論文 - 七島 篤志
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Nanashima Atsushi, Sumida Yorihisa, Murakami Goushi, Sawai Terumistu, Nagayasu Takeshi
Acta Medica Nagasakiensia 60 ( 3 ) 109 - 117 2016年
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：長崎大学医学部
Background: Intermittent occlusion of hepatic inflow, so-called Pringle's maneuver, is a useful technique to control intraoperative bleeding; however, it can lead to ischemia-reperfusion injury. We examined the influence of ischemic time on surgical factors, posthepatectomy liver function and morbidity. Methods: The clinical records of 296 patients who underwent an elective hepatectomy for liver disease between 2004 and 2013 were retrospectively examined. Univariate and multivariate analyses of clinicopathological and surgical factors associated withhepatic-inflow occlusion time were performed. Results: The mean and median times of total hepatic-inflow occlusion were 47±23 minutes (5-173 mL) and 45 minutes, respectively. The occlusion time was significantly correlated with increased indocyanine-green retention rate, total operation time, amount of blood loss or red cell transfusion, postoperative morbidity and hospital stay (each p<0.05). Blood loss upon the use of occlusion tended to be lower than that in its absence (568±602 mL vs. 887±841 mL) (p=0.075). The occlusion time was shorter in limited resection and longer in central bi-segmentectomy or sectionectomy (p<0.05). The occlusion time was significantly correlated with the maximum alanine aminotransferase level (r=0.291, p<0.01). The predictive cut-off value of occlusion time for these correlated parameters ranged between 45 and 46.5 minutes (p<0.05). Hepatic-inflow occlusion was not associated with morbidity in cirrhosis. Conclusion: A longer ischemic time induced increased blood loss or related transfusion, operating time, postoperative liver injury, complication rate and duration of hospital stay.
DOI： 10.11343/amn.60.109
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Tominaga T., Tsuchiya T., Mochinaga K., Arai J., Yamasaki N., Matsumoto K., Miyazaki T., Nagasaki T., Nanashima A., Tsukamoto K., Nagayasu T.
BMC Cancer 16 ( 1 ) 354 - 354 2016年
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：BMC Cancer
© 2016 The Author(s).Background: It has been shown that epidermal growth factor receptor (EGFR) mutation status is associated with 5-fluorouracil (5-FU) sensitivity in non-small-cell lung cancer (NSCLC). However, the relationship between EGFR mutation status and dihydropyrimidine dehydrogenase (DPD), a 5-FU degrading enzyme, is unknown. Methods: We elucidated the crosstalk among the EGFR signal cascade, the DPD gene (DPYD), and DPD protein expression via the transcription factor Sp1 and the effect of EGFR mutation status on the crosstalk. Results: In the PC9 (exon19 E746-A750) study, EGF treatment induced up-regulation of both Sp1 and DPD; gefitinib, an EGFR-tyrosine kinase inhibitor (EGFR-TKI), and mithramycin A, a specific Sp-1 inhibitor, suppressed them. Among EGFR-mutated (PC9, HCC827; exon19 E746-A750 and H1975; exon21 L858R, T790M, gefitinib resistant) and -non-mutated (H1437, H1299) cell lines, EGF administration increased DPYD mRNA expression only in mutated cells (p < 0.05). Accordingly, gefitinib inhibited DPD protein expression only in PC9 and HCC827 cells, and mithramycin A inhibited it in EGFR-mutated cell lines, but not in wild-type. FU treatment decreased the level of cell viability more in gefitinib-treated EGFR-TKI sensitive cell lines. Further, combination treatment of FU and mithramycin A suppressed cell viability even in a gefitinib resistant cell line. Conclusions: The EGFR signal cascade regulates DPD expression via Sp1 in EGFR mutant cells. These results might be a step towards new therapies targeting Sp1 and DPD in NSCLC with different EGFR mutant status.
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Nanashima A., Imamura N., Tsuchimochi Y., Hiyoshi M., Fujii Y.
