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Classification of rectal cancer according to recurrence types-comparison of Japanese guidelines and Western guidelines

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World Journal of Clinical Cases 2022年第36期10卷 13284-13292页

作者： Hiroshi Miyakita yutaro Kamei Lin Fung Chan Kazutake Okada Hajime Kayano Seiichiro yamamoto Department of Digestive System Surgery Tokai University School of MedicineIsehara 259-1193KanagawaJapan

BACKGROUND Rectal cancer is characterized by more local recurrence(LR)and lung metastasis than colon ***,the diagnosis of rectal cancer is not standardized as there is no global consensus on its definition and *** classification of rectal cancer differs between Japanese and Western *** To clarify the characteristics of rectal cancer by comparing the tumor location and characteristics of rectal cancer with those of colon cancer according to each set of *** A total of 958 patients with Stage II and III colorectal cancer were included in the analysis:607 with colon cancer and 351 with rectal *** of rectal cancers was assessed by enema examination and rigid *** to Japan guidelines,rectal cancer is classified as Rb(below the peritoneal inversion),Ra(between the inferior margin of second sacral vertebrae and Rb)or RS(between Ra and sacral promontory).RESULTS There were no significant differences between RS rectal cancer and colon cancer in the rates of liver and lung metastasis or *** metastasis and LR were significantly more common among Rb rectal cancer(in Japan)than in colon cancer(P=0.0043 and P=0.0002,respectively).Lung metastases and LR occurred at significantly higher rates in rectal cancer measuring≤12 cm and≤10 cm than in colon cancers(P=0.0117,P=0.0467,P=0.0036,P=0.0010).Finally,the rates of liver metastasis,lung metastasis,and LR in rectal cancers measuring 11 cm to 15 cm were 6.9%,2.8%,and 5.7%,*** were equivalent to the rates in colon *** High rectal cancer may be treated with the same treatment strategies as colon *** was no difference in the classification of colorectal cancer between Japan and Western countries.

关键词： Colon cancer Metastasis Local recurrence Classification of rectal cancer Western guidelines Japanese guideline

Evaluation of bacterial contamination and medium-term oncological outcomes of intracorporeal anastomosis for colon cancer:A propensity score matching analysis

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 670-680页

作者： Hajime Kayano Nana Mamuro yutaro Kamei Takashi Ogimi Hiroshi Miyakita Toshio Nakagohri Kazuo Koyanagi Masaki Mori Seiichiro yamamoto Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 259-1193KanagawaJapan

BACKGROUND Although intracorporeal anastomosis(IA)for colon cancer requires longer operative time than extracorporeal anastomosis(EA),its short-term postoperative results,such as early recovery of bowel movement,have been reported to be equal or *** IA requires opening the intestinal tract in the abdominal cavity under pneumoperitoneum,there are concerns about intraperitoneal bacterial infection and recurrence of peritoneal dissemination due to the spread of bacteria and tumor ***,intraperitoneal bacterial contamination and medium-term oncological outcomes have not been *** cavity in *** Of 127 patients who underwent laparoscopic colon resection for colon cancer from April 2015 to December 2020,75 underwent EA(EA group),and 52 underwent IA(IA group).After propensity score matching,the primary endpoint was 3-year disease-free survival rates,and secondary endpoints were 3-year overall survival rates,type of recurrence,surgical site infection(SSI)incidence,number of days on antibiotics,and postoperative biological *** Three-year disease-free survival rates did not significantly differ between the IA and EA groups(87.2%and 82.7%,respectively,P=0.4473).The 3-year overall survival rates also did not significantly differ between the IA and EA groups(94.7%and 94.7%,respectively;P=0.9891).There was no difference in the type of recurrence between the two *** addition,there were no significant differences in SSI incidence or the number of days on antibiotics;however,postoperative biological responses,such as the white blood cell count(10200 vs 8650/mm^(3),P=0.0068),C-reactive protein(6.8 vs 4.5 mg/dL,P=0.0011),and body temperature(37.7 vs 37.5℃,P=0.0079),were significantly higher in the IA *** IA is an anastomotic technique that should be widely performed because its risk of intraperitoneal bacterial contamination and medium-term oncological outcomes are comparable to those of EA.

