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Nakahira S.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center | Takeda Y.,Kansai Rosai Hospital | Katsura Y.,Kansai Rosai Hospital | Kato T.,Kansai Rosai Hospital | And 2 more authors.
Surgical Endoscopy and Other Interventional Techniques

Background: Although laparoscopic hepato-biliary-pancreatic surgery has been widely adopted, use of laparoscopic resection for hepatocellular carcinoma (HCC) with advanced portal vein tumor thrombus (PVTT) is uncommon because of the complications involved.Methods: From June 2010 through November 2013, 200 laparoscopic hepatectomies were performed. We report the short-term outcome of laparoscopic hepatectomy for HCC with advanced PVTT in 3 patients. Video presentation is a demonstration of the operative procedures employed in Case 3. In this case, the left hepatic artery and left hepatic duct were divided before tumor thrombectomy, and the bifurcation of the portal vein was clearly visible.Results: Three female patients with HCC concomitant with PVTT in the portal trunk or the opposite branch underwent laparoscopic left hepatectomy with tumor thrombectomy using a laparoscopy-assisted technique (1 patient) or pure laparoscopic technique (2 patients). The median operative time was 592 min (range, 555–891 min), and median estimated blood loss was 1182 ml (range, minimal amount–4800 ml). The median length of hospital stay was 19 days (range, 9–22 days), and there was no postoperative mortality. In Case 1, recurrent tumors developed in the residual lobe after curative resection, and the patient died 10 months after the surgery despite treatment with sorafenib and transcatheter arterial chemoembolization. In Case 2, the patient survived for 10 months after curative resection without tumor recurrence. In Case 3, the patient was treated with sorafenib 1 month after palliative resection; she survived for 4 postoperative months, during which decreased tumor marker levels were observed.Conclusions: Laparoscopic hepatectomy for HCC with advanced PVTT is a safe and feasible procedure in selected patients, when performed by surgeons with expertise in hepatic surgery and minimally invasive techniques. Although these patients cannot be cured by surgery alone, early adjuvant therapy followed by laparoscopic surgery might contribute to a good outcome. © 2014, The Author(s). Source

Aoki D.,Keio University | Katsumata N.,National Cancer Center | Nakanishi T.,Aichi Cancer Center Hospital | Kigawa J.,Tottori University | And 8 more authors.
Japanese Journal of Clinical Oncology

Objective: This Phase II study was carried out to investigate the efficacy, safety and pharmacokinetics of topotecan in Japanese patients with relapsed ovarian carcinoma. Methods: Patients with relapsed ovarian carcinoma after having received one regimen containing platinum-based chemotherapy were eligible for this study. Topotecan was administered at 1.2 mg/m2/day for five consecutive days, repeated every 3 weeks. Results: Seventy-two patients were enrolled in the study. The response rate was 28.2% (95% confidence interval, 18.1-40.1%). Signs of myelosuppression, such as neutropenia (Grade 3, 12.5%; Grade 4, 83.3%), thrombocytopenia (Grade 3, 36.2%; Grade 4, 4.2%) and decreased hemoglobin (Grade 3, 36.1%; Grade 4, 11.1%), were the most common hematological toxicities. Grade 3 febrile neutropenia occurred in 5 (6.9%) patients. There was little intraindividual or interindividual variability in the pharmacokinetics of topotecan. Conclusions: Topotecan at 1.2 mg/m2/day is an effective and tolerable therapeutic option for Japanese patients with relapsed ovarian carcinoma. © The Author (2010). Published by Oxford University Press. All rights reserved. Source

Kajitani N.,Hiroshima University | Kajitani N.,Institute for Clinical Research | Hisaoka-Nakashima K.,Hiroshima University | Morioka N.,Hiroshima University | And 8 more authors.

