JaLCDOI 10.18926/AMO/51071
フルテキストURL 67_4_259.pdf
著者 Idani, Hitoshi| Nakano, Kanyu| Asami, Shinya| Kubota, Tetsushi| Komoto, Satoshi| Kurose, Yohei| Kubo, Shinichiro| Nojima, Hiroki| Hioki, Katsuyoshi| Kin, Hitoshi| Takakura, Norihisa|
抄録 We describe a new simple and easy technique called the "Hook and roll technique" (HRT) that uses an articulating hook cautery to provide a critical view during single incision laparoscopic cholecystectomy (SILC). A 2-cm incision is made at the umbilicus to insert three 5-mm trocars or a multichannel port. After dissection of the serosa of the dorsal and ventral sides of the gall bladder, including Calot's triangle, the angled tip of the hook cautery is inserted between the cystic artery and duct with its tip placed dorsally. The tip is then rotated in a clockwise manner to avoid bile duct injury, allowing the connective tissue between them to be hooked, coagulated and cut. This procedure is repeated several times, followed by dissection between the cystic artery and the liver bed to achieve a critical view. From December 2008 to May 2011, 121 patients underwent SILC using HRT in our hospital without any serious complications. This technique is suitable for SILC, as it is consists of simple procedures that can be performed safely and easily, even by left hand in a cross-over approach, and it allows complete dissection of Calot's triangle to achieve a critical view without using any dissector under dangerous in-line viewing.
キーワード critical view of safety single incision laparoscopic cholecystectomy articulating hook cautery
Amo Type Original Article
発行日 2013-08
出版物タイトル Acta Medica Okayama
67巻
4号
出版者 Okayama University Medical School
開始ページ 259
終了ページ 263
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23970325
Web of Sience KeyUT 000323470100008
JaLCDOI 10.18926/AMO/31646
フルテキストURL fulltext.pdf
著者 Kohka, Hideo| Iwagaki, Hiromi| Yoshino, Tadashi| Kobashi, Kenta| Saito, Shinnya| Isozaki, Hiroshi| Takakura, Norihisa| Tanaka, Noriaki|
抄録 <p>Corticoids are well known for their immunosuppressive properties. Interleukin-10 (IL-10) is an intrinsic antiinflammatory peptide in immune diseases, originally identified as cytokine synthesis inhibitory factor. We examined the effect of hydrocortisone sodium succinate (HSS) on the production of IL-10 by human peripheral blood mononuclear cells (PBMCs). PBMCs from healthy volunteers and cancer-burden patients were preincubated separately with or without HSS for 1 h, then stimulated with 5 microg/ml lipopolysaccharide (LPS). Production of IL-10 by human PBMCs was detected with LPS stimulation and its production was higher in cancer-burden patients than in normal volunteers, although this was not statistically significant. HSS suppressed production of IL-10 by LPS-stimulated PBMCs in a dose-dependent manner both in normal volunteers and in cancer-burden patients. These results indicate that, in addition to their antiinflammatory properties, corticoids act to restore the immunosuppressive states even in cancer-burden states</p>
キーワード steroid interleukin-10 cancer-burden state
Amo Type Article
発行日 1999-02
出版物タイトル Acta Medica Okayama
53巻
1号
出版者 Okayama University Medical School
開始ページ 55
終了ページ 59
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
Web of Sience KeyUT 000078897700009
JaLCDOI 10.18926/AMO/31631
フルテキストURL fulltext.pdf
著者 Iwagaki, Hiromi| Yagi, Takahito| Urushihara, Naoto| Kobashi, Kenta| Morimoto, Yoshinori| Isozaki, Hiroshi| Takakura, Norihisa| Tanaka, Noriaki|
抄録 <p>The relationship between endogenous cytokine antagonists and surgical stress is poorly understood. Surgical stress induces immunosuppression, and the reversed therapy of postoperative immunosuppression has been expected. The aim of the present study was to assess the effect of a serine protease inhibitor on postoperative immune reactivity. Twenty patients with colorectal cancer were randomly separated into experimental and control groups of 10 patients each. The experimental group received perioperative administration of a serine protease inhibitor while the control group did not. Plasma levels of cytokine antagonists, which suppress cell-mediated immunity, such as cortisol, interleukin-1 receptor antagonist, soluble interleukin-2 receptor (sIL-2R) and soluble tumor necrosis factors p55, p75 (sTNF-R55, -R75) were simultaneously measured. Significant reductions of plasma concentration of sIL-2R and sTNF-R55 were observed. Perioperative administration of a serine protease inhibitor may contribute to ameliorating immunosuppression after major surgery.</p>
キーワード surgical stress cytokine antagonist protease inhibitor
Amo Type Article
発行日 1999-10
出版物タイトル Acta Medica Okayama
53巻
5号
出版者 Okayama University Medical School
開始ページ 239
終了ページ 244
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 10561733
Web of Sience KeyUT 000083427100006
JaLCDOI 10.18926/AMO/31304
フルテキストURL fulltext.pdf
著者 Gotohda, Naoto| Iwagaki, Hiromi| Itano, Satoshi| Horiki, Sadayuki| Fujiwara, Toshiya| Saito, Shinya| Hizuta, Akio| Isozaki, Hiroshi| Takakura, Norihisa| Terada, Norihiko| Tanaka, Noriaki|
抄録 <p>POSSUM, a Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity, is a scoring system which assesses perioperative surgical risks (Copeland GP et al.: Br J Surg, 1991, Vol 78, 356-360). The POSSUM scoring system consists of two categories of assessment to assess the risk of surgery. A 12-factor (age, cardiac status, pulse rate, systolic blood pressure, respiratory status, Glasgow Coma Score, serum concentration of urea, potassium and sodium, hemoglobin concentration, white cell count and findings on electrocardiography) and 4-grade physiological score (PS) were developed. This was combined with a 6-factor (type of surgical procedure, number of procedures, blood loss, peritoneal soiling, presence of malignancy and mode of surgery) and 4-grade operative severity score (OSS). The present paper attempts to validate it retrospectively. Postoperative hospitalization period and duration of antibiotics administration were both significantly correlated with OSS, but not with PS. These results suggest that the POSSUM scoring system is useful for predicting the postoperative clinical course.</p>
キーワード surgical risk Physiological and Operative Severity Source for the enUmeration of Mortality and morbidity
Amo Type Article
発行日 1998-12
出版物タイトル Acta Medica Okayama
52巻
6号
出版者 Okayama University Medical School
開始ページ 325
終了ページ 329
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 9876770
Web of Sience KeyUT 000077707300007