Hyperbilirubinemia as a predictor of severity of acute appendicitis.

Objective: This study aimed to investigate the clinical significance of preoperative hyperbilirubinemia in Japanese patients and to assess its clinical potential as a predictor of the severity of acute appendicitis.

Methods: We studied 318 patients with appendicitis who underwent appendectomy between July 2010 and June 2017. We analyzed preoperative data including age, sex, white blood cell count, C-reactive protein (CRP) level, fever, peritoneal irritation signs, and serum total bilirubin level as potential risk factors for complicated (perforated or gangrenous) appendicitis, using multivariate analysis.

A Surgical Case of Inflammatory Myofibroblastic Tumor of the Liver: Potentially Characteristic Gross Features.

We herein reported a very rare surgical case of inflammatory myofibroblastic tumor (IMT) of the liver, showing potentially unique and specific gross findings on its cut surface: our IMT demonstrated a relatively well-demarcated and partly infiltrative and likely extrahepatic (ie serosal) but not intrahepatic mass, appearing firm and hemorrhagic, and yellow-whitish in color. The patient, who was a woman in her early 70s with 2-year follow-up for lung cryptococcosis and traffic accident, incidentally presented with unenhanced and low-density, heterogeneous mass on abdominal dynamic CT in the peripheral right lobe of the liver. We could conclusively diagnose the current lesion as the hepatic IMT after thorough analyses including a wide panel of immunohistochemical antibodies.

Localized malignant pleural mesothelioma arising in the interlobar fissure: a unique surgical case masquerading clinicopathologically as primary lung adenocarcinoma.

An 80-year-old male with previous workplace exposure to asbestos presented with a history of an increase in the pulmonary-to-hilar mass, measuring more than 50 mm in diameter, likely in the right lower lobe. We first interpreted it as suspicious of primary lung adenocarcinoma with direct invasion to the right hilar lymph node. A right middle and lower lobectomy with partial resection of upper lobe was performed, and gross examination showed a hilar tumor lesion, involving the middle/lower lobe to hilar lymph node and looking whitish to yellow-grayish, partly adjacent to the right pulmonary artery.

[Local Recurrence of Rectal Cancer under Perineal Skin after Abdominoperineal Resection].

A woman in her early 50s underwent abdominoperineal resection with left lateral lymph node resection for advanced rectal cancer. The pathological diagnosis was RC, RbP, well-differentiated, type 5, 65×47mm, pT3(A), pN0(0/40), M0, pStage Ⅱ. The local recurrence discovered under the perineal skin 2 months later was treated by resecting the tumor and both inguinal lymph nodes.

Two Surgical Cases of Combined Hepatocellular-Cholangiocarcinoma, Intermediate-Cell Subtype: Potentially Characteristic Gross Features.

We herein reported two rare surgical cases of primary combined hepatocellular-cholangiocellular carcinoma, intermediate-cell subtype (CHC-INT), showing potentially characteristic and specific gross findings on their cut surface: both CHC-INTs demonstrated poorly demarcated and expansive and/or infiltrative hepatic nodules in lobulated margins, appearing clearly whitish in color. We were finally able to accurately diagnose the current lesions after thorough analyses including an appropriate and wide panel of immunohistochemical antibodies. Despite that, all pathologists should be aware that the potentially characteristic gross features of primary CHC-INT might also be one of the powerful supplementary tools for reaching its correct, conclusive diagnosis.

[Case Report of Long-Term Survival for Stage IV Advanced Sigmoid Colon Cancer with Para-Aortic Nodes by R0 Resection and Chemotherapy].

The patient was a man in his early 30s. He underwent sigmoidectomy with D3+ #216 for advanced sigmoid colon cancer with metastatic para-aortic lymph nodes. The pathological diagnosis was colon cancer(S), type 2, moderately differentiated, pT4a(SE), pN3(19/33), pM1a(LYM), pStage IV , KRAS wild-type, EGFR(+).

[Assessment of Short-Term Outcomes of Laparoscopic-Assisted Distal Gastrectomy in Elderly Patients Using Comorbidities as Predictive Factors].

