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Yutaka Atomi

Publications and source records attributed to Yutaka Atomi.

At least 37 records · Page 2Linked to original sources
PubMed2005

Asian-Oceanic Pancreatic Association: conception to actuality.

The Asian-Oceanic Pancreatic Association (AOPA) was organized on July 22, 2005 with the purpose of promoting communication, scholarship, and scientific collaboration, as well as the exchange of knowledge in both basic and clinical research and education in Asian and Oceanic countries. The society will host biennial scientific meetings during the Asian Pacific Digestive Week (APDW) and members consist of individuals rather than regional societies. Given the diversity of its members, English was selected as the common language of communication to facilitate the exchange of ideas. The first AOPA symposium, which aimed to describe the pancreatology in various regions, was held in conjunction with the 60th Annual Meeting of the Japan Society of Gastroenterological Surgery (JSGS). The second scientific meeting will be held during APDW 2007.

Asia↗
PubMed2005

Proposal of histological criteria for intraepithelial atypical/proliferative biliary epithelial lesions of the bile duct in hepatolithiasis with respect to cholangiocarcinoma: preliminary report based on interobserver agreement.

Biliary lining epithelia of the bile ducts in biliary diseases are known to have intraepithelial atypical/proliferative lesions related to the development of cholangiocarcinoma. The purpose of the present study was to determine the histological criteria for these lesions based on interobserver agreement. Digital images of 30 intraepithelial atypical/proliferative lesions in the stone-containing intrahepatic bile ducts of hepatolithiasis (30 cases) were sent to 10 pathologists. At first, 10 pathologists made a diagnosis (either of reactive/regenerative change, low-grade or high-grade biliary intraepithelial neoplasia (BilIN-1 and BilIN-2), or in situ carcinoma (BilIN-3)) based on their own criteria. The histological criteria for these four lesions were then determined, and the digital images of the same lesions with proposed criteria were re-distributed. Interobserver agreement on these four lesions was slightly improved (kappa = 0.44, first diagnosis; 0.49, second diagnosis) and intraobserver agreement was 'almost perfect' (kappa = 0.82 at both first and second diagnosis). Interobserver agreement between BilIN-1 and BilIN-2 and that between BilIN-2 and BilIN-3 were 'moderate', although the agreement between regenerative/reactive change and BilIN-1 was 'fair'. In this report, we propose histological criteria for reactive/regenerative change, BilIN-1, BilIN-2 and BilIN-3. Improvement of interobserver agreement suggests their applicability in diagnostic and research fields.

Bile Duct Neoplasms↗
PubMed2005

Effect of granulocyte colony-stimulating factor on opsonin receptor expression in cerulein-induced acute pancreatitis.

OBJECTIVES: Decreased levels of expression of opsonin receptors (CD11b and CD32/16) on peritoneal exudate neutrophils may lead to susceptibility to infection. Granulocyte colony-stimulating factor (G-CSF) increases the expression levels of CD11b on neutrophils and prolongs neutrophil survival. The effects of G-CSF on neutrophils and opsonin receptor expressions of neutrophils were investigated in cerulein-induced acute pancreatitis. METHODS: Forty-two mice were randomly assigned to each group (n = 6). Mice received subcutaneous G-CSF (120 microg/kg body weight) before the induction of acute pancreatitis with cerulein. Saline was used for instead of G-CSF or cerulein solution in control groups. CD11b and CD32/16 expression levels on circulatory and peritoneal exudate neutrophils were investigated 6 and 24 hours after the induction of acute pancreatitis. RESULTS: Treatment with G-CSF did not aggravate the inflammation of pancreatic tissue evaluated by plasma amylase, acinar necrosis. However, it significantly increased the number of peritoneal exudate neutrophils (P < 0.05) and the CD11b- (P < 0.05) and CD32/16-positive (P < 0.05) peritoneal exudate neutrophils in mice with cerulein-induced acute pancreatitis. The means of fluorescence intensity for CD11b and CD32/16 expressions on circulatory and peritoneal exudate neutrophils were also elevated in the G-CSF groups. CONCLUSION: G-CSF administration increases the numbers of neutrophils and improves expression levels of opsonin receptors on neutrophils in mice with cerulein-induced acute pancreatitis.

Acute Disease↗
PubMed2005

Treatment of pancreatic stones with extracorporeal shock wave lithotripsy: results of a multicenter survey.

