Explanipedia

Prognostic impact of dose reduced S-1 adjuvant chemotherapy in patients with pancreatic ductal adenocarcinoma: a retrospective multicenter study Open

Kazuki Kobayashi, Takahiro Einama, Yoichi Miyata, A. Ide, Naoto Yonamine , et al. · 2025

Background The standard adjuvant chemotherapy for pancreatic ductal adenocarcinoma (PDAC) in Japan is S-1; however, the impact of dose reduction on prognosis remains unclear. We have reported that total dose intensity (TDI) ≥ 62.5% indicat…

Eosinophilic Myenteric Ganglionitis as a Cause of Digestive Tract Perforation Open

Tadakazu Ao, Eiji Shinto, A. Ide, Shohei Mori, Shin Fujisawa , et al. · 2025

The etiology of eosinophilic myenteric ganglionitis (EMG) remains unclear. We present the case of a 62-year-old man who underwent right hemicolectomy with ileostomy and transverse colon mucous fistula due to ascending colon perforation. Pa…

Metformin prevents diabetes development in type 1 diabetes models via suppression of mTOR and STAT3 signaling in immune cells Open

Haruka Suzuki, Shuji Hasegawa, Susumu Fushimi, Kazumi Tagami, Makoto Nishikawa , et al. · 2025

Solitary Fibrous Tumor of the Stomach: Diagnostic Pitfalls and Clinical Implications Open

Tadakazu Ao, Eiji Shinto, Tenma Ichisawa, Koki Ichio, Takafumi Suzuki , et al. · 2025

This case highlights the difficulty in differentiating SFT from GIST preoperatively and underscores the importance of obtaining sufficient tissue samples to allow for immunohistochemical analysis, particularly STAT6 staining. Recognizing g…

Ileo-Sigmoid-Vesical Fistula in a Patient with Williams Syndrome Treated Using One-Stage Surgery: A Case Report Open

Shuhei Kii, Tatsushi Shimokuni, Yuki Kuratani, Sunao Fijiyoshi, Makoto Nishikawa , et al. · 2023

症例は37歳の男性で，幼少時にWilliams症候群と診断され近医に定期通院していた．持続する血膿尿と頻尿を主訴に当院泌尿器科を受診した．腹部CTでS状結腸癌による膀胱浸潤が疑われ，当院消化器内科に紹介された．精査の結果，S状結腸憩室炎による回腸S状結腸膀胱瘻の診断で当科に紹介となった．術中所見で下行結腸，S状結腸に多発憩室を認め，開腹左半結腸切除術，小腸部分切除術，膀胱部分切除術を行った．経過良好で術後11日目に退院した．Williams症候群は染色体7q11.23の微小…

Curative Liver Resection in a Case of Cecum Cancer Liver Metastasis after Coronavirus Disease-19 Following Percutaneous Transhepatic Portal Vein Embolization Open

Sunao Fujiyoshi, Tatsuhiko Kakisaka, Fumihiko Matsuzawa, Tatsushi Shimokuni, Shuhei Kii , et al. · 2022

症例は69歳の男性で,盲腸癌術後の多発肝転移に対し,化学療法施行後に経皮経肝門脈塞栓術,肝切除目的に入院となった.経皮経肝門脈塞栓術後2日目に新型コロナウイルス感染症の院内クラスターが発生し,症例も経皮経肝門脈塞栓術後4日目に発症した.抗ウイルス薬やステロイド,抗凝固療法などを早期より開始したが,呼吸状態が悪化し一時は人工呼吸器導入を検討した.しかし,症状が改善し,発症後4週目で酸素投与終了となった.発症8週後に全身状態の改善を認め,術前評価を再度施行後,拡大肝右葉切除,部…

Duodenal stenosis associated with an ectopic opening of the common bile duct into the duodenal bulb: a case report Open

