Publications by authors named "Yuichiro Uchida"
Article Synopsis
- - The study analyzed the effectiveness of various hepatic functional tests, specifically modified ALBI score, indocyanine green clearance (ICG-R15), and 99mTc-galactosyl human serum albumin (LHL15) scintigraphy, in predicting posthepatectomy liver failure (PHLF) among patients undergoing liver surgery.
- - Out of 413 patients studied, 19% experienced PHLF, with major hepatectomy, mALBI grade, ICG-R15, and presence of esophagogastric varices identified as significant independent risk factors for developing this complication.
- - The results suggested that LHL15, esophagogastric varices assessment, and the mALBI
Background/purpose: Gut microbiota status after pancreaticoduodenectomy (PD) is unclear, and postoperative fatty liver is an important complication after PD. This study evaluated the relationship between postoperative fatty liver and gut microbiota after PD.
Methods: Fecal samples were collected from patients who had undergone PD and remained stable after 6 months of follow-up.
Article Synopsis
- The study investigates the impact of task division among console surgeons during robotic pancreaticoduodenectomy (RPD) on surgical outcomes and education from 2009 to 2023.
- It compares two methods: a single console surgeon versus multiple surgeons, revealing that the multiple approach significantly reduced operation time and postoperative complications.
- The findings suggest that using a multiple approach not only improves surgical results but also enhances learning opportunities for less experienced surgeons.
Article Synopsis
- The study compares two surgical techniques for distal pancreatectomy: robot-assisted approach (RAA) using a laparoscopic vessel-sealing device (LAVSD) and pure-robotic approach (PRA).
- RAA demonstrated significantly shorter operation times and fewer major complications compared to PRA among 62 patients analyzed.
- Despite no statistically significant difference in hospital stay duration, RAA is considered a safe and effective alternative for less experienced surgeons.
Background: Although minimally invasive distal pancreatectomy (MIDP) is considered a standard approach it still presents a non-negligible rate of conversion to open that is mainly related to some difficulty factors, as obesity. The aim of this study is to analyze the preoperative factors associated with conversion in obese patients with MIDP.
Methods: In this multicenter study, all obese patients who underwent MIDP at 18 international expert centers were included.
Article Synopsis
- Pancreatojejunostomy is a complex surgery often performed during robotic pancreaticoduodenectomy (RPD), and the modified Blumgart anastomosis (mBA) method lacks established technical guidelines for robotic use.
- A study at Fujita Health University analyzed data from 78 RPD patients between 2009 and 2023, focusing on the implementation of robotic mBA.
- Results showed a postoperative pancreatic fistula rate of 18%, with no severe complications, and an average anastomotic time of 80 minutes, suggesting that robotic mBA can be a viable standard method for this procedure.
Article Synopsis
- Robotic pancreaticoduodenectomy (RPD) is complex, requiring 20-50 cases for surgeons to improve, with this study examining 76 RPD cases from a hospital over nearly 14 years to track surgical performance evolution.* -
- Patients were categorized into three groups based on the surgeons' experience: competency, proficiency, and mastery, with significant reductions in operation time and major complications as experience increased across these groups.* -
- Results showed that average operation time significantly decreased from 921.5 minutes to 609.2 minutes, and major complications dropped from 52.2% to 9.1% as surgical techniques were optimized, indicating improved surgeon training and procedural efficiency.*
Article Synopsis
- Pancreatic tumor enucleation is a surgical method that removes tumors while preserving pancreatic function, and can be done with minimally invasive techniques.
- The da Vinci SP robotic platform, a new single-port robotics technology, was used for this procedure in a male patient in his 70s with a pancreatic neuroendocrine tumor.
- The surgery took 139 minutes with minimal blood loss (4 mL), and the patient recovered well, going home six days post-operation, suggesting that this method is both effective and less invasive.
Article Synopsis
- The World Health Organization estimates that 5-10 million people are infected with HTLV-1, but this number could be low due to limited data.
