Papers - NANASHIMA Atsushi
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Ets-1 proto-oncogene as a potential predictor for poor prognosis of lung adenocarcinoma
Yamaguchi E., Nakayama T., Nanashima A., Matsumoto K., Yasutake T., Sekine I., Nagayasu T.
Tohoku Journal of Experimental Medicine 213 ( 1 ) 41 - 50 2007.8
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Tohoku Journal of Experimental Medicine
The protooncogene Ets-1 is a transcription factor that is known to regulate certain matrix metallo-proteinases and plasminogen activator, which have been associated with malignant behaviors in solid carcinomas. We hypothesized that Ets-1 expression is also associated with tumor progression and a worse prognosis in lung carcinoma patients. To clarify the role of the Ets-1 proto-oncogene, the expression of Ets-1 in non-small cell lung carcinomas using 156 paraffin-embedded specimens was determined in surgically resected tissue samples. Immunohistochemical staining showed Ets-1 expression in 82 cases of 150 carcinomas (53%): 36 of 52 (69%) squarnous cell carcinomas, 41 of 96 (43%) adenocarcinomas, and 5 of 8 (63%) other carcinomas. In adenocarcinomas, a higher proportion of acinar type expressed Ets-1 compared to papillary or alveolar type (p < 0.05). The proportion of adenocarcinoma that expressed Ets-1 increased with poorer histologic differentiation of the adenocarcinoma (p < 0.05). Ets-1 positive adenocarcinomas had a larger mean size than Ets-1 negative adenocarcinomas (p < 0.01). In adenocarcinoma patients, expression of Ets-1 was associated with disease-free (p = 0.09) and overall survivals (p < 0.05) after lung resection. Such relationship was not observed among squamous cell carcinoma patients. Our findings indicate that Ets-1 expression is related to histopathological differentiation, morphogenesis, and tumor progression of lung adenocarcinomas. Ets-1 appears to be a useful predictor of poor prognosis after surgical resection in lung adenocarcinoma patients. Ets-1 expression could be used to evaluate the malignant behaviors of lung adenocarcinomas. © 2007 Tohoku University Medical Press.
DOI： 10.1620/tjem.213.41
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Comparative study of anastomosis in pancreaticogastrostomy and pancreaticojejunostomy after pancreaticoduodenectomy.
Nanashima A, Sumida Y, Abo T, Shindo H, Fukuoka H, Tanaka K, Takeshita H, Hidaka S, Sawai T, Yasutake T, Nagayasu T
Hepato-gastroenterology 54 ( 76 ) 1243 - 6 2007.6
Language：Japanese Publishing type：Research paper (scientific journal)
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Clinicopathological and intraoperative parameters associated with postoperative hepatic complications.
Nanashima A, Sumida Y, Abo T, Tanaka K, Takeshita H, Hidaka S, Yano H, Sawai T, Obatake M, Yasutake T, Nagayasu T
Hepato-gastroenterology 54 ( 75 ) 839 - 43 2007.4
Language：Japanese Publishing type：Research paper (scientific journal)
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Surgical treatments in cystic diseases of the liver: experience at a single center in Japan.
Nanashima A, Sumida Y, Abo T, Nagasaki T, Sawai T, Takeshita H, Hidaka S, Tanaka K, Yasutake T, Omagari K, Yoshimi K, Yanagi K, Nagayasu T
Hepato-gastroenterology 54 ( 75 ) 849 - 53 2007.4
Language：Japanese Publishing type：Research paper (scientific journal)
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Advantages of thoracoabdominal approach by oblique incision for right-side hepatectomy.
Nanashima A, Sumida Y, Tobinaga S, Shindo H, Shibasaki S, Ide N, Tokunaga T, Tagawa T, Nakamura A, Nagayasu T
Hepato-gastroenterology 54 ( 73 ) 148 - 51 2007.1
Language：Japanese Publishing type：Research paper (scientific journal)
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Thoracoscopy-assisted radiofrequency ablation liver cancer. Report of three cases.
Nanashima A, Sumida Y, Shindo H, Hidaka S, Tanaka K, Obatake M, Sawai T, Yasutake T, Nakamura A, Tagawa T, Nagayasu T
Hepato-gastroenterology 54 ( 73 ) 241 - 5 2007.1
Language：Japanese Publishing type：Research paper (scientific journal)
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Thoracoscopy-assisted radiofrequency ablation for liver cancer. Report of three cases
Nanashima A., Sumida Y., Shindo H., Hidaka S., Tanaka K., Obatake M., Sawai T., Yasutake T., Nakamura A., Tagawa T., Nagayasu T.
