Title Alternative Adenocarcinoma in the jejunum 20 years after surgery for familial adenomatous polyposis
Author Sugihara, Yuusaku| Kawano, Seiji| Harada, Keita| Takashima, Shiho| Takei, Daisuke| Inokuchi, Toshihiro| Takahara, Masahiro| Hiraoka, Sakiko| Mori, Yoshiko| Kishimoto, Hiroyuki| Nagasaka, Takeshi| Okada, Hiroyuki|
Abstract A 58-year-old Japanese man visited a local clinic for the evaluation of a stomachache. He was diagnosed with intestinal obstruction. His medical history included a proctocolectomy at the age of 38 years, due to familial adenomatous polyposis (FAP). He was referred to our institution, where he underwent a computed tomography examination and endoscopy of the small intestine. The pathological diagnosis was adenocarcinoma. No invasive or metastatic lesions were observed. Therefore, partial resection of the ileum with lymphadenectomy and reconstruction of the ileostomy were performed. Pathological examination revealed that the tumor was type 2, pT3 (SS) , pN1, pPM0, pDM0, pRM0, INFb, ly1, v1, pEX0, PN0. Twenty-nine days after the surgery, the patient was diagnosed with lung metastasis and he underwent lung radiofrequency ablation. We suggest that long-term follow-up is necessary for patients after surgery for FAP, because of the risk of malignant disease developing in other organs.
Keywords 家族性大腸腺腫症 (familial adenomatous polyposis) 小腸癌 (jejunal cancer) 小腸内視鏡検査 (small intestine endoscope)
Publication Title Journal of Okayama Medical Association
Published Date 2017-08-01
Volume volume129
Issue issue2
Start Page 111
End Page 114
ISSN 0030-1558
Related Url https://doi.org/10.4044/joma.129.111
language 日本語
Copyright Holders Copyright (c) 2017 岡山医学会
File Version publisher
DOI 10.4044/joma.129.111
JaLCDOI 10.18926/AMO/54817
FullText URL 70_6_511.pdf
Author Gobara, Hideo| Hiraki, Takao| Iguchi, Toshihiro| Fujiwara, Hiroyasu| Nagasaka, Takeshi| Kishimoto, Hiroyuki| Tanaka, Takehiro| Kanazawa, Susumu|
Abstract An 87-year-old Japanese man underwent percutaneous cryoablation (PCA) therapy for his renal cell tumor. We displaced the colon from the tumor using hydrodissection. Computed tomography (CT) immediately after PCA was indicative of iceball extension to the colon wall, and a discontinuous enhancement of the colon wall was observed. We therefore performed an emergency surgery. On laparotomy, we observed a dark-purple area on the affected area of the colon, and the resected specimen showed focal, deep ulceration on the mucosal surface. Photomicrography revealed mucosal necrosis, submucosal hemorrhage, and necrotic foci in the muscularis propria, corresponding to the discontinuous colon wall enhancement on CT and the deep ulceration and dark-purple area on laparotomy. He recovered from surgery and was discharged without any complications.
Keywords bowel injury complication cryoablation renal cell carcinoma thermal ablation
Amo Type Case Report
Published Date 2016-12
Publication Title Acta Medica Okayama
Volume volume70
Issue issue6
Publisher Okayama University Medical School
Start Page 511
End Page 514
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28003679
JaLCDOI 10.18926/AMO/54512
FullText URL 70_4_317.pdf
Author Sakurai, Jun| Matsui, Yusuke| Hiraki, Takao| Iguchi, Toshihiro| Fujiwara, Hiroyasu| Gobara, Hideo| Mitsuhashi, Toshiharu| Nagasaka, Takeshi| Susumu Kanazawa, Susumu Kanazawa|
Abstract The present single center prospective phase II clinical trial is designed to evaluate the efficacy and safety of percutaneous radiofrequency (RF) ablation for colorectal lung metastases. Patients who have colorectal lung metastases without extrapulmonary metastases are included in this study. The primary endpoint is 3-year overall survival (OS) after RF ablation. The secondary endpoints are the prevalence of adverse events within 4 weeks, local tumor progression rate, 1- and 5-year OS, cause-specific survival, and relapse-free survival. The recruitment of patients commenced in July 2014, and the enrolment of 45 patients is intended over the 3 years of study period.
