研究者詳細 - 木村　康利

Misc - 木村　康利

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Hand-assisted laparoscopic pylorus-preserving pancreaticoduodenectomy for pancreas head disease

Y Kimura, K Hirata, M Mukaiya, T Mizuguchi, K Koito, T Katsuramaki

AMERICAN JOURNAL OF SURGERY ( EXCERPTA MEDICA INC ) 189 ( 6 ) 734 - 737 2005年06月

Laparoscopic procedures for pancreatic surgery have been significantly improved recently; however, the number of successful laparoscopic or laparoscopy-assisted pancreaticoduodenectomies (PDs) has been limited. The limitations could be attributed to the complexity of the reconstruction procedures under laparoscopic observations and the high incidence of critical morbidity with PDs. To overcome the shortcomings, we developed the first hand-assisted laparoscopic pylorus-preserving PD and, in this report, present the case of a patient with a low-grade malignant tumor on the pancreas head. (c) 2005 Excerpta Medica Inc. All rights reserved.

DOI

Pancreas-sparing duodenectomy for a recurrent retroperitoneal liposarcoma: Report of a case

Y Kimura, M Mukaiya, T Honma, K Okuya, E Akizuki, C Kihara, T Furuhata, F Hata, T Katsuramaki, T Tsukamoto, K Hirata

SURGERY TODAY ( SPRINGER ) 35 ( 1 ) 91 - 93 2005年01月

Pancreas-sparing duodenectomy (PSD), which allows preservation of the pancreas in its entirety, is a promising procedure for low-grade malignancies of the duodenum, the periampullary region, and the neighboring retroperitoneum. We report a case of recurrent retroperitoneal liposarcoma involving the second and third parts of the duodenum, which was extirpated using PSD, after a right hemicolectomy for tumor invasion of part of the colonic hepatic flexura. The Roux-en-Y jejunal limb was sutured to the duodenal bulb in an end-to-end fashion, and the biliary and pancreatic duct systems were reconstructed with end-to-side anastomoses, placing the jejunal limb distal to the bulbo-jejunostomy after a septoplasty to repair the adjacent pancreatic and biliary ducts. Because retroperitoneal liposarcoma has a low incidence of lymph node metastasis, pancreaticoduodenectomy may be inappropriate, especially if minimally extensive surgery can ensure organ preservation. Pancreas-sparing duodenectomy could be the most appropriate procedure for nonepithelial malignant tumors located around the duodenum distal to the pylorus, which have no involvement with the pancreatic parenchyma or periduodenal lymph nodes.

DOI PubMed CiNii

The management of SSIs in the biliary and pancreatic surgery

Surgery 67 185 - 190 2005年

【外科領域の感染制御】胆・膵切除における感染対策

外科 67 185 - 190 2005年

IV-C. 急性膵炎

消化器疾患最新の治療 2005-2006 2005年

Endo-bowel clamp (PL540S) for safe rectal irrigation in laparoscopy-assisted rectal resection

T Furuhata, F Hata, T Tsuruma, H Nishimori, K Yamaguchi, T Mizuguchi, Y Kimura, T Katsuramaki, M Mukaiya, K Sasaki, K Hirata

SURGERY TODAY ( SPRINGER ) 34 ( 10 ) 882 - 884 2004年10月

We describe a technique of rectal irrigation using an endo-bowel clamp (PL540S) in laparoscopy-assisted rectal resection. One of the major concerns associated with current techniques of laparoscopy-assisted rectal resection is accidental tumor spillage because it is difficult to perform the necessary procedures without grasping and manipulating the bowel and mesorectum near the tumor. Therefore, sufficient intraoperative rectal irrigation is essential for preventing intraluminal implantation of rectal cancer. However, this can be difficult, especially if the tumor is located in the rectum. By placing a PL540S before transection, it is possible to occlude the rectum completely and irrigate it effectively. We think that the PL540S is a valuable device in laparoscopic surgery for rectal cancer.

DOI

Surgical anatomy in the periampullary region and its application to the limitted pancreatectomy

The Hokkaido Journal of Surgery 49 3 - 8 2004年

膵頭十二指腸領域の解剖と縮小手術

北海道外科雑誌 49 3 - 8 2004年

Successful management of severe acute pancreatitis with multiple organ failure.

