171 results match your criteria: "Okazaki Medical Center[Affiliation]"

Impact of body mass index on perioperative outcomes of laparoscopic major hepatectomies.

Surgery

August 2023

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore. Electronic address:

Background: Data on the effect of body mass index on laparoscopic liver resections are conflicting. We performed this study to investigate the association between body mass index and postoperative outcomes after laparoscopic major hepatectomies.

Methods: This is a retrospective review of 4,348 laparoscopic major hepatectomies at 58 centers between 2005 and 2021, of which 3,383 met the study inclusion criteria.

View Article and Find Full Text PDF

Objectives: We aimed to determine when a coexisting pseudocyst was likely to complicate the nonsurgical treatment of pancreatolithiasis.

Methods: We treated 165 patients with pancreatolithiasis nonsurgically between 1992 and 2020, including 21 with pseudocysts. Twelve patients had a single pseudocyst less than 60 mm in diameter.

View Article and Find Full Text PDF

Objective: To examine the associations of self-efficacy and outcome expectancy with adherence to continuous positive airway pressure (CPAP) therapy among Japanese men with obstructive sleep apnea (OSA) using objective adherence data for CPAP therapy.

Methods: We conducted a retrospective study of 497 Japanese men with OSA who were receiving CPAP therapy. Good adherence was defined as CPAP use of ≥4 hours per night for ≥70% of nights.

View Article and Find Full Text PDF

Objectives: As less autopsies are performed, the need for postmortem computed tomography (PMCT) as an alternative is increasing. It is important to know how postmortem changes over time are reflected on CT, in order to improve the diagnostic capability of PMCT and replace forensic pathology evaluations such as time of death estimation.

Methods: In this study, we examined temporal changes on postmortem chest CT images of a rat model.

View Article and Find Full Text PDF

Objectives: We conducted an analysis of first-time tolvaptan users (≥80 years old) to determine the factors associated with the prognosis of elderly patients with heart failure.

Methods: We retrospectively analyzed 66 consecutive patients with worsening heart failure (aged ≥80 years) who were admitted to Fujita Health University Bantane Hospital from 2011 to 2016 and treated with tolvaptan. Differences between the in-hospital death and survival groups were evaluated.

View Article and Find Full Text PDF

Primary optic nerve sheath meningioma (pONSM) is one of the most challenging tumors to manage. Although surgical excision may be considered a treatment option to maintain visual function, the safety of surgery remains debatable due to the non-negligible risk of optic nerve injury. pONSM often grows concentrically around the optic nerve; however, it can also demonstrate an exophytic growth from the optic nerve.

View Article and Find Full Text PDF

Impact of body mass index on the difficulty and outcomes of laparoscopic left lateral sectionectomy.

Eur J Surg Oncol

August 2023

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore. Electronic address:

Article Synopsis
  • - The study investigates how body mass index (BMI) affects outcomes after laparoscopic left lateral sectionectomy (L-LLS), revealing that higher BMI levels (greater than 27kg/m²) lead to increased blood loss, longer operative times, and more open conversions during surgery.
  • - A large sample of 2,183 patients from 59 centers worldwide was analyzed, showing that as BMI increases, so do certain negative surgical outcomes, but patient complications also exhibited a "U" shaped relationship—higher rates were seen in both underweight and obese individuals.
  • - The findings suggest that BMI should be considered in evaluating the difficulty of L-LLS procedures and in future assessments of surgical risk and outcomes.
View Article and Find Full Text PDF
Article Synopsis
  • The study examined the effects of different surgical ablation procedures for atrial fibrillation during aortic valve replacement surgery involving 171 patients across 16 hospitals in Japan from 2010 to 2015.
  • Patients were divided into three groups: those who underwent a full maze operation, those who had pulmonary vein isolation (PVI), and those who had no surgical ablation.
  • While the maze group experienced longer myocardial ischemia time, there were no significant differences in mortality rates at 30 days or 2 years, and both maze and PVI were found to effectively restore sinus rhythm over that period.
View Article and Find Full Text PDF
Article Synopsis
  • - The text discusses a clinical trial on machine perfusion for kidney transplants in Japan, aiming to boost the use of this technique due to its potential benefits for organ preservation.
  • - Thirteen kidney transplant procedures were performed using a specific machine that maintains optimal conditions for the organs, with details on donor types and recipient demographics highlighted.
  • - The results indicated successful preservation with no primary non-functional cases, showing promise for machine perfusion as a method for using marginal donor organs in Japan.
View Article and Find Full Text PDF

