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Association of anastomotic leakage with long-term oncologic outcomes of patients with esophagogastric junction cancer

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World Journal of Gastrointestinal Surgery 2022年第1期14卷 46-55页

作者： masashi Takeuchi Hirofumi Kawakubo Satoru Matsuda Shuhei Mayanagi Tomoyuki Irino Jun Okui Kazumasa fukuda Rieko Nakamura Norihito Wada Hiroya Takeuchi Yuko Kitagawa Department of Surgery Keio University School of MedicineTokyo 160-8582Japan Department of Preventive Medicine and Public Health Keio University School of MedicineTokyo 160-8582Japan Department of Surgery Hamamatsu University School of MedicineShizuoka 431-3192Japan

BACKGROUND Despite improvements in surgical procedures and peri-operative patients management,the postoperative complications in esophagogastric junction(EGJ)cancer remain high because of technical *** studies have indicated the negative influence of postoperative infectious complications on long-term survival after gastrointestinal ***,no study has shown the association between postoperative complications and long-term survival of patients with EGJ *** To elucidate influence of postoperative complications on the long-term outcomes of patients with EGJ *** A total of 122 patients who underwent surgery for EGJ cancer at the Keio University were included in this *** examined the association between complications and long-term oncologic *** In all patients,the 3-year overall survival(OS)rate was 71.9%,and the recurrencefree survival(RFS)rate was 67.5%.Compared with patients without anastomotic leakage,those with anastomotic leakage had poor median OS(8 mo vs not reached,P=0.028)and median RFS(5 mo vs not reached,P=0.055).Among patients with cervical anastomosis,there were not significant differences between patients with and without anastomotic ***,among patients who underwent intrathoracic anastomosis,patients with anastomotic leakage had significantly worse OS(P=0.002)and RFS(P=0.005).CONCLUSION Anastomotic leakage was significantly associated with long-term oncologic outcomes of patients with EGJ cancer,especially those who underwent intrathoracic *** anastomosis with subtotal esophagectomy may be an option for the patients who are at high risk for anastomotic leakage.

关键词： Esophagogastric junction cancer Complication Long-term outcome

Surgery for gastric cancer patients of age 85 and older: Multicenter survey

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World Journal of Gastroenterology 2017年第7期23卷 1215-1223页

作者： Hirotaka Konishi Daisuke Ichikawa Hiroshi Itoh Kenichiro fukuda Naoki Kakihara Manabu Takemura Kaori Okugawa Kiyoshi Uchiyama masashi Nakata Hiroshi Nishi Toshiyuki Kosuga Shuhei Komatsu Kazuma Okamoto Eigo Otsuji Division of Digestive Surgery Department of SurgeryKyoto Prefectural University of Medicine Department of Surgery North Medical CenterKyoto Prefectural University of Medicine Department of Surgery Saiseikai Shigaken Hospital Department of Surgery Japanese Red Cross Kyoto Daini Hospital Department of Surgery Osaka General Hospital of West Japan Railway Company Department of Surgery Omihachiman Community Medical Center Department of Surgery Kyoto Okamoto Memorial Hospital Department of Surgery Kyoto Yamashiro General Medical Center Department of Surgery Saiseikai Kyoto Hospital

AIM To investigate the surgical therapies for gastric cancer(GC) patients of age 85 or older in a multicenter *** Therapeutic opportunities for elderly GC patients have expanded in conjunction with extended life expectancy. However, the number of cases encountered in a single institution is usually very small and surgical therapies for elderly GC patients have not yet been standardized completely. In the present study, a total of 134 GC patients of age 85 or older who underwent surgery in 9 related facilities were retrospectively investigated. The relationships between surgical therapies and clinicopathological or prognostic features were *** Eighty-nine of the patients(66%) presented with a comorbidity, and 26(19% overall) presented with more than two comorbidities. Radical lymphadenectomy was performed in 59 patients(44%), and no patient received pre- or post-operative chemotherapy. Forty of the patients(30%) experienced perioperative complications, but no surgical or perioperative mortality occurred. Laparoscopic surgery was performed in only 12 of the patients(9.0%). Univariate and multivariate analyses of the 113 patients who underwent R0 or R1 resection identified the factors of p T3/4 and limited lymphadenectomy as predictive of worse prognosis(HR = 4.68, P = 0.02 and HR =2.19, P = 0.05, respectively). Non-cancer-specific death was more common in c Stage Ⅰ patients than in c Stage Ⅱ or Ⅲ patients. Limited lymphadenectomy correlated with worse cancer-specific survival(P = 0.01), particularly in c Stage Ⅱ patients(P < 0.01). There were no relationships between limited lymphadenectomy and any comorbidities, except for cerebrovascular disease(P = 0.07). CONCLUSION N o n- c a n c e r- s p e c i f i c d e a t h w a s n o t n e g l i g i b l e, particularly in c Stage Ⅰ, and gastrectomy with radical lymphadenectomy appears to be an effective treatment for cS tage Ⅱ elderly GC patients.

