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941.
Murakami Y Uemura K Sudo T Hashimoto Y Nakashima A Sueda T 《Journal of gastrointestinal surgery》2012,16(3):540-548
Background
Intrahepatic cholangiocarcinoma (ICC) is categorized as peripheral ICC (PICC) or hilar ICC (HICC). The aims of this study are to clarify clinicopathological differences between PICC and HICC and to determine useful prognostic factors for patients with ICC following aggressive surgical resection. 相似文献942.
Uchino H Asano T Nakayama N Kuroda S Houkin K 《No shinkei geka. Neurological surgery》2011,39(1):59-63
The authors present the case of a 61-year-old male with a de novo fusiform vertebral artery aneurysm, probably due to non-traumatic dissection. He underwent flow diversion therapy, using a double overlapping technique, because the origin of the contralateral vertebral artery was stenotic. Placement of two stents resulted in marked reduction of blood flow in the aneurysm. Postoperative course was uneventful. Follow-up 3D-CT angiography revealed a patent blood flow in the stent and a gradual progression of intra-aneurysmal thrombosis. Flow diversion therapy can potentially obliterate the complicated cerebral aneurysm with the preservation of blood flow in the parent artery, and would be one of the important therapeutic options in patients with complicated aneurysms in which conventional strategies such as neck clipping, endovascular coiling and parent artery occlusion are not feasible or contraindicated. 相似文献
943.
Shinichi Hasegawa MD Takaki Yoshikawa MD PhD Yasushi Rino MD Takashi Oshima MD PhD Toru Aoyama MD Tsutomu Hayashi MD Tsutomu Sato MD Norio Yukawa MD Yoichi Kameda MD PhD Takeshi Sasaki MD PhD Hidetaka Ono MD PhD Kazuhito Tsuchida MD Haruhiko Cho MD Chikara Kunisaki MD PhD Munetaka Masuda MD PhD Akira Tsuburaya MD 《Annals of surgical oncology》2013,20(13):4252-4259
Objective
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).Methods
The priority of nodal dissection was evaluated based on the therapeutic value index calculated by multiplying of the frequency of metastasis to each station and the 5-year survival rate of patients with metastasis to that station.Results
A total of 176 patients (95 type II and 81 type III) were examined. Among the lymph nodes that had a metastatic incidence exceeding 10 %, the stations showing the first to fourth highest index were the paracardial and lesser curvature nodes (Nos. 1, 2, and 3) and the node at the root of the left gastric artery (No. 7) in the total cohort, as well as in each type. The next station was the lower thoracic paraesophageal lymph node (No. 110), followed by the nodes along the proximal splenic artery (No. 11p) in type II, whereas it was the nodes along the proximal splenic artery (No. 11p) followed by the para-aortic nodes (No. 16a2), the nodes at the celiac artery (No. 9), and the nodes around the splenic hilum (No. 10) in type III.Conclusions
These results suggest that the highest priority nodal stations to be dissected were the paracardial and lesser curvature nodes (Nos. 1, 2, and 3) and the nodes at the root of the left gastric artery (No. 7), regardless of the Siewert subtype, but the subsequent priority was different depending on the subtype. 相似文献944.
Takeshi Kubota MD PhD Naoki Hiki MD PhD Takeshi Sano MD PhD Shogo Nomura MSc Souya Nunobe MD PhD Koshi Kumagai MD PhD Susumu Aikou MD PhD Ryohei Watanabe MD PhD Toshiyuki Kosuga MD PhD Toshiharu Yamaguchi MD PhD 《Annals of surgical oncology》2014,21(3):891-898
Background
Postoperative complications such as anastomotic leakage were reported to be a major independent prognostic factor for long-term survival in gastrointestinal malignancies. This study sought to clarify the prognostic significance of postoperative inflammatory complications specifically for patients with gastric cancer.Methods
This study included 1,395 patients who underwent curative resection for gastric cancer from 2005 to 2008. Complications were evaluated according to the Clavien-Dindo classification. Overall survival (OS) and disease-specific mortality (DSM) were compared between complication and no-complication groups. Presence of complications was modeled by the Cox proportional hazard model for OS and the Fine and Gray competing risk regression model for DSM to assess the correlation between complication and prognosis.Results
The median follow-up time was 3.1 years. Two hundred seven patients (14.8 %) had complications of grade 2 or higher. Of 131 patients who died within this period, 87 died of gastric cancer. The 3-year OS in the complication group was 84.1 % compared to 93.1 % in the no-complication group (P < 0.0001). The cumulative incidence of DSM was also significantly worse in patients with complications (P < 0.0001). Multivariate analysis identified the same significant increasing risk of complication for both OS (hazard ratio 1.88; 95 % confidence interval 1.26–2.80) and DSM (hazard ratio 1.90; 95 % confidence interval 1.19–3.02).Conclusions
Postoperative complications that can cause prolonged inflammation have an obvious impact not only on the OS but also on the DSM of patients with gastric cancer even if the tumor is resected curatively. 相似文献945.
