Publications by authors named "Gumpei Yoshimatsu"

Background Therapeutic drug monitoring (TDM) is an effective approach to improving the efficacy of drugs with a narrow therapeutic index and high toxicity. TDM-guided dosing of 5-fluorouracil (5-FU) has been shown to result in superior efficacy and fewer adverse events compared to body surface area (BSA)-based dosing. Therefore, accurate measurement of plasma 5-FU concentrations after capecitabine administration is necessary.

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Lymphedema is an intractable disease with few effective therapeutic options. Autologous mesenchymal stem cell (MSC) transplantation is a promising therapy for this disease. However, its use is limited by the cost and time for preparation.

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Background: Loop ileostomy is a common surgical procedure but is associated with complications such as outlet obstruction (OO), parastomal hernia (PH), and high-output stoma (HOS). This study aimed to identify risk factors for these complications, as well as their causal relationships.

Methods: The study included 188 consecutive patients who underwent loop ileostomy between April 2016 and September 2021.

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Porcine islet xenotransplantation is a promising therapy for severe diabetes mellitus. Maintenance of the quality and quantity of porcine islets is important for the success of this treatment. Here, we aimed to elucidate the influence of relatively short-term (14 days) culture on adult porcine islets isolated from three micro-minipigs (P111, P112 and P121).

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Article Synopsis
  • - Colonic varices, often linked to portal hypertension, are rare, and the presence of an arteriovenous fistula (AVF) in the inferior mesenteric artery (IMA) is even more uncommon, presenting unique diagnosis and treatment challenges.
  • - A 48-year-old man with a positive fecal occult blood test was found to have varices and suspected AVF in the IMA region; due to the risks of other interventions, a laparoscopic sigmoidectomy was performed successfully.
  • - This case highlights the need for surgical intervention in managing AVF and colonic varices in the IMA, especially when other treatments are risky and less effective, demonstrating a positive postoperative outcome through proper surgical techniques.
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  • An organoid is a lab-made mini organ that looks like a real organ and can help in medical treatments.
  • Researchers are studying porcine (pig) islet organoids as a possible way to treat severe diabetes, which could be a safer alternative to using pig organs.
  • The study found that while these organoids grow and change over time, they lose their ability to produce insulin, suggesting more research is needed to make them work like real islets.
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Background Accurate lymph node evaluation is essential for staging colon cancer and guiding postoperative treatment decisions. In this study, we compared the efficacy of a simple enzymatic fat dissolution method with the conventional method for lymph node sampling from specimens after colon cancer surgery. Methods We enrolled 58 patients who underwent elective laparoscopic surgery for colon adenocarcinoma between May 2018 and May 2021 at Fukuoka University Hospital in Fukuoka, Japan.

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The AirSeal system (CONMED, NY, USA) can outstandingly keep pneumoperitoneum stable. However, water droplets form on the access port, impairing the performance of comfortable surgical procedures because of the resultant wet surgical field. This study was performed to clarify the mechanism of water droplet formation and to prevent it.

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Critical limb ischemia (CLI) is caused by severe arterial blockage with reduction of blood flow. The aim of this study was to determine whether therapeutic angiogenesis using cellular communication network factor 2 (CCN2) would be useful for treating CLI in an animal model. Recombinant CCN2 was administered intramuscularly to male C57BL/6J mice with hind limb ischemia.

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Porcine islet xenotransplantation represents a promising therapy for severe diabetes mellitus. Long-term culture of porcine islets is a crucial challenge to permit the on-demand provision of islets. We aimed to identify the optimal temperature for the long-term culture of adult porcine islets for xenotransplantation.

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Background: Lymphedema is an intractable disease for which there is currently no established curative therapy. A reliable and long-lasting lymphedema model is essential for development of better treatments. In this study, we aimed to establish a simple, reproducible and long-lasting mouse model of lymphedema.

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Purpose: Elderly people are thought to be more likely than their non-elderly counterparts to experience a decline in activities of daily living (ADL) and quality of life (QOL) due to the onset and treatment of disease. In this study, we investigated whether there was an age-related difference in changes in health-related QOL indices after surgical resection of colorectal cancer (CRC).

Methods: Patients who underwent elective surgery for primary CRC at our hospital between September 2017 and November 2021 were enrolled.

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Article Synopsis
  • A 79-year-old male developed posterior interosseous nerve (PIN) palsy after undergoing robotic rectal cancer surgery, which compromised his ability to move his right wrist and fingers.
  • The surgical positioning involved tucking both arms at the sides, leading to sustained pressure on the upper arm, which likely caused the nerve injury.
  • Fortunately, the patient's symptoms improved with conservative treatment within a month, highlighting the importance of careful surgical positioning to prevent nerve compression injuries.
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Islet transplantation is a useful therapeutic choice for severe diabetes mellitus; however, limited donor supplies have interfered with the use of this treatment. Therefore, the establishment of alternative donor sources and engineered tissue, which enables to produce appropriate insulin for controlling blood glucose, is an important challenge. The adult pig is a promising and feasible donor source and materials for the engineered tissue for the clinical setting among various candidates.