Keywords radiofrequency ablation colorectal cancer lung metastasis
Amo Type Clinical Study Protocols
Published Date 2016-08
Publication Title Acta Medica Okayama
Volume volume70
Issue issue4
Publisher Okayama University Medical School
Start Page 317
End Page 321
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27549681
Web of Sience KeyUT 000384748600016
JaLCDOI 10.18926/AMO/53672
FullText URL 69_5_267.pdf
Author Inada, Ryo| Nagasaka, Takeshi| Kondo, Yoshitaka| Watanabe, Ayako| Toshima, Toshiaki| Kubota, Nobuhito| Kikuchi, Satoru| Ishida, Michihiro| Kuroda, Shinji| Mori, Yoshiko| Kishimoto, Hiroyuki| Fujiwara, Toshiyoshi|
Abstract The aim of this single-institution, retrospective, observational case-control study was to evaluate the safety and feasibility of laparoscopic proctocolectomy (PC) for ulcerative colitis (UC), by comparing it with a case-control series of open PC. Twenty UC patients who underwent laparoscopic PC were retrospectively compared with the open PC group of 12 patients matched for age, sex, and urgency of the operation. In the laparoscopic PC group, the operative time was significantly longer, but the amount of blood loss was significantly smaller. The open PC patients underwent an intraoperative blood transfusion significantly more often, and the serum C-reactive protein level on the first postoperative day was significantly higher in the open PC group. In the laparoscopic PC group, the rate of severe postoperative morbidities, grades 3 and 4 on the Clavien-Dindo classification, was significantly lower, and the median length of hospital stay was significantly shorter. Laparoscopic PC for patients with UC showed superior perioperative outcomes to open PC, except for longer operative time.
Keywords laparoscopic surgery total proctocolectomy open proctocolectomy ulcerative colitis case-matched study
Amo Type Original Article
Published Date 2015-10
Publication Title Acta Medica Okayama
Volume volume69
Issue issue5
Publisher Okayama University Medical School
Start Page 267
End Page 273
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 26490023
Web of Sience KeyUT 000365519600002
Title Alternative Successful laparoscopic resection of a cecal tumor in a 95-year-old man
FullText URL 127_117.pdf
Author Watanabe, Ayako| Inada, Ryo| Nagasaka, Takeshi| Yagi, Tomohiko| Matsumoto, Hijiri| Toshima, Toshiaki| Kikuchi, Satoru| Kuroda, Shinshi| Kondo, Yoshitaka| Mori, Yoshiko| Kishimoto, Hiroyuki| Fujiwara, Toshiyoshi|
Abstract We report a successful laparoscopic resection of a cecal tumor in a 95-year-old Japanese man. The patient visited an initial hospital with a complaint of constipation in March 2014. Computed tomography scan and colonoscopy showed a stenotic ileocecal cancer with pericolic lymph node metastases, and he was referred to our department for management. Since his general condition was maintained, we performed a laparoscopic ileocecal resection with regional lymph node dissection for the patient. The operation achieved curative resection, and the tumor was diagnosed as a moderately differentiated adenocarcinoma and graded as pStage IIIa (pT3, pN0, pM0) according to the Japanese Classification of Colorectal Carcinoma, eighth edition. He was discharged on the 11th postoperative day without perioperative complications. Several large-scale randomized controlled trials (RCTs) revealed that laparoscopic surgeries for colorectal cancers have some advantages compared to open surgeries, including superior short-term outcomes and comparable long-term outcomes. Unfortunately, since these RCTs did not include enough elderly patients, the safety and feasibility of laparoscopic surgery for extremely elderly patients are still unknown. With respect to less-invasive procedures, these advantages of laparoscopic surgery are also thought to be the advantages for elderly colorectal cancer patients.
Keywords 超高齢者(extremely elderly patient) 大腸癌(colorectal cancer) 腹腔鏡手術(laparoscopic surgery)
Publication Title 岡山医学会雑誌
Published Date 2015-08-03
Volume volume127
Issue issue2
Start Page 117
End Page 121
ISSN 0030-1558
Related Url isVersionOf https://doi.org/10.4044/joma.127.117
language 日本語
Copyright Holders Copyright (c) 2015 岡山医学会
File Version publisher
DOI 10.4044/joma.127.117
NAID 130005096253
JaLCDOI 10.18926/AMO/53340
FullText URL 69_2_113.pdf
Author Inada, Ryo| Nagasaka, Takeshi| Toshima, Toshiaki| Mori, Yoshiko| Kondo, Yoshitaka| Kishimoto, Hiroyuki| Hiraki, Takao| Oshiro, Taihei| Kanemitsu, Yukihide| Fujiwara, Toshiyoshi|
Abstract A case of advanced rectal cancer treated by aggressive local and systemic treatment who has survived more than 7 years from initial recurrence is presented. A 55-year-old woman was diagnosed with advanced lower rectal cancer and underwent a low anterior resection with complete removal of all regional lymph nodes and total mesorectal excision. The tumor was diagnosed as a moderately differentiated adenocarcinoma, pStage IIIB (T3, N2a, M0). Twenty-six months after the initial surgery, local recurrence in the pelvis was detected by computed tomography, and total pelvic exenteration with distal sacrectomy (TPES) was performed after systemic chemotherapy with a molecular-targeted drug. Six months after the TPES, multiple lung metastases were detected. Consequently, the patient underwent radiofrequency ablation (RFA) and chemotherapy. The disease has since been controlled for 38 months. As volume control is essential for cancer treatment, it may be important to combine appropriate local therapy with systemic therapy to metastatic or recurrent sites in order to achieve much longer disease control.
