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Comparison of the low-density lipoprotein cholesterol target value and the preventive effect of statins in elderly patients and younger patients

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Journal of Geriatric Cardiology 2017年第6期14卷 383-391页

作者： Akihiro Endo Taiji Okada Misun Pak Yuzo Kagawa Shimpei Ito Hirotomo Sato Kenji Kageshima Yasuyuki Yoshida kazuaki tanabe Division of Cardiology Shimane University Faculty of Medicine Izumo Japan Division of Cardiology Tottori Prefectural Central Hospital Tottori Japan

Objective To assess whether the low-density lipoprotein cholesterol （LDL-C） target value and preventive effect of statins are different between elderly and younger patients. Methods We investigated 304 patients with previous percutaneous coronary intervention who underwent coronary angiography from January 2007 to December 2016 for examination of recurrent ischemia beyond the early restenosis. Patients were classified into two groups： age ≥ 75 years （elderly group： n = 140） and 〈 75 years （younger group： n = 164）. Relationships between the achieved LDL-C level, incidence of late coronary events, and the effectiveness of statins were evaluated. Results During follow-up, 179 patients underwent late coronary revascularization. Recurrent ischemia presenting as acute coronary syndrome （ACS） occurred in 83 cases. Kaplan-Meier curve analysis revealed that in the younger group, recurrent ACS was significantly lower in patients with LDL-C 〈 70 mg/dL than in those with LDL-C ranging from 70 to 〈 100 mg/dL （P = 0.035）; however, there was no difference between these in the elderly group （P = 0.863）. Instead, recurrent ACS was less frequent in patients with LDL-C ranging from 70 mg/dL to 〈 100 mg/dL than in those with LDL-C ≥ 100 mg/dL in the elderly group （v = 0.033）. Statin use was associated with decreased recurrent ACS （P = 0.005）; moreover, only using statins was an independent predictor in the elderly group （HR： 0.375; P = 0.007）. Conclusions Strict control of LDL-C to 〈 70 mg/dL was effective for reducing the incidence of recurrent ACS in younger patients. However, LDL-C 〈 100 mg/dL might be sufficient as the target value of LDL-C-lowering therapy for secondary prevention of ischemic events in Japanese elderly patients.

关键词： Acute coronary syndrome Late coronary event Prevention

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possible role of soluble fibrin monomer complex after gastroenterological surgery

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World Journal of Gastroenterology 2017年第12期23卷 2209-2216页

作者： Masatoshi Kochi Manabu Shimomura Takao Hinoi Hiroyuki Egi kazuaki tanabe Yasuyo Ishizaki Tomohiro Adachi Hirotaka Tashiro Hideki Ohdan Department of Gastroenterological and Transplant Surgery Applied Life SciencesInstitute of Biomedical and Health SciencesHiroshima University Department of Surgery National Hospital Organization Higashihiroshima Medical Center Department of Surgery Institute for Clinical ResearchNational Hospital Organization Kure Medical Center and Chu-goku Cancer Center Department of Surgery National Hospital Organization Hiroshima-nishi Medical Center

AIM To examine the role of soluble fibrin monomer complex(SFMC) in the prediction of hypercoagulable state after gastroenterological *** We collected data on the clinical risk factors and fibrin-related makers from patients who underwent gastroenterological surgery at Hiroshima University Hospital between April 1, 2014 and March 31, 2015. We investigated the clinical significance of SFMC, which is known to reflect the early plasmatic activation of coagulation, in the view of these fibrin related *** A total of 123 patients were included in the present study. There were no patients with symptomatic VTE. Thirty-five(28%) patients received postoperative anticoagulant therapy. In the multivariate analysis, a high SFMC level on POD 1 was independently associated with D-dimer elevation on POD 7(OR = 4.31, 95%CI: 1.10-18.30, P = 0.03). The cutoff SFMC level was 3.8 μg/ml(AUC = 0.78, sensitivity, 63%, specificity, 89%). The D-dimer level on POD 7 was significantly reduced in high-SFMC patients who received anticoagulant therapy in comparison to highSFMC patients who did *** The SFMC on POD 1 strongly predicted the hypercoagulable state after gastroenterological surgery than the clinical risk factors and the other fibrin related markers.

