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1.
Cureus ; 14(11): e31457, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36523740

RESUMO

Pancreatic cancer is often advanced and invades the major blood vessels around the pancreas. Portal vein (PV) and/or superior mesenteric vein (SMV) resection is performed for radical resection. In such cases, end-to-end anastomosis is best if the remnant vein is sufficiently long. However, when the excision distance is long, reconstruction requires an artificial blood vessel. In contrast, there is no consensus concerning the need for splenic vein (SV) reconstruction. We herein report a case in which portal vein thrombus and congestion of the bowel that occurred after PV-SMV reconstruction were improved by additional anastomosis of the PV-SV.

2.
J Breast Cancer ; 24(5): 481-490, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34725974

RESUMO

Locally advanced breast cancer (tumor > 5 cm, widespread infiltration of the skin and muscle, or metastases to lymph nodes) is difficult to resect by surgery, and even when it is resectable, there is a high probability of local recurrence and distant metastasis. Therefore, systemic therapy should be administered first. However, as cutaneous infiltration progresses, the patient's quality of life is impaired by pain, bleeding, presence of exudates, and a foul-smelling odor. Treatment with Mohs paste with systemic therapy can control symptoms associated with skin infiltration and can also be expected to decrease tumor volume. Herein, we report a case in which a tumor was resected following Mohs paste and systemic chemotherapy administration, and the skin defect was reconstructed with a latissimus dorsi myocutaneous flap. We also review the literature for previously reported cases of breast cancer involving Mohs paste.

3.
J UOEH ; 42(4): 331-334, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33268610

RESUMO

When performing esophageal reconstruction, a colonic pedicle graft is chosen as the next candidate to the stomach because of complications arising from the operation time and vascular anastomosis. Vascular anastomosis is not necessarily required for pedicle grafts, but it is necessary to perform additional vascular anastomosis in some cases. We herein report a case of superdrainage in which anastomosis of the colonic vein and the right internal thoracic vein was effective against congestion. A 68-year-old man with thoracic esophageal cancer and pyloric antrum gastric cancer was referred to our hospital. Complete resection was performed with subtotal esophageal resection and total gastrectomy. We added superdrainage (right internal thoracic vein - ileocolic vein) to the colonic pedicle graft, which showed congestion, and performed esophageal reconstruction. Venous superdrainage using a colonic pedicle graft is effective for esophageal reconstruction.


Assuntos
Anastomose Cirúrgica/métodos , Colo/cirurgia , Colo/transplante , Neoplasias Esofágicas/cirurgia , Esôfago/irrigação sanguínea , Esôfago/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Veias/cirurgia , Idoso , Colo/irrigação sanguínea , Gastrectomia/métodos , Humanos , Masculino , Neoplasias Gástricas/cirurgia , Resultado do Tratamento
4.
Anticancer Res ; 40(6): 3371-3377, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487633

RESUMO

BACKGROUND/AIM: Several indicators of systemic inflammation have been reported to predict the outcomes of patients with malignant tumors but have not been fully investigated. The aim of this study was to evaluate whether the preoperative lymphocyte-to-monocyte ratio (LMR) can predict the outcomes of patients with pancreatic head cancer. PATIENTS AND METHODS: We studied 32 patients who underwent curative surgery for pancreatic head cancer in our hospital between 2006 and 2016. Patients were classified into high and low groups according to their LMR. RESULTS: The low LMR group had a significantly lower survival rate than the high LMR group (p=0.0313). A multivariate analysis showed that the pretreatment LMR (p=0.01) was an independent risk factor for cancer-related death. The LMR was correlated with obstructive jaundice (p=0.001). CONCLUSION: Preoperative LMR is a significant predictor of the outcome after pancreaticoduodenectomy in patients with pancreatic head cancer.