Hepato-Gastroenterology 54 ( 73 ) 241 - 245 2007.1
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Hepato-Gastroenterology
To achieve complete ablation of liver cancer in the hepatic dome, thoracoscopy-assisted radiofrequency ablation was attempted in three patients. Under general anesthesia and left lateral position, a thoracoport site was placed in the 6th intercostal space and a small thoracotomy was placed in the 7th intercostal space. In all three cases, the liver cancer was located in the hepatic dome of segment 7/8 and the tumor could not be fully observed on the lung echogram. In Case 1, saline was infused into the thoracic cavity under thoracoscopic observation and percutaneous ablation was safely performed. In Cases 2 and 3, the right diaphragm was opened, guided by ultrasonography, and the electrode was inserted into this working space via the thoracotomy site. At day 7, complete ablation was confirmed by computed tomography. All patients recovered and were discharged after a short hospital stay without severe complications. Tumor recurrence has not been observed in any patient at this stage. For liver cancer located in the right subphrenic dome of the liver, thoracoscopy-assisted ablation is a safe and useful option particularly in patients with poor hepatic function. © H.G.E. Update Medical Publishing S.A.
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The right colon patch graft procedure for extensive intestinal aganglionosis
Obatake M., Nomura M., Inamura Y., Tanaka K., Miyazaki T., Nagasaki T., Nanashima A., Taura Y., Irie T., Yasutake T., Nagayasu T.
Acta Medica Nagasakiensia 51 ( 4 ) 129 - 132 2006.12
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
Extensive intestinal aganglionosis is rare and very difficult to diagnose and treat. The condition is often fatal. A 6-month-old boy who had undergone ileostomy for extensive intestinal aganglionosis was referred to our department. We applied an aganglionic right colon onlay patch to the aganglionic intestine to enhance absorption of water and electrolytes. Three months after the ileocolostomy, the definitive operation, a Swenson-type procedure, was performed. The mesocolon to the onlay patch could be divided because blood supply was adequate from the ileal mesentery via the intestinal wall. Postoperatively, the onlay patch segment appeared normal on colonoscopy and bowel habit was improved. Although the patient still requires parenteral nutrition support due to the short bowel, the right colon onlay patch procedure enables him to be cared for at home and provides an opportunity for normal growth and development.
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A case of recurrent ampullar carcinoma undergoing photodynamic therapy after surgical resection
Sumida Y., Nanashima A., Abo T., Nagasaki T., Hidaka S., Takeshita H., Fukuoka H., Tanaka K., Sawai T., Yasutake T., Nagayasu T., Matsuo T., Shimizu K.
Acta Medica Nagasakiensia 51 ( 3 ) 111 - 114 2006.11
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
We report a successful treatment of photodynamic therapy in patients with remnant ampullar carcinoma who underwent local resection of duodenal papilla. A 56-year-old male patient showed ampullar carcinoma without invading pancreas or duodenum. Pancreatic body and tail were obviously atrophic and local resection of duodenal papilla was performed at associated hospital 3 months ago. However, a resected specimen showed the remnant carcinoma at the edge, and the follow-up endoscopy showed a protruding tumor in the resected portion. Similar to the resected specimen, endoscopic biopsy showed a well differentiated adenocarcinoma in this tumor. Since additional resection was difficult because of the pancreatic function, photodynamic therapy with laser beam of 630 nm wavelength by eximer dye laser (4 mJ/pulse, 40 Hz) was applied to the ampullar carcinoma through endoscope for consecutive two days. Follow-up endoscopy performed 4 weeks after photodynamic therapy showed a remarkable reduction of the tumor, and no cancer tissue was observed by a biopsy. Ablation with argon beam laser was additionally applied to the remnant mass region. Tumor recurrence was not observed for 8 months after photodynamic therapy.
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Nanashima A., Sumida Y., Abo T., Mazume H., Ikari H., Nagasaki T., Takeshita H., Sawai T., Hidaka S., Tanaka K., Yasutake T., Nagayasu T.
Acta Medica Nagasakiensia 51 ( 3 ) 105 - 110 2006.11
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
Extent of hepatectomy for liver tumor is often limited in case the patient has an impaired liver function. We report here our experience in 2 patients with carcinoma involving hilar bile duct who have undergone limited liver resection. Case 1. 76-year-old male, who have had hepatitis C cirrhosis, showed in segment 4 a hepatocellular carcinoma of 4 cm in diameter. The tumor involved the right and left main hepatic ducts and obstructive jaundice was progressed. The patient had liver and respiratory dysfunctions and, therefore, limited resection of lower segments 4 and 5 and resection of hilar hepatic duct and the common bile duct were performed to avoid postoperative morbidity including liver failure. Histopathological diagnosis showed the tumor invasion and thrombus in major hepatic ducts and severe fibrosis in non-cancerous liver. In spite of long-term ascites, gastrointestinal bleeding or sepsis, liver functions were relatively maintained and the patient was discharged 3 months after surgery. Case 2. 64-year-old male, who had obstructive jaundice, showed a carcinoma in the common hepatic duct. After biliary drainage, however, liver dysfunction was not improved for a long period. The common hepatic duct including gall bladder was resected, and superficial spreading of the tumor to the right and left main bile duct was confirmed by the pathologic examination. Therefore, limited hepatic resection of lower segments 4 and 5 and resection of main hepatic ducts were additionally undergone. Although bile leakage of left hepatic duct occurred for 1 month, hepatic function was reserved and the patient was discharged 2 months after surgery. In conclusion, hepatic resection may be limited even in patient with carcinoma invading hilar bile duct in case the hepatic functional reserve is poor for major hepatectomy.