关键词： Hypercoagulable state Gastroenterological surgery Soluble fibrin monomer complex Venous thromboembolism Anticoagulant therapy

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Predictive factors for body weight loss and its impact on quality of life following gastrectomy

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World Journal of Gastroenterology 2017年第26期23卷 4823-4830页

作者： kazuaki tanabe Masazumi Takahashi Takashi Urushihara Yoichi Nakamura Makoto Yamada Sang-Woong Lee Shinnosuke Tanaka Akira Miki Masami Ikeda Koji Nakada Department of Gastroenterological Surgery Hiroshima University Hospital Division of Gastroenterological Surgery Yokohama Municipal Citizen’s Hospital Department of Gastroenterological Breast and Transplant SurgeryHiroshima Prefectural Hospital Department of Surgery Toho University Ohashi Medical Center Department of Surgery Gifu Municipal Hospital Department of General and Gastroentero-logical Surgery Osaka Medical College Department of Gastroenterological Surgery Fukuoka University School of Medicine Department of Surgery Kobe City Medical Center General Hospital Department of Surgery Asama General Hospital Department of Laboratory Medicine the Jikei University School of Medicine

To determine the predictive factors and impact of body weight loss on postgastrectomy quality of life (QOL). METHODSWe applied the newly developed integrated questionnaire postgastrectomy syndrome assessment scale-45, which consists of 45 items including those from the Short Form-8 and Gastrointestinal Symptom Rating Scale instruments, in addition to 22 newly selected items. Between July 2009 and December 2010, completed questionnaires were received from 2520 patients with curative resection at 1 year or more after having undergone one of six types of gastrectomy for Stage I gastric cancer at one of 52 participating institutions. Of those, we analyzed 1777 eligible questionnaires from patients who underwent total gastrectomy with Roux-en-Y procedure (TGRY) or distal gastrectomy with Billroth-I (DGBI) or Roux-en-Y (DGRY) procedures. RESULTSA total of 393, 475 and 909 patients underwent TGRY, DGRY, and DGBI, respectively. The mean age of patients was 62.1 ± 9.2 years. The mean time interval between surgery and retrieval of the questionnaires was 37.0 ± 26.8 mo. On multiple regression analysis, higher preoperative body mass index, total gastrectomy, and female sex, in that order, were independent predictors of greater body weight loss after gastrectomy. There was a significant difference in the degree of weight loss (P 25 kg/m2). Multiple linear regression analysis identified lower postoperative body mass index, rather than greater body weight loss postoperatively, as a certain factor for worse QOL (P 2, 0.028-0.080). CONCLUSIONWhile it is certainly important to maintain adequate body weight after gastrectomy, the impact of body weight loss on QOL is unexpectedly small.

关键词： Quality of life Gastrectomy Weight loss Postgastrectomy syndrome assessment scale-45

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Safety and Efficacy of Laparoscopy-Assisted Gastrectomy after Endoscopic Submucosal Dissection for Early Gastric Cancer: A Retrospective Report

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Journal of Cancer Therapy 2013年第1期4卷 54-60页

作者： Takahisa Suzuki kazuaki tanabe Dang Thuc Anh Vu Toshihiro Misumi Nobuaki Fujikuni Noriaki Tokumoto Hideki Ohdan Department of Gastroenterological and Transplant Surgery Applied Life Sciences Institute of Biomedical & Health Sciences Hiro-shima University Hiroshima Japan.

Background: This study aimed to determine the safety and effectiveness of laparoscopy-assisted distal gastrectomy (LADG) after ESD. Methods: We reviewed patients with gastric cancer who underwent distal gastrectomy after non-curative ESD from May 2000 to July 2010, and classified them into LADG-ESD and open distal gastrectomy (ODG) after non-curative ESD (ODG-ESD). In addition, we analyzed the standard LADG (LADG-standard) during the same period. We retrospectively analyzed surgical outcomes and survival in these 3 groups. Pathological results after gastrectomy were compared between the LADG-ESD and ODG-ESD;Results: Sixty-one patients underwent distal gastrectomy after non-curative ESD. No differences in overall survival were found between the LADG-ESD and ODG-ESD. The average duration to surgery after ESD was 42.4 days. Although the average surgical duration and average length of hospital stay after surgery were longer in the LADG-ESD than in the ODG-ESD, number of LN dissections was statistically identical in these 2 groups. Operative complications in the LADG-ESD (16.0%) was higher than that in the LADG-standard (3.8% - 8.2%) but similar to that in the ODG-ESD (13.9%). Conclusion: The present study suggests that LADG contributes to the effectiveness of the treatment of choice for non-curative endoscopic resection.

