Publications by authors named "Okamura R"

Background: Identifying risk factors for local recurrence (LR) is pivotal in optimizing rectal cancer treatment. Total mesorectal excision (TME) and lateral lymph node dissection (LLND) are the standard treatment for advanced low rectal cancer in Japan. However, large-scale studies to evaluate risk factors for LR are limited.

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An aberrant right subclavian artery (ARSA) is a rare vascular anomaly accompanied by nonrecurrent inferior laryngeal nerve (NRILN). Here, we described the cervical-first approach in thoracoscopic esophagectomy for an esophageal cancer patient with ARSA using the intraoperative nerve monitoring (IONM) system. First, a left cervical procedure proceeded to expose the left vagus nerve to attach the APS electrode of the IONM system, and the left cervical paraesophageal lymph nodes was dissected separately.

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Radical surgery for rectal cancer with bulky lateral pelvic lymph node (LPLN) metastasis involving the sciatic nerve presents both technical and oncological challenges. Preoperative multidisciplinary treatments have recently been anticipated to control the disease as well as to preserve organ function. A 51-year-old man, presenting with right buttock pain and impairment of walking, was diagnosed with sciatic nerve impairment due to right LPLN metastasis from rectal cancer.

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  • The study investigates management strategies for intermediate-risk papillary thyroid carcinoma (PTC) with lateral neck lymph node metastasis, focusing on comparing outcomes between lobectomy plus lateral neck dissection (LND) and total thyroidectomy plus LND.
  • The research was conducted at Ito Hospital in Tokyo, Japan, involving patients who underwent surgery from 2005 to 2012, excluding those with high-risk PTCs or concurrent thyroid cancers.
  • Findings from 401 patients show that overall survival rates after 5, 10, and 15 years were comparable between the two surgical options, indicating lobectomy plus LND is a viable alternative to total thyroidectomy for certain patients.
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  • * Imaging tests revealed multiple brain and lung nodules, and blood tests indicated symptoms consistent with hemophagocytic syndrome.
  • * A bone marrow examination confirmed the presence of Toxoplasma gondii, leading to treatment; however, the patient ultimately developed multiple organ failure and died shortly after admission.
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  • Most follicular lymphomas (FLs) are typically slow-progressing with good outcomes, but some patients face disease worsening within 24 months (POD24), leading to poorer results.
  • This study aimed to identify predictive risk factors for POD24 and analyze the microenvironment characteristics in FL patients experiencing POD24.
  • The research found that higher Ki-67 expression significantly correlates with POD24 events, and those patients also showed a decrease in certain immune cells, suggesting implications for targeted treatment approaches.
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  • Patients with hepatocellular carcinoma (HCC) and extrahepatic metastasis generally have a poor prognosis, but combination therapy with atezolizumab and bevacizumab (ATZ/BEV) shows strong antitumor efficacy.
  • A 74-year-old man with a history of HCC faced severe complications, including rectovesical pouch dissemination, but responded well to ATZ/BEV treatment despite needing to discontinue bevacizumab due to fistula formation.
  • After a year of treatment, the tumors shrank significantly, allowing for curative robot-assisted surgery which confirmed the successful removal of the HCC with clear margins.
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  • This study compares two chemotherapy regimens used in patients undergoing umbilical cord blood transplantation: Flu/Mel/Bu2 (lower busulfan dose) and Flu/Mel/Bu4 (higher busulfan dose).
  • Researchers analyzed data from 87 adult patients to see if there were differences in nonrelapse mortality, relapse rates, progression-free survival, and overall survival between the two regimens.
  • The results showed no significant differences in outcomes, suggesting that the Flu/Mel/Bu2 regimen is a safe and effective option, particularly for older patients.
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Background: Papillary thyroid microcarcinoma (PTMC) management has evolved, with active surveillance (AS) gaining prominence as a management option. However, a key concern for both clinicians and patients is the potential for patient loss to follow-up during AS.

Aims: This study aimed to determine adherence and loss-to-follow-up rates in low-risk PTMC patients undergoing AS versus surgical intervention, in order to gain insights into clinical pathways and safety profiles.

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Treatment of rare/ultra-rare tumors is an unmet need due to a lack of standardized therapies and clinical trials. We developed the Molecular Tumor Board (MTB), a multidisciplinary team that integrates molecular profiling to generate personalized, N-of-One treatments for advanced cancers. This study evaluates 112 patients with rare/ultra-rare tumors who presented to the MTB and were evaluable for clinical therapeutic outcome.

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  • The study focuses on remnant gastric cancer (RGC) which is rare, examining clinical findings, postoperative data, and challenges in its management among 313 patients from 17 Japanese institutions.
  • Results show that a significant portion of patients had early-stage RGC, but disease recurrence rates were notable, especially within the first few years post-surgery, with peritoneal recurrence being the most common.
  • Adjuvant chemotherapy (AC) appeared to improve recurrence-free survival significantly, suggesting that AC might offer similar benefits as in primary gastric cancer despite some limitations in the study design.
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Low-grade appendiceal mucinous neoplasm (LAMN) is principally characterized by low-grade cytology without evidence of invasion to other organs. We report a LAMN surgical case whose appendiceal tumor penetrated the sigmoid colon wall. An 87-year-old man was referred for endoscopic resection (ER) of a colon polyp.