Assuntos
Icterícia Obstrutiva/etiologia , Linfócitos/metabolismo , Monócitos/metabolismo , Neoplasias Pancreáticas/complicações , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Icterícia Obstrutiva/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/mortalidade , Neoplasias Pancreáticas/patologia , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida
5.
Int J Mol Sci ; 16(5): 11213-28, 2015 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-25993292

RESUMO

HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase inhibitors (statins) have been suggested to attenuate abdominal aortic aneurysm (AAA) growth. However, the effects of statins in human AAA tissues are not fully elucidated. The aim of this study was to investigate the direct effects of statins on proinflammatory molecules in human AAA walls in ex vivo culture. Simvastatin strongly inhibited the activation of nuclear factor (NF)-κB induced by tumor necrosis factor (TNF)-α in human AAA walls, but showed little effect on c-jun N-terminal kinase (JNK) activation. Simvastatin, as well as pitavastatin significantly reduced the secretion of matrix metalloproteinase (MMP)-9, monocyte chemoattractant protein (MCP)-2 and epithelial neutrophil-activating peptide (CXCL5) under both basal and TNF-α-stimulated conditions. Similar to statins, the Rac1 inhibitor NSC23766 significantly inhibited the activation of NF-κB, accompanied by a decreased secretion of MMP-9, MCP-2 and CXCL5. Moreover, the effect of simvastatin and the JNK inhibitor SP600125 was additive in inhibiting the secretion of MMP-9, MCP-2 and CXCL5. These findings indicate that statins preferentially inhibit the Rac1/NF-κB pathway to suppress MMP-9 and chemokine secretion in human AAA, suggesting a mechanism for the potential effect of statins in attenuating AAA progression.


Assuntos
Aneurisma da Aorta Abdominal/patologia , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Transdução de Sinais/efeitos dos fármacos , Sinvastatina/farmacologia , Idoso , Idoso de 80 Anos ou mais , Aminoquinolinas/farmacologia , Antracenos/farmacologia , Aorta Abdominal/efeitos dos fármacos , Aorta Abdominal/metabolismo , Aneurisma da Aorta Abdominal/metabolismo , Quimiocina CCL8/metabolismo , Quimiocina CXCL5/metabolismo , Humanos , Técnicas In Vitro , Proteínas Quinases JNK Ativadas por Mitógeno/antagonistas & inibidores , Proteínas Quinases JNK Ativadas por Mitógeno/metabolismo , Masculino , Metaloproteinase 9 da Matriz/metabolismo , Pessoa de Meia-Idade , NF-kappa B/antagonistas & inibidores , NF-kappa B/metabolismo , Pirimidinas/farmacologia , Fator de Necrose Tumoral alfa/metabolismo , Fator de Necrose Tumoral alfa/farmacologia , Proteínas rac1 de Ligação ao GTP/antagonistas & inibidores , Proteínas rac1 de Ligação ao GTP/metabolismo
7.
Cancer Genet ; 206(7-8): 304-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24075948

RESUMO

Binuclear cells have been occasionally observed in nonneoplastic and carcinoma cells. However, in clinical cases, few reports have analyzed and discussed the origins and features, including the proliferative capacity, of binuclear cells. We describe the case of a 75-year-old man with gastric cancer with microscopically prominent binuclear cells in the resected tissue and ascitic fluid. Image cytometry and chromosomal analysis were performed on cells isolated from the ascitic fluid. The DNA histogram pattern showed aneuploidy and the fluorescence in situ hybridization pattern of centromeres 7 and 11 was similar to that of most other mononuclear cancer cells. Furthermore, the binuclear cells showed low proliferative capability based on 5-bromo-2'-deoxyuridine incorporation. Our results demonstrated that the binuclear cells were derived from mononuclear aneuploid cells through incomplete cell division, and, in this case, may have impaired proliferative capacity.


