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Search Results: 1 - 10 of 981 matches for " Yuko Kitagawa "
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Gastric Cancer: Current Status of Diagnosis and Treatment
Tsunehiro Takahashi,Yoshiro Saikawa,Yuko Kitagawa
Cancers , 2013, DOI: 10.3390/cancers5010048
Abstract: Gastric cancer is the second leading cause of death from malignant disease worldwide and most frequently discovered in advanced stages. Because curative surgery is regarded as the only option for cure, early detection of resectable gastric cancer is extremely important for good patient outcomes. Therefore, noninvasive diagnostic modalities such as evolutionary endoscopy and positron emission tomography are utilized as screening tools for gastric cancer. To date, early gastric cancer is being treated using minimally invasive methods such as endoscopic treatment and laparoscopic surgery, while in advanced cancer it is necessary to consider multimodality treatment including chemotherapy, radiotherapy, and surgery. Because of the results of large clinical trials, surgery with extended lymphadenectomy could not be recommended as a standard therapy for advanced gastric cancer. Recent clinical trials had shown survival benefits of adjuvant chemotherapy after curative resection compared with surgery alone. In addition, recent advances of molecular targeted agents would play an important role as one of the modalities for advanced gastric cancer. In this review, we summarize the current status of diagnostic technology and treatment for gastric cancer.
Laparoscopic Submucosal Dissection for Gastrointestinal Stromal Tumor of the Stomach: A Novel Technique for Local Excision with a Minimal Curative Margin  [PDF]
Norihito Wada, Yoshiro Saikawa, Hiroya Takeuchi, Tsunehiro Takahashi, Rieko Nakamura, Hirofumi Kawakubo, Kaori Kameyama, Makio Mukai, Yuko Kitagawa
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.310098
Abstract: Background: Laparoscopic wedge resection is accepted as a curative treatment for small- and mediumsized gastroin-testinal stromal tumors (GISTs) of the stomach. Conventional methods involving surgical staplers require relatively large lateral margins, which may cause deformity and postoperative dysfunction of the gastric remnant. In this study, we introduce a novel technique called laparoscopic submucosal dissection (LSD) in which the defects of the stomach are minimized and a microscopic negative margin is secured. Methods: The normal seromuscular layer of the gastric wall was dissected with a 5 mm lateral margin. Then, the submucosal tissue was divided carefully using a monopolar electrosurgical device with a curved spatula tip. Results: The operation time was 170 min, and the amount of bleeding was very small. We confirmed an intact pseudo-capsule and marginal subserosal or submucosal tissue of the tumor by histological analysis. The postoperative course was uneventful with no complications. Endoscopy showed minimal deformity of the gastric remnant. Conclusions: We think that LSD is a curative and less invasive treatment for GIST of the stomach. Further investigations are necessary to evaluate the oncological and functional outcomes of this procedure.
Cooperation of Cancer Stem Cell Properties and Epithelial-Mesenchymal Transition in the Establishment of Breast Cancer Metastasis
Tetsu Hayashida,Hiromitsu Jinno,Yuko Kitagawa,Masaki Kitajima
Journal of Oncology , 2011, DOI: 10.1155/2011/591427
Abstract: Epithelial-mesenchymal transition (EMT) is a multistep process in which cells acquire molecular alterations such as loss of cell-cell junctions and restructuring of the cytoskeleton. There is an increasing understanding that this process may promote breast cancer progression through promotion of invasive and metastatic tumor growth. Recent observations imply that there may be a cross-talk between EMT and cancer stem cell properties, leading to enhanced tumorigenicity and the capacity to generate heterogeneous tumor cell populations. Here, we review the experimental and clinical evidence for the involvement of EMT in cancer stem cell theory, focusing on the common characteristics of this phenomenon. 