Publications by authors named "Hideki Shimaoka"
Article Synopsis
- Endoscopic therapy has significantly advanced, particularly in using suturing techniques within the gastrointestinal tract.
- Current methods mainly rely on closure with instruments or continuous sutures via an endoscopic needle holder, highlighting a lack of effective nodal suturing options involving extracorporeal ligation.
- This paper presents a new endoscopic ligation technique that employs a flexible endoscope for performing nodal suturing through extracorporeal ligation.
Article Synopsis
- * The GIST measured 12×12 mm and exhibited an intra-luminal growth pattern, prompting the need for surgical intervention.
- * A new technique of full-thickness resection through a submucosal tunnel was used, resulting in a successful R0 resection, indicating no remaining cancerous cells.
Article Synopsis
- 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.
Article Synopsis
- Third-space endoscopic techniques like POET and STER allow surgeons to reach deep tissues that were previously hard to access with traditional endoscopes.
- A case of a 29-year-old man with a 40 × 25 mm leiomyoma in his upper thoracic esophagus demonstrated the effectiveness of POET, which involved full-thickness resection while ensuring safety around surrounding structures like the azygos vein.
- Successful use of POET highlights its potential as a groundbreaking technique for removing non-epithelial lesions, emphasizing the need for detailed imaging and careful dissection during procedures.
Article Synopsis
- * Of the 362 patients studied, 11 had the BRAF V600E mutation, and though tumor size was linked to mutant allele frequency (MAF), no direct correlation was found between MAF and recurrence.
- * The research indicates that while MAF increases over time in some patients, using it for early recurrence prediction in colorectal cancer post-surgery remains challenging.
Article Synopsis
- Laparoscopic pancreas-sparing distal duodenectomy is a minimally invasive surgical method for tumors in the duodenum, but it is technically challenging due to the organ's complex anatomy.
- The procedure was successfully performed on two patients with duodenal tumors, involving careful dissection and mobilization, with operative times of 326 and 370 minutes, and they experienced no complications post-surgery.
- This technique is becoming increasingly important as duodenal tumors are being diagnosed more frequently, and the approach proves to be a safe and effective option for excising such tumors without extensive organ mobilization.
Article Synopsis
- Capecitabine is converted to the anticancer drug 5-fluorouracil (5-FU) in tumors by an enzyme called thymidine phosphorylase (TP), and the study looked at how adding a TP inhibitor (5-nitrouracil or 5-NU) affects plasma 5-FU levels.
- After giving capecitabine, blood samples were tested for 5-FU concentrations at different times and conditions, revealing that samples stored at room temperature had significantly higher 5-FU levels compared to those stored at 4°C.
- The presence of 5-NU decreased 5-FU concentrations, with the most significant differences observed at room temperature, suggesting that both storage
Purpose: The Geriatric Nutritional Risk Index (GNRI) is a new index recently introduced to predict the risk of nutrition-related complications and mortality. Our aim is to examine the association between the GNRI and long-term prognosis in patients with esophageal squamous cell carcinoma (ESCC) who underwent esophagectomy.
Methods: The present study enrolled consecutive 216 patients with ESCC who underwent esophagectomy.
A 69-year-old man, who had undergone distal gastrectomy for duodenal ulcer, was diagnosed with remnant gastric cancer and jejunal mesenteric lymph node metastasis. To improve curability, we planned 2 courses of S-1 and cisplatin therapy. After chemotherapy, primary lesion and lymph node metastases reduced in size drastically.
View Article and Find Full Text PDFCase: Thrombocytopenia, anasarca, fever, renal insufficiency, and organomegaly (TAFRO) syndrome is a newly defined systemic inflammatory disorder with gradual progression of symptoms. A 59-year-old man with fever and ascites of unknown cause developed sudden-onset shock and respiratory failure in the general ward. Cardiac arrest immediately followed.
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- Current therapy for rheumatoid arthritis (RA) involves suppressing the immune response or blocking inflammatory cytokines, but their effects on cancer patients are unclear.
- The study investigated the impact of three biological agents used for RA—tocilizumab, MR16-1, and etanercept—on lung metastasis in a mouse model with colon cancer cells.
- Tofacitinib significantly increased lung nodules and decreased natural killer (NK) cell numbers, suggesting it may promote cancer metastasis, while MR16-1 and etanercept had no impact on NK cells or metastasis.
Efficacy and safety of endoscopic submucosal dissection under general anesthesia.
World J Gastrointest Endosc
July 2016
Article Synopsis
- The study aimed to evaluate the effectiveness and safety of endoscopic submucosal dissection (ESD) performed under general anesthesia.
- A total of 206 patients underwent ESD for various neoplasms, showing very high rates of en bloc resection and low complication rates, with no significant issues like aspiration pneumonia.
- The findings suggest that ESD under general anesthesia is a safe and effective approach, with minimized risks when an anesthesiologist is involved.
Objectives: This study identified respiratory and haemodynamic parameters affected by limited mobilisation therapy in elderly, critically ill, intubated patients in an intensive care unit.
