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Absence of asymptomatic unruptured renal artery pseudoaneurysm on contrast-enhanced computed tomography after robot-assisted partial nephrectomy without parenchymal renorrhaphy

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Asian Journal of Urology 2020年第1期7卷 24-28页

作者： Yoichiro Tohi Shiori Murata Noriyuki Makita Issei Suzuki Masashi Kubota Yoshio Sugino Koji Inoue Hiroyuki Ueda Mutsushi Kawakita Department of Urology Kobe City Medical Center General Hospital2-1-1 Minatojimaminami-choChuo-kuKobe CityJapan Department of Diagnostic Radiology Kobe City Medical Center General Hospital2-1-1 Minatojimaminami-choChuo-kuKobe CityJapan

Objective:To assess the incidence of asymptomatic unruptured renal artery pseudoaneurysm(RAP)on contrast-enhanced computed tomography(CE-CT)after robot-assisted partial nephrectomy(RAPN)without parenchymal renorrhaphy.Methods:From May 2016 to December 2017,78 patients underwent RAPN for renal tumors.Inner suture was performed in the opened collecting system or renal sinus,whereas parenchymal renorrhaphy was not.For hemostasis,the soft coagulation system was used,and absorbable hemostats were placed on the resection bed.CE-CT was carried out within 7 days after surgery.Data on these patients were prospectively collected.A single radiologist determined the diagnosis of RAP.Results:Median(range)data were as follows:Patient age,65(19-82)years;radiographic tumor size,30(12-95)mm;operating time,166(102-294)min;warm ischemic time,16(7-67)min;and blood loss,15(0-4450)mL.One patient(1.6%)required a perioperative blood transfusion.No patient required conversion to open surgery or nephrectomy.CE-CT was carried out at median 6(3-7)days after surgery.CE-CT showed no RAP development in all 61 patients.Urinary leakage was not observed.One patient had acute cholecystitis,a postoperative complication classified as Clavien-Dindo grade higher than 3,which was treated with cholecystectomy.Positive surgical margin was identified in four patients(6.6%).Conclusion:RAPN using soft coagulation and absorbable hemostats without renorrhaphy appears to be feasible and safe.Our technique could eliminate the risk of RAP.

关键词： Pseudoaneurysm Partial nephrectomy Robot-assisted Renorrhaphy

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Patellar dislocation following distal femoral replacement after extraarticular knee resection for bone sarcoma:A case report

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World Journal of Clinical Cases 2022年第11期10卷 3561-3572页

作者： Yuta kubota Kazuhiro Tanaka masashi Hirakawa Tatsuya Iwasaki Masanori Kawano Ichiro Itonaga Hiroshi Tsumura Orthopaedic Surgery Oita UniversityYufu City 879-5593OitaJapan

BACKGROUND For the treatment of bone sarcoma in the distal femur,wide-margin resection and knee reconstruction with tumor endoprosthesis are standard therapies.Extraarticular knee resection is required in cases of tumor invasion of the knee joint;however,the incidence of complications,such as aseptic loosening,prosthesis infection,and implant failure,is higher than that following intra-articular knee resection.To the best of our knowledge,there are three reports of patellar dislocations after replacement of a tumor endoprosthesis.CASE SUMMARY A 36-year-old man with no significant past medical history was admitted to our institution with continuous pain in his left knee for 4 mo.An open biopsy was performed,and the patient was diagnosed with a left distal femoral malignant bone tumor.Extra-articular knee resection and knee reconstruction with a tumor endoprosthesis were performed.Although the alignment of the tumor prosthesis was acceptable,knee instability was noticed postoperatively.The axial radiographic view of the patellar and computed tomography showed lateral patellar dislocation at 4 wk postoperatively.The patient had to undergo a lateral release and proximal realignment.He could perform his daily activities at 9 mo postoperatively.Radiography revealed no patellar re-dislocation.CONCLUSION Proximal realignment may be considered during primary surgery if there is an imbalance in the forces controlling the patellar tracking.

关键词： Bone tumor Distal femoral replacement Lateral release Patellar dislocation Proximal realignment Case report

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EB病毒相关淋巴肿瘤的发病机制及FDG PET/CT显像

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中华核医学与分子影像杂志 2018年第2期38卷 150-150页

作者：唐军 Akira Toriihara Reiko Nakajima Ayako Arai masashi Nakadate Koichiro Abe Kazunori kubota Ukihide Tateishi 上海交通大学医学院附属苏州九龙医院核医学科 Department of Diagnostic Radiology and Nuclear Medicine Tokyo Medical and Dental University