关键词： Early Gastric Cancer Laparoscopic Gastrectomy ESD

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Assessing optimal Roux-en-Y reconstruction technique after total gastrectomy using the Postgastrectomy Syndrome Assessment Scale-45

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World Journal of Clinical Oncology 2022年第5期13卷 376-387页

作者： Masami Ikeda Masashi Yoshida Norio Mitsumori Tsuyoshi Etoh Chikashi Shibata Masanori Terashima Junya Fujita kazuaki tanabe Nobuhiro Takiguchi Atsushi Oshio Koji Nakada Department of Surgery Asama General HospitalNagano 385-8558Japan Department of Surgery International University of Health and Welfare HospitalTochigi 329-2763Japan Department of Surgery The Jikei University School of MedicineTokyo 105-8461Japan Department of Gastroenterological Surgery Oita UniversityOita 879-5593Japan Department of Surgery Tohoku Medical and Pharmaceutical UniversityMiyagi 983-8512Japan Division of Gastric Surgery Shizuoka Cancer CenterShizuoka411-8777Japan Department of Surgery Yao Municipal HospitalOsaka 581-0069Japan Department of Gastroenterological and Transplant Surgery Institute of Biomedical and Health SciencesHiroshima UniversityHiroshima 734-8551Japan Department of Gastroenterological Surgery Chiba Cancer CenterChiba 260-8717Japan Faculty of Letters Arts and SciencesWaseda UniversityTokyo 162-8644Japan Department of Laboratory Medicine The Jikei University School of MedicineTokyo 105-8461Japan

BACKGROUND Following a total gastrectomy,patients suffer the most severe form of postgastrectomy *** is a significant clinical problem as it reduces quality of life(QOL).Roux-en-Y reconstruction,which is regarded as the gold standard for post-total gastrectomy reconstruction,can be performed using various *** the technique used could affect postoperative QOL,there are no previous reports regarding the *** To investigate the effect of different techniques on postoperative *** data was collected from the registry of the postgastrectomy syndrome assessment study(PGSAS).METHODS In the present study,we analyzed 393 total gastrectomy patients from those enrolled in *** were divided into groups depending on whether antecolic or retrocolic jejunal elevation was performed,whether the Roux limb was“40 cm”,“shorter”(≤39 cm),or“longer”(≥41 cm),and whether the device used for esophageal and jejunal anastomosis was a circular or linear ***,we comparatively investigated postoperative QOL of the *** Reconstruction route:Esophageal reflux subscale(SS)occurred significantly less frequently in patients who underwent antecolic *** limb length:“Shorter”Roux limb did not facilitate esophageal reflux SS and somewhat attenuated indigestion SS and abdominal pain *** technique:In terms of esophagojejunostomy techniques,no differences were *** The techniques used for total gastrectomy with Roux-en-Y reconstruction significantly affected postoperative *** results suggest that elevating the Roux limb,which is not overly long,through an antecolic route may improve patients’QOL.

关键词： Total gastrectomy Roux-en-Y Postgastrectomy syndrome Quality of life Postgastrectomy Syndrome Assessment Scale-45

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用于旋翼飞机开发研究的多分野解析框架

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Transactions of Nanjing University of Aeronautics and Astronautics 2024年第1期41卷 43-52页

作者： tanabe Yasutada SUGAWARA Hideaki KIMURA Keita 日本宇宙航空研究开发机构航空技术部日本东京181-0015

介绍了日本宇宙航空研究开发机构研发的用于旋翼飞机的多分野解析框架。Heli Design是在各种旋翼飞机初期概念设计时使用的软件;rFlight可以提供在各种飞行条件下的平衡解析和线性化飞行模型;rBET/RMT是基于叶片要素理论的低保真度空力... 详细信息

