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Protein-losing enteropathy caused by a jejunal ulcer after an internal hernia in Petersen's space: A case report

World Journal of Clinical Cases 2022年第1期10卷 323-330页

作者： Tomohiko Yasuda Nobuyuki Sakurazawa Komei Kuge Jun Omori Hiroki Arai Daisuke Kakinuma masanori watanabe Hideyuki Suzuki Katsuhiko Iwakiri Hiroshi Yoshida Department of Gastrointestinal Surgery Nippon Medical School Chiba Hokusoh HospitalChiba 270-1694Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical SchoolTokyo 113-8603Japan Department of Gastroenterology Nippon Medical SchoolTokyo 113-8603Japan

BACKGROUND The incidence of internal hernias has recently increased in concordance with the popularization of laparoscopic *** particular concern are internal hernias occurring in Petersen's space,a space that is surgically created after treatment for gastric cancer and *** hernias cause devastating sequelae,such as massive intestinal necrosis,fatal Roux limb necrosis,and superior mesenteric vein *** addition,protein-losing enteropathy(PLE)is a rare syndrome involving gastrointestinal protein loss,although its relationship with internal Petersen’s hernias remains *** SUMMARY A 75-year-old man with a history of laparotomy for early gastric cancer developed Petersen's hernia 1 year and 5 mo after *** was successfully treated by reducing the incarcerated small intestine and closure of Petersen’s defect without resection of the small *** 3 mo after his surgery for Petersen’s hernia,he developed bilateral leg edema and *** was diagnosed with PLE with an alpha-1 antitrypsin clearance of 733 mL/24 ***-balloon enteroscopy revealed extensive jejunal ulceration as the etiology,and it facilitated minimum bowel *** analysis showed extensive jejunal ulceration and collagen hyperplasia with nonspecific inflammation of all layers without lymphangiectasia,lymphoma,or vascular *** postoperative course was unremarkable,and his bilateral leg edema and hypoalbuminemia improved after 1 *** was no relapse over the 5-year follow-up *** PLE and extensive jejunal ulceration may occur after Petersen's *** enteroscopy helps identify and resect these lesions.

关键词： Internal hernia Ulcer Protein-losing enteropathy Double-balloon enteroscopy Ischemia-reperfusion injury Case report

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Estimation of Physiologic Ability and Surgical Stress Scoring System Appraises Laparoscopy-Assisted and Open Distal Gastrectomy in Treatment of Early Gastric Cancer

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Journal of Cancer Therapy 2013年第9期4卷 1-5页

作者： Hideki Bou Hideyuki Suzuki Kentaro Maejima Hidetsugu Hanawa masanori watanabe Eiji Uchida Department of Surgery Nippon Medical School Tokyo Japan Institute of Gastroenterology Nippon Medical School Musashi-kosugi Hospital Kawasaki Japan

Laparoscopy-assisted distal gastrectomy (LADG) has been widely used to treat early gastric cancer (EGC). The Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system predicts the risk of fatal postoperative complications by quantifying the patient’s reserve and degree of surgical stress, but there have been a few reports of use of the E-PASS scoring system to assess the risk of mortality following special types of surgical procedures such as LADG. In this study we assessed the feasibility of LADG versus open distal gastrectomy (ODG) by the E-PASS scoring system. The subjects of this study consisted of 69 stage IA gastric cancer patients who underwent LADG (LADG group) and 69 stage IA gastric cancer patients who underwent ODG (ODG group). The mean age of the patients in the LADG group was 68.6 years, which was significantly higher than the mean age of 63.4 years in the ODG group. There were no statistically significant differences between the groups in operation time or preoperative risk score, but there were statistically significant differences in blood loss, surgical stress score, comprehensive risk score, and duration of postoperative hospital stay. We conclude that using the E-PASS scoring system, LADG appreciates a more beneficial procedure for the treatment of EGC than ODG.

关键词： E-PASS LADG ODG

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糖尿病和肥胖症动物模型肌肉及脂肪组织的葡萄糖摄取:利用18F-FDG评价胰岛素和β3受体激动剂的作用

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中华核医学与分子影像杂志 2018年第1期38卷 73-73页

作者：唐军 Seigo Ishino Taku Sugita Yusuke Kondo Mika Okai Kazue Tsuchimori masanori watanabe Ikuo Mori Masaki Hosoya Takashi Horiguchi Hidenori Kamiguchi 上海交通大学医学院附属苏州九龙医院核医学科 Integrated Technology Research Laboratories Pharmaceutical Research Division Takeda Pharmaceutical Company Limited

目的糖尿病和肥胖症的主要原因是胰岛素功能不足导致肌肉和脂肪组织内的糖摄取、糖代谢异常。因此,许多药物的研发都是基于促进肌肉和脂肪组织对葡萄糖的摄取。现已可通过测定血液相关参数来评价上述组织糖代谢的增加,但这仅仅反映了用... 详细信息

