical University880 Kita KobayashiMibuTochigi 321-0293Japan

Primary hepatic leiomyosarcoma are rare tumors with less than 30 cases reported in the English *** specific presentations and often diagnosis delayed until they reach a large size,is the norm with therapy leading to an often dismal prognosis.A 67-year-old man presented complaining of abdominal pain and a palpable abdominal mass since Jan *** ultrasonography and abdominal computed tomography revealed a large tumor in the left lobe of the *** exploration was undertaken and an extended left hepatectomy with extension onto the dorsal part of segment 8 preserving the MHV with partial resection of segment 6 was *** weight of the resected specimen was 1300 g of the left lobectomy specimen and 8 g of the segment 6 partial resection *** pathology report confirmed the diagnosis of *** immunohistochemistry,the tumor cells were positive for smooth muscle actin *** patient is on regular follow up and is currently 9 mo post resection with no evidence of *** report the case of a resected primary hepatic leiomyosarcoma and emphasize the need for a global database for these rare tumors to promote a better and broader understanding of this less understood subject.

关键词： Primary hepatic leiomyosarcoma Smooth muscle actin Smooth muscle Hepatectomy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：