Miura K Fujibuchi W Ishida K Naitoh T Ogawa H Ando T Yazaki N Watanabe K Haneda S Shibata C Sasaki I 《Surgery today》2011,41(2):175-182
The apoptosis and antiapoptotic signaling pathways are important for regulating carcinogenesis and cancer progression, and for determining prognosis. Molecules involved in apoptosis represent potential cancer diagnostic markers and therapeutic targets. The inhibitor of apoptosis protein (IAP) family includes several important molecules involved in apoptosis that might represent such targets. Increasing evidence has demonstrated that the IAP family of proteins is integral for antiapoptotic and nuclear factor-κB signal transduction, and enhanced expression of IAPs contributes to colon carcinogenesis and its poor prognosis, as well as to drug resistance of tumors. X-linked IAP, cIAP1, cIAP2, and survivin are prognostic markers of colorectal cancer, and survivin and cIAP2 are also utilized to predict the effect of anticancer treatment in colorectal cancer patients. Novel therapies such as YM155 and LY2181308 targeting survivin, AEG35156 and phenoxodiol targeting X-linked IAP, AT-406 as a Smac mimetic, and survivin peptides are currently being evaluated in clinical trials. This report reviews the involvement of the IAP family in colorectal adenocarcinoma in order to summarize the role of the IAP family members as diagnostic and therapeutic targets, and to provide an overview of the future course of research in this area. 相似文献
946.
947.
Yosuke Watanabe Fumiyuki Yamasaki Yoshinori Kajiwara Takeshi Takayasu Ryo Nosaka Yuji Akiyama Kazuhiko Sugiyama Kaoru Kurisu 《European journal of radiology》2013
Purpose
We assessed whether a high b-value DWI at b = 4000 s/mm2 would discriminate the histopathological differentiation of the tumor grade of meningiomas, and also focused on the relationship between radiologic features and the tumor grade.Materials and methods
We acquired DWI at 3T with b = 1000 and b = 4000 s/mm2 in 77 patients (42, 31 and 4 patients were WHO grades I (G1), II (G2), and III (G3), respectively). The apparent diffusion coefficient (ADC) was measured by placing multiple regions of interest (ROIs) on ADC maps. The ADC values of each tumor were determined preoperatively from several ROIs, and expressed as the minimum (ADCMIN), mean (ADCMEAN), and maximum absolute values (ADCMAX). We evaluated the relationship between ADCs and histological findings, and assessed the radiologic features such as tumor location, tumor size, presence/absence of peritumoral edema, shape of the tumor, presence/absence of bone destruction or hyperplasia, status of contrast enhancement, presence/absence of calcification and cyst.Results
ADCs of the meningiomas were inversely correlated with the histological grade of meningiomas. According to results of the discriminant analysis, the apparent log likelihood value was greatest for ADCMIN at b = 4000. Furthermore, only the ADCMIN value at b = 4000 was significantly correlated with the histological grade of meningiomas when we performed a multiple logistic regression analysis to identify the significant independent factors such as shape of tumor, presence/absence of bone destruction, status of contrast enhancement, presence/absence of cyst and ADCMIN at b = 4000.Conclusion
A meningioma with a low ADCMIN at a high b-value might imply a high-grade meningioma. 相似文献948.
对金仓鼠肝区作8MeV电子束40Gy一次照射,分别对照射后1,2,3天,1,4,8周和9个月的活体动物肝脏置6.34T磁场强度的波谱仪作31P-磁共振波谱分析,然后摘出动物肝脏作组织学对照研究。结果表明:以β-ATP信号强度为基准计算的各峰值信号强度比中,照射后1~3天的PME增高,照射后1周以上的各组γ-ATP和α-ATP均示降低;细胞内pH示照射后1天升高,2和3天随之降低,照后1~4周再度升高后与前者有显著性差异(P<0.05)。组织学图像示肝细胞点状坏死,肝细胞脂肪变性,肝细胞萎缩等。作者认为:31P-磁共振波谱分析对放射性肝损伤的肝能量代谢测定是准确和有价值的。 相似文献
949.
Shibata T Yasuoka T Inoue K Ikuta T Bito Y 《General thoracic and cardiovascular surgery》2007,55(10):440-441
We hereby present our technique for using the self-retaining flexible arm retractor and its attachments for mitral valve exposure.
The Aortic Valve Assistant, which was developed for aortic valve exposure, is also very useful for exposure of the inferior
wall of the left atrium. Our modified atrial hook provides excellent exposure of the anterior mitral annulus. Extensive dissection
and the combined use of the flexible arm and attachments allows us comfortable access for mitral valve operations. 相似文献
950.
Nobuhiko Tominaga Shuichi Katagiri Yasushi Hamaguchi Tetsuo Nishiura Yuzuru Kanakura Yoshio Kanayama Kazuhiro Nagao Yoshiyuki Kakiuchi Kazuhiro Nishida† Tatsuo Abe† Tasuku Honjo‡ Takeshi Yonezawa Seiichiro Tarui 《British journal of haematology》1988,69(2):213-218
A case of plasma cell leukaemia of non-producer type is described. The patient presented with typical clinical features of plasma cell myeloma, including multiple osteolytic lesions, hypercalcaemia, renal failure and reduced polyclonal immunoglobulins, except that M-component was not detected in either the serum or urine. Morphological examinations showed a plasmacytoid appearance of the neoplastic cells, while immunological studies failed to detect cytoplasmic immunoglobulin or secretory capacity. The surface phenotype of CD38+, PCA-1+, DR-, CD20-, CD24-, CD9-, CD10- and surface immunoglobulin- was compatible with mature plasma cells. Chromosomal analysis showed the 14q+ marker due to translocation (6;14) and deletion of the short arm of chromosome 1. Analysis of immunoglobulin genes revealed the presence of heavy chain gene rearrangement, but the light chain genes, both kappa and lambda, remained in germline configuration. Such defective immunoglobulin gene rearrangement may be responsible for the failure of immunoglobulin biosynthesis and secretion by the neoplastic plasma cells. Furthermore, it is suggested that the morphological and phenotypic development of B cells may not necessarily depend on immunoglobulin light chain gene rearrangement, and that the oncogenic event in myeloma may occur at an earlier stage of B cell differentiation. 相似文献