目的糖尿病和肥胖症的主要原因是胰岛素功能不足导致肌肉和脂肪组织内的糖摄取、糖代谢异常。因此,许多药物的研发都是基于促进肌肉和脂肪组织对葡萄糖的摄取。现已可通过测定血液相关参数来评价上述组织糖代谢的增加,但这仅仅反映了用药后的全身反应。课题组进行了数项研究来调查药理实验中疾病动物模型的不同肌肉和脂肪组织葡萄糖摄取测定的实用性。方法对肥胖大鼠模型(2型糖尿病模型)、饮食诱导的肥胖鼠模型(肥胖模型)和相应的对照组模型分别注射18F-脱氧葡萄糖(FDG),各模型肌肉和脂肪组织(白色和棕色脂肪)的基础葡萄糖摄取通过生物分布法进行比较。另外,可促进肌肉和脂肪组织葡萄糖摄取的胰岛素和β3受体激动剂(CL316,243)亦用于各模型来评价两者的作用。18F-FDG在各组织的摄取通过测量各组织放射性的方法进行,而18F-FDG的分布采用放射自显影的方法来分析。结果2型糖尿病模型与对照组(瘦大鼠)相比,所有组织的测量结果均显示其基础葡萄糖摄取水平降低。肥胖模型的白色脂肪组织也有相同表现,但肥胖模型棕色脂肪组织的基础葡萄糖摄取水平增加。胰岛素可促进2型糖尿病模型和瘦大鼠模型的葡萄糖摄取,尽管前者的葡萄糖摄取增加有所抑制。同样的现象也存在于对照组,但使用胰岛素后肥胖模型的肌肉和棕色脂肪组织没有观察到葡萄糖摄取的明显增加。2型糖尿病模型与瘦大鼠使用β3受体激动剂后可观察到与使用胰岛素后一样的反应,但前者脂肪组织的葡萄糖摄取增加受抑。结论通过18F-FDG监测组织葡萄糖摄取水平能够观察到疾病动物模型和相应对照模型间葡萄糖摄取的差别,同时可识别各组织对胰岛素和β3受体激动剂的反应。总之,18F-FDG生物分布法可在疾病动物模型上用于抗糖尿病和抗肥胖药物的评价研究。

关键词： 18F-FDG 肥胖大鼠模型饮食诱导的肥胖鼠模型胰岛素 β3受体激动剂

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Robotic gastrectomy for gastric cancer

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Journal of Cancer Metastasis and Treatment 2018年第1期4卷 459-467页

作者： masanori Tokunaga Masahiro watanabe Shizuki Sugita Akiko Tonouchi Akio Kaito Takahiro Kinoshita Gastric Cancer Division National Cancer Center Hospital EastKashiwa 277-8577Japan

Robotic gastrectomy(RG)is increasingly performed,particularly in East *** articulated devices,surgeons are able to perform every procedure more comfortably and meticulously,which makes RG ideal from the surgeon’s ***,it is still unclear whether it is a suitable treatment strategy from the patient’s viewpoint,due to the lack of solid evidence obtained from randomized controlled *** feasibility of RG has been demonstrated in many retrospective comparative studies,which showed similar trends,including relatively less estimated blood loss and longer operation time with RG than laparoscopic gastrectomy(LG),equivalent number of harvested lymph nodes and similar length of postoperative hospital stay between RG and ***,considering the higher medical expenses associated with RG,its superiority in terms of long-term survival outcomes will need to be confirmed for it to be accepted more widely.

关键词： da Vinci robot gastric cancer robot assisted gastrectomy laparoscopic gastrectomy

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Outcomes of Single-Incision Laparoscopic Appendectomy at a Single Center

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Surgical Science 2013年第10期4卷 426-428页

作者： Takahiro watanabe Hidetosi Wada masanori Sato Yuichirou Miyaki Junpei Tochikubo Norihiko Shiiya Division of General Surgery and Endoscopic Surgery Surgery I Hamamatsu University School of Medicine Hamamatsu Japan

