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T Okabayashi

Publications and source records attributed to T Okabayashi.

At least 19 recordsLinked to original sources
PubMed2006

Laparoscopic incisional hernia repair. A new mesh fixation method without stapling.

BACKGROUND: Recent advances in laparoscopic surgery have made various abdominal surgeries possible. To avoid wound infection, mesh repair of abdominal incisional hernias is performed laparoscopically. Here we present a new procedure to fix mesh to the abdominal wall. SURGICAL TECHNIQUE: Four anchoring sutures are made using a suture-grasping device; the additional transabdominal sutures are then made with a modified double-needle device. Additional circumferential fixation with tacks is not necessary. CONCLUSIONS: This new mesh fixation method involves simple suturing techniques and is less time consuming than the conventional procedure.

Abdominal Wall↗
PubMed2005

Laparoscopic lymph node dissection around the inferior mesenteric artery for cancer in the lower sigmoid colon and rectum: is D3 lymph node dissection with preservation of the left colic artery feasible?

BACKGROUND: When we perform laparoscopic lymph node dissection around the inferior mesenteric artery (IMA), we preserve the left colic artery (LCA) to maintain the blood supply to the proximal sigmoid colon. In this study, we present our laparoscopic D2 and D3 lymph node (LN) dissection technique and evaluate its applicability and safety. METHODS: We performed LN dissection on 23 rectal and lower sigmoid colon cancer cases from April 2002 to December 2004. For D3 LN dissection, the incision to the mesosigmoid extends to just before the root of the IMA, which is exposed with an ultrasonic cutting and coagulating surgical device to avoid bleeding. Then, the arterial wall is exposed with a dissecting electrocautery spatula down to the LCA, at least 2 cm of which is exposed. Adipose tissue surrounding the IMA and inferior mesenteric vein is dissected. For D2 LN dissection, we partially expose the IMA to confirm the location of the LCA. RESULTS: The mean times taken for D2 and D3 LN dissections were 36.2 and 68.2 min, respectively. Both procedures took longer in male patients. There was a trend for the procedure overall to take less time in female patients. However, D2 dissection took significantly longer in male than female patients (p < 0.05). In women, D3 dissection took significantly longer than D2 (p < 0.05), but this trend was not seen in men. Increased experience among surgeons with this procedure was associated with significantly faster LN dissections in men (p < 0.05), but not in women (p = 0.493). Pearson product moment analysis identified a relationship between body mass index (BMI) and the time taken for D2 LN dissection (r = 0.765), but not D3 LN dissection (r = 0.158). There was no treatment-related morbidity with this technique. CONCLUSIONS: This method was safe and feasible for all patients in this series, but takes longer to perform in male patients.

Aged↗
PubMed2002

CT imaging of intrabiliary growth of colorectal liver metastases: a comparison of pathological findings of resected specimens.

The objective of this study was to assess the usefulness of CT in the pre-operative evaluation of macroscopic intrabiliary tumour growth of colorectal liver metastases. 25 metastatic nodules of 18 patients who underwent an initial hepatectomy for colorectal liver metastasis were retrospectively evaluated. The CT appearance and pathological findings of the resected specimens were correlated. A number of unusual peritumoral features associated with intrabiliary tumour growth were detected by pre-operative CT. These were classified into three patterns: (1) thickened portal tract; (2) intrahepatic bile duct dilatation; and (3) a wedge-shaped area with enhancement. In 8 (32%) of the 25 nodules the portal tract was depicted as thicker than usual and these features were found proximal to the tumour in three instances, distal to the tumour in four instances, and both proximal and distal in one instance. All of the three intrabiliary tumours larger than 30 mm resulted in thickening of the portal tract. Intrahepatic bile duct dilatation was detected in association with 10 (40%) of 25 nodules. Bile duct dilatation was observed in more than one segment when intrabiliary tumour reached the hepatic hilus from the tumour. The presence of bile duct dilatation was not related to either the size of the tumour or the extent of intrabiliary tumour growth. An abnormally high density wedge-shaped area on contrast enhanced CT was another feature indicating intrabiliary tumour growth and was seen in association with four nodules. Such areas were seen in the liver parenchyma distal to the tumour on three occasions, or encompassing the tumour on one accasion. This wedge-shaped area appeared as a well demarcated dark red-brown region in the cut surface of the resected specimen. CT was useful for detecting the presence of intrabiliary tumour growth with these three patterns of radiological findings in patients with liver metastases from colorectal cancer

Aged↗
PubMed2001

A new staging system for mass-forming intrahepatic cholangiocarcinoma: analysis of preoperative and postoperative variables.