关键词：胃的癌症老超过 85 外科有限 lymphadenectomy Multicenter 调查

Local Application of Alendronate on <i>β</i>-Tricalcium Phosphate Accelerated Induction of Osteogenesis with Formation of Giant Osteoclast-Like Cell

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Journal of Biomaterials and Nanobiotechnology 2012年第2期3卷 169-177页

作者： Chisako fukuda Norihiro Akiyama Mitsuru Takemoto Shunsuke Fujibayashi masashi Neo Takashhi Nakamura Department of Orthopaedic Surgery Faculty of Medicine Kyoto University Kyoto Japan.

Intrinsic osteoinductivity—the ability to induce bone formation in ectopic sites without addition of osteogenic factors has been reported in various porous materials. Tartrate-resistant acid phosphatase (TRAP)-positive osteoclast-like cells are thought to play an important role in material-induced osteoinduction. To investigate the influence of osteoclastic activity on intrinsic osteoinduction, we loaded alendronate (10–2 , 10–4 , and 10–6 M) onto porous β-tricalcium phosphate (β-TCP) blocks to inhibit osteoclastic activity, and evaluated osteoinductivity by implantation of the blocks into the dorsal muscles of adult beagle dogs. Alendronate-loaded porous β-TCP blocks increased both speed and amount of osteoinduction, as measured 4 weeks after implantation, with the 10–4 M alendronate-loaded β-TCP being especially active. This finding indicates that β-TCP loaded with 10–4 M alendronate might prove crucial in providing the desirable balance between the degradation rate of bone scaffolds and their osteoinductive replacement. Thus, material-induced osteoinduction may be controlled by local application of alendronate, establishing alendronate loading as a promising therapeutic approach.

关键词： Osteoinduction β-tricalcium Phosphate Alendronate Osteoclast Osteogenesis

Late-onset non-islet cell tumor hypoglycemia: A case report

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World Journal of Clinical Cases 2021年第1期9卷 163-169页

作者： Shunichi Matsumoto Eijiro Yamada Yasuyo Nakajima Naoki Yamaguchi Takashi Okamura Toshiki Yajima Satoshi Yoshino Kazuhiko Horiguchi Emi Ishida masashi Yoshikawa Jun Nagaoka Sho Sekiguchi Mai Sue Shuichi Okada Izumi fukuda Ken Shirabe Masanobu Yamada Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashi 371-8511GunmaJapan Division of General Thoracic Surgery Integrative Center of General SurgeryGunma University HospitalMaebashi 371-8511GunmaJapan Department of Endocrinology Diabetes and MetabolismGraduate School of Medicine Nippon Medical SchoolTokyo 1138602Japan

BACKGROUND Hypoglycemia due to non-insulin-producing tumors is referred to as non-islet cell tumor hypoglycemia(NICTH).As NICTH is a rare lesion,the natural course of NICTH is not well *** report a case of NICTH that was observed 30 years before the onset of *** SUMMARY A 50-year-old man was diagnosed with an abnormal right chest shadow during a routine X-ray examination,but no further examination was undertaken because the lesion appeared *** years after the tumor discovery,the patient was admitted to the hospital with symptoms of severe hypoglycemia,which was diagnosed as NICTH based on a complete *** tumor was resected and found to be a solitary fibrous mass(15.6 cm×13.7 cm×10.4 cm);thereafter,the patient’s blood glucose levels normalized and he completely *** NICTH can have an acute onset,even if the tumor has been present and asymptomatic over a long time period.

关键词： Hypoglycemia Non-islet cell tumor hypoglycemia Blood glucose Solitary tumor Late onset Case report Insulin-like growth factor II

Constructing Genetic Linkage Maps Using the Whole Genome Sequence of Pacific Bluefin Tuna (Thunnus orientalis) and a Comparison of Chromosome Structure among Teleost Species

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Advances in Bioscience and Biotechnology 2016年第2期7卷 85-122页

作者： Tsubasa Uchino Yoji Nakamura masashi Sekino Wataru Kai Atushi Fujiwara Motoshige Yasuike Takuma Sugaya Himeko fukuda Motohiko Sano Takashi Sakamoto Faculty of Marine Science Tokyo University of Marine Science and Technology Tokyo Japan Research Center for Aquatic Genomics National Research Institute of Fisheries Science Fisheries Research Agency Yokohama Japan Research Center for Marine Invertebrate Animals National Research Institute of Fisheries and Environment of Inland Sea Fisheries Research Agency Hiroshima Japan

Pacific bluefin tuna (Thunnus orientalis) is one of the most economically important species in the Percomorpha group of teleost fishes. Their migrations are extensive and depend upon continuous swimming at a high rate of speed throughout their life. The draft genome sequence of this species has been reported but remains highly fragmented. We constructed a Pacific bluefin tuna genetic linkage map using microsatellite markers developed on each of the scaffolds from the draft genome sequence to link these genome fragments and understand the genomic structure of species in Percomorpha. Of the 606 polymerase chain reaction microsatellite primer pairs tested, 473 were polymorphic in the mapping populations for the linkage analysis. We constructed sex-specific maps for 24 linkage groups consisting of 470 markers, which allowed us to place scaffolds that cumulatively represented 20.8% (153.8 Mb) of the sequenced genome onto the linkage groups. The distribution of orthologous genes on the chromosomes of tuna and four other teleost fish species suggested that the constitution of tuna chromosomes is closest to that of medaka. Both species have the 24 chromosomes of the ancestral teleost, including several chromosomal inversions. The integrated map developed in this study will be useful to construct a complete physical map to conduct comparative teleost genomics and genetic studies on economically useful traits in Pacific bluefin tuna.