EB病毒（EBV）是最常见的病毒之一,在世界范围内有超过90%的成人会感染EBV。一些淋巴肿瘤的基因组已被探明,其组织病理亚型有多种,病史和病程也多变。许多与免疫功能不全相关的B细胞淋巴增殖性疾病都与EBV感染有关。随着器官移植和免疫... 详细信息

EB病毒（EBV）是最常见的病毒之一,在世界范围内有超过90%的成人会感染EBV。一些淋巴肿瘤的基因组已被探明,其组织病理亚型有多种,病史和病程也多变。许多与免疫功能不全相关的B细胞淋巴增殖性疾病都与EBV感染有关。随着器官移植和免疫抑制药物使用的日趋普遍,这些疾病的发病率也越来越高。而且,一些免疫功能正常的人也会患EBV阳性的淋巴瘤。利用;F-脱氧葡萄糖（FDG）PET/CT评价不明原因的全身淋巴结病变患者,其中部分患者应考虑有淋巴肿瘤的可能,需仔细分析其病史和病程。该文描述了EBV相关淋巴肿瘤的发病机制,展示了部分典型病例的;F-FDG PET/CT显像结果,并综述了其他EBV相关疾病（如感染性单核细胞增多症和鼻咽癌）。

关键词： EB病毒 FDG PET/CT 淋巴增殖性疾病淋巴瘤

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Elevation of Serum CA-125 in Mucinous Cystadenoma of the Ovary with Torsion: A Rare Occurrence and Review of the Literature

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Surgical Science 2011年第10期2卷 499-501页

作者： Tadao Okada Shohei Honda Hisayuki Miyagi masashi Minato Kanako C. kubota Akinobu Taketomi Department of Pediatric Surgery Hokkaido University Hospital

Aim: Benign neoplasms of the ovary originating from epithelial tissue are common tumors in adult women. They are, however, rarely seen in children or adolescent girls with elevation of serum carbohydrate antigen- 125 (CA-125). The present report describes a rare case of premenarchal women with a giant mucinous cystadenoma (MCA) of the ovary with torsion complicated with elevation of serum CA-125. Case: A 15-year-old, premenarchal, previously healthy girl was referred to our hospital with a 2-week history of left lower abdominal pain. Physical examinations showed a firm and mobile mass with tenderness in the left lower quadrant. Tumor markers showed CA-125 at 124.1 U/ml. An enhanced computed tomography scan showed a multiloculated tumor that was partly solid, compressing the small intestine, uterus, and urinary bladder, but no signs of organ invasion, lymph node swelling, or ascitis. Via a lower transverse incision, the right Fallopian tube was observed to have twisted 1620。 counterclockwise, and a tense cyst measuring 22.0 × 12.0 × 10.5 cm and weighing 1.78 kg was found in the right ovary. Release from torsion and unilateral salpingo-oophorectomy with tumor removal was performed because blood flow to the right Fallopian tube did not improve after torsion release. The histopathological findings showed an MCA of the ovary without cell dysplasia. The patient did not receive adjuvant chemotherapy following surgery. There was no evidence of recurrence at 2 years. Disucussion: We need to consider MCA of the ovary when there is elevation of the serum CA-125 and an ovarian mass.

关键词： CA-125 Mucinous Cystadenoma of the Ovary Salpingo-Oophorectomy Torsion

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Neuroendocrine carcinoma of the esophagus: Report of a case and review of the literature

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Open Journal of Gastroenterology 2012年第2期2卷 85-90页

作者： Keisuke kubota Akihiro Okada Junko Kuroda masashi Yoshida Nobuto Origuchi Keiichiro Ohta Masayuki Itabashi Yoshiyuki Osamura Masaki Kitajima Department of Gastroenterological Surgery International University of Health and Welfare Mita Hospital Tokyo Japan Department of Pathology International University of Health and Welfare Mita Hospital Tokyo Japan

Esophageal neuroendocrine carcinomas are rare, aggressive and have a poor prognosis. Combined therapy using chemotherapy, radiotherapy and/or surgery appear effective for them. Upper gastrointestinal endoscope of a 65-year-old male revealed a localized ulcerative lesion in the middle esophagus. Histology of biopsy specimens indicated a neuroendocrine carcinoma. A computed tomography showed an esophageal tumor with enlarged mediastinal lymph nodes. The patient was administered neoadjuvant chemo-therapy consisting of 5-fluorouracil and cisplatin, which led to partial response. Subtotal esophagectomy with three-field lymphadenectomy was performed. Pathologically, the tumor was 25 mm and infiltrated the proper muscle layer. The tumor cells were arranged in microtubular structures, with small and round cells containing scanty cytoplasm, and exhibited intense mitosis 51/10 HPF. They were positive for synaptophysin and chromogranin A, and Ki-67 labeling index was 70% - 80%. These findings led to the diagnosis of neuroendocrine carcinoma of small cell type. The patient was administered adjuvant chemotherapy using cisplatin and CPT-11, and he is now alive disease-free at the time of this writing.