Kazuki Kobayashi, Michinori Murayama, Hidekazu Sugasawa, Makoto Nishikawa, Kiyoshi Nishiyama , et al. · 2021

Background Ectopic opening of the common bile duct is a rare congenital biliary anomaly. Herein, we present a case of duodenal stenosis with ectopic opening of the common bile duct into the duodenal bulb. Case presentation A 54-year-old ma…

Successful surgical drainage with intraoperative ultrasonography for amebic liver abscess refractory to metronidazole and percutaneous drainage: a case report Open

Keita Kouzu, Takahiro Einama, Makoto Nishikawa, Makiko Fukumura, Hiromi Nagata , et al. · 2020

Background Metronidazole (MNZ) has been clearly established as a medication for amebic liver abscess. In uncomplicated cases, surgical drainage should be avoided. We report a case of amebic liver abscess refractory to MNZ that was successf…

Preoperative Evaluation and Management of Accessory Hepatic Ducts for Cholecystectomy Open

Saori Yabe, Takahito Nakagawa, Kazuyoshi Okumura, Tatsushi Shimokuni, Makoto Nishikawa , et al. · 2020

目的：副肝管は術前診断に至らないことも多く，胆囊摘出術の際に胆道損傷の頻度が高いとされる．当院の胆囊摘出例を検討した．方法：2008～2018年に当科で施行した胆囊摘出例482例を対象とし，副肝管を認めた36例（7.5%）について術前胆道評価，術式，胆道損傷の有無を正常解剖例と比較検討した．結果：副肝管の形態は久次らの副肝管分類でI型が2例，II型が6例，III型が26例，IV型が0例，V型2例で，副肝管の支配領域は後区域が80%を占めた．術前胆道評価での副肝管の診断率は，…

A patient with a pancreatic neuroendocrine tumor and multiple liver metastases achieved a long-term partial response to third-line streptozocin treatment Open

Hiromi Nagata, Takahiro Einama, Mayumi Hoshikawa, Toshimitsu Iwasaki, Yoichi Miyata , et al. · 2019

Risk factors for nonalcoholic fatty liver disease after gastrectomy for gastric cancer Open

Keita Kouzu, Hironori Tsujimoto, Makoto Nishikawa, M Harada, Takao Sugihara , et al. · 2019

Successful resection of a granulocyte colony‑stimulating factor‑producing carcinoma of the pancreas: A case report Open

Takayuki Akasaki, Takahiro Einama, Keita Tashiro, Hiromi Nagata, Kenji Yamazaki , et al. · 2019

Granulocyte colony-stimulating factor (G-CSF) is a naturally occurring glycoprotein that stimulates the proliferation of precursor cells in the bone marrow and their maturation into fully differentiated neutrophils. G-CSF-producing cancers…

Chitinase 3‐like 1 deficiency ameliorates liver fibrosis by promoting hepatic macrophage apoptosis Open

Masaaki Higashiyama, Kengo Tomita, Nao Sugihara, Hiroyuki Nakashima, Hirotaka Furuhashi , et al. · 2019

Aim Chitinase 3‐like 1 (CHI3L1), an 18‐glycosyl hydrolase‐related molecule, is a member of the enzymatically inactive chitinase‐like protein family. Serum levels of CHI3L1 are strongly correlated with hepatic fibrosis progression during ma…

Lipoprotein Lipase Up‐regulation in Hepatic Stellate Cells Exacerbates Liver Fibrosis in Nonalcoholic Steatohepatitis in Mice Open

Toshiaki Teratani, Kengo Tomita, Hirotaka Furuhashi, Nao Sugihara, Masaaki Higashiyama , et al. · 2019

Lipoprotein lipase (LPL) plays a central role in incorporating plasma lipids into tissues and regulates lipid metabolism and energy balance in the human body. Conversely, LPL expression is almost absent in normal adult livers. Therefore, i…

Laparoscopic fenestration for a large ruptured splenic cyst combined with an elevated serum carbohydrate antigen 19–9 level: a case report Open

Yoshitaka Imoto, Takahiro Einama, Makiko Fukumura, Keita Kouzu, Hiromi Nagata , et al. · 2019

Laparoscopic fenestration of a ruptured splenic cyst was performed to preserve the spleen, after the results of abdominal fluid cytology and MRI were negative for malignancy.

