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Find video protocols related to scientific articles indexed in Pubmed.
[Tension hemothorax accompanying rupture of the descending aortic aneurysm].
Kyobu Geka
PUBLISHED: 11-14-2014
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Although, tension hemothorax appears along with thoracic injuries in many cases, the incidence is rare and the concept itself has not yet been established. Moreover, reports on tension hemothorax caused by the rupture of thoracic aortic aneurysms are very rare. Herein, we report a case in which thoracic endovascular aortic repair( TEVAR) was carried out following chest drainage in order to treat tension hemothorax accompanying rupture of the descending aortic aneurysm, thus leading to the survival of the patient.
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A Methylene Blue-assisted Technique for Harvesting Lymph Nodes After Radical Surgery for Gastric Cancer: A Prospective, Randomized, Controlled Study.
Am. J. Surg. Pathol.
PUBLISHED: 10-31-2014
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Harvesting lymph nodes (LNs) after gastrectomy is essential for accurate staging. This trial evaluated the efficiency and quality of a conventional method and a methylene blue-assisted method in a randomized manner. The key eligibility criteria were as follows: (i) histologically proven adenocarcinoma of the stomach; (ii) clinical stage I-III; (iii) R0 resection planned by gastrectomy with D1+ or D2 lymphadenectomy. The primary endpoint was the ratio of the pathologic number of harvested LNs per time (minutes) as an efficacy measure. The secondary endpoint was the number of harvested LNs, as a quality measure. Between August 2012 and December 2012, 60 patients were assigned to undergo treatment using the conventional method (n=29) and the methylene blue dye method (n=31). The baseline demographics were mostly well balanced between the 2 groups. The number of harvested LNs (mean±SD) was 33.6±11.9 in the conventional arm and 43.4±13.9 in the methylene blue arm (P=0.005). The ratio of the number of the harvested LNs per time was 1.12±0.46 LNs/min in the conventional arm and 1.49±0.59 LNs/min in the methylene blue arm (P=0.010). In the subgroup analyses, the quality and efficacy were both superior for the methylene blue dye method compared with the conventional method. The methylene blue technique is recommended for harvesting LNs during gastric cancer surgery on the basis of both the quality and efficacy.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.
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Subclavian artery aneurysm in a patient with vascular Ehlers-Danlos syndrome.
Asian Cardiovasc Thorac Ann
PUBLISHED: 10-09-2014
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We describe our experience of surgical treatment in a 28-year-old woman with vascular Ehlers-Danlos syndrome. A right subclavian artery aneurysm was detected. The right vertebral artery arose from the aneurysm. Digital subtraction angiography showed interruption of the left vertebral artery. The aneurysm was excised and the right vertebral artery was anastomosed end-to-side to the right common carotid artery under deep hypothermia and circulatory arrest. The patient remained very well 4 years after surgery, with no late vascular complication.
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Thyroid lobectomy for papillary thyroid cancer: long-term follow-up study of 1,088 cases.
World J Surg
PUBLISHED: 09-06-2014
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Total thyroidectomy is well accepted as initial surgery for papillary thyroid cancer (PTC), but the extent of the thyroidectomy remains a matter of controversy. This study was designed to investigate the long-term clinical outcome of PTC patients who had undergone thyroid lobectomy and to elucidate the indications of lobectomy as initial surgery.
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Thoracoscopic lung biopsy in 285 patients with diffuse pulmonary disease.
Asian Cardiovasc Thorac Ann
PUBLISHED: 09-04-2014
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Surgical lung biopsy is generally considered the most appropriate method for diagnosing diffuse lung disease. However, there are few reports focusing on only one thoracoscopic technique. This study was designed to determine the morbidity and mortality related to video-assisted thoracoscopic lung biopsy in a single center, thereby providing data on the severity of morbidity and clarifying the risk factors.
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Decreased serum osmolality promotes ductus arteriosus constriction.
Cardiovasc. Res.
PUBLISHED: 09-04-2014
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At birth, dynamic changes occur in serum components and haemodynamics, such as closure of the ductus arteriosus (DA). A previous study demonstrated that, in full-term human neonates, serum osmolality decreased transiently after birth, but recovered over the next few days. However, the significance of this transient decrease in osmolality has never been addressed. The objective of the present study was to examine the role of changes in serum osmolality after birth in DA closure.
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Coronary Subclavian Steal Syndrome Detected During Coronary Bypass Surgery in a Hemodialysis Patient.
J Card Surg
PUBLISHED: 08-25-2014
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Coronary subclavian steal syndrome associated with upper extremity arteriovenous fistula is an uncommon but potentially life-threatening condition. We present a case of a 65-year-old male on hemodialysis with a left upper extremity arteriovenous fistula who underwent coronary revascularization involving bypass with the left internal thoracic artery to the left anterior descending artery. Intraoperative transit-time graft flow measurements and fluorescence imaging showed a reversed flow in the left internal thoracic artery, and the left internal thoracic artery was successfully converted as a free graft from the ascending aorta to the left anterior descending artery.
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Clinicopathological features and EGFR gene mutation status in elderly patients with resected non-small-cell lung cancer.
BMC Cancer
PUBLISHED: 08-25-2014
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The rapid aging of the population in Japan has been accompanied by an increased rate of surgery for lung cancer among elderly patients. It is thus an urgent priority to map out a treatment strategy for elderly patients with primary lung cancer. Although surgical resection remains standard treatment for early stage non-small-cell lung cancer (NSCLC), it is now essential to confirm the status of epidermal growth factor receptor (EGFR) gene mutations when planning treatment strategies. Furthermore, several studies have reported that EGFR mutations are an independent prognostic marker in NSCLC. However, the relations between age group and the molecular and pathological characteristics of NSCLC remain unclear. We studied the status of EGFR mutations in elderly patients with NSCLC and examined the relations of EGFR mutations to clinicopathological factors and outcomes according to age group.
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Diagnosis of metachronous multiple lung adenocarcinoma at the cut-end by epidermal growth factor receptor mutation status discordance 4 years after sublobar resection for adenocarcinoma in situ: report of a case.
Surg. Today
PUBLISHED: 08-21-2014
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We report a case of metachronous multiple lung adenocarcinoma at the cut-end, diagnosed 4 years after sublobar resection for adenocarcinoma in situ (AIS), on the basis of discordance of epidermal growth factor receptor (EGFR) mutation status between the first and second tumor. The patient was an 81-year-old Japanese man, whose chest computer tomography (CT) scan showed mixed ground-glass opacity in the right upper lobe of the lung. Wedge resection was performed and a diagnosis of AIS, non-mucinous (18 × 14 mm), with a margin of 6 mm, was made. A tumor at the cut-end was seen on a CT scan 4 years later, and abnormal uptake was identified by fluorine-18 fluorodeoxyglucose-positron emission tomography. Right upper lobectomy and lymph node dissection were performed and the tumor was diagnosed as invasive adenocarcinoma, acinar predominant. Discordance of EGFR mutation status between the first tumor, harboring exon 19 deletion, and the second tumor, having an L858R point mutation in exon 21, revealed that the second tumor was metachronous multiple lung cancer. This case demonstrates the necessity of comparing EGFR mutation status between the first tumor and the second tumor at the cut-end.
