[Early Recurrence of Triple Negative Breast Cancer with Pathological Complete Response Following Neoadjuvant Chemotherapy and a Poor Prognosis-A Case Report].

In this study, we report the case of a patient with triple-negative breast cancer who achieved a pathological complete response(pCR)following neoadjuvant chemotherapy but experienced early recurrence and had a poor prognosis. A 46-year-old woman with a diagnosis of triple-negative breast cancer(cT2cN3cM0, cStage ⅢC)received neoadjuvant chemotherapy with dose-dense doxorubicin and cyclophosphamide, followed by weekly paclitaxel. The patient underwent a mastectomy and axillary lymph node dissection, achieving pCR.

Evaluation of Perioperative Intestinal Motility Using a Newly Developed Real-Time Monitoring System During Surgery.

Background: This study aimed to investigate perioperative intestinal motility using a novel bowel sound monitoring system in patients undergoing breast and neck surgery.

Materials And Methods: This study enrolled 52 patients who underwent surgery for breast cancer, thyroid tumor, and parathyroid tumor at Kochi Medical School from May 2019 to June 2020. Perioperative bowel sound counts (BSCs) were recorded using a newly developed real-time analysis system in the operating theater.

Evaluation of Follow-up Examinations Using Ultrasonography for Patients With Thyroid Nodules Initially Diagnosed as Benign.

Background/aim: The aim of this study was to determine the natural history of benign thyroid nodules using ultrasonography.

Patients And Methods: The records of 223 patients with benign thyroid nodules treated at the Kochi Medical School from 2010 to 2012 were reviewed retrospectively. Repeated ultrasonography was performed, and the findings were directly compared with previous images.

[A Case of Early-Onset Breast Cancer for Which the Operative Indication for Breast Conservation Was Based on BRCA Genetic Testing].

We report a case of a patient with early-onset breast cancer who decided to undergo adaptation for breast-conserving surgery based on the results of genetic testing. A 25-year-old woman became aware of a lump in her left breast and visited a nearby hospital, where she was diagnosed with breast cancer. She has no personal history.

Gastric outlet obstruction caused by metastatic tumor of the stomach originating from primary breast cancer: A case report.

The most common sites of breast cancer metastasis are the bone, liver, lung and brain, while gastrointestinal metastasis from breast cancer is rare. We herein present the case of a 68-year-old woman who was admitted to our department with nausea and appetite loss. The patient's medical history included right mastectomy with sentinel lymph node biopsy 5 years earlier for invasive lobular carcinoma, measuring 6.

Spontaneous rupture of abdominal wall after breast reconstruction using deep inferior epigastric perforator flap following mastectomy for breast cancer.

Background: The demand for breast reconstruction after mastectomy is rising. The use of deep inferior epigastric perforator (DIEP) flap in autologous reconstruction is a popular approach. There were some reports about abdominal complications after breast reconstruction.

A Novel Color Fluorescence Navigation System for Intraoperative Transcutaneous Lymphatic Mapping and Resection of Sentinel Lymph Nodes in Breast Cancer: Comparison with the Combination of Gamma Probe Scanning and Visible Dye Methods.

Background: This study evaluated the clinical efficacy of a novel imaging system (HyperEye Medical System [HEMS]; Mizuho Corp., Tokyo, Japan) that uses the near-infrared (NIR) fluorescence of indocyanine green to analyze sentinel lymph node (SLN) biopsies for the staging of breast cancer.

Methods: This study enrolled 91 patients with histologically confirmed breast cancer that was clinically node negative with a tumor size <3 cm.

Clinical presentation and treatment of gastric metastasis from other malignancies of solid organs.

The aim of the present study was to analyze the clinicopathologic features and treatment outcomes of gastric metastasis from other malignancies of solid organs. A review was conducted of patients with metastatic tumors in the stomach from other malignancies of solid organs detected endoscopically at the Department of Surgery, Kochi Medical School, from January 1991 to December 2015. Seven patients (four men and three women), with a median age of 64 years (range, 42-71 years), had metastatic gastric tumors.

Evaluation of the minimally invasive parathyroidectomy in patients with primary hyperparathyroidism: A retrospective cohort study.

Introduction: An accurate differential diagnosis between single adenoma (SA) and multiglandular disease (MGD) remains difficult in Technetium-99m sestamibi scintigraphy (MIBI)-negative patients with primary hyperparathyroidism (PHPT). The aim of the present study was to evaluate the minimally invasive parathyroidectomy (MIP) in patients with PHPT.

Methods: Clinical records of 48 patients who underwent neck exploration between November 2002 and June 2012 in Kochi Medical School Hospital were reviewed retrospectively to identify candidates that underwent for MIP which was defined as the selective removal of a SA using less invasive surgery.

[Is the LHRH Agonist Recommended for Fertility Preservation ?].

The POEMS reportedan effect of goserelin for fertility preservation. The Clinical Practice Guideline for Breast Cancer by The Japanese Breast Cancer Society indicates that the use of the LHRH agonist (LHRHa) for preventing chemotherapy-induced early menopause is a grade C-1 recommendation, and its use for fertility preservation is a grade C-2 recommendation. Results from previous studies on the effects of LHRHa for fertility preservation have varied owing to differences in chemotherapy regimens, definitions of ovarian failure, and dosages of tamoxifen.

Intensive versus intermediate glucose control in surgical intensive care unit patients.

Objective: The optimal perioperative blood glucose range to improve surgical site infection (SSI) in surgical intensive care unit (ICU) patients remains unclear. We sought to determine whether the incidence of SSI is reduced by perioperative intensive insulin therapy (IT).

Research Design And Methods: Patients were randomly assigned to receive perioperative intensive IT, with a target blood glucose range of 4.