OBJECTIVES: A retrospective multicenter survey was performed to evaluate the efficacy of extracorporeal shock wave lithotripsy (ESWL) as a treatment of pancreatic stones. METHODS: A survey was sent to 11 institutions belonging to the Japanese Association of Extracorporeal Shock Wave Lithotripsy in Digestive Diseases, and data were collected on 555 patients who underwent ESWL for pancreatic stones between January 1990 and September 2002. The male:female ratio was 5.2:1, and the mean age was 52.5 years. The etiology was alcohol related in 425 patients (76.6%) and idiopathic in 111 patients (20.0%); 204 patients (36.8%) had a single stone and 470 patients (84.7%) were symptomatic. RESULTS: Mean frequency of the procedure was 5.0 times (range, 1-29). Fragmentation of stones was achieved in 513 patients (92.4%), and the complete stone clearance rate after ESWL alone or in combination with interventional endoscopy was 72.6%. Symptom relief was achieved in 428 (91.1%) of 470 patients. Thirty-five patients (6.3%) developed complications, including 30 patients (5.4%) who developed acute pancreatitis. Five hundred four (90.8%) patients were followed for a mean of 44.3 months, during which 122 (22.0%) suffered stone recurrence (mean time to recurrence, 25.1 months). Twenty-two (4.1%) of the 504 patients who were followed required surgery. Pancreatic exocrine function improved in 65 patients (38.0%), was unchanged in 49 patients (28.7%), and progressed in 57 patients (33.3%). Pancreatic endocrine function improved in 44 patients (24.3%), was unchanged in 85 patients (47.0%), and progressed in 52 patients (28.7%). CONCLUSION: ESWL is the treatment of choice for clearing pancreatic stones.

Adolescent↗
PubMed2005

[Recent important insights into treatment of pancreatic cancer].

Although surgical resection provides the only potentially curative modality in patients with pancreatic cancer, the long-term results of pancreatectomy still remain extremely poor. Despite the recent advances made in surgical techniques and/or increased surgical radicality, only limited progress has been made in improving the survival. Moreover, pancreatic cancer in most patients is surgically unresectable at the time of diagnosis. Chemotherapy and/or radiotherapy, therefore, still remain key modalities for treatment of pancreatic cancer. Recently, several randomized trials on the effects of these modalities have been reported. Various newly designed large-scale clinical trials are now in progress. In this article, recent important insights into the surgical treatment, chemotherapy, and radiotherapy of pancreatic cancer are discussed.

Antimetabolites, Antineoplastic↗
PubMed2004

Large contractions in the colonic J-pouch as a possible cause of incomplete evacuation.

BACKGROUND AND AIM: Restoration of neo-rectal capacity is of importance in obtaining better bowel function after low anterior resection for rectal carcinoma. However, evacuatory disorders, such as incomplete evacuation, have been reported in some patients undergoing colonic J-pouch reconstruction. Therefore, we conducted this study to explore the possible factor affecting incomplete evacuation following low anterior resection for rectal carcinoma. PATIENTS/METHODS: The subjects were 37 consecutive patients who had undergone low anterior resection for rectal tumor (colonic J-pouch in 13 patients, straight anastomosis in 24). Clinical and physiological outcomes were determined at a mean follow-up time of 12 months after the operation, and the parameters were compared between patients with and without postoperative incomplete evacuation. RESULTS: Although anastomosis level from the anal verge was lower in the J-pouch group (6.5 cm vs 3.9 cm, P<0.05), there was no significant difference between J-pouch and straight reconstruction regarding clinical and physiological outcomes. Postoperative incomplete evacuation was significantly more frequent in the J-pouch group than in the straight group (46% vs 25%, P<0.05). Postoperative large contractions on ano-rectal manometry were also significantly more apparent in the J-pouch group than in the straight group (31% vs 4%, P<0.05). Presence of postoperative large contractions (P=0.004), anastomotic stricture (P=0.019) and smaller postoperative maximum tolerable volume ( P=0.009) were significantly and independently associated with incomplete evacuation by multivariate analysis. CONCLUSION: Colonic J-pouch reconstruction following ultra-low anterior resection was comparable with higher level straight anastomosis from the clinical and physiological point of view. The presence of large contractions might be an important indicator of incomplete evacuation in patients who are undergoing rectal resection.

Aged↗
PubMed2004

A new reconstruction method for preventing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy.