介绍了日本宇宙航空研究开发机构研发的用于旋翼飞机的多分野解析框架。Heli Design是在各种旋翼飞机初期概念设计时使用的软件;rFlight可以提供在各种飞行条件下的平衡解析和线性化飞行模型;rBET/RMT是基于叶片要素理论的低保真度空力解析软件,和rMode提供的结构模型结合,可以推测旋转翼的弹性变形和各种飞行条件下的空力负载;rFlow3D是基于CFD计算的高保真度数值模拟软件;rGrid系列自动网格构造工具为其提供简单的网格生成;基于rFlow3D的计算结果,r Noise可以预测在任何观测点的噪声。这些软件已经广泛地被应用在各种新型旋翼飞机的开发研究中,其计算精度也已被各种实验结果所应证。

关键词：旋翼飞机多分野解析高保真模拟设计工具

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Glutathione-depleted cyclodextrin pseudo-polyrotaxane nanoparticles for anti-inflammatory oxaliplatin(Ⅳ) prodrug delivery and enhanced colorectal cancer therapy

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Chinese Chemical Letters 2024年第4期35卷 280-286页

作者： Wenjia Wang Xingyue He Xiaojie Wang Tiantian Zhao Osamu Muraoka Genzoh tanabe Weijia Xie Tianjiao Zhou Lei Xing Qingri Jin Hulin Jiang State Key Laboratory of Natural Medicines China Pharmaceutical UniversityNanjing 210009China Faculty of Pharmacy Kinki University HigashiosakaOsaka 577-8502Japan State Key Laboratory of Natural Medicines(SKLNM)and Department of Medicinal Chemistry School of PharmacyChina Pharmaceutical UniversityNanjing 210009China School of Pharmacy Hangzhou Medical CollegeHangzhou 311399China College of Pharmacy Yanbian UniversityYanji 133002China

Oxaliplatin(Oxa) is the first-line chemotherapeutic drug for the treatment of colorectal cancer(CRC). However, long-term Oxa chemotherapy can induce inflammation and increase the levels of cyclooxygenase-2(COX-2) and prostaglandin E2(PGE2), which can promote tumor metastasis. Moreover,high glutathione(GSH) levels in CRC cells significantly reduce Oxa sensitivity and seriously restrict the clinical application of Oxa. Herein, an Oxa(Ⅳ) prodrug with anti-inflammatory properties(desmethyl naproxe, DN) and GSH-depleting cyclodextrin pseudo-polyrotaxane carriers were prepared and further self-assembled into micellar nanoparticles(designated DNPt@PPRI). The relesae of DN from DNPt@PPRI can reduce the level of PGE2 to inhibit inflammation and tumor metastasis by decreasing COX-2 protein,and also synergize with Oxa to inhibit tumor. More importantly, GSH depletion can reduce the detoxification of Oxa and further enhance chemotherapy-induced apoptosis. DNPt@PPRI have a good GSH depletion ability to enhance the sensitivity of Oxa, indicating a potential in the synergistic chemotherapy and chemo-sensitization of colorectal cancer.

关键词： Oxaliplatin Glutathione depletion Tetravalent platinum prodrug Synergistic therapy Colorectal cancer

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Enhanced recovery program is safe and improves postoperative insulin resistance in gastrectomy

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World Journal of Gastrointestinal Surgery 2016年第5期8卷 382-388页

作者： Nobuaki Fujikuni kazuaki tanabe Noriaki Tokumoto Takahisa Suzuki Minoru Hattori Toshihiro Misumi Hideki Ohdan Department of Gastroenterological and Transplant Surgery Hiroshima University Department of Surgery Hiroshima City Hospital Department of Surgery Hiroshima Prefectural Hospital

AIM: To assess the safety of enhanced recovery after surgery(ERAS) program in gastrectomy and influences on nutrition state and insulin-resistance. METHODS: Our ERAS program involved shortening the fasting periods and preoperative carbohydrate loading. Eighty gastrectomy patients were randomly assigned to either the conventional group(CG) or ERAS group(EG). We assessed the clinical characteristics and postoperative outcomes prospectively. The primary endpoint was noninferiority in timely discharge from the hospital within 12 d. Secondary endpoints were the incidence of aspiration at anesthesia induction, incidence of postoperative complications, health related quality of life(HRQOL) using the SF8 Health Survey questionnaire, nutrition state [e.g., albumin, transthyretin(TTR), retinal-binding protein(RBP), and transferrin(Tf)], the homeostasis model assessment-insulin resistance(HOMA-R) index, postoperative urine volume,postoperative weight change, and postoperative oral ***: The ERAS program was noninferior to the conventional program in achieving discharge from the hospital within 12 d(95.0% vs 92.5% respectively; 95%CI:-10.0%-16.0%). There was no significant difference in postoperative morbidity between the two groups. Adverse events such as vomiting and aspiration associated with the induction of general anesthesia were not observed. There were no significant differences with respect to postoperative urine volume, weight change, and oral intake between the two groups. EG patients with preoperative HOMA-R scores above 2.5 experienced significant attenuation of their HOMA-R scores on postoperative day 1 compared to CG patients(P = 0.014). There were no significant differences with respect to rapid turnover proteins(TTR, RBP and Tf) or HRQOL scores using the SF8 ***: Applying the ERAS program to patients who undergo gastrectomy is safe, and improves insulin resistance with no deterioration in QOL.