Pathomorphological features of metastatic lymph nodes as predictors of postoperative prognosis in pancreatic cancer Open

Mayumi Hoshikawa, Sho Ogata, Makoto Nishikawa, Akifumi Kimura, Takahiro Einama , et al. · 2019

To investigate the pathological features of metastatic lymph nodes (LN) in pancreatic ductal adenocarcinoma (PDAC) and to determine factors with prognostic implications. Metastatic LN status is a proven significant factor for predicting po…

Simultaneous Laparoscopic Cholecystectomy and Combined Endoscopic and Laparoscopic Surgery for an Endoluminal Tumor of the Sigmoid Colon: A Case Report Open

Hiroki Nakamoto, Makoto Nishikawa, Takahisa Ishikawa, Ryouji Yokoyama, Akinobu Taketomi · 2019

BACKGROUND One treatment for colon endoluminal tumors is endoscopic resection, i.e., endoscopic mucosal resection (EMR). In this report we describe a case of an endoluminal tumor resected safely and completely by combined endoscopic and la…

A Case of Combined Hepatocellular-Cholangiocarcinoma that was Difficult to Diagnose: A Case Report Open

Hiroki Nakamoto, Takahisa Ishikawa, Ryouzi Yokoyama, Makoto Nishikawa, Yoshifumi Iwaguchi , et al. · 2019

症例は71歳女性.B型慢性肝炎follow中に肝S7に15mmの腫瘍を認めた.精査にて肝細胞癌と診断し,肝S7亜区域切除術を施行.典型的な肝細胞癌,胆管細胞癌の組織は認めず.混合型肝癌で,WHOのcombined hepatocellular-cholangiocarcioma(CHC),subtypes with stem-cell featuresに相当すると考えた.WHOのCHC,subtypes with stem-cell featuresは2010年に現在の原発…

A case of intrahepatic cholangiocarcinoma that was difficult to diagnose prior to surgery: A case report Open

K Nagata, Takahiro Einama, Akifumi Kimura, Michinori Murayama, Hiroteru Takeo , et al. · 2018

The present study reports a case of mass-forming intrahepatic cholangiocarcinoma (ICC), which mimicked cholangiocellular carcinoma (CoCC) during imaging and a needle biopsy examination. A 51-year-old female with no relevant medical history…

Endoscopic Retrograde Cholangiopancreatography (ERCP) with Laparotomic Small-Intestinal Incision Approach for Extraction of a Common Bile Duct (CBD) Stone Following Total Gastrectomy and Roux-en-Y (R-Y) Anastomosis: A Case Report Open

Hiroki Nakamoto, Makoto Nishikawa, Takahisa Ishikawa, Ryouji Yokoyama, Akinobu Taketomi · 2018

BACKGROUND Endoscopic retrograde cholangiopancreatography for common bile duct stone in patients who underwent gastrectomy and Roux-en-Y anastomosis is challenging. We report a case in which we performed endoscopic retrograde cholangiopanc…

Aortic carboxypeptidase–like protein, a WNT ligand, exacerbates nonalcoholic steatohepatitis Open

Toshiaki Teratani, Kengo Tomita, Takahiro Suzuki, Hirotaka Furuhashi, Rie Irie , et al. · 2018

Incidence of nonalcoholic steatohepatitis (NASH), which is considered a hepatic manifestation of metabolic syndrome, has been increasing worldwide with the rise in obesity; however, its pathological mechanism is poorly understood. Here, we…

Ischemic Stenosis of the Small Intestine after Femoral Hernia Incarceration: A Case Report Open