Keywords colorectal cancer recurrence total pelvic exenteration radiofrequency ablation systemic chemotherapy
Amo Type Case Report
Published Date 2015-04
Publication Title Acta Medica Okayama
Volume volume69
Issue issue2
Publisher Okayama University Medical School
Start Page 113
End Page 118
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2015 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 25899633
Web of Sience KeyUT 000353181700006
Author Kikuchi, Satoru| Kishimoto, Hiroyuki| Tazawa, Hiroshi| Hashimoto, Yuuri| Kuroda, Shinji| Nishizaki, Masahiko| Nagasaka, Takeshi| Shirakawa, Yasuhiro| Kagawa, Shunsuke| Urata, Yasuo| Robert M Hoffman| Fujiwara, Toshiyoshi|
Published Date 2014-12-19
Publication Title Molecular Therapy
Content Type Journal Article
Author Kondo, Yoshitaka| Nagasaka, Takeshi| Kobayashi, Satoru| Kobayashi, Naoya| Fujiwara, Toshiyoshi|
Published Date 2014-03
Publication Title Hepato-Gastroenterology
Volume volume61
Issue issue130
Content Type Journal Article
Author Shigeyasu, Kunitoshi| Tazawa, Hiroshi| Hashimoto, Yuuri| Mori, Yoshiko| Nishizaki, Masahiko| Kishimoto, Hiroyuki| Nagasaka, Takeshi| Kuroda, Shinji| Urata, Yasuo| Goel, Ajay| Kagawa, Shunsuke| Fujiwara, Toshiyoshi|
Published Date 2014-05-28
Publication Title Gut
Content Type Journal Article
Author Yamada, Eiji| Shirakawa, Yasuhiro| Yamatsuji, Tomoki| Sakuma, Leon| Takaoka, Munenori| Yamada, Takako| Noma, Kazuhiro| Sakurama, Kazufumi| Fujiwara, Yasuhiro| Tanabe, Shunsuke| Nagasaka, Takeshi| Fujiwara, Toshiyoshi| Naomoto, Yoshio|
Published Date 2012-12
Publication Title Journal of Surgical Research
Volume volume178
Issue issue2
Content Type Journal Article
Author Yano, Shuya| Tazawa, Hiroshi| Hashimoto, Yuuri| Shirakawa, Yasuhiro| Kuroda, Shinji| Nishizaki, Masahiko| Kishimoto, Hiroyuki| Uno, Futoshi| Nagasaka, Takeshi| Urata, Yasuo| Kagawa, Shunsuke| Hoffman, Robert M.| Fujiwara, Toshiyoshi|
Published Date 2013-12-01
Publication Title Clinical Cancer Research
Volume volume19
Issue issue23
Content Type Journal Article
Author Satoh, Daisuke| Yagi, Takahito| Nagasaka, Takeshi| Shinoura, Susumu| Umeda, Yuzo| Yoshida, Ryuichi| Utsumi, Masashi| Tanaka, Takehiro| Sadamori, Hiroshi| Fujiwara, Toshiyoshi|
Published Date 2013-04-27
Publication Title World Journal of Hepatology
Volume volume5
Issue issue4
Content Type Journal Article
Author Nagasaka, Takeshi| Fujiwara, Toshiyoshi|
Published Date 2013-08-01
Publication Title 岡山医学会雑誌
Volume volume125
Issue issue2
Content Type Journal Article
Author Inada, Ryo| Nagasaka, Takeshi| Mori, Yoshiko| Umeda, Yuzo| Kubota, Nobuhito| Morikawa, Tatsuya| Kondo, Yoshitaka| Uno, Futoshi| Sadamori, Yu| Yagi, Takahito| Fujiwara, Toshiyoshi|
Published Date 2013-04-01
Publication Title 岡山医学会雑誌
Volume volume125
Issue issue1
Content Type Journal Article
Author Inada, Ryo| Nagasaka, Takeshi| Takehara, Kiyoto| Sugihara, Masahiro| Mori, Yoshiko| Umeda, Yuzo| Kubota, Nobuhito| Morikawa, Tatsuya| Kondo, Yoshitaka| Uno, Futoshi| Sadamori, Yu| Yagi, Takahito| Fujiwara, Toshiyoshi|
Published Date 2013-04-01
Publication Title 岡山医学会雑誌
Volume volume125
Issue issue1
Content Type Journal Article
JaLCDOI 10.18926/AMO/46628
FullText URL 65_3_169.pdf
Author Takeda, Masanori| Nagasaka, Takeshi| Dong-Sheng, Sun| Nishie, Hiroyuki| Oka, Tetsuhiro| Yamada, Eiji| Mori, Yoshiko| Shigeyasu, Kunitoshi| Morikawa, Tatsuya| Mizobuchi, Satoshi| Fujiwara, Toshiyoshi|