Background and Objectives: Recently, single-incision laparoscopic surgery has been popular for minimally invasive surgery and cosmetic improvement. We studied outcomes of single-incision laparoscopic appendectomy (SILA) in accordance with our strategy for acute appendicitis. Methods: Clinical outcomes were revealed in each of nine emergency SILA (e-SILA) cases and eight interval SILA (i-SILA) cases performed for the treatment of acute appendicitis between September 2010 and August 2012 at our hospital. Results: The male to female ratio was 6:3 for e-SILA and 5:3 for i-SILA cases. Mean ages were 33.1 ± 17.8 years and 41 ± 21.6 years for e-SILA and i-SILA, respectively. The pretreatment white blood cell (WBC) count and C-reactive protein (CRP) levels were 14960 ± 4080/μL and 1.4 ± 2.3 mg/d, respectively, for e-SILA and 12657 ± 4290/μL and 6.7 ± 8.3 mg/d, respectively, for i-SILA. The maximum transverse diameter of appendix was 12.6 ± 3.5 mm for e-SILA and 11.6 ± 3.5 mm for i-SILA. Appendiceal abscesses were encountered in one (11%) e-SILA and three (38%) i-SILA cases. Perforation of the appendix at operation occurred in two (22%) e-SILA cases and no i-SILA cases. Generalized peritonitis occurred in 4 (44%) e-SILA cases but in none of the i-SILA cases. The postoperative hospital stay was 5.3 days for e-SILA, 2.7 days for i-SILA. Conversion to laparotomy was not required in either group. One additional trocar was needed for an e-SILA case, and paralytic ileus occurred as a postoperative complication in one e-SILA case. Conclusion: The outcomes of SILA performed under our strategy were acceptable and useful without major postoperative complications.

关键词： Laparoscopic Appendectomy Single Access Laparoscopic Surgery Minimally Invasive Surgery

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Simplifying Laparoscopic Surgery for Left Side Colon and Rectal Cancer Using Linear Stapler for Vascular Ligation: A Prospective Cohort Study

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Journal of Cancer Therapy 2017年第4期8卷 341-348页

作者： masanori Naito Takeo Sato Takatoshi Nakamura Takahiro Yamanashi Hirohisa Miura Atsuko Tsutsui Masahiko watanabe Department of Surgery School of Medicine Kitasato University Sagamihara Japan

Introduction: Systematic lymphadenectomy and ligation of the feeding artery is extremely important when performing radical resection in colorectal cancer. However, vascular surgery via laparoscopy requires advanced skills and techniques;thus, this procedure needs to be simplified while maintaining quality of the surgery to make it a preferred technique for the surgeons. Methods: There were 49 patients who underwent laparoscopic sigmoidectomy or anterior resection till T2 level for sigmoid colon cancer and recto-sigmoid colon cancer. We analyzed short-term and long-term outcomes between stapling ligation and clipping ligation techniques used in these surgeries. Results: The mean volume of blood loss in the stapling ligation group was 12.8 ± 12.3 ml, which was significantly lower than 41.9 ± 71.2 ml of mean volume of blood loss in the clipping ligation group. There was no significant difference in the mean duration of surgery, the mean number of harvested lymph nodes, morbidity, recurrence, and 5-year relapse free survival rates between the 2 groups. Conclusions: This study demonstrates a surgical technique using staplers for vascular treatment of tumor-feeding arteries as a new technical improvement in laparoscopic colectomy for the treatment of early-stage colon cancer. We found that the described procedure was technically safe, simple, convenient, and oncologically valid.

关键词： Laparoscopic Surgery Colorectal Cancer Vascular Ligation Linear Stapler

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Retrocaval liver lifting maneuver and modifications of total hepatic vascular exclusion for liver tumor resection

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World Journal of Hepatology 2016年第8期8卷 411-420页

作者： Saiho Ko Yuuki Kirihatayfa Yayoi Matsumoto Tadataka Takagi masanori Matsusaka Tomohide Mukogawa Hirofumi Ishikawa Akihiko watanabe Department of Surgery Nara Prefecture General Medical Center

AIM: To evaluate the efficacy of technical modifications of total hepatic vascular exclusion(THVE) for hepatectomy involving inferior vena cava(IVC).METHODS: Of 301 patients who underwent hepatectomy during the immediate previous 5-year period, 8(2.7%) required THVE or modified methods of IVC cross-clamping for resection of liver tumors with massive involvement of the IVC. Seven of the patients had diagnosis of colorectal liver metastases and 1 had diagnosis of hepatocellular carcinoma. All tumors involved the IVC, and THVE was unavoidable for combined resection of the IVC in all 8 of the patients. Technical modifications of THVE were applied to minimize the extent and duration of vascular occlusion, thereby reducing the risk of ***: Broad dissection of the space behind the IVC coupled with lifting up of the liver from the retrocaval space was effective for controlling bleeding around the IVC before and during THVE. The procedures facilitate modification of the positioning of the cranial IVC cross-clamp. Switching the cranial IVC cross-clamp from supra- to retrohepatic IVC or to the confluence of hepatic vein decreased duration of the THVE while restoring hepatic blood flow or systemic circulation via the IVC. Oblique cranial IVC cross-clamping avoided ischemia of the remnant hemi-liver. With these technicalmodifications, the mean duration of THVE was 13.4 ± 8.4 min, which was extremely shorter than that previously reported in the literature. Recovery of liver function was smooth and uneventful for all 8 patients. There was no case of mortality, re-operation, or severe complication(i.e., Clavien-Dindo grade of Ⅲ or more).CONCLUSION: The retrocaval liver lifting maneuver and modifications of cranial cross-clamping were useful for minimizing duration of THVE.

