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Background/Aims: Laparoscopic surgery for periampullary disease is still a challenging operation. The aim of this study was to compare the perioperative outcomes of patients undergoing conventional pancreaticoduodenectomy (PD) with the outcomes of those undergoing laparoscopy-assisted PD. Methodology: A retrospective analysis was conducted on 51 consecutive patients who underwent laparoscopy-assisted or open PD for periampullary disease. Results: There were no significant differences in the preoperative demographic or clinical data of the two study groups. Although there were no significant differences in the operative time between the two study groups, blood loss in the laparoscopy-assisted PD group was significantly smaller than that in the open PD group. There were no significant differences in the occurrence of postoperative complications between the two groups. Conclusions: Laparoscopy-assisted PD is a feasible and safe surgical procedure that provides the advantages expected from a minimally invasive surgery including less blood loss. 相似文献
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Akira Shimada Tomohiko Taki Daisuke Koga Ken Tabuchi Akio Tawa Ryoji Hanada Masahiro Tsuchida Keizo Horibe Ichiro Tsukimoto Souichi Adachi Seiji Kojima Yasuhide Hayashi 《International journal of hematology》2012,96(4):469-476
The prognostic value of WT1 mRNA expression in pediatric acute myeloid leukemia (AML) remains controversial. A sample of newly diagnosed (n?=?158) AML patients from the Japanese Childhood AML Cooperative Treatment Protocol, AML 99, were simultaneously analyzed for WT1 expression, cytogenetic abnormalities and gene alterations (FLT3, KIT, MLL, and RAS). WT1 expression (including more than 2,500 copies/??gRNA) was detected in 122 of the 158 (77.8?%) initial diagnostic AML bone marrow samples (median 45,500 copies/??gRNA). Higher WT1 expression was detected in French American British (FAB)-M0, M3, M7 and lower expression in M4 and M5. Higher WT1 expression was detected in AML with inv(16), t(15;17) and Down syndrome and lower in AML with 11q23 abnormalities. Multivariate analyses demonstrated that FLT3-internal tandem duplication (ITD), KIT mutation, MLL-partial tandem duplication were correlated with poor prognosis; however, higher WT1 expression was not. FLT3-ITD was correlated with WT1 expression and prognosis. Furthermore, 74 WT1 expression after induction chemotherapy was analyzed. Higher WT1 expression after induction chemotherapy was significantly correlated with M1 or M2/M3 marrow, FLT3-ITD and poor prognosis. Multivariate analyses in 74 AML patients revealed that FLT3-ITD, MLL-PTD, and KIT mutations were associated with poor prognosis; however, NRAS Mutation, KRAS mutation and high WT1 expression (>10,000 copies/??gRNA) did not show poor prognosis. Our findings suggest that higher WT1 expression at diagnosis does not correlate with poor prognosis, but that WT1 expression after induction chemotherapy is considered to be a useful predictor of clinical outcome in pediatric AML. 相似文献
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T Kanaoka K Tamura M Ohsawa H Wakui A Maeda T Dejima K Azushima S Haku H Mitsuhashi M Yanagi J Oshikawa K Uneda K Aoki T Fujikawa Y Toya K Uchino S Umemura 《Journal of clinical hypertension (Greenwich, Conn.)》2012,14(8):522-529
J Clin Hypertens (Greenwich). 2012;00:000–000. ©2012 Wiley Periodicals, Inc. Aliskiren is a direct renin inhibitor that exerts its effect at the rate‐limiting step of the renin‐angiotensin system. This study was performed to examine the beneficial effects of aliskiren‐based antihypertensive therapy on the ambulatory blood pressure (BP) profile, central hemodybamics, and arterial stiffness in untreated Japanese patients with mild to moderate hypertension. Twenty‐one Japanese nondiabetic patients with untreated mild to moderate essential hypertension were initially given aliskiren once daily at 150 mg, and the dose was titrated up to 300 mg as needed. After 12 weeks of aliskiren‐based therapy, the clinic, ambulatory, and central BP values as well as brachial‐ankle pulse wave velocity (baPWV) were all significantly decreased compared with baseline (clinic systolic BP, 151±11 mm Hg vs 132±11 mm Hg; clinic diastolic BP, 91±13 mm Hg vs 82±9 mm Hg; 24‐hour systolic BP, 144±12 mm Hg vs 133±11 mm Hg; 24‐hour diastolic BP, 88±8 mm Hg vs 81±9 mm Hg; central BP, 162±16 mm Hg vs 148±14 mm Hg; baPWV, 1625±245 cm/s vs 1495±199 cm/s; P<.05). These results show that aliskiren, as a first‐line regimen, improves the ambulatory BP profile and may have protective vascular effects in Japanese nondiabetic patients with untreated mild to moderate essential hypertension. 相似文献
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Yoshiyuki Kojima Norio Takahashi Nobuhiro Haga Masanori Nomiya Tomohiko Yanagida Kei Ishibashi Ken Aikawa David I Lee 《International journal of urology》2013,20(11):1052-1063
Robot‐assisted radical prostatectomy has been shown to have comparable and possibly improved postoperative continent rates compared with retropubic and laparoscopic radical prostatectomy. However, postoperative urinary incontinence has remained one of the most bothersome postoperative complications. The basic concept of the intraoperative technique to improve postoperative urinary continence is to maintain as normal anatomical and functional structure in the pelvis as possible. Therefore, improved knowledge of the normal structure in the pelvis should lead to a greater understanding of the pathophysiology of urinary incontinence, and further development of intraoperative techniques to improve the outcomes of urinary continence. It might be necessary to carry out three steps to realize improvement of the early return of urinary continence after robot‐assisted radical prostatectomy: (i) preservation (bladder neck, neurovascular bundle, puboprostatic ligament, pubovesical complex, and/or urethral length, etc.); (ii) reconstruction (posterior and/or anterior reconstruction, and/or reattachment of the arcus tendineus to the bladder neck, etc.); and (iii) reinforcement (bladder neck plication and/or sling suspension, etc.). On the basis of these steps, further modifications during robot‐assisted radical prostatectomy should be developed to improve urinary continence and quality of life after robot‐assisted radical prostatectomy. 相似文献
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Norifumi Tsutsumi Morimasa Tomikawa Munenori Uemura Tomohiko Akahoshi Yoshihiro Nagao Kozo Konishi Satoshi Ieiri Jaesung Hong Yoshihiko Maehara Makoto Hashizume 《Surgical endoscopy》2013,27(6):2178-2184