Hiroki Nakamoto, Takahisa Ishikawa, Ryouzi Yokoyama, Makoto Nishikawa, Makoto Ichihara , et al. · 2018

症例は70歳男性．３カ月前からの右鼠径部膨隆，１カ月前からの間欠的腹痛・腹部膨満感を主訴に当科受診し，イレウスの診断で同日にイレウス管を挿入した．イレウス管造影では一部小腸の狭窄を認めた．保存的治療で軽快し食事再開したが，イレウスが再燃し手術を施行した．審査腹腔鏡を施行したところ，小腸の一部に器質的狭窄・右大腿ヘルニアの所見を認め，右大腿輪に小腸が一過性に嵌入し，イレウスおよび小腸狭窄をきたしたものと考えられた．腹腔鏡下小腸切除術を施行した．病理検査では狭窄部小腸に瘢痕性変…

Liver Injury Secondary to Intraoperative Percutaneous Transhepatic Gallbladder Drainage Catheter Removal During Laparoscopic Cholecystectomy: A Case Report Open

Hiroki Nakamoto, Takahisa Ishikawa, Ryouzi Yokoyama, Makoto Nishikawa, Akinobu Taketomi · 2018

症例は75歳女性．持続する上腹部痛を主訴に当院受診．精査の結果急性胆囊炎と診断され，同日に経皮経肝胆囊ドレナージ（PTGBD）としてpigtail catheterを挿入した．その後症状および炎症反応の改善を認め，待機的に腹腔鏡下胆囊摘出術を施行した．術中にpigtail catheterを抜去した際，抜去部の肝実質が損傷し，動脈性出血を認めた．腹腔鏡下での対処は難しく，開腹手術に移行し止血を行った．術後経過は良好であり術後10日目に退院となった．

Abscess Formation in a Right Inguinal Hernia Sac after Appendectomy for Perforated Appendicitis in a Ten-year-old Girl—A Case Report— Open

Hiroki Nakamoto, Ryouji Yokoyama, Makoto Nishikawa, Akinobu Taketomi · 2018

症例は10歳，女性．腹痛を主訴に当院を受診，急性虫垂炎と診断し腹腔鏡下虫垂切除術を施行．虫垂は壊死しており腹腔内には混濁した腹水を認め，穿孔性虫垂炎の所見であった．虫垂切除，洗浄，ドレナージを施行した．鼠径ヘルニアに関わるエピソードはなかったが，術中所見でわずかに内鼠径輪の開大を認めた．術後7日目に右鼠径部に疼痛が出現．CTで右鼠径管内に膿瘍を認めた．穿孔性虫垂炎による汚染した腹水が右内鼠径輪を通して右鼠径管内に流入したことによる膿瘍形成と推察された．膿汁を穿刺吸引し，抗生…

Ectopic Liver Tissue Observed on the Surface of the Gallbladder During Laparoscopic Cholecystectomy: A Case Report Open

Hiroki Nakamoto, Takahisa Ishikawa, Ryouzi Yokoyama, Makoto Nishikawa, Akinobu Taketomi · 2018

A 44-year old woman was admitted to our hospital with a complaint of right flank pain.She was diagnosed with chronic cholecystitis and underwent a laparoscopic cholecystectomy.Intraoperatively, we observed a node on the surface of the gall…

Outcome of Rapid Intraoperative Diagnosis by Telepathology Open

Ryo Kanazawa, Takahiro Ishikawa, Ryouji Yokoyama, Makoto Nishikawa, Yoshihide Igawa , et al. · 2018

全国的に病理医は不足しており，特に中規模以下の病院では病理医が不在であることも珍しくない．一方乳癌領域ではセンチネルリンパ節生検での術式決定や，乳腺断端での追加切除決定のため術中迅速診断は不可欠である．テレパソロジーは病理医が不在な病院でも術中迅速診断を行うことが出来るシステムで有り，当院では2007年よりこのシステムを導入している．当院でのテレパソロジーの成績は全国と比較して劣っておらず，今後病理医不在の病院でテレパソロジーの導入が進む可能性を示した．