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Feasibility of enhanced recovery after surgery in gastric surgery: a retrospective study.
BMC Surg
PUBLISHED: 07-02-2014
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Enhanced recovery after surgery (ERAS) programs have been reported to be feasible and useful for maintaining physiological function and facilitating recovery after colorectal surgery. The feasibility of such programs in gastric surgery remains unclear. This study assessed whether an ERAS program is feasible in patients who undergo gastric surgery.
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The clinicopathological features associated with skip N2 metastases in patients with clinical stage IA non-small-cell lung cancer.
Eur J Cardiothorac Surg
PUBLISHED: 06-25-2014
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Understanding the clinicopathological features of patients with skip N2 metastases (SN2) in clinical early stage lung cancer is important for surgical planning and other treatment considerations; however, the factors associated with SN2 are unclear. This study aimed to investigate the clinicopathological features associated with SN2 in patients with clinical stage IA (cIA) non-small-cell lung cancer (NSCLC).
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Total arch replacement for coarctation of the aorta in an adolescent.
Asian Cardiovasc Thorac Ann
PUBLISHED: 06-15-2014
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A 16-year-old boy suffered a subarachnoid hemorrhage and underwent open head surgery. He was subsequently diagnosed with coarctation of the aorta and referred to our hospital. The coarctation was at the distal transverse arch, just at the site of branching of the subclavian artery. Total arch replacement with selective cerebral perfusion was selected because of the short hypoplastic arch. The patient had an uneventful postoperative course, and was doing well 3 years after the surgery.
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[A Re-do Case of Recurrent Constrictive Pericarditis 35 Years after Pericardiectomy;Report of a Case].
Kyobu Geka
PUBLISHED: 06-12-2014
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Reports of recurrent constrictive pericarditis are scarce. We report a re-do case of recurrent constrictive pericarditis 35 years after pericardiectomy. The calcified pericardium was thick and severely adhesive. We performed pericardiectomy on pump, using Harmonic Scalpel and rib scissors for a safe and secure operation. The calcified pericardium looked like a crab's shell. The patient was discharged on 14th post-operative day. Long-term follow-up is necessary for this patient.
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Late cardiac metastasis from colorectal carcinoma 15 years after surgery.
Asian Cardiovasc Thorac Ann
PUBLISHED: 06-11-2014
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Late recurrence of malignant tumors in the heart more than 10 years after surgery is quite rare, especially for colorectal carcinoma. Here, we report a case of late cardiac metastasis from a primary colorectal carcinoma, which occurred more than 15 years after the initial surgery. To our knowledge, this is the first such reported case.
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Devised loop-in-loop technique in mitral valve repair.
Asian Cardiovasc Thorac Ann
PUBLISHED: 06-03-2014
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The loop technique is useful for multiple chordal reconstructions in mitral valve repair. Although it is easy to anchor the loop to the tip of the prolapsed leaflet, take-down of the anchored loop is not easy. The devised loop-in-loop technique makes intraoperative adjustment of the neochordae quick and easy. This article describes a straightforward and reproducible method for secure anchoring and, if necessary, take-down of neochordae using the loop-in-loop technique for mitral valve repair.
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Risk factors for 6-month continuation of S-1 adjuvant chemotherapy for resected pancreatic cancer.
Cancer Chemother. Pharmacol.
PUBLISHED: 05-19-2014
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The factors which affect the 6-month continuation of adjuvant chemotherapy with S-1 have not been fully evaluated in pancreatic cancer. The objective of this retrospective study was to clarify the risk factors for the discontinuation of S-1 adjuvant chemotherapy after 6 months of treatment.
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Visualization of blood supply route to the reconstructed stomach by indocyanine green fluorescence imaging during esophagectomy.
BMC Med Imaging
PUBLISHED: 05-15-2014
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Ensuring an adequate blood supply is essential to the safe performance of an anastomosis during esophagectomy and the prevention of anastomotic leakage. Recently, indocyanine green (ICG) fluorescence imaging has been used to visualize the blood supply when anastomosis is performed in vascular surgery. We used ICG fluorescence imaging to visualize the blood supply for reconstruction during esophagectomy.
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Pericardial ectopic thymoma presenting with cardiac tamponade: report of a case.
Surg. Today
PUBLISHED: 05-01-2014
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Ectopic thymoma arising from organs other than the thymus, such as the neck, trachea, thyroid, lung and pericardium, is rare. To date, there have been only seven other cases of pericardial thymoma reported in the English literature. We herein report a case of pericardial ectopic thymoma that presented with cardiac tamponade. A 72-year-old Japanese male noticed body weight gain and leg edema. Chest computed tomography (CT) revealed pericardial effusion and an irregularly shaped mass in the pericardial space compressing the right atrium. He was considered to have cardiac tamponade due to a paracardiac tumor that developed following acute cardiac failure. The intraoperative frozen diagnosis was thymoma. Pericardectomy of the thickened pericardium, tumorectomy and thymectomy via a median sternotomy were performed. The final pathological diagnosis was pericardial ectopic thymoma associated with constrictive pericarditis. The differential diagnosis and complete resection of mediastinal tumors such as this rare case of thymoma are important to obtain a better prognosis, as patients with such tumors often present in a state of shock.
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Relation of INHBA gene expression to outcomes in gastric cancer after curative surgery.
Anticancer Res.
PUBLISHED: 04-30-2014
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Inhibin-?A (INHBA), a ligand belonging to the transforming growth factor-? superfamily, is associated with cell proliferation in cancer. We studied the relations of INHBA gene expression to clinicopathological factors and outcomes in 168 patients with gastric cancer who underwent curative surgery. Relative INHBA gene expression was measured in surgical specimens of cancer tissue and adjacent normal mucosa by quantitative real-time, reverse-transcription polymerase chain reaction. INHBA expression levels were significantly higher in cancer tissue than in adjacent normal mucosa and were related to TNM stage and venous invasion. High INHBA gene expression was associated with significantly poorer 5-year overall survival than was low expression. On multivariate analysis, INHBA gene expression was an independent prognostic factor. Overexpression of the INHBA gene is considered a useful independent predictor of outcomes in patients with gastric cancer after curative surgery.