BACKGROUND: With the aim of preventing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy (PPPD), we devised a new reconstruction method in which the pancreas and the bile duct are anastomosed to the proximal jejunum brought through the transverse mesocolon, and the duodenum is antecolically anastomosed to the jejunum below the mesocolon. The right gastric artery is divided in order to place the stomach, the duodenum, and the jejunum in a straight line. METHODS: Thirty patients underwent PPPD with the new reconstruction method (n = 12) or the conventional method (all anastomoses performed retrocolically; n = 18). Early and late complications were compared between the two groups. RESULTS: Delayed gastric emptying occurred respectively in 1 patient (8%) and 13 patients (72%) operated on by the new and conventional method (P <0.001). The incidences of other complications did not differ significantly between the two groups. CONCLUSIONS: The new reconstruction method may prevent delayed gastric emptying after PPPD.

Bile Ducts↗
PubMed2004

Endoscopic treatment or surgery for undifferentiated early gastric cancer?

BACKGROUND: Although almost all (96%) the surgical cases of undifferentiated intramucosal early gastric cancer (EGC) have been found not to have lymph node metastasis (LNM), local treatment by endoscopic mucosal resection (EMR) is not accepted as an alternative treatment to surgery for this type of EGC. If a subgroup of patients with undifferentiated EGC with negligible risk of LNM can be defined, unnecessary surgery can be avoided. This study was conducted to determine this subgroup among undifferentiated EGC patients in whom the risk of LNM can be highly ruled out in an attempt to identify candidates who can be treated by EMR. METHODS: Data from 175 patients surgically resected for undifferentiated EGC were retrospectively collected, and clinicopathological factors were multivariately analyzed to identify predictive factors for LNM. RESULTS: Multivariate logistic regression analysis identified two independent risk factors for LNM, namely, a large tumor (>/=20 mm, P = 0.011) and presence of lymphatic involvement (P = 0.0005). Using these two risk factors as the predictive factors, LNM was observed in 5.8% of patients who had neither of the two predictive factors, whereas 23.1% or 13.1% of patients with one or two predictive factors had LNM, respectively. In contrast, the LNM rate was calculated to be 60% in patients who had both factors. Lymph node metastasis was not found in any of 6 patients with small intramucosal lesions (<10 mm) without lymphatic involvement. CONCLUSIONS: An intramucosal undifferentiated EGC that is smaller than 10 mm without lymphatic involvement can safely be treated by EMR alone, given the negligible possibility of LNM. When histological examination of endoscopically resected specimens shows lymphatic involvement or unexpectedly larger tumor size than that determined at pre-EMR endoscopic diagnosis, an additional surgical procedure should be considered.

Adenocarcinoma↗
PubMed2004

Risk factors for acute biliary pancreatitis.

BACKGROUND: Few studies have analyzed both stone-related and pancreatobiliary anatomical factors that predispose to acute biliary pancreatitis. Both of these factor types were studied by multivariate analysis. METHODS: A total of 143 patients with (n=43) or without (n=100) recent acute biliary pancreatitis who underwent cholecystectomy for gallbladder stones after ERCP were prospectively studied. The interval between the onset of pancreatitis and ERCP ranged from 12 to 35 days (mean, 20 days). Univariate and multivariate analyses for 15 potential risk factors for acute biliary pancreatitis, including operative and ERCP findings, were performed. RESULTS: Univariate analysis identified 5 significant predictive factors for pancreatitis: a diameter of the smallest gallbladder stone of 5 mm or less, a cystic duct diameter of 5 mm or more, 20 or more gallbladder stones, a diameter of the largest gallbladder stone of 5 mm or less, and irregular gallstone surface. Of these 5 factors, the first 3 remained significant in the multivariate analysis. CONCLUSIONS: Both stone-related factors (small and multiple stones) and an anatomical factor (enlarged cystic duct) may contribute to the development of biliary pancreatitis. These features should be carefully considered during management of patients with gallstones.

Acute Disease↗
PubMed2004

Endoscopic papillary balloon dilation causes transient pancreatobiliary and duodenobiliary reflux.