Extrahepatic stem cells mobilized from the bone marrow by the supplementation of branched-chain amino acids ameliorate liver regeneration in an animal model.

Background And Aims: In recent years, bone marrow (BM)-derived stem cell repopulation of injured organs has been increasingly observed; however, the extent to which it occurs and its clinical relevance remain unclear. Here, we investigated on the potential of extrahepatic stem cells to become hepatocytes using the treatment of the oral supplementation of branched-chain amino acids (BCAA).

Methods: In the first, Sprague-Dawley (SD) rats were administered BCAA to promote liver regeneration; in the second, syngenic liver transplantations using wild-type SD rats that do not express green fluorescent protein (GFP) as syngenic donors and GFP-transgenic SD rats as recipients to confirm that an extrahepatic source of cells (GFP(+)) could repopulate the transplanted (GFP(-)) liver were performed.

Efficacy of laparoscopic gastric mobilization for esophagectomy: comparison with open thoraco-abdominal approach.

Background: Less invasive esophagectomy using laparoscopic or thoracoscopic surgery has been reported to have the advantages in short-term recovery over the conventional open thoraco-abdominal approach. However, few reports directly compare laparoscopic gastric mobilization (LGM) and thoracotomy with laparotomy and thoracotomy. The aim of this study was to prove the clinical efficacy of LGM compared with open thoraco-abdominal esophagectomy (OE) in treating thoracic esophageal cancer.

PKIB expression strongly correlated with phosphorylated Akt expression in breast cancers and also with triple-negative breast cancer subtype.

The cAMP-dependent protein kinase inhibitor-β (PKIB) is presumed to be one of the regulatory factors controlling the cAMP-dependent protein kinase A signaling pathway. The aim of this study was to investigate the frequency and patterns of PKIB overexpression in human breast cancer. We also examined the relationship between PKIB and phosphorylated Akt (pAkt) expression in the tumors.

Branched-chain amino acid-enriched nutrients stimulate antioxidant DNA repair in a rat model of liver injury induced by carbon tetrachloride.

Oxidative stress (OS) plays an important role in the progression of chronic liver disease including organ injury and hypoalbuminemia. Long-term oral supplementation with branched-chain amino acids (BCAAs) can inhibit liver dysfunction but their role in the prevention of liver fibrosis and injury to the liver is unclear. The aim of this study was to assess how BCAAs preserve liver function from OS.

Oral supplementation of branched-chain amino acids reduces early recurrence after hepatic resection in patients with hepatocellular carcinoma: a prospective study.

Purposes: The long-term outcomes of branched-chain amino acids (BCAA) administration after hepatic resection in patients with hepatocellular carcinoma (HCC) remain unclear. This study assessed the effect of oral supplementation with BCAA on the development of liver tumorigenesis after hepatic resection in HCC patients.

Methods: Fifty-six patients were randomly assigned to receive either BCAA supplementation (Livact group, n = 26) or a conventional diet (Control group, n = 30).

The effect of the neutrophil elastase inhibitor sivelestat on early injury after liver resection.

Background: The effects of sivelestat on endotoxin-induced lung injury, postperfusion lung injury, and ischemia-reperfusion are known, yet the benefits of sivelestat during liver surgery have yet to be elucidated. The aim of the present study was to assess the effects of sivelestat, with a focus on postoperative chemical data, in hepatectomized patients.

Patients And Methods: A prospective clinical study was conducted in 50 patients undergoing hepatic resection.

Splenic hamartoma: a case report and clinicopathological analysis of Japanese cases.

A 75-year-old man was referred to our department for the treatment of a gastric submucosal tumor-like protrusion which had gradually enlarged over 3 years. After examination with various types of imaging modalities, a splenic mass was diagnosed. Splenectomy was performed because it was difficult to determine preoperatively whether the splenic mass was benign or malignant.

Effect of perioperative intensive insulin therapy for liver dysfunction after hepatic resection.

Background: Intensive insulin therapy (IIT) reduces morbidity and mortality in patients in surgical care units, yet the benefits of IIT during liver surgery, especially on liver function after hepatic resection, are not known. The aim of the present study was to assess the effects of IIT, with a focus on postoperative liver function, in hepatectomized patients.

Methods: A total of 150 patients who underwent surgical management for hepatic diseases between September 2007 and March 2009 at Kochi Medical School were investigated.

Double tract reconstruction after distal gastrectomy for gastric cancer is effective in reducing reflux esophagitis and remnant gastritis with duodenal passage preservation.

Background And Aims: So far, there have been no reports assessing double tract (DT) reconstruction after distal gastrectomy for gastric cancer, which maintains the duodenal passage of food. The aim of this study was to evaluate the clinical results of DT reconstruction compared with Roux-en-Y (RY) and Billroth I (BI) reconstruction following distal gastrectomy.

Patients And Methods: Outcomes following DT (33 patients), RY (38 patients), or BI (47 patients) reconstructions were investigated retrospectively.

Oral supplementation with carbohydrate- and branched-chain amino acid-enriched nutrients improves postoperative quality of life in patients undergoing hepatic resection.

The long-term outcomes of branched-chain amino acid (BCAA) administration in patients undergoing hepatic resection remain unclear. The aim of this study is to assess the impact of oral supplementation with BCAA-enriched nutrients on postoperative quality of life (QOL) in patients undergoing liver resection. A prospective randomized clinical trial was conducted in 96 patients undergoing hepatic resection.

Early gastric cancer with widespread duodenal invasion within the mucosa.

We report a rare case of early gastric cancer confined to the mucosal layer with extensive duodenal invasion, curatively removed with distal gastrectomy. An 84-year-old Japanese woman was referred to our hospital with gastric cancer. A barium meal examination and esophagogastroduodenoscopy revealed an irregular nodulated lesion measuring 6.