关键词： Colon cancer Intracorporeal anastomosis 3-year disease-free survival Recurrence Surgical site infection Postoperative biological response

The liver-to-spleen ratio is a risk factor predicting oxygen demand in COVID-19 patients

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Infectious Medicine

Infectious Medicine 2023年第2期2卷 105-111页

作者： Hiromasa Nakayasu Shogo Sakurai Shuichi Sugiyama Kotaro Shiratori Kohei Okawa Yoshihiro Kitahara Shingo Takahashi Toshihiro Masuda yutaro Kishimoto Mika Saigusa Akito yamamoto Taisuke Akamatsu Satoru Morita Kazuhiro Asada Toshihiro Shirai Department of Respiratory Medicine Shizuoka General Hospital4-27-1 Kita-AndoAoi420-0805 ShizuokaJapan

Background:We aimed to investigate risk factors predicting oxygen demand in COVID-19 ***:Patients admitted to Shizuoka General Hospital with COVID-19 from August 2020 to August 2021 were ***,we divided patients into groups with and without oxygen ***,we compared patients’clinical characteristics and laboratory and radiological findings to determine factors predicting oxygen ***:One hundred seventy patients with COVID-19(aged 58±15 years,57 females)were *** comorbidities were cardiovascular diseases(47.6%),diabetes mellitus(28.8%),and dyslipidemia(26.5%).Elder age,higher body mass index,cardiovascular diseases,diabetes mellitus,lower lymphocyte count,albumin,hep-atic attenuation value,and the liver-to-spleen ratio(L/S),higher D-dimer,aspartate aminotransferase,lactate dehydrogenase,troponin-T,C-reactive protein,KL-6,chest and abdominal circumference,and visceral fat were found in patients with oxygen *** to the multivariate logistic regression analysis,L/S,lympho-cyte count,D-dimer,and abdominal circumference under the diaphragm were independent risk factors predicting oxygen demand in COVID-19 ***:On admission,L/S,lymphocyte count,D-dimer,and abdominal circumference were predictive factors for oxygen *** factors may help in the appropriate triage of COVID-19 patients in the decision to admit them to the hospital.

关键词： COVID-19 SARS-CoV-2 Oxygen demand The liver-to-spleen ratio Abdominal circumference

Effects of Direct Switching Dual Bronchodilators between Dry Powder and Soft Mist Inhalers in COPD Patients

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Open Journal of Respiratory Diseases 2020年第1期10卷 11-19页

作者： Taisuke Akamatsu Toshihiro Shirai Hiromasa Nakayasu Kanami Tamura Toshihiro Masuda Shingo Takahashi Yuko Tanaka Hirofumi Watanabe yutaro Kishimoto Kyohei Oishi Mika Saigusa Akito yamamoto Satoru Morita Kazuhiro Asada Department of Respiratory Medicine Shizuoka General Hospital Shizuoka Japan

Objective: Dual bronchodilation with long-acting muscarinic antagonist and long-acting β2-agonist combinations are available worldwide in COPD patients. However, the choice of agents remains under debate. We hypothesized that switching devices between dry powder and soft mist inhalers without a wash-out period to mimic clinical practice would improve clinical symptoms and lung function. The aim of this study was to examine the effects of switching between once-daily glycopyrronium/indacaterol (GLY/IND) or umeclidinium/vilanterol (UMEC/VI), dry powder inhalers, and tiotropium/olodaterol (TIO/OLO), a soft mist inhaler, in COPD patients. Methods: This was a prospective, open-label, 8-week, observational study with follow-up. Subjects included 57 COPD patients, who attended outpatient clinics at Shizuoka General Hospital for routine check-ups between February and December 2015, receiving GLY/IND (50/110 μg) or UMEC/VI (62.5/25 μg). After an 8-week run-in period, medications were switched to TIO/OLO (5/5 μg). Study outcomes included patient’s global rating (PGR), modified MRC (mMRC), COPD assessment test (CAT), and spirometric and forced oscillatory parameters after 8 weeks. PGR used in this study was a 7-point scale ranging from 1 to 7, with 4 in the middle. Patients who consented to switch from TIO/OLO to GLY/IND or UMEC/VI were followed-up thereafter. Results: In total, 53 patients completed the study (mean age, 75 years;48 males and 5 females;GOLD 1/2/3/4 = 19/27/6/1;mMRC 0/1/2/3/4 = 14/22/12/4/1;UMEC/VI 26, GLY/IND 27). PGR, mMRC, and CAT improved in 20 (38%), 9 (17%), and 15 patients (28%), respectively. Respiratory system resistance at 5 Hz (R5), 20 Hz (R20), and the difference between R5 and R20 (R5 - R20) significantly improved. In a follow-up of 16 patients after switching from TIO/OLO to UMEC/VI (9) or GLY/IND (7), PGR, mMRC, and CAT improved in 5 (31%), 3 (12%), and 4 patients (25%), respectively, and R20 significantly improved (p = 0.011). Conclusions: Switc

关键词： Device Dry Powder Inhaler Dual Bronchodilator Soft Mist Inhaler Switching