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Open Journal of Modern Neurosurgery 2018年第3期8卷 276-281页

作者： yuji Endo Naoki Sato Hidekazu Takahashi Mamoru ota Toshihito Ishikawa Katsuhiro Endo Kenichi Ebihara Department of Neurosurgery Masu Memorial Hospital Fukushima Japan Department of Neurosurgery Ageo Central General Hospital Saitama Japan

We herein report on a case in which magnetic resonance angiography (MRA) following carotid endarterectomy revealed the appearance of angiostenosis due to an artifact of metallic powder, which was thought to have come from an old surgical instrument. The patient was a 77-year-old male. Carotid endarterectomy (CEA) was performed for stenosis in the internal carotid artery of his left neck (82%). Upon observing a decline in renal function following CEA surgery, a postoperative cervical MRA revealed the appearance of high-grade stenosis at the common carotid artery on which surgery was performed. No stenosis was revealed upon carotid ultrasonography and angiography. In the original MRA image, an orbicular low intensity area was observed in concordance with the narrow segment. 3D computed tomography (3D-CT) revealed a metallic finding, suggesting it was an artifact caused by metal powder. Close inspection of the metal surgical instruments used during surgery revealed slight damage to a suture snare which had been used for 30 years. Going forward, it is necessary to pay attention to old surgical instruments, introduce a system by which the number of years and the frequency of use of each surgical instrument can be learned, and replace them with new equipment as necessary.

关键词： Carotid Endarterectomy Operation Metal Artifact Surgical Instruments

Successful Surgical Treatment of Metachronous Oligometastases from Non-B, Non-C Hepatocellular Carcinoma

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Open Journal of Thoracic Surgery 2016年第2期6卷 7-11页

作者： Haruchika Yamamoto yuji Hirami Tomohiro Toji Yoko Shinno Tetsuya ota Minoru Naito Akio Andou Department of General Thoracic Surgery National Hospital Organization Okayama Medical Center Okayama Japan Department of Pathology National Hospital Organization Okayama Medical Center Okayama Japan Department of General and Gastroenterological Surgery National Hospital Organization Okayama Medical Center Okayama Japan

Hepatocellular Carcinoma (HCC) rarely metastasizes to bone or mediastinum. In some patients, surgical treatment of oligometastatic lesions from colorectal cancer, breast cancer, or non-small cell lung cancer results in satisfactory survival. However, data concerning oligometastatic lesions from HCC are scarce. We report the case of a patient with long-term survival after resection of metachronous oligometastases of HCC. A 54-year-old woman underwent hepatic resection for non-B, non-C HCC. A solitary left tenth rib tumor was detected 20 months after initial surgery and was surgically resected. A solitary mediastinal tumor was detected 6 months after the second operation and the patient again underwent surgical resection. Histopathological examination of both lesions confirmed metastasis of HCC. The patient has had no further recurrence 7 years after initial surgery without chemotherapy or radiotherapy.

关键词： Hepatocellular Carcinoma Mediastinal Metastases Rib Metastases Oligometastases

Successful resection of metachronous para-aortic, Virchow lymph node and liver metastatic recurrence of rectal cancer

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World Journal of Gastroenterology 2015年第44期21卷 12722-12728页

作者： Nobuyoshi Takeshita Toru Fukunaga Masayuki Kimura yuji Sugamoto Kentaro Tasaki Isamu Hoshino Takumi ota Tetsuro Maruyama Tomohide Tamachi Takashi Hosokawa Yo Asai Hisahiro Matsubara Department of Surgery Numazu City Hospital Department of Frontier Surgery Chiba University Graduate School of Medicine

A 66-year-old female presented with the main complaint of defecation trouble and abdominal distention. With diagnosis of rectal cancer, c SS, c N0, c H0, c P0, c M0 c Stage Ⅱ, Hartmann's operation with D3 lymph node dissection was performed and a para-aortic lymph node and a disseminated node near the primary tumor were resected. Histological examination showed moderately differentiated adenocarcinoma, p SS, p N3, p H0, p P1, p M1(para-aortic lymph node, dissemination) f Stage Ⅳ. After the operation, the patient received chemotherapy with FOLFIRI regimen. After 12 cycles of FOLFIRI regimen, computed tomography(CT) detected an 11 mm of liver metastasis in the posteroinferior segment of right hepatic lobe. With diagnosis of liver metastatic recurrence, we performed partial hepatectomy. Histological examination revealed moderately differentiated adenocarcinoma as a metastatic rectal cancer with cut end microscopically positive. After the second operation, the patient received chemotherapy with TS1 alone for 2 years. Ten months after the break, CT detected a 20 mm of paraaortic lymph node metastasis and a 10 mm of lymph node metastasis at the hepato-duodenal ligament. With diagnosis of lymph node metastatic recurrences, we performed lymph node dissection. Histological examination revealed moderately differentiated adenocarcinoma as metastatic rectal cancer in paraaortic and hepato-duodenal ligament areas. After the third operation, we started chemotherapy with modified FOLFOX6 regimen. After 2 cycles of modified FOLFOX6 regimen, due to the onset of neutropenia and liver dysfunction, we switched to capecitabine aloneand continued it for 6 mo and then stopped. Eleven months after the break, CT detected two swelling 12 mm of lymph nodes at the left supraclavicular region. With diagnosis of Virchow lymph node metastatic recurrence, we started chemotherapy with capecitabine plus bevacizumab regimen. Due to the onset of neutropenia and hand foot syndrome(Grade 3), we managed