Methods: Over 18 months, we retrospectively assessed physiological changes during 43 mobilisation therapy sessions in 23 patients requiring mechanical ventilation for >48h. We compared heart rate, mean arterial blood pressure, respiratory rate, partial pressure of oxygen in arterial blood/inspired fraction of oxygen and lactate before and after mobilisation therapy, which entailed sitting on the edge of a hospital bed without back support.
Article Synopsis
- An 82-year-old Japanese man was admitted to the hospital for constipation and abdominal pain, where imaging showed both a large fecal buildup and free air in his abdomen.
- The patient underwent emergency surgery for suspected gastrointestinal perforation, but no actual perforation or damage was found in the digestive tract.
- The case suggests that the free air was likely caused by a mucosal injury due to pressure from the accumulated feces, and the patient recovered well post-surgery, being discharged after 13 days.
Article Synopsis
- - The study aimed to see if an intensive preoperative respiratory rehabilitation (PR) program could prevent pulmonary complications after esophagectomy in esophageal cancer patients.
- - It involved 60 patients, with one group undergoing rehabilitation for over a week and the other group not receiving any prior rehab.
- - Results showed significantly lower complications in the PR group, indicating that preoperative rehabilitation can effectively reduce risk factors for postoperative issues.
Prone Position Is Useful in Thoracoscopic Enucleation of Esophageal Leiomyoma.
Case Rep Gastroenterol
June 2015
Article Synopsis
- * He underwent thoracoscopic enucleation of the tumor, initially suspected to be an esophageal leiomyoma, and the diagnosis was confirmed post-surgery.
- * The patient recovered well without complications and was discharged on the 12th day, suggesting that the prone position may be a better positioning option for this type of surgery than the left lateral position.
Background: The Fundamental Critical Care Support (FCCS) course has been introduced after minimal adaptation according to Japanese clinical settings. The original course in the USA is often used to prepare residents for rotations in the intensive care unit (ICU). Therefore, the FCCS program can be appropriate for the basic training of critical care in Japan to standardize critical care management.
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- * A case involving a 14-day-old male neonate with Cantrell syndrome highlighted challenges during anesthesia for surgery aimed at repairing heart and abdominal defects, including a significant drop in blood pressure during the procedure.
- * Post-surgery care in the ICU required intensive monitoring and management due to risks of circulatory and respiratory failure, emphasizing the need for careful handling of associated complications like pulmonary issues and elevated abdominal pressure.
Dexmedetomidine sedation for pediatric post-Fontan procedure patients.
Pediatr Crit Care Med
March 2009
Article Synopsis
- - The study examined the effects of dexmedetomidine (DEX) on pediatric patients who had undergone Fontan surgery, focusing on their hemodynamic, respiratory, and sedation responses.
- - Fourteen children were reviewed, with nine receiving DEX for sedation and five in a control group receiving standard sedation; the DEX group showed no increase in respiratory issues, thus indicating a lower risk of elevated pulmonary vascular resistance.
- - Despite the benefits of using DEX in managing post-surgery complications, the study also noted a concerning trend of significant bradycardia, leading to the need for cardiac pacemakers in some patients.
Article Synopsis
- The study examined how rat bone marrow stromal cells (MSCs) differentiate into bone-forming cells on hydroxyapatite disks with varying porosities (30%, 50%, and 70%).
- MSCs treated with dexamethasone showed increased alkaline phosphatase activity and osteocalcin production, indicating enhanced bone formation, particularly on the more porous disks.
- In vivo, bone grafts with higher porosity (HA50 and HA70) led to greater bone formation over time compared to HA30, highlighting that scaffold porosity significantly affects the osteogenic potential of implanted MSCs.
Osteogenic differentiation of human dental papilla mesenchymal cells.
Biochem Biophys Res Commun
April 2006
Article Synopsis
- * When cultured with nutrients like beta-glycerophosphate and ascorbic acid for two weeks, these cells showed signs of mineralization and behaved like bone-forming cells, indicated by increased alkaline phosphatase activity and osteocalcin levels.
- * The cultured cells can be frozen and thawed without losing their ability to form bone, confirming their potential for use in bone tissue engineering.
Temporal changes in mRNAs for metallothionein (MT) isoforms in subcultures of rat marrow mesenchymal stem cells (MSCs) after treatment with dexamethasone were investigated. Both MT-1 and MT-2 mRNA expression in the cultured MSCs with dexamethasone showed maximum levels at d 1, whereas ALP and osteocalcin mRNAs peaked at d 12. MT-3 mRNA was not detected in the cultured MSCs at any time.
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- * Five types of HA composites were tested: HA alone, GDF/HA, MSCs/HA, GDF/MSCs/HA, and BMP/MSCs/HA, with only the GDF/MSCs/HA showing significant bone formation by 2 weeks.
- * GDF-MS/HA composites enhanced bone growth compared to other combinations, indicating they could be promising for use as bone grafts in tissue engineering.
Rat and human bone marrow cells (BMCs) were cultured on a composite ceramic of zinc-containing beta-tricalcium phosphate and hydroxyapatite (ZnTCP/HAP) with a (Ca+Zn)/P molar ratio of 1.60 and varying zinc contents. After a 2-week culture of the BMCs in the presence of beta-glycerophosphate and dexamethasone, many macroscopic mineralized areas with high alkaline phosphatase (ALP) activity were seen on the ZnTCP/HAP ceramic disks.
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