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The transanal/perineal (ta/tp) endoscopic approach has been widely used for anorectal surgery in recent years, but carbon dioxide embolism is a possible lethal complication. The frequency of this complication in this approach is not known. In this study, we investigated the frequency of intraoperative (including occult) carbon dioxide embolism using transesophageal echocardiography.

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Article Synopsis
  • - The study analyzed data from 2533 rectal cancer patients who underwent either abdominoperineal resection (APR) or sphincter-saving surgery (SSS) to determine the impact of surgical type on patient outcomes in Japan.
  • - While univariate analysis indicated worse oncological outcomes for APR compared to SSS, multivariate analysis revealed no significant differences in overall survival (OS) or relapse-free survival (RFS) between the two procedures.
  • - The study concluded that while APR did have a higher risk of positive pathological radial margin (pRM), both surgical methods yielded similar oncological outcomes, highlighting the importance of achieving negative pRM in APR to enhance patient prognosis.
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The appreciation that cancer growth is promoted by a dynamic tumor microenvironment (TME) has spawned novel approaches to cancer treatment. New therapies include agents that activate quiescent T effector cells and agents that interfere with abnormal neovascularity. Although promising, many experimental therapies targeted at the TME have systemic toxicity.

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  • - Surgery for anal fistula cancer in patients with Crohn's disease often requires extensive procedures, traditionally involving a myocutaneous flap, but this case report highlights an alternative approach using an omental flap and negative pressure wound therapy (NPWT) to minimize invasiveness.
  • - A 47-year-old woman with a long history of Crohn's disease and recurrent anal fistulas underwent laparoscopic total pelvic exenteration, where her perineal wound was successfully managed with an omental flap and NPWT, resulting in wound closure by postoperative day 20.
  • - The combination of NPWT and an omental flap is suggested as a safe and effective strategy for managing surgery-related complications, offering a less invasive option while preventing infections
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  • This study investigates the potential of using circulating tumor DNA (ctDNA) from colorectal cancer patients to predict tumor recurrence, focusing on mutations in the KRAS gene.
  • It involved analyzing blood samples from 84 patients with specific KRAS mutations, although no direct link was found between KRAS mutation levels and tumor recurrence.
  • The findings indicate correlations between tumor characteristics (like size and stage) and preoperative KRAS mutation levels, but suggest that ctDNA detection for predicting recurrence isn't reliable post-surgery.
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Background: Some clinical trials have shown the usefulness of stem cell therapy for diabetic foot ulcers. However, the donor supply is limited, and the process is time consuming and expensive. This study assessed the therapeutic effects of neonatal porcine bone marrow-derived mesenchymal stem cell (npBM-MSC) xenotransplantation using diabetic wound model mice.

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Although islet transplantation (ITx) is a promising therapy for severe diabetes mellitus, further advancements are necessary. Adiponectin, an adipokine that regulates lipid and glucose metabolism, exerts favorable effects on islets, such as reinforcement of the insulin-releasing function. This study evaluated the possibility of adiponectin use to improve ITx outcomes.

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Article Synopsis
  • - Total pelvic exenteration (TPE) is a complex surgical procedure often needed for advanced or recurrent gynecologic cancer, particularly challenging in patients with prior surgeries and treatments.
  • - The study presents a new combined surgical technique using laparoscopic and transperineal endoscopic TPE (TpTPE), which was successfully performed on a 42-year-old woman with recurrent cervical cancer affecting multiple pelvic organs.
  • - The procedure took approximately 887 minutes with minimal blood loss, and the patient had a smooth recovery, highlighting TpTPE as a viable option for treating locally advanced pelvic tumors.
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  • The study explores complications related to the lithotomy position during surgery, particularly focusing on lower leg pressure and its potential risks.
  • Data were collected from 106 patients undergoing laparoscopic surgery, measuring pressure at various points on the lower legs and adjusting positions when pressure exceeded 50 mmHg.
  • Results indicated that higher pressure levels were consistently found on the upper outside of the right leg, with no compression-related complications reported since implementing continuous pressure monitoring.
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Islet transplantation is a type of cellular replacement therapy for severe diabetes that is limited by compromising effect on engrafted islets. Trials aiming to improve the function of transplanted islets have also been challenging. This study attempted to elucidate whether regulation of growth hormone secretagogue receptor-1a (GHS-R1a), one of the ghrelin receptors, improve the therapeutic effects of islet transplantation using [D-Lys3]-GHRP-6 (DLS), a specific GHS-R1a antagonist.

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