1. Introduction Relapse and resultant metastatic spread to distant sites of malignant neoplasms remain the leading cause of mortality associated with cancer [1, 2]. The classical metastatic cascade includes intravasation by cancer cells, their circulation in the lymph and blood vascular systems, extravasation, and growth into metastatic foci [3, 4]. However, metastasis is considered to be an inefficient process, since only very few cells among the numerous cancer cells in the circulation have the ability to invade and form distant nodules [5]. In the past decade, two different concepts related to solid tumor progression have emerged and been intensively studied to explain these complicated phenomena. There is a growing understanding that epithelial-mesenchymal transition (EMT) can contribute to invasive and metastatic tumor growth. This process is considered to ultimately promote cancer cell progression through the basement membrane and invasion into the surrounding microenvironment, such as the lymph and blood vascular systems, contributing to intra- or extravasation [6–8]. On the other hand, there is increasing data to support the hypothesis that most tumors include a minor subpopulation of cells with distinct properties similar to somatic stem cells, which are referred to as cancer stem cells (CSCs) or tumor-initiating cells. CSCs have been reported to have enhanced tumorigenicity, compared with the majority of tumor cells from the same tumor, and the capacity to generate heterogeneous tumor cell populations [9–11]. Initially, these concepts were individually studied; however, Mani et al. suggested that there may be an association between EMT and the gain of CSC properties in breast cancer cells in 2008 [12], and another group reported that gene expression patterns of CSC-associated pathways were involved in EMT [13]. Here, we review recent studies of CSCs
A Single-Center Open-Label Single-Arm Study Evaluating Efficacy and Safety of Skin Adhesive EpinexusTM in Surgical Patients  [PDF]
Kazuo Kishi, Noriko Aramaki-Hattori, Yoshiaki Sakamoto, Keisuke Okabe, Tetsu Hayashida, Maiko Takahashi, Yuko Kitagawa, Masataka Saito, Takeya Adachi, Aki Honda, Hiromitsu Jinno
Modern Plastic Surgery (MPS) , 2017, DOI: 10.4236/mps.2017.74004
Abstract: Existing skin adhesives may, however, cause inflammatory response to toxicity of formaldehyde generated as hydrolysate of polycyanoacrylate (the main ingredient), delay in wound closure due to the adhesive’s flowing into the wound from the edges, or a wide scar. EpinexusTM (Mitsui Chemicals, Inc.), the skin adhesive used for this study, was developed to prevent these risks. For the method of this study, This was a single-center, open-label, single-arm, intervention study of an acrylate skin adhesive, EpinexusTM. The primary endpoint was safety. The secondary endpoints were wound closure, cosmetic outcome (Manchester Scar Scale), and usability. Failures and adverse events were also appropriately evaluated. As a result, there were no particular adverse events such as inflammatory findings, which demonstrated that there is no problem in safety. Some common adverse events were observed, but no adverse events for which a causal relationship cannot be ruled out or failures. As a conclusion, there was no problem in wound closure, cosmetic outcome, or usability. This was a pilot study of EpinexusTM of an ongoing, single-center, open-label, parallel-group, comparative study in 60 subjects comparing EpinexusTMwith an existing skin adhesive, Dermabond? Advanced.
Efficacy and Safety of the Skin Adhesive EpinexusTM in Surgical Patients  [PDF]
Noriko Aramaki-Hattori, Keisuke Okabe, Yoshiaki Sakamoto, Shigeki Sakai, Tetsu Hayashida, Maiko Takahashi, Tomoko Seki, Yuko Kitagawa, Hiromitsu Jinno, Kazuo Kishi
Modern Plastic Surgery (MPS) , 2018, DOI: 10.4236/mps.2018.84008
Abstract: This single-center, randomized, and controlled intervention study compared an acrylate skin adhesive, EpinexusTM (Mitsui Chemicals, Inc., Tokyo) with Dermabond AdvancedR (Ethicon, Inc., Somerville, New Jersey). The primary endpoint was cosmetic outcome at 52 weeks after treatment (Manchester Scar Scale), and the secondary endpoints were cosmetic outcome at 4 and 26 weeks after treatment (Manchester Scar Scale), wound closure, and usability. We evaluated 59 patients (29 cases and 30 controls). Failures and adverse events were also evaluated, and 8 adverse events (5 cases and 3 controls) were reported (epidermolysis, n = 4; contact dermatitis, n = 1; eczema, n = 1; and surgical wound dehiscence, n = 2). No difference was observed between groups in cosmetic outcome at 52 and 24 weeks; however, at 4 weeks, cases showed better cosmetic outcome compared with controls. With regard to usability, the treatment duration and application time were significantly longer with EpinexusTM, and ease of application was significantly better with Dermabond AdvancedR.