International Journal of Surgery Case Reports 25 66 - 70 2016年
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：International Journal of Surgery Case Reports
© 2016 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an openaccess article under the CC BY-NC-ND license.Introduction This case report is intended to inform pancreas surgeons of our experience in operative management of aberrant pancreatic artery. Presentation of case A 63-year-old woman was admitted to our institute's Department of Surgery with obstructive jaundice, and the pancreas head tumor was found. To improve liver dysfunction, an endoscopic retrograde nasogastric biliary drainage tube was placed in the bile duct. Endoscopic fine-needle aspiration showed a pancreas head carcinoma invading the common bile duct, the aberrant right hepatic artery arising from the superior mesenteric artery, and the portal vein. Enhanced computed tomography showed the communicating artery between the right and left hepatic artery via the hepatic hilar plate. By way of imaging preoperative examination, a pancreaticoduodenectomy combined resection of the aberrant right hepatic artery and portal vein was conducted without arterial anastomosis. Hepatic arterial flow was confirmed by intraoperative Doppler ultrasonography, and R0 resection without tumor exposure at the dissected plane was achieved. The patient's postoperative course was uneventful. Discussion In this case report, perioperative detail examination by imaging diagnosis with respect to hepatic arterial communication to achieve curative resection in a pancreas head cancer was necessary. Non-anastomosis of hepatic artery was achieved, and the necessity of R0 resection was stressed by such management. Conclusion By the preoperative and intraoperative imaging managements conducted, combined resection of the aberrant right hepatic artery without anastomosis was achieved by pancreaticoduodenectomy for pancreas head cancer. However, improvements in imaging diagnosis and careful management of R0 resection are important.
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Kanemaru M., Nanashima A., Iwamura T., Sueta H., Sano K., Uchiyama S., Magata H.
Japanese Journal of Gastroenterological Surgery 49 ( 8 ) 721 - 729 2016年
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Japanese Journal of Gastroenterological Surgery
© 2016 The Japanese Society of Gastroenterological Surgery.Here we report a case of a survivor who twice underwent surgical resection for recurrences. A 67-year-old man underwent total gastrectomy and D2 lymph node dissection for a stage IIIA adenocarcinoma of the esophagogastric junction. Three years later, he underwent partial resection of the liver for metastasis of segment 8 of the liver. One year and 5 months after hepatectomy, he underwent distal pancreatectomy and splenectomy for metastasis of the lymph nodes along the distal splenic artery. At 6 years and 6 months after initial surgery and 2 years after the last surgery, no sign of recurrent cancer has been identified by endoscopical and radiological follow-up examinations. This case report shows the benefit of surgical resection for recurrent cancer of the esophagogastric junction.
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Nanashima A., Nanashima A., Hatachi G., Tominaga T., Murakami G., Takagi K., Arai J., Wada H., Nagayasu T., Sumida Y.
Tohoku Journal of Experimental Medicine 238 ( 1 ) 9 - 16 2015年12月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Tohoku Journal of Experimental Medicine
© 2016 Tohoku University Medical Press.Nogo-B, located in the endoplasmic reticulum, is an isoform belonging to the reticulon protein family, which is expressed specifically in cholangiocytes and non-parenchymal cells in the liver. Nogo-B expression is down-regulated with the progression of liver fibrosis, but its distinct function in liver malignancies has not been fully clarified. We have hypothesized that Nogo-B expression may be altered in intrahepatic cholangiocarcinoma (ICC), a relatively rare type of primary liver cancer with highly malignant behavior. The present study aimed to investigate the relationship between Nogo-B expression, assessed by immunohistochemical staining, and clinicopathological factors and prognosis in 34 ICC patients. Positive expression was observed in 19 (56%) of 34 ICC specimens: 6 patients (18%) with positivity levels of 1+ (positive cells in 10-50% of cancer cells) and 13 patients (38%) with 2+ (positive cells over 50%). Importantly, the remaining 15 patients (44%) were categorized as negative expression (Nogo-B-positive cells, less than 10%). Conversely, the mass-forming type of ICC tended to express Nogo-B with the degree of 2+ positivity, compared to the periductal infiltration type (p = 0.064), and the mass-forming type showed a better 5-year survival rate (66% vs. 5%) after hepatectomy (p < 0.05). However, the degree of positivity was not associated with tumor relapse rate, disease-free and overall survival, although each of the periductal infiltration type, intrahepatic metastasis, larger tumor size, and lower microvessel counts was associated with lower survival rates. We propose that Nogo-B expression is down-regulated in ICC, the implication of which, however, remains to be investigated.
