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  • 1
    Online Resource
    Online Resource
    Significance of the Splenic Vein and Its Branches in Pancreatoduodenectomy with Resection of the Portal Vein System
    S. Karger AG ; 2015
    In:  Digestive Surgery Vol. 32, No. 5 ( 2015), p. 382-388
    Details
    In: Digestive Surgery, S. Karger AG, Vol. 32, No. 5 ( 2015), p. 382-388
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Pancreatic head carcinoma frequently invades the superior mesenteric vein (SMV) and/or portal vein (PV). We aimed to evaluate the outcome of transection of the splenic vein (SV) and inferior mesenteric vein (IMV) in pancreatoduodenectomy (PD) with SMV and/or PV resection. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We retrospectively analyzed the records of 660 patients who had undergone pancreatectomy at our institution from January 2004 to October 2013, and selected 141 consecutive patients who had undergone PD with concurrent SMV/PV resection. Postoperative hypersplenism and the presence of remnant branches were evaluated. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The SV had been transected in 81 patients and preserved in 60. Postoperative complications and white blood cell counts were similar between the groups. The postoperative splenic volume was not significantly associated with the status of the SV or IMV on the transected SV. The platelet count was significantly lower, and the incidence of collateral veins was higher after SV transection than after SV preservation until 6 months after surgery; these variables were similar in the long term. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 SV reconstruction might be unnecessary when SV transection is required. Preservation of the IMV on the remnant SV might not prevent sinistral portal hypertension.
    Type of Medium: Online Resource
    ISSN: 0253-4886 , 1421-9883
    URL: Article
    DOI: 10.1159/000438797
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1468560-7
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  • 2
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    Online Resource
    Lipid Core Burden Index Assessed by Near-Infrared Spectroscopy of Symptomatic Carotid Plaques: Association with Magnetic Resonance T1-Weighted Imaging
    S. Karger AG ; 2021
    In:  Cerebrovascular Diseases Vol. 50, No. 5 ( 2021), p. 597-604
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 50, No. 5 ( 2021), p. 597-604
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Vulnerable plaques are a strong predictor of cerebrovascular ischemic events, and high lipid core plaques (LCPs) are associated with an increased risk of embolic infarcts during carotid artery stenting (CAS). Recent developments in magnetic resonance (MR) plaque imaging have enabled noninvasive assessment of carotid plaque vulnerability, and the lipid component and intraplaque hemorrhage (IPH) are visible as high signal intensity areas on T1-weighted MR images. Recently, catheter-based near-infrared spectroscopy (NIRS) has been shown to accurately distinguish LCPs without IPH. This study aimed to determine whether the results of assessment of high LCPs by catheter-based NIRS correlate with the results of MR plaque imaging. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We recruited 82 consecutive symptomatic carotid artery stenosis patients who were treated with CAS under NIRS and MR plaque assessment. Maximum lipid core burden index (max-LCBI) at minimal luminal areas (MLA), defined as max-LCBI 〈 sub 〉 MLA 〈 /sub 〉 , and max-LCBI for any 4-mm segment in a target lesion, defined as max-LCBI 〈 sub 〉 AREA 〈 /sub 〉 , were assessed by NIRS. Correlations were investigated between max-LCBI and MR T1-weighted plaque signal intensity ratio (T1W-SIR) and MR time-of-flight signal intensity ratio (TOF-SIR) in the same regions as assessed by NIRS. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Both T1W-SIR 〈 sub 〉 MLA 〈 /sub 〉 and T1W-SIR 〈 sub 〉 AREA 〈 /sub 〉 were significantly lower in the high LCP group (max-LCBI & #x3e;504, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001 for both), while TOF-SIR 〈 sub 〉 MLA 〈 /sub 〉 and TOF-SIR 〈 sub 〉 AREA 〈 /sub 〉 were significantly higher in the high LCP group ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001 and 〈 i 〉 p 〈 /i 〉 = 0.004, respectively). A significant linear correlation was present between max-LCBI 〈 sub 〉 MLA 〈 /sub 〉 and both TIW-SIR 〈 sub 〉 MLA 〈 /sub 〉 and TOF-SIR 〈 sub 〉 MLA 〈 /sub 〉 ( 〈 i 〉 r 〈 /i 〉 = −0.610 and 0.452, respectively, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.0001 for both). Furthermore, logistic regression analysis revealed that T1W-SIR 〈 sub 〉 MLA 〈 /sub 〉 and TOF-SIR 〈 sub 〉 MLA 〈 /sub 〉 were significantly associated with a high LCP assessed by NIRS (OR, 44.19 and 0.43; 95% CI: 6.55–298.19 and 0.19–0.96; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001 and = 0.039, respectively). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 A high LCP assessed by NIRS correlates with the signal intensity ratio of MR imaging in symptomatic patients with unstable carotid plaques.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000516888