BACKGROUND: The objective of this study was to analyze the clinicopathologic variables and the postoperative outcome in patients with mass-forming intrahepatic cholangiocarcinoma (ICC) to identify important factors for predicting postresection prognosis. Although it has been reported that mass-forming ICC has a different etiology and biologic features compared with hepatocellular carcinoma (HCC), patients with ICC have been dealt with clinicopathologically in the same manner as patients with HCC. METHODS: Sixty patients who underwent hepatectomy for mass-forming ICC with curative intent between 1981 and 1999 were studied. Fourteen preoperative clinical and diagnostic parameters and 12 postoperative surgicopathologic parameters were analyzed. RESULTS: The rate of operative mortality in this patient cohort was 5%, and the overall 1-year, 3-year, and 5-year survival rates were 68%, 35%, and 29%, respectively, with a median survival of 19.6 months. A multivariate analysis revealed that independent negative prognostic factors were 1) hepatic regional lymph node metastasis, 2) multiple tumor presentation, 3) symptomatic tumor, and 4) the presence of vascular invasion. Using these factors, a new staging system was devised: Stage I disease was defined as a solitary tumor without vascular invasion, Stage II disease was defined as a solitary tumor with vascular invasion, Stage IIIA disease was defined as multiple tumors with or without vascular invasion, Stage IIIB disease was defined as any tumor with regional lymph node metastasis, and Stage IV disease was defined as any tumor with distant metastases. The Kaplan-Meier estimated 3-year survival rate and the median survival for each subgroup were 74% for patients with Stage I disease (median survival is the time when the cumulative survival rate of some patients' group declined to 50%; thus, the median survival could not be calculated in patients with Stage I disease because survival was 74% at the latest follow-up), 48% and 26.2 months for patients with Stage II disease, 18% and 16.8 months for patients with Stage IIIA disease, and 7% and 11.2 months for patients with Stage IIIB disease, respectively (P < 0.0001). None of the patients met the criteria for Stage IV disease. CONCLUSIONS: The current results support the use of a new staging system for patients with ICC that is simple and predicts well the differences in survival after patients undergo hepatic resection.

Adult↗
PubMed2001

Endoscopically demonstrable esophageal changes after Helicobacter pylori eradication in patients with gastric disease.

BACKGROUND AND AIMS: An increased prevalence of reflux esophagitis has been reported following Helicobacter pylori (H. pylori) eradication in patients with duodenal ulcers in Western countries. However, it has remained unknown whether this might also appertain to individuals with other diseases. We therefore carried out this study to determine the effect of eradicating H. pylori infection in a series of Japanese patients. METHODS: Of a total of 203 H. pylori-positive patients successfully cured of infection, 82 cases (58 males, 24 females) with gastric disease, but not duodenal ulcers, were included in the present study; median age 56 years (range 18-80) and median follow up of 24 months (range 6-65). The patients were investigated clinically and endoscopically at regular intervals. RESULTS: Mild reflux esophagitis developed after eradication in three of 55 (5.5%) patients formerly without this condition, while it improved after eradication in five of 27 (18.5%) patients, with the disease endoscopically diagnosed prior to eradication. The estimated incidence of esophagitis within 3 years was 4.8% after cure of infection. Short segment Barrett's esophagus developed after eradication in six of 58 (10.3%) patients who did not have it prior to the therapy, while the condition did not improve in 24 patients affected before eradication. CONCLUSIONS: Endoscopic esophageal changes after H. pylori eradication in the present series of Japanese patients were relatively infrequent and mild. This therapeutic approach thus appears to be safe and unproblematic.

Adolescent↗
PubMed2001

Seroprevalence of antibodies against spotted fever group rickettsia among dogs and humans in Okinawa, Japan.

