Publications by authors named "Kazuaki Tanabe"
Background: Sustainability of the 24/7 acute coronary syndrome response system is at risk due to the Work Style Reform for physicians.
Methods And Results: A survey of 93 facilities in Chugoku-Shikoku region found that 30% of facilities expected acute coronary syndrome services to be restricted due to the Work Style Reform. Approximately 35% had implemented task shifting, which reduced physicians' workload by 30% and improved team care.
Amiodarone is an antiarrhythmic drug that is widely used for atrial fibrillation and other refractory arrhythmias. Although beneficial, its long-term administration is associated with adverse effects on various organs. One patient presented with amiodarone-induced liver injury, which led to liver failure.
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- Current guidelines advocate for primary PCI in patients experiencing acute myocardial infarction, but there is limited data on its effectiveness in patients over 90 years old.
- A study in Shimane Prefecture categorized patients with acute coronary syndrome into age groups and found that the use of primary PCI decreases as age increases, with a notable rise in in-hospital mortality for super-old patients compared to old patients.
- Despite higher in-hospital mortality rates in super-old patients, there was no significant difference in long-term major adverse cardiovascular events when comparing super-old and old patients after 30 days.
Background: Adjuvant docetaxel plus S1 (DS) chemotherapy after gastrectomy with D2 lymph node dissection is the standard treatment for stage III gastric cancer in Japan; however, some patients are unable to receive adequate drug administration because of the deterioration of their conditions. This study aimed to investigate the correlation between tolerability for postoperative adjuvant DS chemotherapy and prognosis, and the factors affecting tolerability.
Methods: This retrospective study involved patients with stage III gastric cancer who underwent curative resection between 2018 and 2021 from a multicenter database.
Background/aim: The randomized phase II COMPASS trial revealed that neither the regimen nor the number of courses of preoperative neoadjuvant chemotherapy (NAC) for locally advanced gastric cancer (GC) significantly influence overall survival (OS). However, the impact of NAC regimens on OS may vary from patient to patient. The aim of this study was to identify biomarkers that can predict more appropriate individualized NAC regimens for improved prognosis using biopsy specimens from the COMPASS trial.
View Article and Find Full Text PDFOutcomes of laparoscopic and endoscopic cooperative surgery for gastric submucosal tumors: A retrospective multicenter study at 21 Japanese institutions.
Yoshikazu Hashimoto Nobutsugu Abe Souya Nunobe Hirofumi Kawakubo Tetsuya Sumiyoshi Kazuaki Tanabe Satoshi Tanabe
Ann Gastroenterol Surg
September 2024
Article Synopsis
- A multicenter study assessed the safety and mid-term outcomes of classical laparoscopic and endoscopic cooperative surgery (LECS) for treating gastric submucosal tumors (G-SMTs) following national health insurance coverage.
- The study involved 201 patients across 21 institutions from April 2014 to March 2016, identifying classical LECS as the most common procedure performed, with a good resection rate and manageable complications.
- Results indicated that while most surgeries had favorable outcomes, postoperative complications occurred in 5% of cases, emphasizing the general effectiveness of these methods in clinical practice.
Article Synopsis
- - The study investigated how intraesophageal pressure impacts quality of life in patients who had total gastrectomy with Roux-en-Y anastomosis, using high-resolution impedance manometry (HRIM) on 12 participants post-surgery.
- - Most patients exhibited normal esophageal motility, and factors like integrated relaxation pressure and lower esophageal sphincter residual pressure correlated with specific symptoms, such as diarrhea and indigestion.
- - The findings suggest that HRIM is a valuable tool for assessing esophageal function and its effects on quality of life following total gastrectomy.
Article Synopsis
- Hepatoid adenocarcinoma of the stomach (HAS) is a rare and aggressive type of gastric cancer, making up less than 1% of cases, often leading to liver metastasis and poor prognosis; treatment guidelines are currently lacking.
- A study involving 19 male patients diagnosed with HAS aimed to analyze the outcomes of surgical interventions (gastrectomy and hepatectomy) and assess prognostic factors, revealing a 5-year survival rate of 67.7% post-gastrectomy and a 100% survival rate for 3 years after hepatectomy in patients with liver metastasis.
- The findings suggest that the prognosis for HAS may be more optimistic than
Article Synopsis
- A 68-year-old man with pericarditis linked to immunoglobulin G4-related disease experienced worsening symptoms, including leg swelling and difficulty breathing, despite initial treatment with prednisolone and diuretics.
- Diagnostic tests revealed constrictive pericarditis, prompting the consideration of pericardiectomy, but concerns were raised about his liver dysfunction.
- Combinational elastography showed no liver fibrosis, indicating that the liver issues were likely reversible due to congestion caused by the heart condition, which informed the decision for surgery.
Article Synopsis
- This study investigates the barriers to regular breast cancer screening among working women in Japan, focusing on those aged 40-60.
- Surveys revealed that factors like part-time employment, lack of children, and an unsupportive workplace contributed to the reluctance to participate in screenings.
- The conclusion emphasizes the need for better education about breast cancer to raise awareness and support screening without inducing excessive fear.
Article Synopsis
- Shear wave elastography (SWE) is a noninvasive method used to measure organ stiffness, primarily focusing on liver stiffness to assess congestion in patients with heart failure (HF).
- This study evaluated the use of SWE not just for the liver, but also for thyroid congestion in 21 patients with HF, highlighting a significant correlation between thyroid and liver stiffness measurements.
- The results suggest that thyroid stiffness assessed by SWE is associated with clinical markers such as thyroid hormones and right atrial pressure, indicating that thyroid congestion may reflect overall cardiac congestion and potentially lead to thyroid dysfunction.
Article Synopsis
- Individualized assessments are important for elderly patients with gastric cancer to create effective surgical treatment plans.