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1482069-9
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  • 3
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    Perioperative Serum Carcinoembryonic Antigen Levels Predict Recurrence and Survival of Patients with Pathological T2-4 Gastric Cancer Treated with Curative Gastrectomy
    S. Karger AG ; 2018
    In:  Digestive Surgery Vol. 35, No. 1 ( 2018), p. 55-63
    Details
    In: Digestive Surgery, S. Karger AG, Vol. 35, No. 1 ( 2018), p. 55-63
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Do serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 levels serve as prognostic indicators in patients with gastric cancer (GC)? This is a question that has long been disputed. The aim of this study was to evaluate the significance of perioperative serum levels of CEA and CA19-9 for predicting the recurrence and long-term survival after patients with pT2-4 GC undergo curative gastrectomy. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This study included 251 patients with radically resected pT2-4 GC without preoperative treatment. Associations between the preoperative and postoperative serum levels of CEA or CA19-9 and postoperative long-term outcomes and recurrence patterns were evaluated. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Preoperative CEA 〉 5.0 ng/mL was an independent prognostic factor of overall survival. Elevation of both preoperative CEA and CA19-9 levels showed no synergistic adverse effects on prognosis. Preoperative levels of these markers achieved superior predictive performance compared with the postoperative values. Adverse prognosis is significantly associated with persistent elevation of CEA levels before and after gastrectomy. Elevation of CEA levels, particularly at postoperative measurement, was significantly associated with hematogenous recurrence. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Determination of perioperative CEA levels facilitated predictions of recurrence patterns and prognosis among patients with pT2-4 GC who underwent curative gastrectomy.
    Type of Medium: Online Resource
    ISSN: 0253-4886 , 1421-9883
    URL: Article
    DOI: 10.1159/000471931
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1468560-7
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  • 4
    Online Resource
    Online Resource
    Upper Limb Motor Function Affects the Outcome after Treatment with Botulinum Toxin A
    S. Karger AG ; 2019
    In:  European Neurology Vol. 81, No. 1-2 ( 2019), p. 30-36
    Details
    In: European Neurology, S. Karger AG, Vol. 81, No. 1-2 ( 2019), p. 30-36
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Treatment with Botulinum toxin A (BoNT-A) is effective in decreasing upper limb spasticity. 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 This study aimed to determine the differences in the outcome based on the upper limb motor function before BoNT-A treatment. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The subjects were 61 patients who underwent BoNT-A treatment for upper limb spasticity. Limb function was evaluated using the Fugl-Meyer Assessment upper extremity (FMA-UE), modified Ashworth scale, passive range of motion and disability assessment scale before treatment as well as 2, 6, and 12 weeks after treatment. We divided the total and each subscale of FMA-UE before BoNT-A administration into beyond-the-mean-score group (higher score group) and below-the-mean-score group (lower score group). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In both the higher and lower score groups of the FMA-UE total and modified Ashworth scale scores improved significantly after treatment. In FMA-UE, the higher score group of subscale A improved significantly, but subscale C decreased significantly at 2 and 6 weeks after the administration. The lower score group of total, subscale A, and B improved significantly. In the disability assessment scale, the self-dressing capability at 6 weeks and limb position at 2, 6 and 12 weeks after the administration improved significantly in the higher score group. In the lower score group, the hygiene capability at 2 weeks as well as the dressing capability and limb position improved significantly at 2, 6 and 12 weeks after administration. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The time course after administration of BoNT-A differed based on upper limb motor function before injection. When administering BoNT-A into the finger flexor muscles of a patient, we should carefully judge the indications for administration.