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Outcomes of Lobectomy in 'Active' Octogenarians with Clinical Stage I Non-Small-Cell Lung Cancer.
Ann Thorac Cardiovasc Surg
PUBLISHED: 04-22-2014
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Introduction: In octogenarians with early stage of lung cancer, sublobar resection has been shown to be no inferior survival to lobectomy. However, some octogenarians remain physically and mentally active.Methods: We retrospectively studied 65 octogenarians who underwent curative resection for clinical stage I NSCLC (excluding adenocarcinoma in situ). All patients were assessed by cardiologists and underwent stair-climbing tests (five flights, 18 m) and cognitive function tests. Lobectomy was performed in patients who could climb 5 flights of stairs without stopping or oxygen desaturation of >4%.Results: The actuarial survival rate was 68.6% at 5 years, and the median survival time was 109.2 months. Forty-three patients met the criteria for lobectomy. As compared with sublobar resection, lobectomy was associated with significantly higher rates of overall survival (78.4% vs. 48.5%; p = 0.02) and disease-specific survival (88.4% vs. 61.7%; p = 0.02) at 5 years. On multivariate analysis, male sex (hazard ratio, 3.827; 1.382-10.596) and sublobar resection (2.261; 1.054-5.360) were independent risk factors for survival. Mental disorders occurred in 6 patients (9.2%), and their score on preoperative cognitive function tests was significantly lower than that of patients without mental disorders (22.7 vs. 26.0, p <0.01).Conclusion: Outcomes of lobectomy are good in physically and mentally competent octogenarians.
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[A case of postmenopausal breast cancer becoming HER2 positive after neoadjuvant hormone therapy].
Gan To Kagaku Ryoho
PUBLISHED: 04-19-2014
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A 75-year-old woman presented to a local doctor with a lump in the right breast. On physical examination, a tumor measuring 24mm was palpable in the BD area of her right breast. Mammography showed category 5 disease, and ultrasonography revealed a tumor measuring 24×16 mm. A mammotome biopsy provided a diagnosis of invasive ductal carcinoma of the breast(ER 7/PgR 4/HER2 1+), and the tumor was classified as stage IIA(T2N0M0)according to the UICC-TNM classification. She was recommended surgery but she rejected this option and underwent hormone therapy with anastrozole (1mg/day). One year and 8months after beginning the treatment, ultrasonography showed the tumor to measure 7.0×5.7 mm, and hormone therapy resulted in a partial response(PR). The patient hoped to undergo an operation, so she was referred to our hospital, and a right partial mastectomy and sentinel node biopsy was performed. A histopathological exami- nation indicated scirrhous carcinoma, 18mm, nuclear grade 1, f, ly1, v0, n0, ER 3/PgR 3/HER2 3+. The curative effect was grade 1a. The tumor had become HER2 positive, so the patient was then administered radiotherapy and trastuzumab and anastrozole as adjuvant therapy. Herein, we report our experience with a case of breast cancer that only became HER2 positive after hormone therapy, and also provide some bibliographic comments on this occurrence.
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Vitamin E deficiency begins within 6 months after gastrectomy for gastric cancer.
World J Surg
PUBLISHED: 03-27-2014
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To clarify factors related to vitamin E malabsorption after gastric surgery, we evaluated serum vitamin E levels in patients who had undergone gastrectomy for gastric cancer.
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Comparison between CT tumor size and pathological tumor size in frozen section examinations of lung adenocarcinoma.
Lung Cancer
PUBLISHED: 03-18-2014
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We examined the appropriate measurement for pathological tumor size by comparing radiological and pathological tumor size of resected lung adenocarcinoma in FSE.
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Constrictive pericarditis caused by immunoglobulin G4-related disease.
Ann. Thorac. Surg.
PUBLISHED: 03-04-2014
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An 81-year-old man with congestive heart failure was admitted to our hospital. Computed tomography of the chest revealed pericardial thickening without calcification. Ultrasonic echocardiography and cardiac magnetic resonance imaging demonstrated diastolic dysfunction. Cardiac catheterization showed bilateral elevation of ventricular end-diastolic pressure with a square root sign. The preoperative serum immunoglobulin G4 (IgG4) level was abnormally high. Pericardiectomy and pericardiotomy were considered to be indicated and were performed. Histopathologic examination revealed tissue infiltration by IgG4-positive plasma cells, and constrictive pericarditis caused by IgG4-related disease was diagnosed. Postoperatively, the patient received additional corticosteroid therapy. The latest cardiac magnetic resonance image showed further improvement in diastolic function.
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Methylene blue-assisted technique for harvesting lymph nodes after radical surgery for gastric cancer: a prospective randomized phase III study.
BMC Cancer
PUBLISHED: 03-03-2014
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This randomized Phase III trial will evaluate whether the methylene blue-assisted technique is efficient for harvesting lymph nodes after radical surgery for gastric cancer.
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Using NU-KNIT® for hemostasis around recurrent laryngeal nerve during transthoracic esophagectomy with lymphadenectomy for esophageal cancer.
BMC Res Notes
PUBLISHED: 02-26-2014
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We thought that using electrocautery for hemostasis caused recurrent laryngeal nerve palsy. We reflected the prolonged use of electrocautery and employed NU-KNIT® to achieve hemostasis nearby the recurrent laryngeal nerve. We assessed that using NU-KNIT® hemostasis prevented or not postoperative recurrent laryngeal nerve palsy, retrospectively. The present study was evaluated to compare using electrocautery hemostasis with using NU-KNIT® hemostasis during lymphadenectomy along recurrent laryngeal nerve. The variables compared were morbidity rate of recurrent laryngeal nerve palsy, operation time, and blood loss.
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Impact of infectious complications on gastric cancer recurrence.
Gastric Cancer
PUBLISHED: 02-23-2014
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Postoperative infectious complications increase disease recurrence in colorectal cancer patients. We herein investigated the impact of infectious complications on gastric cancer recurrence after curative surgery.
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Usefulness of real-time three-dimensional trans-oesophageal echocardiography for detection of isolated unroofed coronary sinus.
Cardiol Young
PUBLISHED: 02-20-2014
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We report a case of unroofed coronary sinus not associated with the persistent left superior vena cava. Definite diagnosis of the unroofed coronary sinus was obtained by trans-oesophageal echocardiography, which revealed the unroofed portion with left-to-right shunt. Real-time three-dimensional trans-oesophageal echocardiography could show the whole pictures of the defect, which was useful information for surgical repair.
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Impact of overexpression of Sushi repeat-containing protein X-linked 2 gene on outcomes of gastric cancer.