关键词： Total hepatic vascular exclusion Retrocaval liver lifting maneuver Oblique clamping Switching the cl

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Near-infrared polarimetry of the GG Tauri A binary system

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Research in Astronomy and Astrophysics 2014年第11期14卷 1438-1446页

作者： Yoichi Itoh Yumiko Oasa Tomoyuki Kudo Nobuhiko Kusakabe Jun Hashimoto Lyu Abe Wolfgang Brandner Timothy D.Brandt Joseph C.Carson Sebastian Egner Markus Feldt Carol A.Grady Olivier Guyon Yutaka Hayano Masahiko Hayashi Saeko S.Hayashi Thomas Henning Klaus W.Hodapp Miki Ishii masanori Iye Markus Janson Ryo Kandori Gillian R.Knapp Masayuki Kuzuhara Jungmi Kwon Taro Matsuo Michael W.McElwain Shoken Miyama Jun-Ichi Morino Amaya Moro-Martin Tetsuo Nishimura Tae-Soo Pyo Eugene Serabyn Takuya Suenaga Hiroshi Suto Ryuji Suzuki Yasuhiro H.Takahashi Naruhisa Takato Hiroshi Terada Christian Thalmann Daigo Tomono Edwin L.Turner Makoto watanabe John Wisniewski Toru Yamada Satoshi Mayama Thayne Currie Hideki Takami Tomonori Usuda Motohide Tamura Nishi-Harima Astronomical Observatory Center for AstronomyUniversity of Hyogo407-2NishigaichiSayoHyogo 679-5313Japan Faculty of Education Saitama University255 Shimo-OkuboSakuraSaitamaSaitama338-8570Japan Subaru Telescope National Astronomical Observatory of Japan650 North Ahoku PlaceHiloHI 96720USA National Astronomical Observatory of Japan 2-21-1OsawaMitakaTokyo181-8588Japan H.L.Dodge Department of Physics & Astronomy University of Oklahoma440 W Brooks St.NormanOK 73019USA Laboratoire Lagrange (UMR 7293) Universit de Nice-Sophia AntipolisCNRSObservatoire de la Cote d’Azur28 avenue Valrose06108 Nice Cedex 2France Max Planck Institute for Astronomy Knigstuhl 1769117 HeidelbergGermany Department of Astrophysical Science Princeton UniversityPeyton HallIvy LanePrincetonNJ 08544USA Department of Physics and Astronomy College of Charleston58 Coming St.CharlestonSC29424USA Subaru Telescope National Astronomical Observatory of Japan650 North A’ohoku PlaceHiloHI 96720USA Exoplanets and Stellar Astrophysics Laboratory Code 667Goddard Space Flight CenterGreenbeltMD 20771USA Eureka Scientific 2452 DelmerSuite 100Oakland CA 96002USA Goddard Center for Astrobiology GreenbeltMD 20771USA Institute for Astronomy University of Hawaii640 N.Aohoku PlaceHiloHI 96720USA Department of Earth and Planetary Sciences Tokyo Institute of TechnologyOokayamaMeguro-kuTokyo 152-8551Japan Department of Astronomy Kyoto UniversityKitashirakawa-Oiwake-choSakyo-kuKyotoKyoto 606-8502Japan Hiroshima University 1-3-2KagamiyamaHigashihiroshimaHiroshima 739-8511Japan Department of Astrophysics CAB-CSIC/INTA28850 Torrejón de ArdozMadridSpain Jet Propulsion Laboratory California Institute of TechnologyPasadenaCA91109USA Department of Astronomical Science The Graduate University for Advanced Studies2-21-1OsawaMitakaTokyo181-8588Japan Department of Astronomy The University of Tokyo7-3-1HongoBunkyo-kuTokyo113-0033Japan Astronomical Institute "Anton Pannekoek" University

A high angular resolution near-infrared image that shows the intensity of polarization for the GG Tau A binary system was obtained with the Subaru Telescope. The image shows a circumbinary disk scattering the light from the central binary. The azimuthal profile of the intensity of polarization for the circumbinary disk is roughly reproduced by a simple disk model with the Henyey-Greenstein phase function and the Rayleigh function, indicating there are small dust grains at the surface of the disk. Combined with a previous observation of the circumbinary disk, our image indicates that the gap structure in the circumbinary disk orbits counterclockwise, but material in the disk orbits clockwise. We propose that there is a shadow caused by material located between the central binary and the circumbinary disk. The separations and position angles of the stellar components of the binary in the past 20 yr are consistent with the binary orbit with a = 33.4 AU and e = 0.34.

关键词： stars individual (GG Tauri) -- stars pre-maln sequence - techniques high angular resolution

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