We evaluated serum antibodies against Rickettsia japonica in 517 dogs (430 stray dogs and 87 pet dogs) and 164 humans in Okinawa, Japan, by indirect immunofluorescence assay. The seropositive rate in stray dogs was significantly higher than that in pet dogs (30.7 versus 4.6%, P<0.01). This high prevalence rate is attributed to the understandably frequent environmental exposure of stray dogs to tick infestation. Human samples obtained from Okinawa and Sapporo also showed a significant difference in seropositive antibody percentages (45.1 and 12.0%, respectively, P<0.01). This result suggests that there has been pre-exposure to spotted fever group rickettsia in humans in Okinawa.

Animals↗
PubMed2001

Antipituitary antibodies in patients with lymphocytic hypophysitis.

BACKGROUND: Lymphocytic hypophysitis is one of the causes of hypopituitarism, which is considered an autoimmune reaction in the anterior pituitary. METHOD: We examined antipituitary antibodies in patients with lymphocytic hypophysitis and related diseases by immunoblotting method. RESULTS: Autoantibodies to a 22-kDa human pituitary cytosolic protein were identified in significantly higher frequencies in sera from patients with lymphocytic hypophysitis (11 of 15, 73.3%) and isolated ACTH deficiency (7 of 9, 77.8%) compared with Hashimoto thyroiditis, Basedow's disease and normal control subjects. Also, reactivity against a 49-kDa human pituitary cytosolic protein was seen in 6 of 15 patients (40%) with lymphocytic hypophysitis. N-terminal amino acid sequences of 22-kDa human and rat pituitary cytosolic protein were FPTIPLSVL and FPAMPLSSLFAN, respectively, suggesting that they are human and rat growth hormone, respectively. The pituitary dysfunction (at least one hormone dysfunction) was observed in 11 of 14 patients. Nine of them (82%) showed 22 kDa antibody but 2 of them (18%) did not. CONCLUSION: The present study demonstrated that pituitary autoantibodies could be involved in the pathogenesis of lymphocytic hypophysitis and could be a positive marker for the disease.

Adrenocorticotropic Hormone↗
PubMed2000

Early carcinoma of the gastric cardia in Japan: is it different from that in the West?

BACKGROUND: The incidence of adenocarcinoma of the gastric cardia has increased recently in the West. However, in Japan, most patients with gastric carcinoma have disease that is situated in the body and the distal stomach. The objectives of this study were to compare the clinicopathologic findings of patients with early gastric carcinoma (EGC) arising at the cardia and those with carcinoma in more distal parts of the stomach, then comparing the findings with those from patients with carcinoma of the gastric cardia in the West. METHODS: Three thousand one hundred forty-four patients with EGC who underwent surgical resection between 1962 and 1997 at the National Cancer Center Hospital in Tokyo were studied. Seventy patients with EGC at the cardia were compared with those who had lesions in the middle and lower parts of the stomach. The body mass index (BMI), smoking, and drinking were evaluated using all patients with cardia EGC and 344 patients in a matched cohort in the latter group. RESULTS: Seventy patients had an EGC located just at the cardia, whereas 2796 patients had lesions in the lower two-thirds of the stomach. The former lesions were different from those in the distal two-thirds of the stomach: More often, they were of an elevated type (34% vs. 14%, respectively, they were histologically well differentiated in 89% (vs. 59%), and there were more submucosal tumors (53% vs. 41%). The BMI, smoking, and drinking in the two groups were not different. The incidence of Barrett esophagus and gastroesophageal reflux disease (GERD) in patients with EGC were 2. 9% (2 of 70 patients) and 5.7% (4 of 70 patients), respectively. CONCLUSIONS: There were many significant differences in clinicopathologic characteristics between patients with carcinoma of the cardia and patients with carcinoma of the distal stomach in Japan. The incidence of early cardia carcinoma was very low in Japan, and obesity, smoking, drinking, Barrett esophagus, or GERD were not related to its occurrence, in contrast to reports in the West.

Adenocarcinoma↗
PubMed2000

[A case of ANCA positive idiopathic crescentic glomerulonephritis initiated with fever and liver dysfunction].

