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Tips and tricks of surgical technique for pancreatic cancer: portal vein resection and reconstruction (with videos) 下载免费PDF全文
Hideyuki Yoshitomi Atsushi Kato Hiroaki Shimizu Masayuki Ohtsuka Katsunori Furukawa Tsukasa Takayashiki Satoshi Kuboki Shigetsugu Takano Daiki Okamura Daisuke Suzuki Nozomu Sakai Shingo Kagawa Masaru Miyazaki 《Journal of hepato-biliary-pancreatic sciences》2014,21(9):E69-E74
Surgical resection is the only hope for cure in patients with pancreatic cancer. To improve the resectability and achieve better prognosis of this lethal disease, extended resection for pancreatic cancer has been applied. We have performed portal vein resection aggressively for pancreatic cancer with portal vein invasion. We also established a method of portal vein reconstruction using the left renal vein graft for tumors widely extended to the portal vein. Our data show similar survival between patients with portal vein obstruction and those without invasion. We also show that portal vein reconstruction using the left renal vein graft can be performed safely without severe liver damage. With video, we introduce our surgical technique for portal vein resection and reconstruction, especially focusing on the usage of the left renal vein graft, providing several tips for a safe and successful procedure. 相似文献
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Sato A Hiroe M Akiyama D Hikita H Nozato T Hoshi T Kimura T Wang Z Sakai S Imanaka-Yoshida K Yoshida T Aonuma K 《Journal of cardiac failure》2012,18(6):480-486
BackgroundTenascin-C (TN-C), an extracellular matrix glycoprotein, is not normally expressed in the adult heart but transiently reappears under various pathologic conditions to play important roles in tissue remodeling. It is unclear whether serum TN-C levels add prognostic information independent from traditional prognostic markers.Methods and ResultsWe assessed 239 patients with first ST-segment elevation myocardial infarction who underwent successful percutaneous coronary intervention. We measured serum TN-C and plasma B-type natriuretic peptide (BNP) levels on day 5 after admission and compared long-term clinical outcome. During the follow-up period (24.3 ± 13 months), 54 patients experienced primary composite cardiac events (cardiac death or hospitalization for worsening heart failure). Multivariable Cox proportional hazards analysis indicated that serum TN-C (hazard ratio 2.92, 95% confidence interval [CI] 1.55–5.67; P < .001) and plasma BNP levels (hazard ratio 1.84, 95% CI 1.17–2.97; P = .008) were significant independent predictors for cardiac events after adjustment for multiple confounders. The combination of TN-C and BNP resulted in an increase of the c-statistic from 0.821 to 0.877 (P < .001) and an integrated discrimination improvement gain of 14.0% (P < .001).ConclusionsSerum TN-C level on day 5 after admission is potentially useful for early risk stratification after AMI beyond established prognostic markers. 相似文献
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Aihara H Sato A Takeyasu N Nishina H Hoshi T Akiyama D Kakefuda Y Watabe H Aonuma K;for the ICAS Registry Investigators 《Catheterization and cardiovascular interventions》2012,80(4):556-563
Objectives : The aim of this study was to evaluate whether combination therapy of clopidogrel and proton pump inhibitors (PPIs) causes higher numbers of cardiovascular events than clopidogrel alone in Japanese patients. Background : PPIs are often prescribed in combination with clopidogrel following coronary stenting. PPIs are reported to diminish the effect of clopidogrel because both are metabolized by CYP2C19. However, no reports address the effects of PPIs on cardiovascular events following coronary stenting in the Japanese population. Methods : A total of 1,887 patients treated with clopidogrel following coronary stenting were enrolled in the Ibaraki Cardiac Assessment Study (ICAS) registry. All subjects were classified into two groups according to treatment without (n = 819) or with (n = 1,068) PPI. Propensity score analysis matched 1:1 according to treatment without PPI (n = 500) or with PPI (n = 500). Primary endpoint was the composite of all‐cause death or myocardial infarction. Results : No significant difference was observed in the primary endpoint between the group without PPI and the group with PPI (4.6% vs. 4.6%, P = 0.77). In contrast, a significant difference was found between the group without PPI and with PPI in regard to the incidence of gastrointestinal bleeding at the end of the follow‐up period and the specific PPI prescribed (2.4% vs. 0.8%, adjusted HR = 0.30, 95% Confidence interval 0.08‐0.87, P = 0.026) after propensity score matching. Conclusions : No significant association between PPI use and primary endpoint was observed in the Japanese population, whereas PPI use resulted in a significant reduction in the rate of gastrointestinal bleeding. © 2012 Wiley Periodicals, Inc. 相似文献
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Polystyrenic microspheres in the sub 5 micrometer size range (micro-gel) with –CH2Cl active sites were synthesized via the dispersion polymerization of 4-chloromethylstyrene, divinyl benzene and methoxy polyethylene glycol acrylate. Then, theophylline residues were introduced onto the polystyrenic microspheres via the substitution of the chloride in the –CH2Cl group to prepare chelate type microspheres of μ-T2. It was found that the microspheres have co-continuous structures, monodispersed particle sizes, and excellent solvent and water wettability. Using the μ-T2 microspheres possessing theophylline residues, adsorption experiments involving the adsorption of palladium(ii), copper(ii) and platinum(iv) from acidic chloride media under both individual and mixed conditions were carried out and it was found that the μ-T2 microspheres exhibited excellent adsorption selectivity for palladium(ii) over copper(ii) and platinum(iv). It was also revealed that thiourea or ammonia solutions are the most effective in desorbing palladium ions from the microspheres. Despite being used in four adsorption–desorption cycles, the μ-T2 microspheres were still able to strongly adsorb palladium ions, with an adsorption of over 85%. In addition, the μ-T2 microspheres also showed palladium capturing ability even in very dilute palladium solutions (below 1.0 ppm). Interestingly, the μ-T2 microsphere-adsorbed palladium ions exhibited excellent catalytic activity in the Suzuki–Miyaura coupling reaction of bromobenzene and phenylboronic acid, yielding biphenyl in 100% under the conditions within 1 hour at 50 °C in water.Sub 5 micrometer sized polystyrenic microspheres bearing theophylline residues were synthesized and used as adsorbent and catalytic support for palladium ions. 相似文献
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Kayano Daiki Wakabayashi Hiroshi Nakajima Kenichi Kuroda Rie Watanabe Satoru Inaki Anri Toratani Ayane Akatani Norihito Yamase Takafumi Kunita Yuji Hiromasa Tomo Takata Aki Mori Hiroshi Saito Shintaro Araki Raita Taki Junichi Kinuya Seigo 《Annals of nuclear medicine》2020,34(6):397-406
Annals of Nuclear Medicine - The aim of the study was to investigate the outcomes and prognostic factors of high-dose 131I-metaiodobenzylguanidine (131I-MIBG) therapy in patients with refractory or... 相似文献