- Reliable data exists for only about 1.5 billion people worldwide, leaving many infections potentially undetected.
- The study evaluates a new rapid test, Espline HTLV-I/II, which could enhance our ability to quickly and easily identify HTLV-1 infections without needing expensive lab equipment.
Article Synopsis
- Robotic distal pancreatectomy (RDP) shows better short-term outcomes than laparoscopic distal pancreatectomy (LDP) in obese patients with a BMI of 30 or higher, including lower complication rates and less blood loss.
- The study included 446 obese patients over a 10-year span, focusing on surgery effectiveness and treatment comparisons at 18 expert centers.
- RDP was found to have a lower conversion rate to open surgery and achieved better spleen preservation compared to LDP, highlighting its advantages for surgical interventions in this patient group.
Adult T-cell leukemia/lymphoma (ATL) is a hematopoietic malignancy with a poor prognosis that develops in approximately 5% of human T-cell leukemia virus type 1 (HTLV-1) carriers. Cyclin-dependent kinase 9 (CDK9), together with Cyclin T, forms a transcription elongation factor, positive transcription elongation factor b (P-TEFb). P-TEFb promotes transcriptional elongation by phosphorylating the second serine (Ser2) of the seven amino acid repeat sequence in the C-terminal domain of RNA polymerase II (RNAP II).
View Article and Find Full Text PDFWe present a step-economical divergent synthetic approach for isoflavene derivatives using the Suzuki-Miyaura cross coupling of a 3-boryl-2H-chromene and three aryl bromides. 3-Boryl-2H-chromene, which is not a well-explored species, was prepared via Miyaura-Ishiyama borylation of a 3-chloro-2H-chromene obtained through a Claisen rearrangement cyclization cascade reaction. Further conversion of the cross-coupling products, three isoflavene derivatives, afforded three isoflavonoid natural products with one or two additional reaction steps.
View Article and Find Full Text PDFSurgical techniques and outcomes of minimally invasive anatomic liver resection (AR) using the extrahepatic Glissonian approach for hepatocellular carcinoma (HCC) are undefined. In 327 HCC cases undergoing 185 open (OAR) and 142 minimally invasive (MIAR; 102 laparoscopic and 40 robotic) ARs, perioperative and long-term outcomes were compared between the approaches, using propensity score matching. After matching (91:91), compared to OAR, MIAR was significantly associated with longer operative time (643 vs.
View Article and Find Full Text PDFArticle Synopsis
- Robotic surgery offers benefits like high optical magnification and precise movement of forceps but has limitations such as a narrow surgical field and lack of tactile feedback.
- In a case involving an 80-year-old man undergoing robotic distal pancreatectomy, injury to the splenic artery resulted in severe and uncontrollable bleeding.
- Surgeons must remain vigilant about the interaction of robotic instruments with surrounding structures, emphasizing the need for regular assessments of the surgical field to prevent errors.
Article Synopsis
- Essential thrombocythemia (ET) cases can sometimes be triple-negative (TN), meaning they don't have the common JAK2, CALR, or MPL mutations, accounting for 10%-20% of ET cases.
- A study of 119 ET patients found that 20 (16.8%) were triple-negative, often presenting with younger ages and lower white blood cell counts and lactate dehydrogenase levels.
- The researchers identified several novel driver mutations in these TN cases, including some germline mutations linked to hereditary thrombocytosis, suggesting a need for further exploration of genetic factors in TN ET for better clinical management.
BACKGROUND ＆ AIMS: Optimizing treatments balancing prognosis and therapeutic invasiveness is important in the management of pancreatic cancer (PC) owing to global ageing. This study aimed to verify the different utility of biomarkers by patients' age. MATERIALS ＆ METHODS: This is a single-center, retrospective cohort analysis involving 160 patients who undertook pancreaticoduodenectomy (PD) for PC.