关键词： Pacific Bluefin Tuna Microsatellite Marker Genetic Linkage Map

Proton Beam Therapy for Hepatocellular Carcinoma after the Fontan Procedure

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Journal of Cancer Therapy 2021年第10期12卷 554-562页

作者： Haruko Numajiri masashi Mizumoto Toshiyuki Okumura Nobuyoshi Fukumitsu Naoyuki Hasegawa Kazunori Ishige Kuniaki fukuda Tomoko Ishizu Katsutoshi Tokushige Hideyuki Sakurai Department of Radiation Oncology Proton Medical Research Center University of Tsukuba Hospital Tsukuba Japan Department of Radiation Oncology Kobe Proton Center Kobe Japan Department of Gastroenterology University of Tsukuba Hospital Tsukuba Japan Department of Gastroenterology Kasumigaura Medical Center Tsuchiura Japan Department of Cardiology University of Tsukuba Hospital Tsukuba Japan Department of Internal Medicine Institute of Gastroenterology Tokyo Women’s Medical University Tokyo Japan

Background: Hepatocellular carcinoma (HCC) is more likely to occur in patients with a history of Fontan surgery, possibly due to long-term liver congestion. Proton beam therapy (PBT) may be effective for HCC that develops after Fontan surgery. Methods: Six lesions in 5 patients (3 females, 2 males) received PBT. The median age of the patients was 33 (range 21 - 42) years, and the median age at the time of the Fontan procedure was 6 (5 - 13) years. Four patients had multiple HCC at the time of PBT. The median tumor size was 57 (22 - 80) mm and 4 patients were classified as Child-Pugh B. Two patients received transcatheter arterial chemoembolization before PBT. The schedule of PBT was 66 Gy (RBE) in 10 fractions for 2 lesions, 72.6 Gy (RBE) in 22 fractions for 2 lesions, and 74 GyE (RBE) in 37 fractions for 2 lesions. Results: The median follow-up period was 31 (10 - 46) months, and the numbers of survivors, deaths from primary diseases, and deaths from other diseases were 3, 1, and 1, respectively. There were no local recurrences, one intrahepatic metastasis, one lung metastasis, and one intrathoracic metastasis. Conclusion: Although experiences on a small number of patients cannot conclude things, we believe that PBT can be a reasonable choice of radical treatment for HCC occurring after the Fontan procedure.

关键词： Radiotherapy Proton Beam Therapy Hepatocellular Carcinoma Fontan Pro-cedure

Continued Diagnostic Difficulties in Preoperatively Differentiating Lipiodized Oil and Residual Metallic Material: A Case Report

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Case Reports in Clinical Medicine 2016年第4期5卷 125-129页

作者： masashi Haraguchi Shinichiro Ito Kohei Kotera Aya Fukushima Toshio fukuda Hirotaka Tokai Kazumasa Noda Masataka Hirabaru Toshiyuki Adachi Nobuhiro Tada Keiji Inoue Shinya Onizuka Shigeki Minami Department of Surgery Nagasaki Harbor Medical Center City Hospital Nagasaki Japan Department of Obstetrics and Gynecology Nagasaki Harbor Medical Center City Hospital Nagasaki Japan Department of Radiology Nagasaki Harbor Medical Center City Hospital Nagasaki Japan

Retained foreign objects in the abdomen and pelvis are serious clinical problems yet the imaging required can present difficulties. Prolonged retention of lipiodized oil used for hysterosalpingography over years is very rare. However, lipiodized oil had previously been misdiagnosed as residual metallic material. We are reporting a case in which the latest computed tomography (CT) equipment seemed inadequate for obtaining a clear pre-operative diagnosis. Here, we describe the case of a 33-year-old Japanese female whose pelvis had contained retained lipiodized oil that had been suspected as residual metallic material. The preoperative diagnosis was very difficult and included three-dimensional computed tomography (3D-CT) of unclear results despite expectations of resolution. By laparoscopic surgery, we removed a cyst of approximately 2 cm containing a yellowish oily fluid. Postoperatively, we demonstrated that the fluid was lipiodized oil. A postoperative experiment to attempt distinguishing lipiodized oil from metal through gemstone spectral CT imaging did not offer clarity either. Distinguishing between retained lipiodized oil and metallic material in the abdominal cavity may still present unexpected difficulties even with the latest medical equipments.

关键词： Lipiodized Oil Hysterosalpingography Residual Metallic Material