J Surg Oncol
PUBLISHED: 02-16-2014
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Sushi repeat-containing protein X-linked 2 (SRPX2) was first described as a downstream target gene for E2A-HLA, which causes pro-B acute leukemia. SRPX2 is considered to promote cellular migration and adhesion in cancers. Our objective was to evaluate the relative expression of the SRPX2 gene and to determine whether such expression correlates with outcomes in patients with gastric cancer.
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A propensity score-matching analysis comparing the oncological outcomes of laparoscopic and open surgery in patients with Stage I/II colon and upper rectal cancers.
Surg. Today
PUBLISHED: 02-13-2014
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Previous studies from Western countries have shown similar survival outcomes after both open and laparoscopic resections. In Japan, radical D3 dissections performed by open resection have been routinely performed for ?T2- or ?N1-stage cancers, and relatively favorable survival outcomes were obtained. This study compared the survival in patients with Stage I/II colon and upper rectal cancers undergoing laparoscopic and open resection.
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Randomized comparison of surgical stress and the nutritional status between laparoscopy-assisted and open distal gastrectomy for gastric cancer.
Ann. Surg. Oncol.
PUBLISHED: 02-06-2014
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Laparoscopy-assisted distal gastrectomy (LADG) for gastric cancer may prevent the development of an impaired nutritional status due to reduced surgical stress compared with open distal gastrectomy (ODG).
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Prognostic factors in stage IB gastric cancer.
World J. Gastroenterol.
PUBLISHED: 01-19-2014
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To identify the subset of patients with stage IB gastric cancer with an unfavorable prognosis.
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Lung abscess combined with chronic osteomyelitis of the mandible successfully treated with video-assisted thoracoscopic surgery.
Clin Respir J
PUBLISHED: 01-16-2014
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With the progress of antibiotic therapy, the mortality of lung abscess has been improved, and surgical intervention has declined. However, surgery is still required in selected cases that are intractable to antibiotic treatment. Video-assisted thoracoscopic surgery (VATS) is beneficial for treatment and/or diagnosis of pulmonary disease as it provides a less invasive surgical technique and reduces prolongation of post-operative recovery. However, the indication of VATS lobectomy for lung abscess is controversial as a result of particular complications, i.e. wet lung, intrapleural adhesion and ease of bleeding. We herein report a rare combination of lung abscess and osteomyelitis of mandible resulting from the same pathogen successfully treated with VATS lobectomy. We propose VATS lobectomy for lung abscess. This procedure might be the best treatment candidate for selected cases of lung abscess.
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Perivascular epithelioid cell tumor of the rectum: report of a case and review of the literature.
World J Surg Oncol
PUBLISHED: 01-13-2014
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We report a case of perivascular epithelioid cell tumor arising in the rectum of a 55-year-old woman. The tumor was treated by transanal endoscopic microsurgery. After 1 year follow-up, the patient is alive with no radiologic or endoscopic evidence of recurrence. Perivascular epithelioid cell tumor is a rare mesenchymal tumor characterized by co-expression of melanocytic and smooth muscle markers. This rare tumor can arise in various organs, including the falciform ligament, uterus, uterine cervix, liver, kidney, lung, breast, cardiac septum, pancreas, prostate, thigh, and gastrointestinal tract. Perivascular epithelioid cell tumor of the gastrointestinal tract is very rare, with only 23 previously reported cases. We review the literature on perivascular epithelioid cell tumors arising in the gastrointestinal tract.
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A prospective randomized controlled trial of subcutaneous passive drainage for the prevention of superficial surgical site infections in open and laparoscopic colorectal surgery.
Int J Colorectal Dis
PUBLISHED: 01-03-2014
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A number of studies have evaluated the effects of subcutaneous drainage during digestive surgery. All of the previous studies assessed the usefulness of active-suctioning drain, including two randomized controlled studies which found no benefit for the placement of active-suctioning drains in digestive surgery. The utility of passive drainage has not been evaluated previously. The purpose of this study was to evaluate the efficacy of subcutaneous passive drainage system for preventing surgical site infections during major colorectal surgery.
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Allelic imbalance in the miR-31 host gene locus in lung cancer--its potential role in carcinogenesis.
PLoS ONE
PUBLISHED: 01-01-2014
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Small non-protein coding RNA, microRNA (miR), which regulate messenger RNA levels, have recently been identified, and may play important roles in the pathogenesis of various diseases. The present study focused on miR-31 and investigated its potential involvement in lung carcinogenesis. The expression of miR-31 was altered in lung cancer cells through either the amplification or loss of the host gene locus. The strong expression of miR-31 in large cell carcinomas was attributed to the gene amplification. Meanwhile, the loss of miR-31 expression was more frequently observed in aggressive adenocarcinomas. Thus, miR-31 may play a pleiotropic role in the development of lung cancers among different histological types. To the best of our knowledge, this is the first study to show the potential causative mechanism of the altered expression of miR-31 and suggest its potentially diverse significance in the different histological types of lung cancers.
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Proteome analysis for downstream targets of oncogenic KRAS--the potential participation of CLIC4 in carcinogenesis in the lung.
PLoS ONE
PUBLISHED: 01-01-2014
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This study investigated the proteome modulated by oncogenic KRAS in immortalized airway epithelial cells. Chloride intracellular channel protein 4 (CLIC4), S100 proteins (S100A2 and S100A11), tropomyosin 2, cathepsin L1, integrins?3, eukaryotic elongation factor 1, vimentin, and others were discriminated. We here focused on CLIC4 to investigate its potential involvement in carcinogenesis in the lung because previous studies suggested that some chloride channels and chloride channel regulators could function as tumor suppressors. CILC4 protein levels were reduced in some lung cancer cell lines. The restoration of CLIC4 in lung cancer cell lines in which CLIC4 expression was reduced attenuated their growth activity. The immunohistochemical expression of the CLIC4 protein was weaker in primary lung cancer cells than in non-tumorous airway epithelial cells and was occasionally undetectable in some tumors. CLIC4 protein levels were significantly lower in a subtype of mucinous ADC than in others, and were also significantly lower in KRAS-mutated ADC than in EGFR-mutated ADC. These results suggest that the alteration in CLIC4 could be involved in restrictedly the development of a specific fraction of lung adenocarcinomas. The potential benefit of the proteome modulated by oncogenic KRAS to lung cancer research has been demonstrated.
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Expression of HDAC9 in lung cancer--potential role in lung carcinogenesis.