Assuntos
Adenocarcinoma/patologia , Núcleo Celular/patologia , Neoplasias Gástricas/patologia , Adenocarcinoma/diagnóstico , Idoso , Citodiagnóstico , Diagnóstico Diferencial , Diploide , Humanos , Citometria por Imagem , Hibridização in Situ Fluorescente , Masculino , Neoplasias Gástricas/diagnóstico
8.
Surg Today ; 43(9): 1008-12, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23052750

RESUMO

PURPOSE: To evaluate the newly developed continuous suture technique in dunking pancreatojejunostomy without pancreatic duct stenting after pancreatoduodenectomy (PD). METHODS: Thirty-four consecutive pancreaticojejunostomies (patient age 73 ± 11, 41-88) with continuous sutures without stenting after PD were performed from 2006 to 2011. This study evaluated the operation time, intraoperative blood loss, initial postoperative day of oral feeding, postoperative hospital stay, postoperative early complications, and late complications. The indications for surgery included bile duct cancer (n = 12), pancreatic cancer (n = 11), intraductal papillary mucinous neoplasm (n = 3), cancer of the papilla (n = 3), duodenal cancer (n = 2), and others (n = 3). Portal vein or superior mesenteric vein resections and reconstructions were performed in 7 patients, and another organ was resected in 3. RESULTS: No operative or in-hospital deaths occurred. The operation time (minutes) was 315 ± 68 and, postoperative hospital stay (days) was 27 ± 16. Pancreatic fistula, wound infection, and delayed gastric emptying were observed in 15, 15, and 9 %, respectively. Grade C pancreatic fistula was seen in 2 patients. Both recovered after laparotomy and drainage and were successfully discharged. Worsening diabetes mellitus was seen in 2 of 34 patients, and dilatation of the pancreatic duct was seen in 3 of 28 patients. CONCLUSION: The newly developed continuous suture technique in dunking pancreatojejunostomy without stenting may therefore produce favorable results in PD.


Assuntos
Pancreaticojejunostomia/métodos , Técnicas de Sutura , Adulto , Idoso , Idoso de 80 Anos ou mais , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Ductos Pancreáticos , Pancreaticoduodenectomia , Cuidados Pós-Operatórios/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Stents , Fatores de Tempo , Resultado do Tratamento
9.
Kyobu Geka ; 64(2): 165-8, 2011 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-21387626

RESUMO

A 52-year-old man admitted to our hospital with a pulmonary nodule detected by chest X-ray. Painless mass was located on the right anterior chest below the right clavicle, but enlarged recently. Chest computed tomography (CT) and magnetic resonance imaging (MRI) showed the hourglass shaped mass penetrating his right 2nd intercostal muscle, and growing to intra- and extra-thoracic areas. 60 x 40 x 50 mm in size. His laboratory findings were almost within normal ranges. We performed resection of the tumor and partial resection of the 2nd and 3rd ribs with a help of thoracoscopy. Pathological diagnosis was "intramuscular lipoma-infiltrating type, no malignancy". Assistance of thoracoscopic approach was found to be useful for complete resection of the tumor existing intra- and extra-thoracic areas.


Assuntos
Lipoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Parede Torácica , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias de Tecidos Moles/diagnóstico
10.
Kyobu Geka ; 63(6): 500-3, 2010 Jun.
Artigo em Japonês | MEDLINE | ID: mdl-20533745

RESUMO

A 57-year-old man admitted to our hospital with a pulmonary nodule detected by chest X-ray. Chest X-ray and chest computed tomography (CT) showed a solitary nodule with a spiculation in the right lower lobe (S8), 17 x 15 mm in size. His laboratory findings were almost within normal ranges. Positron emission tomography (PET) showed positive detection correspond to the nodule (SUV max: 5.76). Pathological diagnosis by CT-guided lung biopsy was suspected of gastrointestinal stromal tumor (GIST). Further examination of digestive organs revealed no abnormalities. The enlargement of the nodule was noted 2 weeks later, 23 x 18 mm in size. We couldn't rule out a malignant tumor and performed partial resection of the right lower lobe. Pathological diagnosis by intraoperative frozen section was "inflammatory myofibroblastic tumor (IMT), no malignancy". The patient is alive without any signs of recurrence for 4 months postoperatively.


