High therapeutic potential for systemic delivery of a liposome-conjugated herpes simplex virus.

Purpose: Oncolytic viral therapy is a newly developed modality to treat tumors. Many clinical trials worldwide have examined the efficacy of locally injected oncolytic viruses. However, systemic intravascular injections are limited by the humoral immune response, which dramatically decreases the level of infection.

Pancreatic head resection with segmental duodenectomy for pancreatic neoplasms.

Background/purpose: We have experienced 67 cases of pancreatic head resection with segmental duodenectomy (PHRSD) for benign or low-grade malignant tumor of the pancreatic head region. Here we introduce our operative technique for these 67 cases.

Methods: Pancreatic head resection is performed with segmental duodenectomy including minor and major papilla.

Leukemia inhibitory factor receptor (LIFR) is detected as a novel suppressor gene of hepatocellular carcinoma using double-combination array.

Hepatocellular carcinoma (HCC) is one of the world's top five causes of cancer-related deaths and treatment options are limited in this type of cancer. In the present study, we attempt to identify the novel suppressor genes of HCC using a double-combination array we designed. Leukemia inhibitory factor receptor (LIFR) is one of suppressor genes using this method.

Middle pancreatectomy: safety and long-term results.

Background: Pancreaticoduodenectomy and distal pancreatectomy for lesions of the neck or body of the pancreas sacrifice a large amount of normal pancreatic tissue. Middle pancreatectomy (MP) is a parenchyma sparing technique that reduces the risk of postoperative endocrine and exocrine insufficiency. This study aims to evaluate the perioperative and long-term results of MP and to clarify whether MP can be performed with outcomes comparable with traditional pancreatectomies.

Detection of metallothionein 1G as a methylated tumor suppressor gene in human hepatocellular carcinoma using a novel method of double combination array analysis.

Gene expression profiling or karyotyping analysis has made it possible to identify novel genes with altered expressions or copy numbers that have not been previously reported in liver cancer. On the same HCC sample, we performed double array analysis, both expression profiling and karyotyping analysis using a single nucleotide polymorphism (SNP) array in an attempt to find a novel tumor suppressor gene for its prognostic marker. We conducted expression array and SNP chip array using tumor and corresponding non-tumor tissues from the resected liver specimen of a 68-year-old woman who had chronic hepatitis type C.

Prognostic factors for survival after extended pancreatectomy for pancreatic head cancer: influence of resection margin status on survival.

Objectives: Although a positive resection margin has been reported to be a strong prognostic factor after resection for pancreatic cancer, several studies indicated that resection status did not independently affect survival. The aim of this study was to examine the influence of resection margin status on survival after extended radical resection for pancreatic head cancer.

Methods: One hundred thirty-eight cases of pancreatoduodenectomy and 38 cases of pylorus-preserving pancreatoduodenectomy for invasive ductal carcinoma of the pancreas were retrospectively analyzed.

Pancreatic cancer with distant metastases: a contraindication for radical surgery?

Background/aims: The purpose of this study was to analyze cases of resected pancreatic cancer with distant metastasis (M1) and to review the surgical indication for these patients.

Methodology: Between July 1981 and December 2007, 542 patients with pancreatic cancer underwent surgery at the Department of Surgery II, Nagoya University. These patients included 48 cases of paraaortic lymph node metastases, 11 cases of hepatic metastases and 6 cases of peritoneal metastases.

Autologous blood storage before hepatectomy for hepatocellular carcinoma.

Background/aims: Perioperative homologous blood transfusion (HBT) has been reported to be a significant prognostic factor for recurrence in hepatocellular carcinoma (HCC) patients after hepatectomy. Autologous blood storage (ABS) has been used to avoid perioperative HBT. The aim of this study was to evaluate the benefit of ABS before the surgery in HCC patients.

Nonfunctioning neuroendocrine pancreatic tumors: our experience and management.

Background And Purpose: We present our experience in the treatment of nonfunctioning neuroendocrine pancreatic tumors (NFNPTs) to define the clinical and pathological characteristics and to suggest proper management.

Methods: The records of 17 patients with NFNPTs operated on between 1998 and 2008 were retrospectively reviewed, and all tumors were classified clinicopathologically as benign, uncertain, and malignant, based on the World Health Organization (WHO) classification of neuroendocrine tumors.

Results: There were four benign, six uncertain, and seven malignant NFNPTs.

The tumor suppressor NPRL2 in hepatocellular carcinoma plays an important role in progression and can be served as an independent prognostic factor.

Background/aims: Hepatocarcinogenesis is a multifactorial, multistep process that involves the activation of oncogenes or the inactivation of tumor suppressor genes throughout the different stages of hepatocellular carcinoma (HCC) progression. NPRL2 is one of the candidate tumor suppressor genes identified on chromosome 3p21.3, a region which frequently contains genetic abnormalities found in the early stages of the development of various human cancers.

Pancreatic cancer with paraaortic lymph node metastasis: a contraindication for radical surgery?

Objectives: The purpose of this study was to determine the operative indications for pancreatic cancer with paraaortic lymph node metastases (No. 16 [+]).