Recently, multiple neurotrophic/growth factors have been proposed to play an important role in the therapeutic action of antidepressants. In this study, we prepared astrocyte- and neuron-enriched cultures from the neonatal rat cortex, and examined the changes in neurotrophic/growth factor expression by antidepressant treatment using real-time PCR. Treatment with amitriptyline (a tricyclic antidepressant) significantly increased the expression of fibroblast growth factor-2 (FGF-2), brain-derived neurotrophic factor, vascular endothelial growth factor and glial cell line-derived neurotrophic factor mRNA with a different time course in astrocyte cultures, but not in neuron-enriched cultures. Only the expression of FGF-2 was higher in astrocyte cultures than in neuron-enriched cultures. We focused on the FGF-2 production in astrocytes. Several different classes of antidepressants, but not non-antidepressants, also induced FGF-2 mRNA expression. Noradrenaline (NA) is known to induce FGF-2 expression in astrocyte cultures, as with antidepressants. Therefore, we also assessed the mechanism of NA-induced FGF-2 expression, in comparison to amitriptyline. NA increased the FGF-2 mRNA expression via α1 and β-adrenergic receptors; however, the amitriptyline-induced FGF-2 mRNA expression was not mediated via these adrenergic receptors. Furthermore, the amitriptyline-induced FGF-2 mRNA expression was completely blocked by cycloheximide (an inhibitor of protein synthesis), while the NA-induced FGF-2 mRNA was not. These data suggest that the regulation of FGF-2 mRNA expression by amitriptyline was distinct from that by NA. Taken together, antidepressant-stimulated astrocytes may therefore be important mediators that produce several neurotrophic/growth factors, especially FGF-2, through a monoamine-independent and a de novo protein synthesis-dependent mechanism. © 2012 Kajitani et al. Source

Matsuda M.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center | Matsuda M.,Institute for Clinical Research | Kawamoto T.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center | Tamura R.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center
Obesity Research and Clinical Practice

Background: Hepatic steatosis is considered one of the features of metabolic syndrome (MetS). Polyunsaturated fatty acid (PUFA) metabolism is modulated in obesity. However, it has yet to be fully elucidated whether a serum PUFA profile is associated with hepatic steatosis. Objective: We aimed to clarify the relationship between a serum PUFA profile and liver lipid content. Methods: A cross-sectional study was conducted on 288 patients with dyslipidemia, diabetes, or coronary artery disease on statin therapy. Several PUFAs were measured, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), dihomo-γ-linolenic acid (DGLA) and arachidonic acid (AA) in serum lipids, and δ-5 desaturase (D5D) activity was estimated by AA to DGLA ratio. Abdominal computed tomography (CT) measured visceral fat area (VFA) and the ratio of CT attenuation for liver to spleen (L/S). Results: The L/S ratio showed significant correlations with serum DGLA level and D5D activity (p <. 0.0001 for both). Serum DGLA level and D5D activity were significantly correlated with body mass index (BMI) or VFA, and with Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) (p <. 0.0001 for all). Multivariate logistic analysis revealed that a high DGLA level or low D5D activity was a significant determinant for hepatic steatosis (p <. 0.0001 for both) independent of BMI and HOMA-IR. ROC analysis revealed that they significantly enhanced the value of MetS-related factors in predicting hepatic steatosis (p <. 0.05 for both). Conclusions: A high DGLA level and low D5D activity in serum lipids may be useful markers predicting hepatic steatosis incrementally to MetS-related conventional factors. © 2016 Asia Oceania Association for the Study of Obesity. Source

Kitahara Y.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center | Araki Y.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center | Nakano K.,National Hospital Organization Kure Medical Center and Chugoku Cancer Center
Respiratory Medicine Case Reports

Hot tub lung is a lung disease caused by Mycobacterium avium complex. We report the first case of familial hot tub lung appearing simultaneously in a husband and wife. Our case supports the consideration that hot tub lung is a hypersensitivity pneumonitis rather than an infectious lung disease. It also suggests that the state of hot tub lung changes seasonally depending on temperature variations, in a manner similar to summer-type hypersensitivity pneumonitis. This case demonstrates similarities between hot tub lung and summer-type hypersensitivity pneumonitis in regards to familial occurrence and seasonal changes in the disease state. © 2016 The Authors. Source

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