Inflammatory myofibroblastic tumor (IMT) is a rare tumor composed of myofibroblasts with inflammatory blood cell infiltration. It commonly occurs in the lungs and rarely in the esophagus. We herein report a valuable case of IMT originating in the esophagus.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the drainage patterns of the Uncal vein (UV) in patients with petroclival meningioma (PCM) during the anterior transpetrosal approach (ATPA), highlighting its similarity to the drainage of the superficial middle cerebral vein (SMCV).
  • A total of 43 PCM patients and 20 control patients with unruptured intracranial aneurysms were analyzed using preoperative digital subtraction angiography to assess their drainage patterns.
  • Results show that the DMCV drained to the UV less frequently in PCM patients compared to controls, increasing the risk of venous complications, suggesting that preoperative evaluation of UV drainage patterns is essential for safer surgical outcomes.
View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to compare outcomes of robotic major hepatectomy (R-MH) versus laparoscopic major hepatectomy (L-MH), exploring whether R-MH offers any advantages.
  • An analysis of 4822 patient cases across 59 centers revealed that R-MH resulted in significantly less blood loss, fewer applications of the Pringle maneuver, and lower rates of conversion to open surgery.
  • Moreover, R-MH showed reduced postoperative morbidity and shorter hospital stays for patients with cirrhosis compared to L-MH, indicating its potential benefits.
View Article and Find Full Text PDF
Article Synopsis
  • The study explores how using kidney donors after cardiac death (DCD) can address organ shortages and highlights the importance of understanding delayed graft function (DGF), which is a common issue in these transplants.* -
  • Researchers analyzed plasma samples from patients who received kidneys from living donors (LD), brain-dead donors (BD), and DCD donors, finding that total cell-free DNA (tCF-DNA) levels were significantly higher in DCD and BD transplants compared to LD transplants.* -
  • The study concludes that elevated tCF-DNA levels are associated with DGF and could serve as a predictive biomarker for kidney recovery after DCD transplantation.*
View Article and Find Full Text PDF
Article Synopsis
  • The Acetyl Salicylic Elimination Trial (ASET) is a pilot study in Japan that investigates the use of low-dose prasugrel monotherapy in patients who undergo percutaneous coronary intervention (PCI) for chronic or acute coronary syndromes.
  • The study involves 400 patients and is conducted in two phases: one for chronic coronary syndrome (CCS) patients and another for non-ST-elevation acute coronary syndrome (NSTE-ACS) patients, with different follow-up durations.
  • The main goals are to evaluate the safety and feasibility of this treatment while monitoring for serious complications, such as stent thrombosis and significant bleeding events.
View Article and Find Full Text PDF

Background: Lung cancer frequently occurs in lungs with background idiopathic interstitial pneumonias (IIPs). Limited resection is often selected to treat lung cancer in patients with IIPs in whom respiratory function is already compromised. However, accurate surgical margins are essential for curative resection; underestimating these margins is a risk for residual lung cancer after surgery.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the safety of using a lower dose (3.75 mg/day) of prasugrel alone, without aspirin, after a routine procedure called PCI in Japanese patients with chronic coronary syndrome.
  • Conducted as a pilot study with 206 participants, the results showed no major bleeding or ischemic events after 3 months, indicating that the reduced-dose prasugrel is a feasible option.
  • This research suggests an "aspirin-free" approach might be a safe alternative to the standard dual antiplatelet therapy used after PCI in certain low-risk patients.
View Article and Find Full Text PDF

COVID-19 symptom-onset to diagnosis and diagnosis to treatment intervals are significant predictors of disease progression and hospitalization in high-risk patients: A real world analysis.