Pancreas 28 211 - 3 2004年

DOI

Quantification of vascular endothelial growth factor-C and its receptor-3 messenger RNA with real-time quantitative polymerase chain reaction as a predictor of lymph node metastasis in human colorectal cancer

M Kawakami, T Furuhata, Y Kimura, K Yamaguchi, F Hata, K Sasaki, K Hirata

SURGERY ( MOSBY, INC ) 133 ( 3 ) 300 - 308 2003年03月

Background. This study was undertaken to determine whether vascular endothelial growth factor-C (VEGF-C) and the expression of its receptor VEGF receptor-3 (VEGFR-3) are correlated with lymph node metastasis in human colorectal cancer and whether their expression levels might be used to predict lymph node metastasis. Methods. Fifty-three surgical specimens of colorectal cancer with (n = 24) or without (n = 29) lymph node metastasis were studied. The messenger RNA (mRNA) expression of VEGF-C and VEGER-3 was quantified with a new method for kinetic quantitative polymerase chain reaction (PCR), real-time quantitative (RTQ) reverse transcriptase-PCR. In addition, their protein expressions were assessed immunohistochemically. Results. The VEGF-C mRNA level in primary tumors correlated with VEGF-C protein expression, lymph node metastasis, and lymphatic invasion. Sixteen of 24 patients with lymph node metastasis showed VEGF-C mRNA overexpression. Morphologically, VEGF-C protein expression in primary tumors showed a statistically significant relationship with lymph node metastasis and lymphatic invasion. Conclusion. Real-time quantitative reverse transcriptase-PCR is a sensitive method for detection and quantification of VEGF-C and VEGER-3 mRNA expression. Furthermore, the expression levels of VEGF-C mRNA and protein in colorectal cancer are correlated with lymph node metastasis and lymphatic invasion.

DOI

Frequent beta-catenin alteration in gallbladder carcinomas

J Exp Clin Cancer Res 22 321 - 8 2003年

Emergency medicine and guideline; Acute pancreatitis

The Japanese journal of cute medicine 27 1769 - 1774 2003年

The Conventional Pancreaticoduodenectomy with gastrectomy

Gastrointestinal Surgery 26 1715 - 1724 2003年

The procedures for standard pancreaticoduodenectomy

Gastroenterological surgery 26 1715 - 1724 2003年

【アトラスでみる膵癌の手術手技】胃切除を伴う標準的膵頭十二指腸切除術

消化器外科 26 1715 - 1724 2003年

Preoperative estimation of risk in hepatectomy using technetium-99m-galactosyl human serum albumin receptor amount by nonlinear 3-compartment model.

Hepatogastroenterology 50 174 - 7 2003年

Expression analysis of vascular endothelial growth factors and their relationships to lymph node metastasis in human colorectal cancer.

J Exp Clin Cancer Res 22 229 - 37 2003年

救急医療のコンセンサス】救急医療とガイドライン急性膵炎

真弓俊彦, 荒田慎寿, 浦英樹

救急医学 ( へるす出版 ) 27 ( 12 ) 1769 - 1774 2003年

CiNii

【アトラスでみる膵癌の手術手技】胃切除を伴う標準的膵頭十二指腸切除術

消化器外科 26 1715 - 1724 2003年

Traumatic transection of the pancreas head: report of a case with santorini duct injury treated by damage-control surgery.

Pancreas 26 205 - 7 2003年

DOI

Efficacy of SPIO-MR imaging in the diagnosis of liver metastases from colorectal carcinomas

T Furuhata, K Okita, T Tsuruma, F Hata, Y Kimura, T Katsuramaki, M Mukaiya, N Hirokawa, T Ichimura, N Yama, K Koito, K Sasaki, K Hirata