View Article and Find Full Text PDFBackground: Conventional open distal pancreatectomy with en bloc celiac axis resection (DP-CAR) using the ventral approach is technically challenging, highly invasive, and not easy to ensure ample dorsal surgical margins. Hence, we describe a novel minimally invasive strategy for DP-CAR using the retroperitoneal-first laparoscopic approach (Retlap), i.e.
View Article and Find Full Text PDFPurpose: Anatomic isolated liver segmentectomy 8 (ILSeg8) for malignancies remains technically challenging. The feasibility, safety, and oncologic validity of laparoscopic ILSeg8 are undefined, and thus were evaluated in comparison with the open approach.
Methods: This study enrolled 35 open and 29 laparoscopic ILSeg8 cases of hepatocellular carcinoma (n = 47), metastatic liver tumors (n = 16), and intrahepatic cholangiocarcinoma (n = 1) at our institution.
The diagnosis of bile duct tumors can be difficult at times. A transpapillary bile duct biopsy findings with endoscopic retrograde cholangiopancreatography sometimes contradict diagnostic imaging findings. In bile duct tumors, inflammatory polyps in the extrahepatic bile duct are relatively rare with extrahepatic cholangitis.
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- Formamides are important in pharmaceutical synthesis, but the use of N-formylcarbazole for formylating amines hasn’t been previously documented.
- This study presents the first successful examples of using N-formylcarbazole as a formylation reagent for amines.
- N-formylcarbazole selectively reacts with less hindered aliphatic primary and secondary amines, while larger or less reactive amines, like anilines, show minimal reactivity.
Background/purpose: Surgical outcomes and utility of robotic liver resection (RLR) are undefined.
Methods: We retrospectively studied perioperative and long-term outcomes of the single-center 120 RLRs including non-anatomic (NAR, n = 58) and anatomic (AR, n = 62) resections. To evaluate the feasibility and safety of RLR, perioperative outcomes of RLR (n = 103) were compared to those of open (OLR, n = 495) or laparoscopic (LLR, n = 451) resection in liver-only resections without reconstruction, using 1:1 propensity score matching (PSM).
Background: Borderline resectable pancreatic cancer (BRPC) is a category of pancreatic cancer that is anatomically widely spread, and curative resection is uncommon with upfront surgery. Intensity-modulated radiation therapy (IMRT) is a form of radiation therapy that delivers precise radiation to a tumor while minimizing the dose to surrounding normal tissues. Here, we conducted a phase 2 study to estimate the curability and efficacy of neoadjuvant chemoradiotherapy using IMRT (NACIMRT) for patients with BRPC with arterial abutment (BRPC-A).
View Article and Find Full Text PDFAdult T-cell leukemia/lymphoma (ATL) develops after a long period of human T-cell leukemia virus (HTLV)-1 infection and is associated with host aging in addition to genetic abnormalities in HTLV-1 infected cells. SIRT1 is a histone deacetylase involved in cell cycle and apoptosis. We previously showed the high expression of SIRT1 protein in peripheral blood mononuclear cells from patients with ATL.
View Article and Find Full Text PDFBackground: /Objectives: Although the presence of lymph node metastasis (LNM) defines malignant potential, preoperative prediction of LNM has not been established for non-functional pancreatic neuroendocrine neoplasm (NF-PNEN). We sought to develop a prediction system using only preoperatively available factors that would stratify the risk of LNM for NF-PNEN.
Methods: We retrospectively reviewed patients who underwent R0/1 resection of NF-PNEN at Kyoto University (2007-2019) and the University of California, San Francisco (2010-2019).
Background: Minimally invasive pancreaticoduodenectomy (MIPD), including laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD), is technically demanding because of pancreaticojejunostomy (PJ). Postoperative pancreatic fistula (POPF) is the most serious complication of MIPD and open pancreaticoduodenectomy (OPD). Contrary to expectations, conventional PJ in MIPD did not improve POPF rate and length of hospital stay.
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