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Congenital intrathoracic kidney with right Bochdalek defect.
Obatake M, Nakata T, Nomura M, Nanashima A, Inamura Y, Tanaka K, Nagayasu T
Pediatric surgery international 22 ( 10 ) 861 - 3 2006.10
Language：Japanese Publishing type：Research paper (scientific journal)
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Sumida Y., Yamashita H., Inoue M., Ohsawa K., Sato H., Nanashima A., Nagayasu T.
Acta Medica Nagasakiensia 51 ( 2 ) 51 - 56 2006.7
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
Macrophage migration inhibitory factor (MIF) is a pro-inflammatory cytokine essential for delayed hypersensitivity in vivo, and is involved in bronchiolitis obliterans and late rejection in lung transplantation. We tested here whether neutralization of MIF using anti-MIF antibody prevents such a response. We examined the MIF mRNA expression level and changes in allograft tracheal epithelium and intraluminal obstruction in a rat allograft model. Lewis rat (RT1 I ) underwent heterotopic tracheal transplantation from Brown Norway rats (RT1 n ) in the omentum. Anti-MIF antibody was injected in the peritoneum. Rats were divided into three groups (non-treated allograft, allograft treated with normal rabbit IgG and allograft treated with anti-MIF antibody). Implants were harvested on days 7 or 21 for histological analysis. MIF mRNA expression was higher in the allograft at days 7 and 21 than in the isograft. The epithelium in non-treated allograft was almost absent at day 7. The epithelial height in the anti-MIF-treated graft was higher than that in normal IgG-treated grafts. The intraluminal space was mostly replaced by granulation tissue at day 21 in the untreated group. The proportion of obliterans was lowest in the anti-MIF group, the second lowest in the untreated group and the third lowest in the normal IgG-treated grafts, and the difference was significant (p < 0.001) between the first two groups. Our results indicate that anti-MIF antibody suppresses allogenic tracheal rejection.
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Decrease of telomeres and increase of interstitial telomeric sites in chromosomes of short-term cultured gastric carcinoma cells detected by fluorescence in situ hybridization.
Kashima K, Nanashima A, Yasutake T, Sawai T, Tsuji T, Hidaka S, Akama F, Miyashita K, Tagawa Y, Nagayasu T
Anticancer research 26 ( 4B ) 2849 - 55 2006.7
Language：Japanese Publishing type：Research paper (scientific journal)
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Relationship between CT volumetry and functional liver volume using technetium-99m galactosyl serum albumin scintigraphy in patients undergoing preoperative portal vein embolization before major hepatectomy: a preliminary study.
Nanashima A, Yamaguchi H, Shibasaki S, Morino S, Ide N, Takeshita H, Tsuji T, Sawai T, Nakagoe T, Nagayasu T, Ogawa Y
Digestive diseases and sciences 51 ( 7 ) 1190 - 5 2006.7
Language：Japanese Publishing type：Research paper (scientific journal)
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Parameters associated with changes in liver volume in patients undergoing portal vein embolization.
Nanashima A, Sumida Y, Shibasaki S, Takeshita H, Hidaka S, Sawai T, Shindou H, Abo T, Yasutake T, Nagayasu T, Sakamoto I
The Journal of surgical research 133 ( 2 ) 95 - 101 2006.6
Language：Japanese Publishing type：Research paper (scientific journal)
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Nanashima A., Shibasaki S., Sakamoto I., Sueyoshi E., Sumida Y., Abo T., Nagasaki T., Sawai T., Yasutake T., Nagayasu T.