Laparoscopic-assisted distal gastrectomy(LADG)is a recently developed minimally invasive surgery for management of early gastric cancer. We describe short-term results obtained from a retrospective study of LADG, performed in elderly patients, using comorbidities as predictive factors. We studied 160 patients diagnosed with gastric cancer who underwent LADG between January 2005 and October 2016.

Complete Response Obtained with S-1 Plus CDDP Therapy in a Patient with Multiple Liver Metastases from Gastric Cancer.

A 58-year-old woman with advanced gastric cancer underwent total gastrectomy in May 2012. The histological diagnosis was poorly differentiated adenocarcinoma, cT4a (SE), pN1, cM0; fStage IIIA. Chemotherapy by S-1 was started after surgery.

Ten Cases of Colovesical Fistula due to Sigmoid Diverticulitis.

Colovesical fistula (CVF) resulting from colon diverticulosis is a comparatively rare disease, and neither the diagnosis nor treatment has been established. Our experience with CVF due to sigmoid diverticulitis over a 9-year period was reviewed to clarify the clinical presentation and diagnostic confirmation. Ten patients with CVF were identified in this period, and chief complaints, laboratory findings, presenting symptoms, diagnostic investigations, and subsequent treatments were reviewed.

[Bacteria isolated from surgical infections and its susceptibilities to antimicrobial agents - Special references to bacteria isolated between April 2011 and March 2012].

Bacteria isolated from surgical infections during the period from April 2011 to March 2012 were investigated in a multicenter study in Japan, and the following results were obtained. In this series, 785 strains including 31 strains of Candida spp. were isolated from 204 (78.

[Bacteria isolated from surgical infections and its susceptibilities to antimicrobial agents--special references to bacteria isolated between April 2010 and March 2011].

Bacteria isolated from surgical infections during the period from April 2010 to March 2011 were investigated in a multicenter study in Japan, and the following results were obtained. In this series, 631 strains including 25 strains of Candida spp. were isolated from 170 (81.

Protective effect of eicosapentaenoic acid on insulin resistance in hyperlipidemic patients and on the postoperative course of cardiac surgery patients: the possible involvement of adiponectin.

Accumulated studies have shown that ω-3 polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) have protective roles against inflammatory responses such as hyperlipidemia, diabetes mellitus (DM) and cardiovascular diseases. Here we examined the effects of administering EPA to hyperlipidemic patients and other patients undergoing cardiac surgery to determine whether this treatment would increase plasma EPA levels and to clarify the association between EPA treatment and adiponectin production in hyperlipidemic patients. We also assessed the effect of preoperative EPA administration on postoperative adverse events such as postoperative atrial fibrillation (POAF) and postoperative infection in the cardiac surgery patients.

[Effects of a Kampo medicine on postoperative infection].

We studied the effects of preoperative administration of Hochuekkito (TJ-41) on the host response of patients undergoing gastrectomy or colectomy in a prospective, randomized, multicenter clinical trial. Forty-eight patients were randomized into two groups: one received 7.5 g/day of TJ-41 for 7 days before surgery (n = 22); and the other served as the control group (n = 26).

[Radiofrequency ablation therapy combined with hepatectomy for liver metastasis of colorectal cancer].

Radiofrequency ablation (RFA) therapy combined with hepatectomy was performed in 5 patients with synchronous liver metastases of colorectal cancer. RFA of liver metastases was performed using a Cool-tip electrode (Radionics; Burlington, MA, USA). The ablation time used in each session varied according to the tumor size and intraoperative impedance.

Analysis of surgical outcomes of diverticular disease of the colon.

We analyzed retrospectively the surgical outcomes of diverticular diseases of the colon at the surgical division of Fukuyama Medical Center. Data were collected from 39 patients who underwent surgery for diverticular disease at Fukuyama Medical Center. Thirty-nine patients were admitted between 2005 and 2010.

[Bacteria isolated from surgical infections and its susceptibilities to antimicrobial agents--special references to bacteria isolated between April 2009 and March 2010].

Bacteria isolated from surgical infections during the period from April 2009 to March 2010 were investigated in a multicenter study in Japan, and the following results were obtained. In this series, 671 strains including 16 strains of Candida spp. were isolated from 174 (79.

[Bacteria isolated from surgical infections and their susceptibilities to antimicrobial agents --special references to bacteria isolated between April 2008 and March 2009].