Int J Clin Exp Pathol
PUBLISHED: 01-01-2014
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Our previous studies identified important molecules involved in lung carcinogenesis through a comprehensive search for the downstream targets of oncogenic KRAS, and these findings suggested that an investigation into the downstream targets of oncogenic KRAS might represent a useful strategy for elucidating the common molecular bases of lung cancer. Among the downstream targets of oncogenic KRAS, a focus was placed on HDAC9, a member of the histone deacetylase family, in the present study because epigenetic modification of DNA or the histone proteins is known to play an important role in carcinogenesis. The immunohistochemical expression of HDAC9 was examined in surgically resected primary lung cancers (130 adenocarcinoma, 49 squamous cell carcinomas, one large cell carcinoma, and 6 small cell carcinomas) and potential associations between its expression level and pathologic factors were analyzed. The results showed that HDAC9 expression levels were lower in lung cancer cells than in non-tumor epithelial cells, and were also significantly lower in adenocarcinomas among the histological types. Moreover, HDAC9 expression levels were significantly lower in adenocarcinomas with lymphatic canal involvement. The restoration of HDAC9 in lung cancer cells losing its expression severely attenuated their growth activity in vitro. These results suggest that HDAC9 may be a suppressor and its downregulation might promote the progression process, especially in lung adenocarcinomas.
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Prostaglandin E2 Inhibits Elastogenesis in the Ductus Arteriosus via EP4 Signaling.
Circulation
PUBLISHED: 10-21-2013
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Elastic fiber formation begins in mid-gestation and increases dramatically during the last trimester in the great arteries, providing elasticity and thus preventing vascular wall structure collapse. However, the ductus arteriosus (DA), a fetal bypass artery between the aorta and pulmonary artery, exhibits lower levels of elastic fiber formation, which promotes vascular collapse and subsequent closure of the DA after birth. The molecular mechanisms for this inhibited elastogenesis in the DA, which is necessary for the establishment of adult circulation, remain largely unknown.
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The use of surgical glue in acute type A aortic dissection.
Gen Thorac Cardiovasc Surg
PUBLISHED: 09-20-2013
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Acute type A aortic dissection (AAAD) remains a lethal disease. With advances in operative methods and perioperative management, surgical outcomes continue to improve, but in-hospital mortality still ranges from 10 to 30 % in most series. The surgical technique of choice for aortic root repair remains controversial. Surgical glue created a breakthrough in surgery for acute aortic dissection. We review the surgical techniques with the use of surgical glue for AAAD.
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[Curative resection of a case of advanced gastric cancer with peritoneal dissemination responding well to combination chemotherapy of docetaxel,cisplatin and S-1].
Gan To Kagaku Ryoho
PUBLISHED: 09-20-2013
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We report a curative resection of a case with advanced gastric cancer responding remarkably well to combination chemotherapy of docetaxel, cisplatin and S-1. The patient was a 71-year-old man with gastric cancer of Borrmann type 3 accompanied with N3. Staging laparoscopy revealed peritoneal dissemination. He was administered docetaxel intravenously at 40mg/ m2 on day 1, cisplatin intravenously at 60 mg/m2 on day 1, and S-1 orally at 80 mg/m2 on days 1 to 14. This treatment was repeated every 28 days as one course. According to gastroscope and CT findings, a significant tumor reduction was obtained after 4 courses. After 6 courses, a CT scan revealed partial response of the lymph node metastasis, and the serum CEA value was normalized. Curative total gastrectomy was performed. The histological effect of the primary lesion was judged to be grade 2. Combination chemotherapy of S-1, cisplatin and docetaxel can be effective and feasible for advanced gastric cancer.
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Chylorrhea following laparoscopy assisted distal gastrectomy with D1+ dissection for early gastric cancer: A case report.
Int J Surg Case Rep
PUBLISHED: 08-28-2013
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Chylorrhea is a form of lymphorrhea involving digested lipid products absorbed in the small intestine. Here we report a rare case of chylorrhea after laparoscopy-assisted distal gastrectomy (LADG) with D1+ dissection that resolved following administration of a low-fat diet.
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Laparoscopy-assisted distal gastrectomy for an early gastric cancer patient with situs inversus totalis.
Int Surg
PUBLISHED: 08-27-2013
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Abstract Situs inversus totalis (SIT) is a congenital condition in which there is complete right to left reversal of the thoracic and abdominal organs. This report describes laparoscopy-assisted distal gastrectomy (LADG) for an early gastric cancer patient with SIT. The preoperative diagnosis was c-stage IA (cT1a cN0 cH0 cP0 cM0). LADG with D1+ dissection and Billroth-I reconstruction was successfully performed by standing at the opposite position. The operating time was 234 minutes and blood loss was 5 mL. Although a mechanical obstruction occurred after surgery, the patient recovered after re-operation with Roux-en-Y bypass.
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Priority of lymph node dissection for Siewert type II/III adenocarcinoma of the esophagogastric junction.
Ann. Surg. Oncol.
PUBLISHED: 08-14-2013
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The purpose of this study was to clarify the priority of nodal dissection in Siewert types II and III adenocarcinoma of the esophagogastric junction (AEG).
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Partial translocation mitral valve replacement with autologous pericardial patch reinforcement of ventricularized left atrial wall for severe annular calcification extending to the left ventricle.
J Card Surg
PUBLISHED: 07-28-2013
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We describe a technique of partial translocation with an autologous pericardial patch reinforcement of the left atrial wall in patients with extensive mitral annular calcification (MAC) who require mitral valve replacement.
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Stent-graft Implantation for Clinically Diagnosed Syphilitic Aortic Aneurysm in an HIV-infected Patient.
Ann Thorac Cardiovasc Surg
PUBLISHED: 06-19-2013
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We describe our experience with stent-graft placement in a patient with a clinically diagnosed syphilitic aortic aneurysm.The patient was a 43-year-old man with syphilitic and human immunodeficiency virus (HIV) co-infection. Computed tomography (CT) revealed an aortic aneurysm with 89 mm in maximum size which was located at distal aortic arch and was considered syphilis derived saccular aneurysm. The aneurysm was judged at high risk of rupture from its shape. We decided to perform stent-graft implantation. Before surgery, the patient was given antibacterial and anti-HIV agents. Hand-made fenestrated stent graft by Tokyo Medical University was implanted. The graft was placed from the ascending aorta to Th 9 level in the descending aorta. The aneurysm completely disappeared during follow-up, with no flare-up of syphilitic infection up to 2 years after surgery.The number of patients with syphilis and human immunodeficiency virus co-infection is now increasing. Stent-graft implantation may be an effective treatment in such immunocompromised patients.
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Mitral valve surgery in a patient with dextrocardia and 180° counter-clockwise rotated heart due to congenital agenesis of the right lung.
J Card Surg
PUBLISHED: 05-30-2013
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We report a case of severe mitral regurgitation (MR) with dextrocardia and 180° counterclockwise rotated situs solitus heart. We describe the technique for mitral valve surgery in a patient with dextrocardia and agenesis of the right lung.
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Epigenetic silencing of checkpoint with fork-head associated and ring finger gene expression in esophageal cancer.