Diagnosis of Distal Cholangiocarcinoma after the Removal of Choledocholithiasis
Yasuhiro Ito,Takeshi Kenmochi,Tomohisa Egawa,Shinobu Hayashi,Atsushi Nagashima,Yuko Kitagawa
Gastroenterology Research and Practice , 2012, DOI: 10.1155/2012/396869
Abstract: Background and Aim. Distal cholangiocarcinoma associated with choledocholithiasis has not been reported, and the causal relationship remains to be established. We evaluated diagnosis of distal cholangiocarcinoma diagnosed after the removal of choledocholithiasis. Patients and Methods. We assigned 9 cases of cholangiocarcinoma with choledocholithiasis to Group A. As a control group, 37 patients with cholangiocarcinoma without choledocholithiasis were assigned to Group B. Results. Abdominal pain at admission is the only significant difference between Group A and Group B . All patients in Group A had gall bladder stones, compared with 7 patients (19%) in Group B . Of the 9 patients in Group A, endoscopic retrade cholangiopancreatography (ERCP) detected normality in 2 patients (22%) and abnormalities in 7 patients (78%). Of the 32 patients in Group B, ERCP detected normality in 4 patients (13%) and abnormalities in 28 patients (88%) . Intraductal ultrasonography (IDUS) detected a tumor in 8 patients in Group A, while in Group B, IDUS detected normality in 1 patient (3%) and tumors in 29 patients (97%) . Conclusions. IDUS after stone removal may potentially help in the detection of unexpected tumors. Therefore, we believe that IDUS after stone removal will lead to improve outcome and prognosis. 1. Introduction The frequency of cholangiocarcinoma is increasing globally, and it currently accounts for 3% of all gastrointestinal cancers [1]. The 5-year survival rates of patients with perihilar and distal tumors have been reported to be 10% and 23%, respectively [2]. Early cholangiocarcinoma is difficult to diagnose because the symptoms usually occur late in the disease. Because these tumors tend to invade the surrounding vessels and nerves, most patients have unresectable disease at diagnosis and poor survival. The prognosis remains unsatisfactory even if the patient undergoes extensive surgery, which is the only curative treatment for these tumors. Therefore, early detection and diagnosis are needed to improve long-term survival. Reports of distal cholangiocarcinoma associated with choledocholithiasis are very rare, and the causal relationship is not established despite the fact that intrahepatic cholangiocarcinoma is a risk factor associated with hepatolithiasis. In this study, we retrospectively analyzed cases of patients with distal cholangiocarcinoma diagnosed after the removal of choledocholithiasis. 2. Patients and Methods 2.1. Patients Cholangiocarcinoma is anatomically classified as intrahepatic or extrahepatic. Extrahepatic cholangiocarcinoma is
Induction of Foxp3-Expressing Regulatory T-Cells by Donor Blood Transfusion Is Required for Tolerance to Rat Liver Allografts
Yuta Abe,Hidejiro Urakami,Dmitry Ostanin,Gazi Zibari,Tetsu Hayashida,Yuko Kitagawa,Matthew B. Grisham
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0007840
Abstract: Donor-specific blood transfusion (DST) prior to solid organ transplantation has been shown to induce long-term allograft survival in the absence of immunosuppressive therapy. Although the mechanisms underlying DST-induced allograft tolerance are not well defined, there is evidence to suggest DST induces one or more populations of antigen-specific regulatory cells that suppress allograft rejection. However, neither the identity nor the regulatory properties of these tolerogenic lymphocytes have been reported. Therefore, the objective of this study was to define the kinetics, phenotype and suppressive function of the regulatory cells induced by DST alone or in combination with liver allograft transplantation (LTx).
Lymphatic marker podoplanin/D2-40 in human advanced cirrhotic liver- Re-evaluations of microlymphatic abnormalities
Hiroaki Yokomori, Masaya Oda, Fumihiko Kaneko, Shigeyuki Kawachi, Minoru Tanabe, Kazunori Yoshimura, Yuko Kitagawa, Toshifumi Hibi
BMC Gastroenterology , 2010, DOI: 10.1186/1471-230x-10-131
Abstract: Surgical wedge biopsy specimens were obtained from non-cirrhotic portions of human livers (normal control) and from cirrhotic livers (LC) (Child A-LC and Child C-LC). Immunohistochemical (IHC), Western blot, and immunoelectron microscopic studies were conducted using D2-40 as markers for lymphatic vessels, as well as CD34 for capillary blood vessels.Imunostaining of D2-40 produced a strong reaction in lymphatic vessels only, especially in Child C-LC. It was possible to distinguish the portal venules from the small lymphatic vessels using D-40. Immunoelectron microscopy revealed strong D2-40 expression along the luminal and abluminal portions of the cell membrane of LECs in Child C-LC tissue.It is possible to distinguish portal venules from small lymphatic vessels using D2-40 as marker. D2-40- labeling in lymphatic capillary endothelial cells is related to the degree of fibrosis in cirrhotic liver.During cirrhosis, the hepatic microvascular phenotype is transformed from sinusoids to continuous capillaries [1]. This crucial process includes excessive deposition of extracellular matrix in the space of Disse. Eventually, formation of basement membranes and defenestration of endothelial cells occur, thereby compromising the normal transfer of nutrients between sinusoidal blood and hepatocytes. All metabolites exchanged between the bloodstream and the hepatocytes pass through the space of Disse that extends from the nonluminal side of the sinusoidal endothelial cell to the microvilli of the hepatocellular membrane, and is considered to be confluent with the hepatic lymphatics of the portal tracts [2]. Increased lymph flow is known to occur in cases of diffuse abnormalities of the liver architecture, e.g. fibrosis and cirrhosis [3]. In human cirrhosis, increased lymph production has been described repeatedly; dilated lymph vessels were documented using angiography and computer tomographic scans in liver fibrotic and cirrhotic patients [4].Hepatic lymph vessel expansion and