DIGESTIVE SURGERY ( KARGER ) 20 ( 4 ) 321 - 325 2003年

Aim: To determine whether superparamagnetic iron oxide-enhanced magnetic resonance imaging (SPIO-MRI) could replace intravenous contrast-enhanced spiral CT (iv-CT) and spiral CT during arterial portography (CTAP) combined with spiral CT hepatic angiography (CTHA) in the diagnosis of liver metastases from colorectal carcinomas. Methods: Twenty-six adult patients with liver metastases were studied preoperatively by means of iv-CT, CTAP/CTHA, and SPIO-MRI. Preoperative diagnoses using iv-CT, CTAP/CTHA, and SPIO-MRI were compared with intraoperative and pathological findings in resected specimens. The gold standard for the lesions that were resected was histological examination. Intraoperative findings represented the gold standard for lesions that were not resected. Results: Twenty-six patients were found to have a total number of 43 liver metastases. The sensitivities of iv-CT, CTAP/CTHA, and SPIO-MRI were 74.4, 100, and 90.7%, respectively. SPIO-MRI was significantly superior to iv-CT (p < 0.05). The positive predictive values of iv-CT, CTAP/CTHA, and SPIO-MRI were 97.0, 91.5, and 100%, respectively. CTAP/CTHA yielded four false-positive lesions. In contrast, we detected no false-positive findings using SPIO-MRI. Conclusions: These results suggest that SPIO-MRI might not completely replace CTAP/CTHA, but could replace iv-CT in the diagnosis of liver metastases from colorectal carcinomas. It is thought that SPIO-MRI is a promising imaging modality for diagnosing liver metastases in patients with colorectal carcinoma because of its relatively high sensitivity and extremely high specificity. Copyright (C) 2003 S. Karger AG, Basel.

DOI

Changes in serum levels of apolipoprotein A-1 as an indicator of protein metabolism after hepatectomy

T Katsuramaki, K Hirata, Y Kimura, M Nagayama, M Meguro, H Kimura, T Honma, T Furuhata, U Hideki, F Hata, M Mukaiya

WOUND REPAIR AND REGENERATION ( BLACKWELL PUBLISHING INC ) 10 ( 1 ) 77 - 82 2002年01月

The clinical significance of serum apolipoprotein A-1 levels as an indicator of hepatic protein synthesis after hepatectomy was investigated. A total of 50 patients who had undergone hepatectomy at our department from 1997 to 1999 were selected for this study, The serum levels of apolipoprotein A-1, indocyanine green dye retention at 15 minutes, lectin-cholesterol acyltransferase, prealbumin, and high-density lipoprotein cholesterol were measured in these patients preoperatively and on postoperative days 7 and 14, The type of hepatic resection conducted was partial resection in 13 cases, subsegmentectomy in 13 cases, segmentectomy in five cases, and bisegmentectomy in 19 cases, All the patients tolerated the operation, and none of the cases had any severe complications, such as liver failure, In most cases, the serum apolipoprotein A-1 levels decreased on postoperative day 7 and recovered by day 14, There were no significant differences in the changes in apolipoprotein A-1 levels between patients with the individual types of operative procedures. The serum apolipoprotein A-1 levels showed significant correlations with the serum high-density lipoprotein cholesterol, lectin-cholesterol acyltransferase and prealbumin levels on postoperative days 7 and 14, however, there was no significant correlation with the indocyanine green retention test, When the cases were divided into three groups according to the serum level of apolipoprotein A-1 on postoperative day 7 (group A: over 81 mg/dl, group B: 61-80 mg/dl, group C: under 60 mg/dl), the serum indocyanine green retention, prealbumin, lectin-cholesterol acyltransferase and high-density lipoprotein cholesterol levels in group C were significantly lower than those in group A on postoperative day 7. On the basis of these results, it is suggested that the pattern of changes in the serum apolipoprotein A-1 levels may be a good indicator of the hepatic protein synthetic ability during the perioperative period after hepatectomy.

DOI

[A case of recurrent hepatocellular carcinoma successfully treated with a combination therapy of interferon-alpha and intravenous continuous infusion of 5-fluorouracil]

Gan To Kagaku Ryoho 29 1801 - 4 2002年

p53 とは何か

Digestive Surgery 6 2 - 3 2002年

beta-Catenin alteration in cancer of the ampulla of Vater.

J Exp Clin Cancer Res 21 23 - 7 2002年

大腸癌術後に発症した遷延性ダグラス窩膿瘍の一例

外科感染症研究会雑誌 14 157 - 162 2002年

Histopathological characteristics of biliary tract carcinomas arising from the pancreaticobiliary maljunction

Pancreaticobiliary Maljunction 2002年

Obstructive jaundice due to internal herniation: a case report and review of the literature.

Hepatogastroenterology 49 1030 - 2 2002年

Whatﾕs new in SURGERY FRONTIER -c-ets-1-

SURGERY FRONTIER 8 73 - 76 2001年

Vascular endothelial growth factor C promotes human gastric carcinoma lymph node metastasis in mice.