BACKGROUND: Endoscopic papillary balloon dilation reduces sphincter function at least transiently or partially, which may allow pancreatobiliary and duodenobiliary reflux to occur. This study prospectively evaluated pancreatobiliary and duodenobiliary reflux after endoscopic papillary balloon dilation. METHODS: In 12 patients with choledocholithiasis, ductal bile was sampled for amylase concentration and bacterial culture during ERCP, before and at 7 days to 5 years after endoscopic papillary balloon dilation. To provide comparative and control data, ductal bile was sampled in 12 patients with gallbladder cholesterol polyps and 6 with anomalous pancreaticobiliary junction who did not undergo endoscopic papillary balloon dilation. RESULTS: Amylase concentrations in ductal bile from patients with choledocholithiasis before endoscopic papillary balloon dilation were marginally significantly higher (before Bonferroni correction) compared with concentrations in bile from patients with gallbladder polyps. The concentration of amylase in bile was significantly increased at 7 days after endoscopic papillary balloon dilation compared with that before endoscopic papillary balloon dilation; the level was comparable with that of patients with an anomalous pancreaticobiliary junction. Subsequently, the amylase concentration gradually decreased and was approximately equal to the pre-endoscopic papillary balloon dilation level at 1 year. Bacteriocholia was frequent (67%-92%) for up to 3 months after endoscopic papillary balloon dilation but was rare thereafter. CONCLUSIONS: Endoscopic papillary balloon dilation causes transient pancreatobiliary and duodenobiliary reflux. However, reflux is no longer present at 1 year after endoscopic papillary balloon dilation.

Adenoma, Bile Duct↗
PubMed2004

Predictive factors for lymph node metastasis of differentiated submucosally invasive gastric cancer.

BACKGROUND: For early gastric cancer, submucosal invasion may be unrecognized until histopathologic examination of the specimen obtained by EMR. Gastrectomy with lymphadenectomy is the standard treatment for such submucosal cancers. However, approximately 80% of submucosal cancers do not have lymph node metastasis. Unnecessary surgery could be avoided if a subgroup of patients with submucosal cancer with negligible risk of lymph node metastasis can be defined. This study was conducted to define such a subgroup. METHODS: Data from 104 patients surgically treated for differentiated submucosal cancers were retrospectively collected. A multivariate analysis of clinicopathologic factors was performed to identify predictive factors for lymph node metastasis. RESULTS: Three independent risk factors, namely, female gender (p=0.0174), deep invasion (> or =500 microm) into the submucosal layer (p=0.001), and presence of lymphatic involvement (p < 0.0001) were associated with lymph node metastasis. Lymph node metastasis was not observed in any patient who had limited submucosal invasion and absence of lymphatic involvement. The rate of lymph node metastasis was calculated to be 80% in patients who had both deep submucosal invasion and lymphatic involvement. CONCLUSIONS: If endoscopic resection specimens exhibit no deep penetration (<500 microm) into the submucosal layer and lymphatic involvement is absent, EMR may be sufficient treatment for submucosal well-differentiated early gastric cancers. A long-term follow-up study of patients with such lesions treated by EMR alone is required.

Adolescent↗
PubMed2004

Cystic neoplasm of the pancreas: a Japanese multiinstitutional study of intraductal papillary mucinous tumor and mucinous cystic tumor.

The Japan Pancreas Society performed a multiinstitutional, retrospective study of 1379 cases of intraductal papillary mucinous tumor (IPMT) and 179 cases of mucinous cystic tumor (MCT) of the pancreas. Clinicopathologic features and postoperative long-term outcomes were investigated. IPMT were most frequently found in men and in the head of the pancreas. In contrast, all patients with MCT were women. Ovarian-type stroma were found in only 42.2% of the MCT cases. Prognostic indicators of malignant IPMT included advanced age, positive symptoms, abundant mucous secretion, presence of large nodules and/or large cysts, remarkable dilatation of the main pancreatic duct, and main duct- or combined-type IPMT. Advanced age, positive symptoms, and presence of large nodules and/or large cysts were predictive of malignant MCT. The 5-year survival rate of IPMT patients was 98%-100% in adenoma to noninvasive carcinoma cases, 89% in minimally invasive carcinoma cases, and 57.7% in invasive carcinoma cases. The 5-year survival rate of MCT patients was 100% in adenoma to minimally invasive carcinoma cases and 37.5% in invasive carcinoma cases. In conclusion, IPMT and MCT show distinct clinicopathologic and prognostic differences. The results from this study may contribute to the diagnosis and treatment of IPMT and MCT.

Adenocarcinoma, Mucinous↗