DOI： 10.1620/tjem.238.9
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Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy. 査読あり
Nanashima, A., Abo, T., Arai, J., Tsucchiya, T., Miyazaki, T., Takagi, K., Chen, X. and Nagayasu, T.:
Indian Journal of Surgery. 77 ( S3 ) 923 - 929 2015年12月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy.
Nanashima A, Abo T, Arai J, Tsuchiya T, Miyazaki T, Takagi K, Chen X, Nagayasu T
The Indian journal of surgery 77 ( Suppl 3 ) 923 - 9 2015年12月
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Photodynamic Therapy using Talaporfin Sodium for the Recurrence of Cholangiocarcinoma after Surgical Resction. 査読あり
Shimizu, S., Nakazawa, T., Hayashi, K., Naitoh, I., Miyabe, K., Kondo, H., Nishi, Y., Umemura, S., Hori, Y., Kato, A., Morisaki, T., Nanashima, A., Ohara, H. and Joh, H.:
Internal Medicine. 54 ( 18 ) 221 - 2326 2015年9月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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A favourable prognostic marker for EGFR mutant non-small cell lung cancer: immunohistochemical analysis of MUC5B.
Wakata K, Tsuchiya T, Tomoshige K, Takagi K, Yamasaki N, Matsumoto K, Miyazaki T, Nanashima A, Whitsett JA, Maeda Y, Nagayasu T
BMJ open 5 ( 7 ) e008366 2015年7月
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胃癌に対する5-アミノレブリン酸を用いたレーザー光線力学的内視鏡診断． 査読あり
磯本一, 萩原久美, 妹尾健正, 大仁田賢, 山口直之, 中尾一彦, 七島篤志:
日本レーザー医学会雑誌． 36 ( 2 ) 114 - 118 2015年7月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Prognostic Impact of Preoperative Lymph Node Enlargement in Intrahepatic Cholangiocaricinoma： A Multi-Institutional Study br the Kyushu Study Group of Liver Surgery 査読あり
Adachi, T., Eguchi, S., Beppu, T., Ueno, S., Shiraishi, M., Okuda, K., Yamaguchi, Y., Kondo, K., Nanashima, A., Ohta, M., Takami, Y., Noritomi, T., Kitahara, K. and Fujioka, H.:
Annals of Surgical Oncology 22 ( 7 ) 2269 - 6678 2015年7月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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Prognostic Impact of Preoperative Lymph Node Enlargement in Intrahepatic Cholangiocarcinoma: A Multi-Institutional Study by the Kyushu Study Group of Liver Surgery.
Adachi T, Eguchi S, Beppu T, Ueno S, Shiraishi M, Okuda K, Yamashita Y, Kondo K, Nanashima A, Ohta M, Takami Y, Noritomi T, Kitahara K, Fujioka H
Annals of surgical oncology 22 ( 7 ) 2269 - 78 2015年7月
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A variant of multicystic biliary hamartoma presenting as an intrahepatic cystic neoplasm
Tominaga T., Abo T., Kinoshita N., Murakami T., Sato Y., Nakanuma Y., Harada K., Masuda J., Nagayasu T., Nanashima A., Nanashima A.
Clinical Journal of Gastroenterology 8 ( 3 ) 162 - 166 2015年6月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Clinical Journal of Gastroenterology
© 2015, Springer Japan.A rare case of an intrahepatic multicystic tumor is described. A 26-year-old man visited our hospital because of abdominal discomfort. Contrast-enhanced computed tomography and magnetic resonance cholangiopancreatography revealed a 10 × 7 cm multicystic tumor of the bile duct in the right side of the liver. The gross appearance of the tumor resembled an intraductal papillary neoplasm of the bile duct, and right hepatectomy with regional lymphadenectomy was performed. Histologically, these cystic lesions were composed of variably and irregularly dilated duct structures lined by columnar epithelium resembling bile duct lining. There were no atypical cells and no papillary growth of the epithelial cells. Interestingly, the dilated ducts contained inspissated bile, and the inter-cystic parenchyma contained variable but irregularly distributed and hamartomatous hepatic parenchyma with an abnormal lobular pattern. Though it had atypical features of a hamartoma in some aspects (age, smooth muscle), this case could finally be regarded as a variant of multicystic biliary hamartoma.