J Exp Clin Cancer Res 20 419 - 28 2001年

膵管胆道合流異常を伴った胆嚢癌におけるWnt-wingless signalingの異常

木村康利, 古畑智久, 向谷充宏, 柳内良之, 川上雅代, 佐藤昌明, 一宮慎吾, 平間敏憲, 平田公一

胆道 ( 日本胆道学会 ) 14 ( 4 ) 339 - 346 2000年

胆嚢癌の発癌,進展に関与する癌関連遺伝子の検索を目的に,β-catenin蛋白をコードするctnnb-1遺伝子の変異検索を行った.ctnnb-1遺伝子のexon 3はGSK-3βによるリン酸化部位であり,これをPCR-SSCP法にて解析した.さらに,免疫組織化学的検討を行いβ-catenin蛋白の細胞内局在の異常を解析した. 対象は膵管胆道合流異常を合併した胆嚢癌5例と胆嚢癌の合併のない合流異常症8例の胆嚢である.その結果,胆嚢癌5例中3例に,遺伝子変異を同定し得なかったものの,β-catenin蛋白の核,または細胞質への移行が確認された.合流異常症例の胆道系組織(非癌部)では,遺伝子変異,細胞内局在をともに認めなかったことから,Wnt-winglessの情報伝達系におけるβ-catenin蛋白の異常蓄積は胆嚢癌の発生,進展において北較的後期に関与する可能性が示唆された.

DOI CiNii

肝切除術の基本手技

外科治療 83 698 - 706 2000年

切除不能進行膵癌に対する大内臓神経切離術の経験

北海道外科 45 49 - 53 2000年

転移性膵体部腫瘍に対し膵体部横断切除後、膵管膵管吻合で再建しえた一例

手術 54 1919 - 1923 2000年

病態に応じた輸液 (8)代謝性アルカローシスの場合

臨床外科 55 591 - 593 2000年

DOI

GML sensitizes cancer cells to Taxol by induction of apoptosis

Y Kimura, T Furuhata, T Shiratsuchi, H Nishimori, K Hirata, Y Nakamura, T Tokino

ONCOGENE ( STOCKTON PRESS ) 15 ( 11 ) 1369 - 1374 1997年09月

Recently we identified a novel gene, gml, whose expression is regulated in a p53-dependent manner and found that gml expression was correlated with the sensitivity of esophageal cancer cells to anticancer drugs. To further investigate the biological mechanism of gml in determining the chemosensitivity of cancer cells to clinically useful agents, we introduced gml cDNA into TE10, an esophageal cancer cell line that lacks endogenous gml expression. In two resulting stable cell lines which expressed gml cDNA in the absence of wild-type p53, cell death occurred within 6 h after treatment with Taxol. TE10 parent cells or TE10 cells transfected with vector alone displayed relative resistance for 36 h. Induction of gml did not by itself affect viability. Morphological analysis confirmed that the increased chemosensitivity to Taxol conferred by gml was due to apoptosis. These data suggest that reduced expression of gml is likely to be associated with poor response rates to chemotherapy, and that an assay for gml expression might serve a clinical purpose as a predictor of chemotherapeutic sensitivity.

DOI PubMed CiNii

Genomic structure and chromosomal localization of GML (GPI-anchored molecule-like protein), a gene induced by p53

Y Kimura, T Furuhata, T Urano, K Hirata, Y Nakamura, T Tokino

GENOMICS ( ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS ) 41 ( 3 ) 477 - 480 1997年05月

Among its known functions, tumor suppressor gene p53 serves as a transcriptional regulator and mediates various signals through activation of downstream genes, We recently identified a novel gene, GML (glycosylphosphatidylinositol (GPI)-anchored molecule-like protein), whose expression is specifically induced by wildtype p53, To characterize the GML gene further, we determined 35.8 kb of DNA sequence that included a consensus binding sequence for p53 and the entire GML gene. The GML gene consists of four exons, and the p53-binding sequence is present in the 5'-flanking region. in genomic organization this gene resembles genes encoding murine Ly-6 glycoproteins, a human homologue of the Ly-6 family called RIG-E, and CD59; products of these genes, known as GPI-anchored proteins, are variously involved in signal transduction, cell-cell adhesion, and cell-matrix attachment. FISH analysis revealed that the GML gene is located on human chromosome 8q24.3. Genes encoding at least two other GPI-anchored molecules, E48 and RIG-E, are also located in this region. (C) 1997 Academic Press.

DOI PubMed CiNii

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