We studied a case of a 63 year old Japanese man who presented in October, 1994 with general fatigue, low grade fever, micro hematuria and leukocytosis, elevated CRP as well as liver dysfunction. A liver biopsy at that time revealed mild cholangiolitis. Six months later he was admitted because of weight loss, protein urea, and renal failure. At that time he was positive for antineutrophil cytoplasmic antibody(ANCA) with perinuclear staining patter(p-ANCA) done by indirect immunofluorescence. He was also positive for anti-myeloperoxidase antibody(MPO-ANCA) done by ELISA. A renal biopsy showed idiopathic crescentic glomerulonephritis with pauci-immune type(ICGN). Despite therapy with steroids and cyclophosphamide, which improved his subjective symptoms, his renal failure accelerated necessitating hemodialysis which he has been on for over four years. In conclusion, this patient has a rare case of ICGN that presented with liver dysfunction similar to autoimmune hepatitis. Since ANCA has been known to be associated with systemic vasculitides as well as chronic inflammatory diseases(e.g. ICGN, microscopic polyarteritis nodosa, ulcerative colitis or autoimmune liver diseases), both the crescent formation in this patient's glomeruli and cholangiolitis in his liver may have shared the common etiology related to ANCA.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed2000

Prevalence of spotted fever rickettsial antibodies in dogs and rodents in the Philippines.

Antibodies against spotted fever group rickettsiae have been detected in blood samples of dogs and rodents obtained from selected areas in the Philippines. In this serosurvey, the positive percentage rates are 8.3% (11/132) in dogs and 12.2% (6/49) in rats. Positive results were read from samples tested with Rickettsia japonica antigen. No positive result was obtained in blood samples of rats and house mice using R. akari antigen. The findings of this study are the first to confirm the detection of spotted fever group rickettsial antibodies in the Philippines.

Animals↗
PubMed1999

Millimeter-Wave Spectrum of Fluorodiacetylene (H&sbond;C&tbond;C&sbond;C&tbond;C&sbond;F).

The millimeter-wave spectrum of HCCCCF was observed in the ground state as well as in the low-lying vibrationally excited states nu7, nu8, nu9 and also associated nu8 + nu9, 2nu9, and 3nu9 states. The HCCCCF molecule was produced by a dc glow discharge in a flowing vapor of 2,3,4,5,6-pentafluorostyrene. The l-type doubling constants determined are in good agreement with the values predicted from the harmonic force field calculation. Copyright 1999 Academic Press.

Journal Article↗
PubMed1999

Analysis of Rovibrational Resonances Observed in the Microwave Spectrum of FCCCN.

Microwave spectrum of fluorocyanoacetylene (FCCCN) produced by a glow discharge in pentafluorobenzonitrile (C6F5CN) was observed using a source modulation spectrometer with a free-space absorption cell. Rotational transitions in the range from J = 9-8 to 53-52 were observed for the vibrationally excited states of nu4 (C&sbond;C stretch), nu5 (CCN bend), nu6 (FCC bend), nu7 (CCC bend), and their associated overtone and combination states up to about 1000 cm-1. Most of the vibrational states above 500 cm-1 are perturbed by rovibrational resonances. The effective vibration-rotation constant of the nu4 state has a negative value (-0.4 MHz), although a vibration-rotation constant generally has a positive value in the excited state of the stretching vibrational mode in a linear molecule. This anomalous behavior is interpreted as due to the rovibrational resonances between the nu4 and several nearby states. By the simultaneous analysis of the states concerned, the unperturbed vibrational energy and rotational constant of the nu4 state are obtained to be 686.50(76) cm-1 and 2068.2387(21) MHz, respectively, where the uncertainties correspond to one standard deviation. Copyright 1999 Academic Press.

Journal Article↗
PubMed1999

Serosurvey of wild rodents for Rickettsioses (spotted fever, murine typhus and Q fever) in Java Island, Indonesia.