关键词： Esophagus Neuroendocrine Carcinoma Surgery Chemotherapy

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Efficacy of 5-Fluorouracil and High-Concentration Cisplatin Suspended in Lipiodol by Short-Term Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

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Journal of Cancer Therapy 2015年第13期6卷 1151-1161页

作者： Yutaka Yata masashi Namikawa Tatsuya Ohyama Takashi Ohsaki Daisuke Kanda Takeshi Hatanaka Kei Shibuya Jun kubota Hitoshi Takagi Terumi Takahara Teruo Yoshinaga Department of Gastroenterology Saiseikai Maebashi Hospital Maebashi-City Japan Department of Radiology Saiseikai Maebashi Hospital Maebashi-City Japan Third Department of Internal Medicine Toyama University Toyama-City Japan

Background: Since advanced hepatocellular carcinoma (HCC) is potentially fatal, and patients’ quality of life (QOL) often deteriorates during their treatment, improving the prognosis and QOL of patients given chemotherapy is very important. In addition, cost-effective treatments are highly desirable when chemotherapy must be given repeatedly. The aim of this study was to evaluate the efficacy and usefulness of 5-fluorouracil (5-FU) and high-concentration cisplatin by short-term hepatic arterial infusion chemotherapy (3-day FPL) in advanced HCC patients. Methods: Thirty patients with unresectable advanced HCC were enrolled. The patients underwent hepatic arterial infusion chemotherapy via the implanted port system with 5-FU on days 1 - 3 and a fine-powder formulation of cisplatin in suspended pre-warmed lipiodol on day 2 every 4 to 10 weeks. Tumor response was assessed one month later with CT. Results: All patients had evidence of portal vein invasion (Vp2-4). Four patients achieved a complete response (CR), 8 patients achieved a partial response (PR), and 7 patients had stable disease (SD). The median progression-free survival (PFS) and overall survival (OS) were 198 days and 452 days, respectively. The OS was significantly longer in the successful disease control group (CR, PR, and SD) than in the progressive disease group (P < 0.005). Conclusions: Three-day FPL was effective and tolerable in advanced HCC patients due to its shorter time of administration than conventional FP therapy. Therefore, repetitive 3-day FPL appears useful and contributes to improving the prognosis and QOL of patients with advanced HCC. In addition, this protocol is a cost-effective treatment.

关键词： Advanced Hepatocellular Carcinoma (HCC) Portal Vein Tumor Thrombosis (PVTT) Hepatic Arterial Infusion Chemotherapy (HAIC) 5-FU a Fine-Powder Formulation of Cisplatin Quality of Life (QOL) Cost-Effective Treatment

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Clinical Outcomes of Patients Who Perform High-Load Activities after Total Hip Arthroplasty in Snowy Agricultural Areas

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Surgical Science 2018年第8期9卷 248-255页

作者： Tetsuya Kawano Hiroaki Kijima Toshiaki Aizawa Shin Yamada Natsuo Konishi Hitoshi kubota Hiroshi Tazawa Takayuki Tani Norio Suzuki Keiji Kamo Yoshihiko Okudera Ken Sasaki masashi Fujii Yosuke Iwamoto Itsuki Nagahata Takanori Miura Naohisa Miyakoshi Yoichi Shimada Department of Orthopedic Surgery Kita-Akita Municipal Hospital Akita Japan Akita Hip Research Group Akita Japan Department of Orthopedic Surgery Akita University Graduate School of Medicine Akita Japan

Background: In snowy agricultural areas, weeding and snow shoveling are essential activities, and sports activities are common recreational activities. Clarifying the relationships between the degrees of these activities after total hip arthroplasty (THA) and the clinical outcomes may enable us to predict the results of THA for high-load activity patients. Methods: The subjects were 227 post-THA patients who were followed up between 2012 and 2014. Patient-reported outcomes were investigated by the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) and a questionnaire on postoperative activity. In addition, the Japanese Orthopaedic Association Hip Score (JOA score) was used to quantify hip function. Results: Patients who resumed activities had significantly higher JOA and JHEQ scores than patients who had given up their activities. However, 25.8% of patients had not resumed weeding with a squatting posture. Furthermore, 20% had not resumed sports activities. The most common reason for giving up these activities was fear of implant failure. Conclusions: If the patients were informed that there is no problem restarting their activities after THA, the patients could resume activities and their clinical outcomes may be improved.

关键词： Total Hip Arthroplasty Postoperative Activities Weeding Snow Shoveling

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