Liver International 26 ( 5 ) 587 - 594 2006.6
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Liver International
Background: Hepatic blood flow was associated with degree of hepatic damage. Measurements of blood flow using ultrasonography (US) may vary due to any observer's and patient's conditions. The utility of magnetic resonance imaging (MRI) flowmetry in portal and hepatic veins was assessed. Patients and methods: Using the phase-contrast method, the mean flow velocity of portal (PVF) and hepatic vein (HVF) were determined by MRI and US in 75 consecutive patients with liver diseases, including 58 patients undergoing hepatectomy. The correlations between these paramet ers and clinicopathological findings were examined. Results: PVF and HVF measured by MRI flowmetry were 12.8±4.5 and 14.7±5.3 cm/s, respectively. There was no significant correlation of both flows between MRI and US. PVF correlated significantly with portal pressure (r=-0.722; P < 0.05). There was a negative correlation between HVF and histological activity index score (r=-0.366; P < 0.05). PVF and HVF were lower in patients with cirrhosis and higher staging score (2-4) and PVF was lower in patients with higher grading score (2-3; P < 0.05). PVF and HVF were not significantly associated with postoperative complications. Conclusions: Our results suggest that MRI flowmetry is a potentially useful tool for measurement of hepatic blood flow and recommend its use for estimation of liver cirrhosis-associated impairment. © 2006 Blackwell Munksgaard.
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Nanashima A., Sumida Y., Abo T., Takeshita H., Tanaka K., Sawai T., Yasutake T., Omagari K., Nagayasu T.
Acta Medica Nagasakiensia 51 ( 1 ) 27 - 30 2006.5
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Acta Medica Nagasakiensia
The Tokyo score, a new prognostic staging system consisting of albumin, bilirubin, and size and number of tumor has recently been proposed. To evaluate its usefulness, we examined the survival of 213 patients of hepatocellular carcinoma who had undergone hepatectomy. Disease-free and overall survival rates were calculated and difference in these rates between patients with different Tokyo scores was tested for significance using log-rank test. Regarding disease-free survival, there was a significant difference in survival between patients with Tokyo score of 0 and 1 (p < 0.05); however, there was no significant difference among patients with Tokyo score of 1, 2, 3 and 4. Regarding overall survival, there were a significant difference between patients with Tokyo score 0 and 1 (p < 0.01); however, there was no significant difference among patients with Tokyo score of 1, 2, 3 and 4. The 3- and 5-year disease-free survival rates in patients with Tokyo score of 0 were 61% and 46% respectively, and the 3- and 5-year overall survival rates in them were 97% and 81%, respectively. Survival in patients with Tokyo score of 0 was significantly better than in those with Tokyo score of 1. The Tokyo score, a simple staging system that combines tumor factors and hepatic function, might be a good predictor of prognosis for patients of early-stage hepatocellular carcinoma with hepatectomy.
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Intraductal papillary neoplasm of the bile duct extending superficially from the intrahepatic to extrahepatic bile duct.
Nanashima A, Sumida Y, Tamaru N, Nakanuma Y, Abo T, Tanaka K, Sawai T, Yasutake T, Nagayasu T, Hayashi T, Fukuda Y
Journal of gastroenterology 41 ( 5 ) 495 - 9 2006.5
Language：Japanese Publishing type：Research paper (scientific journal)
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Factors affecting survival after bronchoplasty and broncho-angioplasty for lung cancer: single institutional review of 147 patients.
Nagayasu T, Matsumoto K, Tagawa T, Nakamura A, Yamasaki N, Nanashima A
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery 29 ( 4 ) 585 - 90 2006.4
Language：Japanese Publishing type：Research paper (scientific journal)
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Nanashima A., Sumida Y., Tobinaga S., Shibata K., Shindo H., Obatake M., Shibasaki S., Ide N., Nagayasu T.
HPB 8 ( 2 ) 137 - 141 2006.4
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：HPB
Background. α-Fetoprotein (AFP) has been used as a marker for hepatocellular carcinoma (HCC). However, AFP levels are often high in patients with chronic hepatitis or cirrhosis. Protein-induced vitamin K absence or antagonist II (PIVKA-II) is more sensitive for the diagnosis of HCC and prediction of patient survival. Changes in these markers after treatment may reflect treatment curability and patient outcome. Methods. We conducted a retrospective analysis of prognosis of 63 HCC patients with high preoperative levels of AFP and PIVKA-II who underwent hepatectomy and examined the relationship between postoperative changes in both markers at 1 month and patient survival. Subjects were divided into three groups according to changes in these tumour markers after hepatectomy: normalization (N) group, decreased but still above the normal level (D) group and unchanged (U) group. Results. There were no significant differences in the numbers of patients who developed tumour recurrence between changes in AFP and PIVKA-II. Survival analysis showed no significant differences in tumour-free and overall survivals between groups with respect to AFP level. The PIVKA-II-N group showed significantly better tumour-free and overall survival compared with the D and U groups (p < 0.01). Multivariate analysis that included other prognostic factors identified changes in PIVKA-II level as a significant and independent prognostic factor associated with overall survival. Discussion. Although changes in AFP did not correlate with patient prognosis, normalization of PIVKA-II was significantly associated with good patient survival after hepatectomy. Normalization of PIVKA-II after hepatectomy reflected the efficacy of treatment and is a suitable predictor of prognosis in HCC patients. © 2006 Taylor & Francis.