    Type of Medium: Online Resource
    ISSN: 0014-3022 , 1421-9913
    URL: Article
    DOI: 10.1159/000499907
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1482237-4
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  • 5
    Online Resource
    Online Resource
    Successful Chemoradiotherapy for Undifferentiated Malignant Neoplasm Arising from the Left Pulmonary Artery
    S. Karger AG ; 2014
    In:  Case Reports in Oncology Vol. 7, No. 2 ( 2014-7-16), p. 484-490
    Details
    In: Case Reports in Oncology, S. Karger AG, Vol. 7, No. 2 ( 2014-7-16), p. 484-490
    Abstract: Undifferentiated malignant neoplasms, which occur primarily in the pulmonary artery, are extremely rare and associated with poor outcomes as there is no effective therapy. A 67-year-old woman visited our hospital with complaints of dry cough and dyspnea on exertion. A contrast-enhanced chest computed tomography revealed an intravascular tumor obstructing the left pulmonary artery and a pedunculated lesion extending to the main and right pulmonary artery. Multiple metastases in the lung, bones and bilateral adrenal glands were identified by fluorodeoxyglucose-positron emission tomography. A small sample was obtained by catheter aspiration biopsy of the intravascular tumor, and examination revealed undifferentiated small atypical cells. The tumor was diagnosed as an undifferentiated neoplasm arising from the pulmonary artery based on immunohistochemical findings, including the absence of expressions of organ-specific markers. Systemic chemotherapy (paclitaxel and carboplatin) and concurrent radiation were performed as treatment for the primary tumor. Marked shrinkage of the intravascular tumor was achieved, and no serious adverse events were observed during therapy. Chemotherapy was continued for 5 months, but the patient died because of tumor progression 9 months after the initial diagnosis. Chemoradiotherapy has efficacy against undifferentiated neoplasm of the pulmonary artery.
    Type of Medium: Online Resource
    ISSN: 1662-6575
    URL: Article
    DOI: 10.1159/000365387
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 2458961-5
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  • 6
    Online Resource
    Online Resource
    Recurrence Risk after Noncardioembolic Mild Ischemic Stroke in a Japanese Population
    S. Karger AG ; 2011
    In:  Cerebrovascular Diseases Vol. 31, No. 4 ( 2011), p. 365-372
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 31, No. 4 ( 2011), p. 365-372
    Abstract: 〈 i 〉 Background and Purpose: 〈 /i 〉 This study aimed to identify the recurrence rate and risk factors or clinical variables predictive of vascular events after mild ischemic stroke (IS). 〈 i 〉 Methods: 〈 /i 〉 From December 2006 to September 2007, patients with acute IS with a modified Rankin Scale of 0∼1 were consecutively enrolled in this study. Variables including sex, family history of vascular disease, age, height, weight, stroke subtype, blood pressure, lipid profile, fasting glucose, HbA1c, smoking, alcohol consumption, exercise habits, waist circumference, ankle-brachial pressure index, salt intake and physical activity were assessed. The primary outcome was stroke recurrence or other vascular events such as myocardial infarction, angina pectoris, and peripheral artery disease. Survival curves were calculated by Kaplan-Meier survival analysis, and hazard ratios for recurrence were determined by univariate and multivariate Cox proportional hazards regression models. 〈 i 〉 Results: 〈 /i 〉 A total of 102 mild IS patients (78 men and 24 women, mean age 64 years) were successfully followed for 3 years. Of those 102 patients, 25 (24.5%) had stroke recurrence, and 4 (3.9%) had a coronary event. Among the variables studied, abnormal ankle-brachial pressure index, metabolic syndrome, stroke subtypes, salt intake and poor lifestyle management were significant independent predictors of stroke recurrence or cardiovascular events. 〈 i 〉 Conclusions: 〈 /i 〉 In mild IS patients within 3 years after onset, not only pathophysiological factors but also lifestyle factors can aid in the identification of patients at high risk for recurrence.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000323233
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1482069-9
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