A Case of Metastasis from Ascending Colon Cancer to the Uterine Body and Retroperitoneum after Surgery Open

Hiroki Nakamoto, Takahisa Ishikawa, Ryouji Yokoyama, Makoto Nishikawa, Makoto Ichihara , et al. · 2018

症例は79歳女性で，２年前に上行結腸癌に対して腹腔鏡下結腸右半切除術を施行した．病理所見は中分化型管状腺癌，T4b（SI，後腹膜），N0，M0，Stage Ⅱであり静脈侵襲v2の所見があった．術後カペシタビンの内服を８コース施行した．術後２年目のCTで子宮体部にリング状に造影効果を認める不整形腫瘤を認めるとともに骨盤底部に小結節像を認めた．PETで同部位に集積亢進を認め悪性腫瘍と判断した．上行結腸癌の転移，もしくは子宮原発腫瘍とその播種転移病変と診断した．他に病変は指摘され…

A Case of en Bloc Resection of a Lower Rectal Tumor Using a Combination of Endoscopic Submucosal Dissection and Transanal Resection Open

Hiroki Nakamoto, Takahisa Ishikawa, Ryouzi Yokoyama, Makoto Nishikawa, Akinobu Taketomi · 2018

症例は70代女性．下血を主訴に当院内科受診．下部消化管内視鏡検査にて下部直腸（Rb）に30mm大の０-Ⅰ型腫瘍を認めた．生検を施行しgroup4と診断されたため切除の方針とした．腫瘍は肛門管上縁を越えて肛門側へ進展しており，ESDでは肛門管領域の静脈叢からの出血の対処が難しいことがあり，またTARでは腫瘍口側の視認性が悪いことがあり，それぞれの利点を生かし難点を補う目的でESDとTARを合同で行うこととした．手術はESDによる肛門管上縁までの切離を先行し，その後TARにより…

Splenic Metastasis after Sigmoid Colon Cancer Surgery with a Difficulty of Early Diagnosis: A Case Report Open

Hiroki Nakamoto, Takahisa Ishikawa, Ryouzi Yokoyama, Makoto Nishikawa, Akinobu Taketomi · 2018

症例は79歳男性．４年前にS状結腸癌に対して腹腔鏡下S状結腸切除を施行した．病理所見は中分化型管状腺癌，T４（SI，腹壁），N0，M0，Stage Ⅱでありly1，v2の所見があった．術後カペシタビンの内服を８コース施行した．術後１年３カ月後よりCEAの漸増を認め，術後１年半後にCT，FDG-PET施行するも可視病変を認めなかった．その４カ月後のCTで多発脾腫瘍，脾下極近傍の結節像を認めた．多発脾転移，腹膜播種もしくは副脾転移と考え他部位に明らかな病変を認めないことより脾摘…

Pulmonary Tuberculosis during Chemotherapy after Miles' Surgery for a Patient with Autoimmune Hepatitis—A Case Report— Open

Hiroki Nakamoto, Ryouzi Yokoyama, Makoto Nishikawa, Akinobu Taketomi · 2018

症例は78歳，男性．自己免疫性肝炎に対してプレドニゾロン10mg/日を内服中であった．直腸癌に対して腹腔鏡下Miles手術を施行し，T3，N1，M0，stage IIIaと診断した．術後1年目CTで遠隔転移を認め，Bevacizumab+FOLFILI療法を開始した．9コース後に発熱を主訴に来院．肺炎と診断し抗菌薬治療を開始した．症状改善なく入院11日目に喀痰による抗酸菌染色が陽性となり，結核治療施設に転院とした．転院後に抗結核薬の内服を開始し，2カ月後に喀痰塗抹検査が陰性…

Makoto Nishikawa YOU? Author Swipe