Oncol Lett
PUBLISHED: 04-29-2013
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Checkpoint with fork-head associated and ring finger (CHFR) is a mitotic checkpoint gene with tumor-suppressor functions. Previous studies have described the hypermethylation of the CpG island in the promoter region as a key mechanism involved in silencing tumor suppressor genes. The epigenetic alterations regulating CHFR expression and the clinical significance of CHFR downregulation remain unclear. A total of 40 patients with esophageal squamous cell carcinoma who underwent primary resection were enrolled in this study. CHFR mRNA expression was quantified, followed by an evaluation of the methylation status using methylation-specific polymerase chain reaction (MSP) techniques in 29 patients. The correlation between CHFR expression and MSP status was then analyzed. In addition, the significance of CHFR expression was determined, with respect to clinicopathological features and overall survival. Aberrant hypermethylation of the CHFR gene was observed in 13 of 29 primary esophageal cancers. The CHFR expression levels of the methylated status samples was significantly lower than that of the unmethylated status samples (P=0.014). CHFR expression levels did not exhibit clinical significance with respect to the patient characteristics or overall survival. Hypermethylation of the CHFR gene is a common event in the development of primary esophageal cancer. CpG island hypermethylation of the promoter region in the CHFR gene is a key mechanism involved in silencing the CHFR gene in patients with esophageal cancer.
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Clinical significance of SPARC gene expression in patients with gastric cancer.
J Surg Oncol
PUBLISHED: 04-25-2013
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Secreted protein acidic and rich in cysteine (SPARC) is one of the first known matricellular proteins that modulates interactions between cells and extracellular matrix. Recent studies investigated the clinical significance of SPARC gene expression in the development, progression, and metastasis of cancer. The present study examined the relations of the relative expression of the SPARC gene to clinicopathological factors and overall survival in patients with gastric cancer.
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Intramural haematoma should be referred to as thrombosed-type aortic dissection.
Eur J Cardiothorac Surg
PUBLISHED: 03-20-2013
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Intramural haematoma is defined pathologically as aortic dissection without an intimal tear. We therefore believe that this term is inappropriate as an acute clinical diagnosis, and instead, use the term thrombosed-type acute aortic dissection. We compared the features of thrombosed-type acute aortic dissection with those of classic dissection.
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Human epidermal growth factor receptor 2 (Her-2) and S-1 adjuvant chemotherapy in stage 2/3 gastric cancer patients who underwent D2 gastrectomy.
Surg. Today
PUBLISHED: 03-20-2013
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The trastuzumab for Gastric Cancer study newly defined tumors that were positive for human epidermal receptor-2 (Her-2) and created a Her-2-oriented treatment strategy that is also applicable in the adjuvant setting for stage 2/3 cancers. However, there is currently no information available on the rate of Her-2 positivity and the relapse-free survival (RFS) stratified by Her-2 status in stage 2/3 patients.
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[A case of adenocarcinoma of small intestine surviving for many years].
Gan To Kagaku Ryoho
PUBLISHED: 03-20-2013
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In adenocarcinoma of the small intestine, delays in diagnosis are frequent. The majority of patients present with advancedstage disease, and have either lymph node involvement or distant metastatic disease. Surgical resection is a mainstay in treatment of this disease, and the effectiveness of chemotherapy for advanced-stage or metastatic disease has been reported. We report a case of adenocarcinoma of the small intestine surviving for many years after surgical resection and chemotherapy. A 47-year-old woman underwent a small intestine resection, because she had a small intestinal tumor with obstruction. Histopathological examination revealed moderately-differentiated adenocarcinoma with lymph node metastasis. Adjuvant chemotherapy with S-1 was administered for a year, but in March 2006, a recurrent lesion at the right ovary was detected, and she underwent right adnexectomy. Because the ascites cytology revealed class V, chemotherapy was administered. In December 2008, CA19-9 elevated and magnetic resonance imaging showed a tumor behind the uterus, which was diagnosed as a recurrent disease. Because the tumor invaded the rectum, she received a low anterior resection, hysterectomy, and left adnexectomy. After surgical resection, UFT/UZEL was administered for half a year. In July 2010, computed tomography showed multiple lung metastases, and chemotherapy was performed again. However, the regimen was changed because her tumor marker elevated. She is being treated using a combination of cisplatin and irinotecan.
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Neoadjuvant chemotherapy for gastric cancer in Japan: a standing position by comparing with adjuvant chemotherapy.
Surg. Today
PUBLISHED: 03-19-2013
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Adjuvant chemotherapy aims to eradicate micrometastatic tumor cells before and after curative surgery. Many Phase III trials have been conducted to study the efficacy of postoperative adjuvant chemotherapy; however, most trials have failed to show any survival benefit because of their low statistical power and/or poor patient compliance. Since 2000, two pivotal Phase III trials, the ACTS-GC and the CLASSIC, have demonstrated the efficacy of postoperative adjuvant chemotherapy following D2 gastrectomy. Although treatment with S-1 for 1 year or combination therapy with capecitabine and oxaliplatin for 6 months is effective, more intensive chemotherapy is necessary to further improve the survival rates. In Europe, two Phase III trials, the MAGIC and the FNCLCC/FFCD, have produced results that strongly suggest that neoadjuvant chemotherapy is beneficial. The advantages of neoadjuvant chemotherapy include a high rate of R0 resection, tumor regression, high compliance and the avoidance of unnecessary surgery. The disadvantage of neoadjuvant chemotherapy is over-diagnosis. In Japan, the Japan Clinical Oncology Group has conducted several clinical trials using neoadjuvant chemotherapy to target extensive nodal disease and/or scirrhous carcinomas. The optimal courses and regimens of neoadjuvant chemotherapy should, therefore, be clarified in the future.
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Risk analysis and improvement of strategies in patients who have acute type A aortic dissection with coronary artery dissection.
Eur J Cardiothorac Surg
PUBLISHED: 03-15-2013
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To identify the risk factors for mortality and establish improved treatment strategies in patients who have acute type A aortic dissection with coronary artery dissection.
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Stabilization of MDA-7/IL-24 for colon cancer therapy.
Cancer Lett.