Assuntos
Granuloma de Células Plasmáticas Pulmonar/patologia , Diagnóstico Diferencial , Humanos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade
11.
Kyobu Geka ; 63(2): 164-7, 2010 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-20141088

RESUMO

A 79-year-old woman underwent video-assisted thoracic surgery (VATS)-left S6 segmentectomy for left lung cancer (papillary adenocarcinoma, pT1N0M0, stage IA), and were followed-up at our hospital. Chest X-ray and chest computed tomography (CT) showed ground-glass opacity (GGO) with thin-walled cavity in the right S1, 3 cm in size and small nodule in the right S2, S3 at 1st operation. The shadow in S1 was not changed but nodular lesion in S2, S3 enlarged 7 months later. CT-guided biopsy revealed well differentiated adenocarcinoma VATS-right upper lobectomy was performed and both lesions were diagnosed as "adenocarcinoma with mixed subtypes (BAC : acinar type), synchronous multiple lung cancer one of which formed thin-walled cavity" histopathologically. The patient was discharged on 20th-postoperative day and alive without any signs of recurrence for 16 months post-operatively.


Assuntos
Adenocarcinoma Papilar/cirurgia , Neoplasias Pulmonares/cirurgia , Neoplasias Primárias Múltiplas/cirurgia , Idoso , Feminino , Humanos , Cirurgia Torácica Vídeoassistida
12.
Atherosclerosis ; 208(2): 366-9, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19683237

RESUMO

Lysyl oxidase (LOX) is an enzyme critical for the stability of extracellular matrix and also known to have diverse biological functions. Little is known, however, about the role of LOX in regulating inflammation. Here we demonstrate that LOX suppresses secretion of monocyte chemoattractant protein-1 (MCP-1) in cultured vascular smooth muscle cells. Furthermore, enhancement of LOX activity reduces MCP-1 in a mouse model of abdominal aortic aneurysm (AAA), thereby preventing macrophage infiltration and AAA progression. These findings suggest that LOX has a novel function in resolving inflammation by reducing MCP-1 in AAA.


Assuntos
Aneurisma da Aorta Abdominal/metabolismo , Quimiocina CCL2/metabolismo , Proteína-Lisina 6-Oxidase/fisiologia , Adenoviridae/metabolismo , Animais , Aneurisma da Aorta Abdominal/terapia , Citocinas/metabolismo , Progressão da Doença , Inflamação , Macrófagos/metabolismo , Masculino , Camundongos , Músculo Liso Vascular/citologia , Proteína-Lisina 6-Oxidase/metabolismo , Ratos , Ratos Wistar , Reação em Cadeia da Polimerase Via Transcriptase Reversa
13.
Ann Vasc Surg ; 22(3): 476-80, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18466824

RESUMO

Infected aneurysms due to Campylobacter fetus subspecies fetus have rarely been reported. Here, we describe the first case of infected aneurysm of bilateral deep femoral arteries due to C. fetus fetus. We successfully treated this case by administration of antibiotics effective for C. fetus fetus and bilateral obturator bypass with complete resection of the infected aneurysms. The aneurysmal wall culture disclosed the presence of C. fetus fetus in a microaerobic atmosphere after the operation. A distinctive culture condition was necessary to detect C. fetus fetus. In the case of infected aneurysms, we should be aware of the possibility of infection with C. fetus fetus, and an appropriate culture for this organism may be needed.


Assuntos
Aneurisma Infectado/microbiologia , Infecções por Campylobacter/microbiologia , Campylobacter fetus/isolamento & purificação , Artéria Femoral/microbiologia , Idoso , Aneurisma Infectado/diagnóstico por imagem , Aneurisma Infectado/terapia , Antibacterianos/uso terapêutico , Implante de Prótese Vascular , Infecções por Campylobacter/diagnóstico por imagem , Infecções por Campylobacter/terapia , Campylobacter fetus/classificação , Artéria Femoral/diagnóstico por imagem , Artéria Femoral/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios X , Resultado do Tratamento
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