Okuda Y.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
Asian journal of endoscopic surgery | Year: 2013
While the amount of blood loss during laparoscopic hepatectomy tends to be smaller than that during open hepatectomy, intermittent vascular occlusion to control hepatic inflow can diminish blood loss during laparoscopic hepatectomy. Described herein is a useful and convenient method for intermittent vascular occlusion, which was standardized for laparoscopic hepatectomy. A tourniquet system consisting of cloth tape and a 20-cm catheter was used for intermittent vascular occlusion. This was placed through a hole in the abdominal wall from which a 5-mm trocar had been extracted. By operating this tourniquet system outside the patient's body, we were easily able to repeat intermittent vascular occlusion. Twenty-three patients underwent laparoscopic hepatectomy using this system. The mean time of operation and vascular occlusion were 311.6 and 83.6 min, respectively. The mean blood loss was 215.0 mL. There were no intraoperative blood transfusions or critical postoperative complications. The average length of postoperative hospital stay was 6.5 days. The mean time to place this system was 354 s, and there were no complications caused by this system. During totally laparoscopic hepatectomy, surgeons can perform intermittent vascular occlusion safely by using this method. © 2012 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.
Koizumi F.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
British Journal of Cancer | Year: 2016
Background:We aimed to analyse clinical and gene expression profiles to predict pathologic complete response and disease-free survival using two consecutive, prospective, preoperative chemotherapy trial cohorts.Methods:Clinicopathological and gene expression data were evaluated in a cohort from two consecutive phase II preoperative studies that included patients with stage IIA–IIIC breast cancer of all subtypes. Analysed specimens were obtained before preoperative chemotherapy, and cDNA microarray analyses were performed using the Affymetrix Gene Chip U133 plus 2.0.Results:Between December 2005 and December 2010, 122 patients were analysed. The pathologic complete response rate was significantly higher in HER2+ and HR−/HER2− cancers. Age, pathologic complete response, HR−/HER2− status, and lymph node positivity (⩾4) were significant poor prognostic factors for disease-free survival. For the cDNA microarray analyses, sufficient tumour samples were available from 78 of the 107 patients (73%). An 8-gene signature predictive of pathologic complete response and a 17-gene signature predictive of prognosis were identified. Patients were categorised into low-risk (n=45) and high-risk groups (n=33) (HR 70.0, P=0.004).Conclusions:This study yielded preliminary data on the expression of specific genes predicting pathologic complete response and disease-free survival in a cohort of chemonaïve breast cancer patients. Further validation may distinguish those who would benefit most from perioperative chemotherapy as well as those needing further intervention.British Journal of Cancer advance online publication 14 July 2016; doi:10.1038/bjc.2016.184 www.bjcancer.com. © 2016 Cancer Research UK
Takahashi K.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2013
We report a rare case of fibrosing mediastinitis diagnosed by thoracoscopic biopsy. A 56-year-old female visited our hospital with an abnormal mediastinal shadow on chest X ray. Chest computed tomography revealed a paravertebral tumor from Th9 to Th11. Pathological examination of thoracoscopic biopsy specimen showed fibrous tissue with mild inflammation and no malignant feature. Final diagnosis was idiopathic fibrosing mediastinitis. The paravertebral lesion shrinked spontaneously 5 months later after biopsy.
Onoyama H.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2011
A 74-year-old man, whose chief complaint was epigastralgia, was referred to our hospital and diagnosed gastric cancer with liver metastasis. Gastrointestinal endoscopy showed a tumor on the lesser curvature of cardia of stomach. He was diagnosed as neuroendocrine cell carcinoma by biopsy specimens. He was treated by combined chemotherapy of CPT-11 and CDDP. After 11 courses, endoscopic examination revealed a complete disappearance of the primary tumor. CT-scan and MRI showed that the liver metastasis had been disappeared. We diagnosed as clinical CR and performed total gastrectomy with lymph node dissection and partial hepatectomy. Histological findings revealed a few cells in stomach and no cancer cells in the liver. He was treated with adjuvant chemotherapy of S-1. After 3-course, he suffered from anemia of grade 3, thus we interrupted chemotherapy. The patient remains alive for 28 months without recurrence. We conclude that chemotherapy was effective for neuroendocrine cell carcinoma of the stomach, which was to be considered of poor prognosis, and that liver resectomy was often effective.
Tsuda H.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital |
Tanaka K.,Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
Internal Medicine | Year: 2012
We report two cases of isolated unilateral pupil-sparing partial fascicular oculomotor paresis. Patient 1 was a 72-year-old man who developed left-sided palsy of the inferior rectus muscle (IR), medial rectus muscle (MR), superior rectus muscle (SR), inferior oblique muscle (IO), and levator palpebrae superioris (LP) due to infarction of the left paramedian thalamic artery. Patient 2 was a 70-year-old woman who developed rightsided palsy of MR, SR, IO and LP due to infarction of the right superior paramedian mesencephalic artery. These results suggest that the fibers to IR may be located in the most rostral portion of the oculomotor fascicles. © 2012 The Japanese Society of Internal Medicine.