关键词： gastrectomy carbon hydrogen oxygen insulin resistance enhanced recovery after surgery Randomized controlled trial

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俯卧位采集和CT衰减校正在CZTSPECT显像检测冠状动脉疾病中的比较

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中华核医学与分子影像杂志 2018年第4期38卷 304-304页

作者：唐军 Shimpei Ito Akihiro Endo Taiji Okada Taku Nakamura Takashi Sugamori Nobuyuki Takahashi Hiroyuki Yoshitomi kazuaki tanabe 上海交通大学医学院附属苏州九龙医院核医学科 215021 Division of Cardiology Shimane University Faculty of Medicine Izumo Japan

【摘要】目的带碲-锌-镉（CZT）固态探测器的核素显像仪可更好地诊断和评估胸痛患者，但其与普通γ照相机一样存在下壁和（或）下侧壁的衰减现象。在常规仰卧位采集图像的基础上加做CT衰减校正（CTAC）和俯卧位图像采集，来分析比较仰... 详细信息

【摘要】目的带碲-锌-镉（CZT）固态探测器的核素显像仪可更好地诊断和评估胸痛患者，但其与普通γ照相机一样存在下壁和（或）下侧壁的衰减现象。在常规仰卧位采集图像的基础上加做CT衰减校正（CTAC）和俯卧位图像采集，来分析比较仰卧位显像、仰卧位＋CTAC和俯卧位显像的结果。

关键词：图像采集显像检测衰减校正冠状动脉疾病俯卧位 CT 仰卧位 γ照相机

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Surgical strategies for challenging common bile duct stones in the endoscopic era: A comprehensive review of current evidence

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World Journal of Gastrointestinal Endoscopy 2024年第6期16卷 305-317页

作者： Tharathorn Suwatthanarak Vitoon Chinswangwatanakul Asada Methasate Chainarong Phalanusitthepha Minoru tanabe Keiichi Akita Thawatchai Akaraviputh Minimally Invasive Surgery Unit Department of SurgeryFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok Noi 10700BangkokThailand Graduate School of Medical and Dental Sciences Tokyo Medical and Dental UniversityBunkyo 113-8519TokyoJapan Department of Hepatobiliary and Pancreatic Surgery Tokyo Medical and Dental UniversityBunkyo 113-8519TokyoJapan Department of Clinical Anatomy Tokyo Medical and Dental UniversityBunkyo 113-8519TokyoJapan

While endoscopic retrograde cholangiopancreatography(ERCP)remains the primary treatment modality for common bile duct stones(CBDS)or choledocho-lithiasis due to advancements in instruments,surgical intervention,known as common bile duct exploration(CBDE),is still necessary in cases of difficult CBDS,failed endoscopic treatment,or altered *** evidence also supports CBDE in patients requesting single-step cholecystectomy and bile duct stone removal with comparable *** review elucidates relevant clinical anatomy,selection indications,and outcomes to enhance surgical *** selection between trans-cystic(TC)vs trans-choledochal(TD)approaches is described,along with stone removal techniques and ductal *** surgical techniques and strategies for both the TC and TD approaches,including instrument selection,is also ***,this review comprehensively addresses operation-specific complications such as bile leakage,stricture,and entrapment,and focuses on preventive measures and treatment *** review aims to optimize the management of CBDS through laparoscopic CBDE,with the goal of improving patient outcomes and minimizing risks.

关键词： Choledocholithiasis Common bile duct stone Difficult common bile duct stone Common bile duct exploration Laparoscopic common bile duct exploration

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