- A study involving 571 patients found that factors like poor health status, comorbidities, and a high C-reactive protein to albumin ratio (CAR) can predict surgical complications in elderly patients.
- High CAR was linked to increased complications and worse overall survival and recurrence-free survival, but this connection was not seen in younger patients.
Article Synopsis
- This study evaluates the functional outcomes of esophagogastric anastomosis in patients who had proximal gastrectomy using the hinged double flap method for gastric cancer, focusing on high-resolution impedance manometry (HRIM).
- Researchers analyzed data from 25 patients post-surgery, retrieving questionnaires from 16 participants to assess post-surgery symptoms through the Postgastrectomy Syndrome Assessment Scale-37 (PGSAS-37).
- Findings indicated that while some HRIM measurements were normal, many patients experienced high lower esophageal sphincter (LES) residual pressure during swallowing, which was linked to worsening reflux and diarrhea symptoms post-surgery.
Article Synopsis
- Organoid technology is a new 3D cell culture system that can mimic a patient's cancer, offering a potential model for immunotherapy, but lacks effective gastric cancer organoid (GCO) models that allow immune cell interaction.
- This study developed a coculture model using Matrigel where immune cells can move freely and interact with GCOs, preserving the organoid's 3D structure and cancer characteristics.
- The new model allows for real-time observation of immune responses and tumor destruction, enabling the evaluation of immune cell effectiveness and the potential prediction of immune checkpoint inhibitor responses in patients.
Article Synopsis
- Prolonged on-scene times (OSTs) in emergency medical situations are a significant issue, especially for patients with minor diseases or injuries; previous studies largely focused on trauma and critical cases.
- A study analyzing data from the Higashihiroshima Fire Department from 2016 to 2022 identified various factors contributing to prolonged OSTs, such as the type of accident, frequency of hospital inquiries, and demographics like age and sex.
- Key findings revealed that events like fire accidents and natural disasters led to the longest delays, with older and female patients experiencing longer OSTs than other groups.
Article Synopsis
- The study explores characteristics of adult ambulance users in Japan who are diagnosed with minor injuries or nonurgent medical conditions, highlighting that about 60% of such cases don't require hospitalization.
- Utilizing data from ambulance requests in Higashihiroshima from 2016 to 2020, researchers applied a soft clustering method to identify six distinct segments of these users based on various factors.
- The findings reveal specific patterns among groups, such as those involved in nighttime neurological issues or fire accidents, indicating a need for tailored approaches in addressing the needs of different segments of nonurgent ambulance users.
Article Synopsis
- * Out of 22,640 PCI procedures, 22 patients (0.69%) experienced burr entrapment, with successful extraction occurring in 91% of cases without the need for emergency surgery.
- * The findings highlight the incidence, management strategies, and outcomes of burr entrapment, providing useful insights for healthcare professionals dealing with similar complications.
Article Synopsis
- Research explored the link between apolipoprotein (apo) levels after percutaneous coronary intervention (PCI) and long-term major adverse cardiac events (MACEs), revealing their potential prognostic value.
- The study involved 241 patients over a mean follow-up period of about 5.7 years, where 78 experienced cardiovascular incidents, indicating a significant correlation between higher apo B levels and increased risk of MACEs.
- Findings showed that apo B levels and the apo B/apo A1 ratio were more effective predictors of cardiac events than traditional lipid measurements like LDL-C levels, suggesting a shift in how we assess cardiovascular risk post-PCI.
Article Synopsis
- - The study explored how the immune system may serve as a predictor for preoperative weight loss in obese patients undergoing bariatric surgery, involving 34 participants and examining various clinical and biochemical data.
- - Findings indicated that certain immune markers, such as lymphocyte count and C-reactive protein (CRP) levels, showed negative correlations with both preoperative excess weight loss and total weight loss, suggesting a link between immune response and weight loss outcomes.
- - Notably, there was a significant difference in a specific immune cell activation marker (CD69) between patients with high and low preoperative weight loss, indicating that immune system factors, particularly those related to systemic inflammation, could impact weight loss success prior to surgery.
Article Synopsis
- - The study investigates KIF18B, a gene previously unreported in gastric cancer (GC), particularly in the context of gastric mucin phenotype GC, which is prevalent in Japan and associated with mortality.
- - Analysis involved RNA sequencing and immunohistochemistry on 96 GC cases, revealing KIF18B expression in 54% of cases and its correlation with poor survival rates, as well as associations with other important molecules.
- - Functional studies showed that silencing KIF18B in GC cells enhanced growth and altered the expression of key proteins involved in cell behavior, suggesting it could be a significant prognostic marker and contribute to understanding the cancer's development.
Article Synopsis
- Helicobacter pylori (HP) eradication is generally advised after treating early gastric cancer (EGC) with surgery, but there’s uncertainty about its necessity due to reports of spontaneous HP resolution post-surgery.
- A study followed 80 gastric cancer patients who underwent partial gastrectomy from 2016 to 2020, finding that 42.5% experienced spontaneous clearance of HP within a year.
- The use of proton pump inhibitors (PPIs) was associated with higher rates of HP resolution, though the type of surgical reconstruction didn’t significantly affect HP disappearance rates.
Role of echocardiography in patients treated with immune checkpoints inhibitors.
J Echocardiogr
December 2023
Article Synopsis
- Immune checkpoint inhibitors (ICIs) can cause serious cardiac immune-related adverse events (irAEs) such as myocarditis and arrhythmias, though these events are rare.
- The field of cardio-oncology is gaining interest as it studies heart issues related to cancer treatments, potentially improving understanding and management of cardiac irAEs.
- The review highlights the pathogenic mechanisms behind cardiac irAEs and emphasizes the importance of echocardiography in monitoring patients undergoing ICI therapy.