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A Vatiant of Multicystic Biiary Hamartoma Presenting as anIntrahepatic Custic Neoplasm. 査読あり
Tominaga, T., Abo, T., Kinoshita, N., Murakami, T., Sato, Y., Nakanuma, Y., Harada, K., Masuda, J., Nagayasu, T. and Nanashima, A.:
Clinical Journal of Gastroenteroogy 8 ( 3 ) 162 - 166 2015年6月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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In vivo Fluorescence Navigation of Gastric and Upper Gastrointestinal Tumors by 5-Aminolevulinic Acid Mediated Photodynamic Diagnosis with a Laser-equipped Video Image Endoscope 査読あり
Isomoto, H., Nanashima, A., Senoo, T., Ogiwara, K., Hashisako, M., Ohnita, K., Yamaguchi, N., Kunizaki, M., Hidaka, S., Fukuda, H., Ishii, H., Matsumoto, K., Minami, H., Akazawa, Y., Takehima, F., Fukuoka, J., Nagayasu, T. and Nakao,K.:
Photodiagnosis and Photodynami Therapy 12 ( 2 ) 201 - 208 2015年6月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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In vivo fluorescence navigation of gastric and upper gastrointestinal tumors by 5-aminolevulinic acid mediated photodynamic diagnosis with a laser-equipped video image endoscope. 査読あり
Isomoto H, Nanashima A, Senoo T, Ogiwara K, Hashisako M, Ohnita K, Yamaguchi N, Kunizaki M, Hidaka S, Fukuda H, Ishii H, Matsushima K, Minami H, Akazawa Y, Takeshima F, Fukuoka J, Nagayasu T, Nakao K
Photodiagnosis and Photodynamic Therapy 12 ( 2 ) 201 - 208 2015年6月
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Current status of photodynamic therapy in digestive tract carcinoma in Japan.
Nanashima A, Nagayasu T
International journal of molecular sciences 16 ( 2 ) 3434 - 40 2015年2月
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Abo T., Nanashima A., Tobinaga S., Hidaka S., Taura N., Takagi K., Arai J., Miyaaki H., Shibata H., Nagayasu T.
European Journal of Surgical Oncology 41 ( 2 ) 257 - 264 2015年2月
記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：European Journal of Surgical Oncology
© 2014 Elsevier Ltd. Background To improve the diagnostic accuracy for hepatic tumors on the liver surface, we investigated the usefulness of an indocyanine green-photodynamic eye (ICG-PDE) system by comparison with Sonazoid intraoperative ultrasonography (IOUS) in 117 patients. Hepatic segmentation by ICG-PDE was also evaluated. Methods ICG was administered preoperatively for functional testing and images of the tumor were observed during hepatectomy using a PDE camera. ICG was injected into portal veins to determine hepatic segmentation. Results Accurate diagnosis of liver tumors was achieved with ICG-PDE in 75% of patients, lower than with IOUS (94%). False-positive and false-negative diagnosis rates for ICG-PDE were 24% and 9%, respectively. New small HCCs were detected in 3 patients. The ICG fluorescent pattern in tumors was strong staining in 41%, weak staining in 13%, rim staining in 20% and no staining in 26%. Hepatocellular carcinoma predominantly showed strong staining (61%), while rim staining predominated in cholangiocellular carcinoma (60%) and liver metastasis (55%). Hepatic segmental staining was performed in 28 patients, proving successful in 89%. Conclusion ICG-PDE is a useful tool for detecting the precise tumor location at the liver surface, identifying new small tumors, and determining liver segmentation for liver resection.
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Current Status of Photodynamic Therapy in DIgestive Tract Carcinoma in Japan． 査読あり
Nanashima, A. and Nagayasu, T.:
International Journal of Molecular Science 16 ( 2 ) 3434 - 3440 2015年2月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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Usefulness of Intraoperative Diagnosis of Hepatic Tumors Located at the Liver Surface and Hepatic Segmental Visualization Using Indocyanine Green-photodynamic Eye Imaging． 査読あり
Abo, T., Nanashima, A., Toibnaga, S., HIdaka, S., Taura, T., Miyaaki, H., Shibata, H. and Nagayasu, T.:
European Journal of Surgical Oncology 41 ( 2 ) 257 - 264 2015年2月
記述言語：英語 掲載種別：研究論文（学術雑誌）