The impact of surgical outcome after pancreaticoduodenectomy in elderly patients
Yasuhiro Ito, Takeshi Kenmochi, Tomoyuki Irino, Tomohisa Egawa, Shinobu Hayashi, Atsushi Nagashima, Yuko Kitagawa
World Journal of Surgical Oncology , 2011, DOI: 10.1186/1477-7819-9-102
Abstract: Subjects were 98 patients who underwent PD during the time period from April 2005 to April 2011. During this study, 31 patients were 75 years of age or older (group A), and the other 67 patients were less than 75 years old (group B). Preoperative demographic and clinical data, surgical procedure, pathologic diagnosis, postoperative course and complication details were collected prospectively and they were analyzed in two group.There was no statistical difference between patient groups in terms of gender, comorbidity, preoperative drainage, diagnosis, or laboratory data. Preoperative albumin values were lower in group A (P = 0.04). The mean surgical time in group A was 408.1 ± 73.47 min. Blood loss and blood transfusion were not significantly different between both groups. There was no statistical differences in mortality rate (P = 0.14), morbidity rate (P = 0.43), and mean length of hospital stay (P = 0.22) between both groups.Long-term survival was also no statistically significant difference between the two groups using the log-rank test (P = 0.10).It cannot be ignored that the elderly population is getting larger. We must investigate the management of elderly patients after PD and prepare further for more experiences of PD. If appropriate surgical management is provided to elderly patients, we suggest that PD will lead to no adverse effects after surgery, and PD can be performed safely in elderly patients. We conclude that age should not be a contraindication to PD.The elderly population has increased in many countries. Indications for cancer treatment in elderly patients have expanded, because surgical techniques and medical management have improved remarkably. However, given that the morbidity and mortality associated with surgical procedures are poorly defined in this population, the decision to perform an operation in an elderly patient can be difficult [1]. Therefore, surgeons must give this decision careful consideration. Pancreaticoduodenectomy (PD), which
A male case of an undifferentiated carcinoma with osteoclast-like giant cells originating in an indeterminate mucin-producing cystic neoplasm of the pancreas. A case report and review of the literature
Takeyuki Wada, Osamu Itano, Go Oshima, Naokazu Chiba, Hideki Ishikawa, Yasumasa Koyama, Wenlin Du, Yuko Kitagawa
World Journal of Surgical Oncology , 2011, DOI: 10.1186/1477-7819-9-100
Abstract: Undifferentiated carcinoma (UC) with osteoclast-like giant cells (OGCs) is rare neoplasm of the pancreas. The tumor was first described by Rosai in 1968 [1], and similar tumors also have been identified in the skin, thyroid gland, ovary, breast, kidney, prostate, and soft tissue. In the pancreas, it was mostly recorded in ductal adenocarcinomas. Since Posen et al. reported the first case of an UC with OGCs of the pancreas associated with a mucus-secreting cystadenocarcinoma in 1981 [2], there have been 11 additional cases of UC with OGCs of the pancreas originating in mucinous cystic neoplasms (MCN) and indeterminate mucin-producing cystic neoplasm reported in the English language literature [2-12]. Among these cases, only one male case has been reported [8]. In this report, we describe a new male case of UC with OGCs that originated in an indeterminate mucin-producing cystic neoplasm of the pancreas, and discuss the clinicopathological features as well as present a review of the pertinent literature.A 59 year-old man presented at our hospital with a complaint of fullness in the upper abdomen. A physical examination showed a palpable mass in the upper left abdomen. Laboratory tests showed anemia and inflammatory reactivity, hemoglobin (Hgb) was 9.7 g/dl and C-reactive protein (CRP) was 3.01 mg/dl. Carbohydrate antigen 19-9 (CA19-9) was 274 U/ml and carcinoembryonic antigen (CEA) was 29.6 ng/ml. A computed tomography scan revealed a large cystic mass in the upper left quadrant of the abdomen that appeared to originate from the pancreatic tail (Figure 1). In magnetic resonance images, the cystic component showed variable signal intensities, and nodular components were seen in the cystic wall. Magnetic resonance cholangio-pancreatography showed narrowing and irregularity of the main pancreatic duct. Although it was a male case, we concluded tentatively that tumor might be a MCN of pancreas based on its characteristic appearance resembling the shape of an orange. An ope
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