The prevalence of antibodies against spotted fever group rickettsia (SFGR), murine typhus and Q fever were investigated in wild rats captured in Indonesia. Sera of 327 rats were collected from Jakarta and Boyolali on Java Island. The prevalences of antibodies against SFGR and murine typhus were 128 (39.1%) and 48 (14.7%), respectively. Antibodies against Q fever were not detected in these serum samples. Antibodies against SFGR were found in all species of rats (20.8-51.9%). The antibody positive rate against murine typhus in Rattus norvegicus (38.0%) was significantly higher than that in other rat species (0-4.8%, p<0.01). The antibody positive rates against SFGR and murine typhus in rats captured in Jakarta were significantly higher than those in rats captured in Boyolali (p<0.01). In this survey, all species of rats had antibodies against SFGR, indicating that the 4 species of tested rats (R. norvegicus, R. rattus, R. exulans, R. tiomanicus) were infected with SFGR and that SFGR may infest the whole of Java Island. Most of the rats that were antibody-positive against murine typhus were captured in Jakarta. Therefore, R. norvegicus and R. rattus are likely to be important hosts of murine typhus in Jakarta. The antibody-positive rates against SFGR and murine typhus in rats captured in the dry season were significantly higher than those in rats captured in the rainy season. This may coincide with the active periods of ticks and fleas in Indonesia.

Animals↗
PubMed1999

Short report: prevalence of antibodies against spotted fever, murine typhus, and Q fever rickettsiae in humans living in Zambia.

The causative agents of rickettsial diseases (Rickettsia conorii, R. typhi, and Coxiella burnetii) have been reported throughout the African continent. However, there have been no reports on epidemiologic surveys of these infections in Zambia. This study was designed to clarify the prevalence of three rickettsioses in 377 humans in Zambia. The seroprevalence of antibodies against R. conorii, R. typhi, and C. burnetii was 16.7%, 5.0%, and 8.2%, respectively. The rates of antibody positivity against R. conorii and C. burnetii were higher in the eastern (23.1% and 11.8%) and western (16.8% and 7.4%) areas of Zambia than in the northern (3.0% and 3.0%) area of this country. There was little difference among the three areas in the distribution of antibodies against R. typhi. Since cattle breeding is more extensive in the western and eastern areas than in the northern area, it is thought that cattle-breeding areas are foci of R. conorii and C. burnetii infections in Zambia.

Adolescent↗
PubMed1999

Evaluation of cyclin D1 mRNA expression in gastric and colorectal cancers.

Cyclin D1 is a G1 cyclin that controls the transition of the cell cycle from G1 phase to S phase, and its gene is located on chromosome 11q13. We evaluated the expression of cyclin D1 mRNA in surgically resected specimens of gastric and colorectal cancers using quantitative RT-PCR. In this method, cDNA derived from cyclin D1 mRNA was amplified in a tube together with an internal control. The expression of cyclin D1 mRNA was high in 8 of 36 gastric cancer tissues (22%) and 9 of 27 (33%) colorectal cancer tissues, compared to normal mucosal tissues. In gastric cancers, the rate of cyclin D1 mRNA expression (an index of the density of DNA bands) was significantly higher in patients with tumors invading beyond the submucosal layer, regional lymph nodes and lymphatic vessels (i.e., patients with stage III or IV). In colorectal cancers, the rate of cyclin D1 mRNA expression was significantly higher in patients with venous invasion. Moreover, in patients with colorectal cancer, the survival rate of high-expression group was significantly lower than in low-expression group. Our results suggested that overexpression of cyclin D1 mRNA reflected the severity of gastric cancer and poor prognosis of colorectal cancer.

Adult↗
PubMed1998

Microwave Spectroscopy of BrBO.

The microwave spectra of the four isotopomers of the BrBO molecule (79Br10BO, 81Br10BO, 79Br11BO, and 81Br11BO) were observed in a dc glow discharge plasma of a mixture of boron tribromide vapor and oxygen gas. Rotational transitions of BrBO were measured for the ground state as well as for the vibrationally excited states, nu2 (bend) and nu3 (Br-B str.), for all of four isotopomers, and associated 2nu2, nu2 + nu3, and 2nu3 for the 11B species. The l = 0 substate of the 2nu2 state interacts with the nu3 state through the Fermi resonance. The rotational constants determined for the ground states of the four isotopomers yield the substitution structure, rs(Br&sbond;B) = 1.835791(70) Å and rs(B&dbond;O) = 1.20472(25) Å. The pi character and ionic character of the Br-B bond, which are estimated from the bromine quadrupole coupling constant eQq, are discussed through the comparison with those of related molecules such as BrCN and BrBS. Copyright 1998 Academic Press.

Journal Article↗