关键词： Rectal cancer Surgical resection Virchow lymph nod

Safety and efficacy of metallic stent for unresectable distal malignant biliary obstruction in elderly patients

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World Journal of Gastroenterology 2018年第1期24卷 69-75页

作者： yuji Sakai Tomohisa Iwai Kenji Shimura Katsushige Gon Kazuya Koizumi Masashi Ijima Kazuro Chiba Seigo Nakatani Harutoshi Sugiyama Toshio Tsuyuguchi Terumi Kamisawa Iruu Maetani Mitsuhiro Kida Department of Gastroenterology and Nephrology Graduate School of MedicineChiba UniversityChiba 260-8670Japan Department of Gastroenterology Kitasato University School of MedicineKanagawa 252-0375Japan Department of Gastroenterology Asahi Central HospitalChiba 289-2511Japan Division of Gastroenterology and Hepatology Department of Internal MedicineToho University Ohashi Medical CenterTokyo 153-8515Japan Gastroenterology Medicine Center Shonan Kamakura General HospitalKanagawa 247-8533Japan Department of Gastroenterology Subaru Health Insurance Society Ota Memorial HospitalGunma 373-8585Japan Department of Gastroenterology Tokyo Metropolitan Cancer and Infectious Diseases CenterKomagome HospitalTokyo 113-8677Japan

AIM To study the safety of insertion of metallic stents in elderly patients with unresectable distal malignant biliary *** Of 272 patients with unresectable distal malignant biliary obstruction, 184 patients under the age of 80 were classified into Group A, and 88 subjects aged 80 years or more were classified into Group B. The safety of metallic stent insertion, metal stent patency period, and the obstruction rate were examined in each *** In Group B, patients had a significantly worse per-formance status, high blood pressure, heart disease, cerebrovascular disease, and dementia; besides the rate of patients orally administered antiplatelet drugs or anticoagulants tended to be higher(P < 0.05). Metallic stents were successfully inserted in all patients. The median patency period was 265.000 ± 26.779(1-965) d; 252.000 ± 35.998(1-618) d in Group A and 269.000 ± 47.885(1-965) d in Group B, with no significant difference between the two groups. Metallic stent obstruction occurred in 82 of the 272(30.15%) patients; in 53/184(28.80%) patients in Group A and in 29/88(32.95%) of those in Group B, showing no significant difference between the two groups. Procedural accidents due to metal stent insertion occurred in 24/272(8.8%) patients; in 17/184(9.2%) of patients in Group A and in 7/88(8.0%) of those in Group B, with no significant difference between the two groups, *** These results suggested that metallic stents can be safely inserted to treat unresectable distal malignant biliary obstruction even in elderly patients aged 80 years or more.

关键词： Elderly patients Metallic stent Malignant biliary obstruction

Surgical Experience of a Partial Atrioventricular Septal Defect in an Elderly Patient: A Case Report

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World Journal of Cardiovascular Surgery 2013年第2期3卷 31-33页

作者： Yukiharu Sugimura Masaaki Toyama Masanori Katoh yuji Kato Department of Cardiovascular Surgery Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital Ota Japan Department of Cardiovascular Surgery Kameda Medical Center Chiba Japan

The following paper describes patch closure (bovine pericardial sheet) of an ostium primum atrial septal defect and mitral valve repair (sutured mitral valve cleft + autologous pericardial annuloplasty + Alfieri’s method) in a 50-year-old man. He had been perfectly well until he was brought to the emergency room because of acute heart failure. Chest radiography revealed right-side heart enlargement. Electrocardiography indicated atrial flutter. Echocardiography revealed a large ostium primum atrial septal defect and moderate mitral regurgitation. The pulmonary-to-systemic blood flow ratio was 3.24. First, cardiologists performed catheter ablation of the cavotricuspid isthmus for atrial flutter. We performed patch closure of an ostium primum atrial septal defect and mitral valve repair after the patient’s heart failure was under control. The patient was discharged 13 days postoperatively in a satisfactory condition without any critical complications.

关键词： Partial Atrioventricular Septal Defect Incomplete Endocardial Cushion Defect Mitral Regurgitation Elderly Patient Repair

远程传输心电图监测与平板计算机检查系统在东日本大地震灾区的应用价值

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江苏实用心电学杂志 2015年第2期24卷 110-110页

作者：周丽王红宇 Yukio Ozawa Shino Endo Masakatsu ota yuji Kasamaki Kenicahi Hashimoto Koji Matsubara 山西医科大学第二医院心电图室 MJC心血管研究所日本大学医学院

为了评价快速响应的远程传输心电图监测与医生使用平板计算机检查系统在东日本大地震灾区居民心电监护中的实用价值,对2012年12月21日至2014年2月14日两年间遭遇地震的1 369位居民进行远程传输心电图监测,其中男346例、女1 023例,平均6... 详细信息

为了评价快速响应的远程传输心电图监测与医生使用平板计算机检查系统在东日本大地震灾区居民心电监护中的实用价值,对2012年12月21日至2014年2月14日两年间遭遇地震的1 369位居民进行远程传输心电图监测,其中男346例、女1 023例,平均69.9岁。医疗工作者在被监测者的房间里使用CG2100型便携式远程传输心电图仪记录心电图,采用左右手间的双极导联方式;并将这些心电图传输到距地震区约400 km的地方,

关键词：心电图监测远程传输东日本检查系统心电图仪双极导联心电监护监测者医疗工作者左束支传导阻滞