Abstract Secreted frizzled-related protein 2, (SFRP2) is a Wnt inhibitor whose promoter CpGs were recently found to be methylated at high frequency in colorectal cancers (CRCs). We hypothesized that the pattern of SFRP2 methylation may differ throughout the promoter during progressive tumorigenesis. Using combined bisulfite restriction analysis (COBRA), two methylation-sensitive regions (Regions A and B) of the SFRP2 promoter were investigated in 569 specimens of colorectal tissue:222 CRCs, 103 adenomatous polyps (APs), 208 normal colonic mucosa from CRC patients (N-Cs), and 36 normal colonic mucosa from subjects with no evidence of colorectal neoplasia at colonoscopy (N-Ns). Extensive (including both Regions A and B) and partial (either Region A or B) SFRP2 methylation levels were found in 61.7% and 24.8% of CRCs, 8.7% and 37.9% of APs, 3.9% and 39.9% of N-Cs, and 0% and 30.6% of N-Ns, respectively. Extensive methylation of the SFRP2 promoter was present primarily in CRCs, while partial methylation was common in APs. Whereas APs with the KRAS mutant showed no correlation to any pattern of SFRP2 methylation, extensive methylation of the SFRP2 promoter was significantly associated with KRAS mutant CRCs (p<.0001), suggesting that genetic alteration in the RAS-RAF pathway might precede the spread of CpG methylation through the SFRP2 promoter, which is observed in over 60% of advanced colorectal tumors.
Keywords BRAF/KRAS mutations promoter methylation colorectal cancer
Amo Type Original Article
Published Date 2011-06
Publication Title Acta Medica Okayama
Volume volume65
Issue issue3
Publisher Okayama University Medical School
Start Page 169
End Page 177
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 21709714
Web of Sience KeyUT 000292017500003
Author Nagasaka, Takeshi| Tanaka, Noriaki| Sun, Dong-Sheng| Naomoto, Yoshio| Mastubara, Nagahide| Yagi, Takahito| Fujiwara, Toshiyoshi|
Published Date 2010-08-02
Publication Title 岡山医学会雑誌
Volume volume122
Issue issue2
Content Type Journal Article
JaLCDOI 10.18926/AMO/30741
FullText URL fulltext.pdf
Author Nagasaka, Takeshi| Goel, Ajay| Matsubara, Nagahide| Tanaka, Noriaki|
Abstract Aberrant promoter methylation, an 'epigenetic' form of genomic instability that leads to transcriptional silencing of tumor suppressor genes, is increasingly being recognized as a crucial component in the evolution of human cancers. With our limited knowledge of the molecular basis and timing of the initiation of altered methylation events in the stepwise progression of cancers, the biggest challenge we currently face is to identify novel biomarkers and technologies for the timely screening of patients carrying such alterations. One such strategy would be to develop tests for the detection of fecal DNA methylation patterns that will improve the sensitivity of noninvasive screening tests for colorectal neoplasia, and moreover, will decrease both mortality and the incremental costs of treating colorectal cancers.
Keywords fecal DNA colorectal cancer methylation epigenetics
Amo Type Review
Published Date 2006-10
Publication Title Acta Medica Okayama
Volume volume60
Issue issue5
Publisher Okayama University Medical School
Start Page 249
End Page 256
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 17072371
Web of Sience KeyUT 000241509000001
Author 永坂 岳司| 松原 長秀| 笹本 博美| 高畑 隆臣| 竹田 正範| 木村 圭吾| 内田 卓之| 石井 龍宏| 長尾 厚樹| 小南 賢吉郎| 中川 仁志| 神原 健| 能登原 憲司| 磯崎 博司| 田中 紀章|
Published Date 2005-09-01
Publication Title 岡山医学会雑誌
Volume volume117
Issue issue2
Content Type Journal Article
Author Nagasaka, Takeshi|
Published Date 2004-03-25
Publication Title
Content Type Thesis or Dissertation