Bacteria isolated from infections in abdominal surgery during the period from April 2008 to March 2009 were investigated in a multicenter study in Japan, and the following results were obtained. In this series, 712 strains including 18 strains of Candida spp. were isolated from 173 (80.

[Bacteria isolated from surgical infections and their susceptibility to antimicrobial agents--special reference to bacteria isolated between April 2007 and March 2008].

Bacteria isolated from infections in abdominal surgery during the period from April 2007 to March 2008 were investigated in a multicenter study in Japan, and the following results were obtained. In this series, 707 strains including 24 strains of Candida spp. were isolated from 181 (79.

Immunohistochemical staining of liver grafts with a monoclonal antibody against HCV-Envelope 2 for recurrent hepatitis C after living donor liver transplantation.

Aim: We evaluated the expression of hepatitis C virus (HCV) antigen on liver grafts by immunohistochemical staining (IHS) using IG222 monoclonal antibody (mAb) against HCV-envelope 2 (E2).

Methods: The study material was 84 liver biopsy specimens obtained from 28 patients who underwent living donor liver transplantation (LDLT) for HCV infection. The biopsy samples were examined histopathologically, and by IHS using IG222 mAb against HCV-E2.

[A case of resection of synchronous multiple liver metastases from colorectal cancer after FOLFOX chemotherapy].

A 41-year-old man with multiple liver metastases from sigmoid colon cancer received a radical resection of the original tumor and 16 courses of weekly high-dose 5-FU(WHF)chemotherapy via hepatic arterial reservoir. The metastatic lesions showed stable disease(SD), and systemic chemotherapy by mFOLFOX6 was begun via CV port. After 14 courses of mFOLFOX4, abdominal CT revealed liver metastases were remarkably reduced in size.

Specific Removal of Monocytes from Peripheral Blood of Septic Patients by Polymyxin B-immobilized Filter Column.

Lipopolysaccharide (LPS) is one of the major causes of septic shock. The polymyxin B-immobilized filter column (PMX) was developed for the adsorption of endotoxin by direct hemoperfusion and has been used for the treatment of LPS-induced septic shock. In this study, we demonstrated that PMX also specifically bound monocytes from the peripheral blood leukocytes of septic patients by mean of an analysis of bound cells using immunocytochemical and electron microscopic techniques.

[Bacteria isolated from surgical infections and its susceptibilities to antimicrobial agents--special references to bacteria isolated between April 2006 and March 2007].

Tendency of isolated bacteria from infections in abdominal surgery during the period from April 2006 to March 2007 were investigated in a multicenter study in Japan, and the following results were obtained. In this series, 474 strains including 23 strains of Candida spp. were isolated from 170 (75.

Deficient response of IL-6 impaired liver regeneration after hepatectomy in patients with viral hepatitis.

Background/aims: Liver regeneration after surgical resection is still a serious concern. The present study is designed to understand the relations between liver injury/regeneration and cytokines after hepatectomy with viral hepatitis.

Methodology: Twenty-one consecutive patients undergoing liver resection were studied, which included two patients with biliary tract cancer, three patients with hepatic metastases from colorectal cancer, and sixteen patients with primary liver tumor.

Significant correlation between surgical stress of hepatectomy and changes in the serum levels of HGF, IL-6 and soluble Fas in patients with viral hepatitis.

Background/aims: Liver damage after hepatectomy is still a serious concern. The present study was designed to clarify the relations between liver injury/surgical stress and cytokines after hepatectomy, in patients with viral hepatitis.

Methodology: Ten consecutive patients undergoing hepatectomy were studied, all with hepatocellular carcinoma due to viral hepatitis.

Preoperative oral administration of pentoxifylline ameliorates respiratory index after cardiopulmonary bypass through decreased production of IL-6.

Activation of inflammatory response during cardiopulmonary bypass (CPB) may lead to considerable post-operative mortality. Recently, pentoxifylline (PTX), a methylxanthine derivative, has been reported to be effective in inhibiting proinflammatory cytokine production. This study aimed to determine whether or not PTX prevented CPB-induced systemic inflammatory response syndrome (SIRS) in patients undergoing cardiovascular surgery.