PUBLISHED: 02-26-2013
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Colon cancer is one of the most commonly diagnosed cancers in the United States. Recombinant MDA-7/IL-24 has showed its selective cytotoxicity against cancer cells, and Ad-mda7 (INGN-241) is currently under clinical investigation for solid tumors. Here, we investigated the expression of MDA-7/IL-24 in colorectal cancer (CRC) tissues from 202 patients. Compared with the adjacent mucosa, CRC tissues displayed significantly lower MDA-7/IL-24 levels. The MDA-7/IL-24 levels in CRC were significantly associated with patients survival rate in a 6-year period. These results indicate MDA-7/IL-24 level is both a diagnostic and prognostic biomarker for CRC, and support the role of MDA-7/IL-24 in the treatment of CRC. To elevate MDA-7/IL-24 level for colon cancer treatment, we successfully developed a small-molecule compound SC144 with the ability to up-regulate MDA-7/IL-24 expression via direct binding and stabilizing MDA-7/IL-24 in human colon cancer cells. Among the analogs tested, SC144 exhibited the highest cytotoxicity in a panel of colon cancer cell lines in a p53-independent manner, accompanied by cell cycle arrest in G0/G1 with downregulation of Cyclin D1 levels, and apoptosis induction with upregulation of cell surface-bound Fas/CD95. These results combined with our previous studies support the anticancer role of MDA-7/IL-24 as well as the clinical development of SC144 for colon cancer treatment.
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Elevated microsatellite alterations at selected tetra-nucleotide (EMAST) in non-small cell lung cancers--a potential determinant of susceptibility to multiple malignancies.
Int J Clin Exp Pathol
PUBLISHED: 02-15-2013
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The present study evaluated the potential clinicopathologic significance of elevated microsatellite alteration at selected tetra-nucleotide (EMAST) in non-small cell lung cancer (NSCLC). Sixty-five NSCLCs (19 squamous cell carcinomas, 39 adenocarcinomas, one adenosquamous cell carcinoma, and 6 large cell carcinomas) were examined for EMAST in the ten selected tetra-nucleotide markers. Traditional microsatellite instability (MSI) in the five mono- or di-nucleotide markers of the Bethesda panel was also examined, and compared with EMAST. The incidence of EMAST was higher than that of traditional MSI, as 64.6% (42/65) and 12.3% (8/65) tumors respectively exhibited EMAST and traditional MSI in at least one marker. EMAST and traditional MSI appear to occur independently, as no significant association in their incidence was found (Fishers exact test, P = 0.146). Subjects who exhibited EMAST in two or more markers had a significantly higher incidence of history of other malignant neoplasms (42.9% [9/21]), compared to those with less than two markers (16.3% [7/43] (Chi-square test, P = 0.021)). Taken together, impairment of molecular machinery for maintaining stable replication of the tetra-nucleotide-repeating regions, which would differ from machinery for mono- or di-nucleotide-repeating regions, may elevate susceptibility to NSCLCs and certain neoplastic diseases. Elucidation of the potential molecular mechanism of EMAST is expected to lead to a discovery of a novel genetic background determining susceptibility to NSCLC and other multiple neoplasms. This is the first report describing a clinicopathologic significance of EMAST in NSCLC.
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Frequency and implication of ST-T abnormalities on hospital admission electrocardiograms in patients with type A acute aortic dissection.
Am. J. Cardiol.
PUBLISHED: 02-06-2013
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Although patients with Stanford type A acute aortic dissection often show ST-T abnormalities at presentation, the frequency and implication of such findings remain unclear. To clarify these points, admission electrocardiograms from 233 patients admitted ?6 hours after symptom onset who underwent emergency surgery for type A acute aortic dissection were studied. The prevalence of electrocardiographic (ECG) patterns was 51% for ST-T abnormalities (4% for ST-segment elevation and 47% for ST-segment depression and/or negative T waves), 30% for normal ECG findings or no significant ST-T changes, and 19% for ECG confounders such as bundle branch block or left ventricular hypertrophy. Patients with ST-T abnormalities had higher prevalence of pericardial effusion (48% vs 9% and 38%), cardiac tamponade (28% vs 3% and 18%), moderate or severe aortic regurgitation (28% vs 7% and 18%), shock on admission (34% vs 3% and 13%), coronary ostial involvement (14% vs 1% and 2%), concomitant coronary artery bypass surgery (9% vs 1% and 0%), and in-hospital mortality (11% vs 1% and 4%) compared with patients with normal ECG findings or no significant ST-T changes and those who had ECG confounders (p <0.05 for all). On multivariate analysis, ST-T abnormalities were the only independent predictor of in-hospital mortality (odds ratio 3.87, 95% confidence interval 1.02 to 14.7, p = 0.035). In conclusion, about 50% of patients who underwent emergency surgery for type A acute aortic dissection had ST-T abnormalities, characterized predominantly by ST-segment depression or negative T waves, in the acute phase. ST-T abnormalities were associated with more complicated features and independently predicted in-hospital death.
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Mid-term outcomes of acute type B aortic dissection in Japan single center.
Ann Thorac Cardiovasc Surg
PUBLISHED: 01-31-2013
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Purpose: To study mid-term outcomes in patients admitted to receive treatment for acute type B aortic dissection. Methods: The study group comprised 229 patients with acute type B aortic dissection treated between January 2000 and July 2010. 128 patients had a thrombosed false lumen, and 101 had a patent false lumen. Results: In the thrombosed group, 6 had rupture, 4 had malperfusion, and 118 had no complications. There were 5 early deaths (3.9%). In the patent group, 12 had rupture, 19 had malperfusion, and 70 had no complications. There were 6 early deaths (5.9%). Overall survival rates in the thrombosed group and the patent group were 94.7 ± 2.2% and 90.2 ± 3.2% at 1 year, and 84.3 ± 4.6% and 85.9 ± 4.3% at 5 years (p = 0.892), respectively. Aorta-related event-free rates were 85.6 ± 3.4% and 48.3 ± 5.5% at 1 year, and 76.0 ± 5.1% and 35.2 ± 7.2% at 5 years (p <0.001), respectively. Conclusions: The incidences of rupture and malperfusion during the acute phase were higher in the patent group compared with the thrombosed group. At the late period, although the aorta-related event rate was higher in the patent group, the survival rate did not differ between two groups. Close follow-up and aggressive intervention strategy of the patent group may result comparable outcomes with the thrombosed group.
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Gallbladder herniation into the lesser sac through the foramen of Winslow: report of a case.
Surg. Today
PUBLISHED: 01-22-2013
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We report a case of gallbladder hernia into the lesser sac through the foramen of Winslow. The patient was a 90-year-old woman, admitted to hospital with obstructive jaundice. Computed tomography (CT) showed a left-deviated and remarkably enlarged gallbladder dragging the liver, and a dilated intrahepatic bile duct. The deviated gallbladder was thought to compress the common bile duct, causing the obstruction. Laparoscopic examination revealed gallbladder herniation into the lesser sac without a floating gallbladder; thus, we performed laparoscopic cholecystectomy. Herniation of the gallbladder is the rarest of all internal hernias and most reported cases have involved a floating gallbladder. The case we report here is therefore considered especially unusual.
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Left atrium ball thrombus in a patient with hemorrhagic cerebral infarction.