Respir Investig

March 2023

Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake 470-192, Japan; Department of Respiratory Medicine, Daiyukai General Hospital, Daiyukai Health System, Ichinomiya 491-8551, Japan. Electronic address:

Background: Coronavirus disease (COVID-19) is overwhelming healthcare systems worldwide. This study aimed to elucidate factors that influence disease progression to pneumonia and hospitalization before and after antiviral treatment for COVID-19 in an outpatient setting.

Methods: A total of 206 high-risk patients with COVID-19 were treated with sotrovimab, remdesivir, and molnupiravir at the Toshiwakai clinic between January 4 and April 30, 2022.

View Article and Find Full Text PDF
Article Synopsis
  • Minimal invasive liver resections (MLRs) are safer alternatives to traditional open surgery, but the effects of neoadjuvant chemotherapy (NAT) on their difficulty are not well understood.
  • This study analyzed data from 1,034 patients across 57 centers who underwent laparoscopic and robotic MLRs for colorectal liver metastases (CRLM), comparing those who received NAT to those who did not using statistical matching methods.
  • Results showed no significant differences in perioperative outcomes after matching, although the NAT group experienced slightly higher blood loss but shorter hospital stays, indicating that NAT has minimal impact on the difficulty and overall outcomes of MLRs for CRLM.*
View Article and Find Full Text PDF

Eczema herpeticum (EH) is a disseminated cutaneous infection with herpes simplex virus (HSV) that develops in patients with atopic dermatitis. The kinetics and clinical significance of HSV viremia in EH are poorly understood. Herein, we report HSV DNAemia in a child with EH 12 months after the completion of chemotherapy for Hodgkin lymphoma.

View Article and Find Full Text PDF

Recurrence of liver cancers after liver resection (LR), such as recurrences of hepatocellular carcinoma and colorectal liver metastases, is often treated with repeat LR (RLR) as the only curative treatment. However, RLR is associated with an increased risk of complications. The indications for the currently emerging laparoscopic LR and its advantages and disadvantages for repeat treatment are still under discussion.

View Article and Find Full Text PDF
Article Synopsis
  • Valvuloplastic esophagogastrostomy (VEG) using the double flap technique (DFT) is explored as a way to prevent reflux oesophagitis after proximal gastrectomy (PG), with a study focusing on its effectiveness.
  • The study involved 80 patients and found that one year post-surgery, 10% developed grade B or higher reflux oesophagitis, with the resection length of over 20 mm being the main risk factor.
  • Patients with over 20 mm resected esophagus experienced longer surgery times and higher complication rates, highlighting a need for better surgical options for those requiring more extensive resection.
View Article and Find Full Text PDF

Multiple System Atrophy: Advances in Diagnosis and Therapy.

J Mov Disord

January 2023

Department of Neurology, Fujita Health University, School of Medicine, Toyoake, Japan.

This review summarizes improvements in understanding the pathophysiology and early clinical symptoms of multiple system atrophy (MSA) and advancements in diagnostic methods and disease-modifying therapies for the condition. In 2022, the Movement Disorder Society proposed new diagnostic criteria to develop disease-modifying therapies and promote clinical trials of MSA since the second consensus was proposed in 2008. Regarding pathogenesis, cutting-edge findings have accumulated on the interactions of α-synuclein, neuroinflammation, and oligodendroglia with neurons.

View Article and Find Full Text PDF

Hepatocellular carcinoma (HCC) patients have chronic liver disease with functional deterioration and multicentric oncogenicity. Liver surgeries for the patients should be planned on both oncological effects and sparing liver function. In colorectal patients with post-chemotherapy liver injury and multiple bilateral tumors, handling multiple tumors in a fragile/easy-to-bleed liver is an important issue.

View Article and Find Full Text PDF

Background: Aggressive lipid lowering by high-dose statin treatment has been established for the secondary prevention of coronary artery disease (CAD). Regarding the low-density lipoprotein cholesterol (LDL-C) level, however, the "The lower is the better" concept has been controversial to date. We hypothesized that there is an optimal LDL-C level, i.

View Article and Find Full Text PDF