Methods: Between July 1981 and March 2007, 335 patients with pancreatic cancer including 45 No.

Considerations for intravascular administration of oncolytic herpes virus for the treatment of multiple liver metastases.

Purpose: Oncolytic viral therapy is a newly developed modality for treating tumors. Many clinical trials using oncolytic virus have been performed worldwide, but most of them have used local injection in the tumor. Determination of the effect and safety of intravascular virus injection instead of local injection is necessary for clinical use against multiple liver metastases and systemic metastases.

Correlations of the expression of vascular endothelial growth factor B and its isoforms in hepatocellular carcinoma with clinico-pathological parameters.

Background: The vascular endothelial growth factor (VEGF) is involved in the growth of cancer cells through angiogenesis. At present the role of VEGF-B has not been clarified completely. We investigated correlations of the expression of VEGF-B and its isoforms, VEGF-B167 and VEGF-B186, by alternative splicing in hepatocellular carcinoma (HCC) with the pathological findings and prognosis.

Intra-operative application of real-time tissue elastography for the diagnosis of liver tumours.

Objective: Real-time tissue elastography (RTE) has made it possible to visualize tissue elasticity. The aim of this study was to evaluate the usefulness of RTE for the differential diagnosis of liver tumours during surgical exploration.

Methods: Fifty-five liver tumours in 44 patients were examined with RTE, concomitant with routine intra-operative ultrasonography.

Cystic lymphangioma of the gallbladder: report of a case.

Abdominal lymphangioma is usually diagnosed within the first 2 years of life and is extremely rare in adults. The most common location of abdominal lymphangioma is the mesentery, but there are sporadic reports of its development in the gallbladder. A 66-year-old woman was found to have a cystic lesion near the gallbladder.

Effects of tumor selective replication-competent herpes viruses in combination with gemcitabine on pancreatic cancer.

Purpose: Pancreatic cancer still has a poor prognosis, even if aggressive therapy is pursued. Currently, new modalities of oncolytic virus therapy are being tested against this cancer. The combination of one of two representative mutant herpes simplex viruses (R3616: gamma(1)34.

Frequent promoter methylation of M-cadherin in hepatocellular carcinoma is associated with poor prognosis.

Background: Many cadherins (CDH) are associated with various types of cancer and their genetic and epigenetic alterations might be involved in carcinogenesis.

Materials And Methods: We examined the methylation status of CDH genes in primary hepatocellular carcinoma (HCC) and corresponding noncancerous liver tissues derived from 47 patients, and evaluated the correlation with clinicopathological parameters.

Results: Hypermethylation was detected at a ratio ranging from 0% to 55.

Clinical implications of peritoneal cytology in potentially resectable pancreatic cancer: positive peritoneal cytology may not confer an adverse prognosis.

Objectives: To determine the value of peritoneal washing cytology (CY) in determining resectability of pancreatic cancer.

Summary Background Data: CY has been used widely in the diagnosis and staging of several cancers. However, its predictive value in identifying potentially resectable pancreatic cancer is undetermined.

Laparoscopic cholecystectomy for left-sided gallbladder: report of two cases.

We report two cases in which patients, who had different junctions of the cystic duct with the common bile duct (CBD), with left-sided gallbladders were treated with laparoscopic cholecystectomy. The first patient, a 69-year-old man, could be diagnosed intraoperatively, and his cystic duct joined the CBD from the right side. The gallbladder of the second patient, a 52-year-old woman, was located on the left side of the CBD, and the cystic duct entered the left hepatic duct directly.

Analysis of clinicopathological features and predictors of malignancy in intraductal papillary mucinous neoplasms of the pancreas.

Background/aims: Intraductal papillary mucinous neoplasms (IPMNs) are increasingly recognized, but it is very difficult to evaluate accurately the malignancy of these neoplasms by modern imaging. We reviewed our experience in order to elucidate predictors of tumor malignancy, invasiveness, and outcome.

Methodology: The clinicopathological features and surgical outcomes of 57 patients with IPMNs who underwent surgery in Nagoya University Hospital were analyzed.

A proposal of an appropriate surgical approach for cancer of the ampulla of Vater: retrospective analysis of 73 resected cases.

Background/aims: Because early ampullary cancer has a good prognosis, less invasive surgery should be considered. But recent reports point out limitations of ampullectomy.

Methodology: Between April 1975 and March 2005, seventy-three patients with ampullary cancer were treated.

Early detection of liver failure after hepatectomy by indocyanine green elimination rate measured by pulse dye-densitometry.

Background/purpose: Following a major hepatectomy, some degree of clinical and biochemical dysfunction occurs. Surgeons usually check serum total bilirubin levels to diagnose postoperative liver dysfunction. However, we cannot predict liver failure by biochemical data alone within the early postoperative period.

Oncological problems in pancreatic cancer surgery.

Despite the development of more sophisticated diagnostic techniques, pancreatic carcinoma has not yet been detected in the early stage. Surgical resection provides the only chance for cure or long-term survival. The resection rate has increased due to recent advances in surgical techniques and the application of extensive surgery.