Ann. Thorac. Surg.
PUBLISHED: 01-21-2013
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The patient was a 72-year-old man with left hemiparesis. Multiple hemorrhagic cerebral infarctions were recognized on a computed tomographic (CT) scan. A transesophageal echocardiogram showed a huge left atrial mass, which was floating and nearly obstructed the mitral orifice in the diastolic phase. Emergency left atrial mass removal was performed. To reduce the risk of critical brain hemorrhage, the dose of heparin was reduced (100 U/kg) and 1 mg/kg/h of nafamostat mesilate was administered into the venous circuit during extracorporeal circulation. A postoperative brain CT scan showed no evidence of deterioration of cerebral hemorrhage. Pathologic examination showed a ball thrombus.
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Acute aortic dissection associated with sleep apnea syndrome.
Ann Thorac Cardiovasc Surg
PUBLISHED: 01-16-2013
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Background: Sleep apnea syndrome (SAS) is an independent risk factor for hypertension which is a major risk factor for acute aortic dissection. The purposes of this study were to assess the prevalence of SAS in patients with acute aortic dissection, delineate the characteristics of patients who have acute aortic dissection with SAS.Methods: Of 95 consecutive patients with acute aortic dissection, 13 had episodes of sleep apnea and nocturnal hypoxemia. A portable sleep monitoring system was used to assess sleep status in the 13 patients.Results: The SAS-positive group consisted of 12 patients (12.6%), 8 with type A dissection and 4 with type B dissection. Age was significantly lower in the SASpositive group (47.2 ± 8.5 years) than in the SAS-negative group (64.9 ± 10.3 years)(p <0.001). The male:female ratio was significantly higher in the SAS-positive group than in the SAS-negative group (p <0.001). The body mass index was significantly greater in the SAS-positive group than in the SAS-negative group (p <0.001). All12 patients in the SAS-positive group had hypertension.Conclusions: Patients who have acute aortic dissection with SAS are characterized by being tall, fat, and relatively young men with hypertension. Sleep apnea syndrome may be a risk factor for acute aortic dissection in middle-aged men.
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Clinical outcomes of emergency surgery for acute type B aortic dissection with rupture.
Eur J Cardiothorac Surg
PUBLISHED: 01-16-2013
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The purpose of this study was to evaluate the clinical outcomes of emergency surgery for acute type B aortic dissection with rupture and to compare results between open surgery and thoracic endovascular aortic repair (TEVAR).
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Successful endovascular treatment of a ruptured superior mesenteric artery in a patient with Ehlers?Danlos syndrome.
Ann Vasc Surg
PUBLISHED: 01-14-2013
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The purpose of this study was to describe covered-stent treatment of a ruptured dissection of the superior mesenteric artery (SMA) in a patient with Ehlers?Danlos syndrome. The patient was a 13-year-old girl initially presenting with abdominal pain. Dissection and rupture of the SMA were diagnosed on detailed examination. Conservative treatment was performed initially because open surgery was considered high risk. However, the abdominal pain recurred, and we decided to perform endovascular therapy. A coronary artery covered stent was placed in the true lumen to close the entry site of the dissection. The false lumen was obliterated using a post-dilation technique, completing treatment of the rupture. The patient recovered uneventfully after surgery. Classic-type Ehlers?Danlos syndrome was diagnosed on the basis of physical findings and genetic analysis. The stent has remained adequately patent as of 2 years after surgery. This case report shows that dissection and rupture of the SMA can be treated successfully using a covered coronary artery stent in a patient with Ehlers?Danlos syndrome.
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[Prognosis and clinical course of gastric cancer with para-aortic lymph node metastasis after curative D2 gastrectomy and adjuvant chemotherapy with S-1].
Gan To Kagaku Ryoho
PUBLISHED: 12-29-2011
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Survival and clinical course were unknown in patients with recurrence of para-aortic lymph node after curative D2 gastrectomy and adjuvant S-1 chemotherapy.
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[Pancreatic resection for metastatic tumors to the pancreas].
Gan To Kagaku Ryoho
PUBLISHED: 12-29-2011
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We report 3 cases of resectable pancreatic metastasis. CASE 1: A 76-year-old woman was followed after nephrectomy for renal cell carcinoma for 13 years. CT examination demonstrated a high vascular lesion in the pancreatic body and tail. We conducted distal pancreatectomy and diagnosed with metastatic tumor from renal cell carcinoma. She died of liver metastasis 8 years after pancreatic resection. CASE 2: A 64-year-old man, who had undergone right lower lobectomy for lung cancer a year ago, was found to have a mass in the pancreatic tail. We performed distal pancreatectomy and diagnosed with metastatic tumor from lung cancer. He died of lung metastasis 12 months after pancreatic resection. CASE 3: A 62- year-old woman, who had undergone left nephrectomy for renal cell carcinoma 3 years ago, was found to have a mass in the pancreatic body. With a diagnosis of metastatic pancreatic tumor from renal cell carcinoma, distal pancreatectomy was done. She died of liver and lung metastases 15 months after pancreatic resection. Long-term survival can be achieved in patients undergoing a pancreatic standard resection including lymphadenectomy for isolated metastasis from nonpancreatic sites.
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[S-1/krestin immunochemotherapy for patients with advanced gastric cancer].
Gan To Kagaku Ryoho
PUBLISHED: 12-29-2011
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S-1 mono-therapy for advanced gastric cancer is hard to continue in some patients due to adverse events. We retrospectively examined the patients who received S-1/Krestin( PSK) immunochemotherapy for advanced gastric cancer.
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[Cyanotic heart disease. Part 2].
Kyobu Geka
PUBLISHED: 09-16-2011
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Tetralogy of Fallot is the most common cyanotic heart disease. Its operative mortality and long-term result are quite good in these days. At the late phase after the correction, pulmonary valve regurgitation associated with right side heart failure, aortic valve regurgitation, arrhythmia and sudden death become major adverse outcomes. Double-outlet right ventricle is a cyanotic heart disease with a wide spectrum of morphology and is divided according to the site of ventricular septal defect: subaortic, subpulmonary, doubly committed and remote type. Its operative methods are completely dependent on its morphology, and vary such as intracardiac tunnel repair, Rastelli type repair, arterial switch procedure and Fontan type repair. Left ventricular outflow tract obstruction is one of the most important problems after the correction. Recent operative strategies for the treatment of tricuspid atresia and single ventricle are quite similar and its final goal is the completion of right heart bypass operation using total cavo-pulmonary connection with staging strategy. Pleural effusion, ascites, protein loosing enteropathy and supraventricular arrhythmia are major adverse outcomes after Fontan type repair, while extracardiac total cavopulmonary connection is expected to reduce the incidence of supraventricular arrhythmia.
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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.