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  • Diffuse large B-cell lymphoma (DLBCL) shows varied clinical and genetic characteristics, but differences between primary extranodal and nodal DLBCL, especially involving double-expressor lymphoma (DEL), remain unclear.
  • The study analyzed 61 primary extranodal and 128 nodal DLBCL cases, finding that nodal DLBCL had higher BCL2 expression, while DEL was linked to poor outcomes in extranodal cases.
  • Results indicated that DEL significantly impacted progression-free and overall survival in primary extranodal DLBCL patients, establishing it as a crucial adverse prognostic factor.
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Background: Neoplasms derived from remnant appendix are rarely described, with most cases arising from the appendiceal "stump". Here, we present two surgical cases of appendiceal neoplasms derived from appendiceal "tip" remnants.

Case Presentation: The first patient was a 71-year-old man who had undergone laparoscopic appendectomy for acute appendicitis 12 years prior.

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Seriniquinone was isolated as a melanoma-selective anti-cancer agent from a culture broth of the marine-derived bacterium Serinicoccus marinus CNJ927 in 2014. It targets the unique small protein, dermcidin, which affects the drug resistance of cancer cells. Due to its significant activity against cancer cells, particularly melanoma, and its unique target, seriniquinone has been developed as a new pharmacophore.

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Background: Esophageal diverticulum is commonly associated with esophageal motility disorders, which can be diagnosed using high-resolution manometry (HRM) according to the Chicago classification. Although midesophageal diverticulum (M-ED) is associated with inflammatory processes, esophageal motility disorders have been recently identified as an etiology of M-ED.

Case Presentation: We present the case of a patient with M-ED and elevated intrabolus pressure (IBP), which did not meet the criteria for esophageal motility disorders according to the Chicago classification.

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Approaches to preserve corticomotor excitability (CE) are attracting interest as a treatment for pain-induced changes in neural plasticity. We determined the effects of mirror therapy (MT) on skeletal muscle pain. Fifteen healthy adults who received hypertonic saline injections (5.

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In this scoping review, we aimed to comprehensively clarify the methodology of Mental practice (MP) by systematically mapping studies documenting the application of MP to post-stroke paralytic upper-extremity function. Specifically, when is an MP intervention most commonly applied after stroke onset? What is the corresponding MP load (intervention time, number of intervention days, and intervention period)? What are the most common methods of Motor Imagery (MI) recall and MI tasks used during the application of MP? Is MP often used in conjunction with individual rehabilitation? What are the paralyzed side's upper-limb and cognitive function levels at the start of an MP intervention? The research questions were identified according to PRISMA-ScR. The PubMed, Scopus, Medline, and Cochrane Library databases were used to screen articles published until 19 July 2022.

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Unlabelled: Laparoscopic complete mesocolic excision with central vessel ligation has been widely accepted for its oncological benefits in colon cancer surgery. However, laparoscopic right hemicolectomy involves a risk for vascular injury during dissection around the surgical trunk. This technical difficulty has been attributed to the limited movement of conventional laparoscopic forceps.

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  • * Researchers examined 91 patients with blood cancers and found that those with certain FOXP3 genotypes (FOXP3-3279C/A or FOXP3-3279A/A) are at a significantly higher risk for severe chronic graft-versus-host disease (cGVHD).
  • * The findings suggest that this genetic marker could help predict which patients are more likely to experience severe cGVHD after transplantation, aiding in better patient management.
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Background: Liver injury associated with oxaliplatin (L-OHP)-based chemotherapy can significantly impact the treatment outcomes of patients with colorectal cancer liver metastases, especially when combined with surgery. To date, no definitive biomarker that can predict the risk of liver injury has been identified. This study aimed to investigate whether organoids can be used as tools to predict the risk of liver injury.

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Immune checkpoint inhibitor (ICI)-induced thrombocytopenias are rare immune-related adverse events (irAE), but ICI-related thrombotic thrombocytopenic purpura (TTP) is extremely rare. A 79-year-old woman with non-small cell lung cancer received maintenance therapy with the anti-human PD-L1 monoclonal antibody durvalumab. Four weeks after the last infusion, she developed overt TTP.

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Introduction: Virtual reality-based mirror therapy (VRMT) has recently attracted attention as a novel and promising approach for treating upper extremity dysfunction in patients with stroke. However, the clinical efficacy of VRMT has not been investigated.

Methods: This study aimed to conduct a meta-analysis to evaluate the effects of VRMT on upper extremity dysfunction in patients with stroke.

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Osteoprotegerin (OPG) is a secreted cytokine that functions as a decoy receptor for receptor activator of nuclear factor kappa-B (RANK) ligand (RANKL). Anti-RANKL treatment for bone metastasis has been widely accepted for solid tumors. However, the mechanism of OPG-RANKL-RANK signaling in systemic colorectal cancer (CRC) metastasis remains unclear.

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  • Intraoperative neurophysiological monitoring (IONM) helps prevent damage to the recurrent laryngeal nerve (RLN) during thyroid surgeries, with loss of signal (LOS) indicating potential nerve injury.
  • A study of 1,442 patients documented significant differences in recovery based on the type of LOS, revealing that 74.2% of LOS in benign tumors were global type, while cancer patients more often experienced segmental type paralysis.
  • Postoperative outcomes showed that patients with global LOS had better recovery rates and lower vocal cord dysfunction compared to those with segmental LOS, particularly in cancer cases where segmental LOS led to a significantly higher rate of vocal cord issues at 6 months.
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