1.Acupuncture for sports disorders in track and field events.
Toshikazu MIYAMOTO ; Hideo KOBAYASI ; Hidetoshi MORI ; Keishi YOSHIKAWA ; Kazushi NISHIJO ; Tetsuya KURODA ; Tetsuo HOSOKAWA ; Takeshi TOMIYASU
Journal of the Japan Society of Acupuncture and Moxibustion 1987;37(2):111-119
We investigated sports disorders in 112 (82 men, 30 women) members of Field and Track Club, University of Tsukuba.
Before acupuncture treatment, they entered their painful and fatigued areas in our chart and were tested by Cornel Medical Index.
After six months, we questioned 51 (38 men, 13 women) members treated by acupuncture on effects.
The following results were obtained.
1. The painful areas varied with athletic events, that were muscles and joints they moved frequently.
The painful areas were mostly low backs and thighs in a short distance and hurdle race, hips and legs in a middle and long distance, low backs and legs in a jumping event, elbows and low backs in a throwing event.
2. As a result of Cornel Medical Index, it was proved that many members had more mental than physical symptoms.
3. Most of members treated by acupuncture could still go on with training in spite of pains.
4. The effects of treatment continued for 2-3 days.
5. The effects were rated as follows: better 78.4%, no change 14%, worse 6%.
2.Recent refinements of glissonean pedicle approach for liver resection
Yu Saito M.D. ; Mitsuo Shimada M.D ; Satoru Imura M.D ; Yuji Morine M.D ; Tetsuya Ikemoto M.D. ; Yusuke Arakawa M.D. ; Shuichi Iwahashi M.D. ; Shinichiro Yamada M.D ; Daichi Ichikawa M.D ; Masato Yoshikawa M.D. ; Hiroki Teraoku M.D.
Innovation 2014;8(4):142-143
Background: The glissonean pedicle approach was introduced by Couinaud
and Takasaki in the early 1980s. The key of the glissonean pedicle approach is
clamping the pedicle first, secondly confirming the territory, and finally dissecting
the liver parenchyma. In this presentation, we introduced our recent refinements
of glissonean pedicle approach for liver resection.
“Approach to the glissonean pedicles at the hepatic hilus” Couinaud described
three approaches to the hepatic hilus. 1) Intra-fascial access (Control method):
The conventional dissection at the hilus or within the sheath is referred to as intrafascial
access However, dissection performed under the hilar plate is dangerous
and surgeons have to consider any variations of the hepatic artery and bile ducts.
2) Extra-fascial access (Glissonean pedicle approach): The glissonean pedicle is
dissected from the liver parenchyma at the hepatic hilus before dissecting the
liver parenchyma. This procedure prevents intrahepatic metastasis of HCC, which
spreads along the portal vein and improves the overall survival after surgery.
3) Extra-fascial and transfissural access: If the main portal fissure or the left
suprahepatic fissure is opened after dissecting the liver parenchyma, the surgeon
can confirm the pedicles that arise from the hilar plate or the umbilical plate.
“Operative techniques” 1) Preoperative 3D simulation of the precise anatomy
of portal vein, hepatic artery and bile duct at hepatic hilus should be performed.
2) Right glissonean pedicle: The hilar plate is detached from the quadrate lobe.
The assistant pulls the liver parenchyma cranially and the operator conversely
pulls the hepatoduodenal ligament caudally. Mayo scissors are inserted along the
liver parenchyma between the liver parenchyma and glissonean capsule (Fig.1).
Then forceps are inserted in the same way and the right main pedicle is taped
(Fig.2). The right anterior and posterior glissonean pedicles are taped as well. 3)
Left glissonean pedicle: The hilar plate is detached from the liver parenchyma.
Then, the Arantius duct is confirmed and the left pedicle is dissected along the left
pedicle at the ventral side of the Arantius duct.
“Pitfall of glissonean pedicle approach” The right pedicle should be dissected
in the liver side as much as possible to prevent the injury of left hepatic duct.
If possible, the right pedicle is recommended to be dissected at the level of the
second branches separately (Fig.3). The right posterior hepatic duct sometimes
branches from the left hepatic duct and the Arantius duct is confirmed and the left
pedicle should be dissected along the left pedicle at the ventral side of the Arantius
duct because the right posterior hepatic duct branches from the left hepatic duct
at the dorsal side of Arantius’ duct. In addition, the intraoperative cholangiogram
should be used in the case with the abnormal anatomy of bile duct.
Conclusions: Any anatomical hepatectomy can be performed using “glissonean
pedicle approach” which allows simple, safe and easy liver resection.
3.Twenty years of otsu medical stucents association since 1969.
Michiya Ohtaka ; Tsuyoshi Ikai ; Shinji Fushiki ; Kiyoaki Kitamura ; Yasuyuki Tatsugami ; Junichiro Morikawa ; Yoshio Nakamura ; Takeshi Aoyama ; Tetsuya Yoshikawa ; Akira Matsuda ; Yoshifumi Yokota ; Takuzo Nambu ; Takeshi Moridera ; Nobuki Yamaoka ; Hiroyuki Naito ; Fumikazu Ikeda ; Hiroyuki Furukawa ; Hiroshi Yakushigawa ; Hiroshi Fujimoto ; Kishiko Hayashi ; Tsuyoshi Ohtaka ; Noboru Takano ; Yoshie Ibuki ; Tsutomu Yamanaka ; Akira Matsuda
Medical Education 1991;22(2):115-120
4.Kampo and Cancer Immunity in the Era of Immune Checkpoint Inhibitors
Mitsuo SHIMADA ; Yuji MORINE ; Tetsuya IKEMOTO ; Kozo YOSHIKAWA ; Chie TAKASU
Kampo Medicine 2019;70(2):162-166
Kampo medicine is well known to play an important role in cancer therapy, especially as a supportive therapy. We literally investigated the significance of Kampo medicine on antitumor effect including our data in the era that cancer immunotherapy using immune checkpoint inhibitors is a main stream. Up to now, many reports have been published regarding the mechanism of Kampo medicine on augmentation of immunity, particularly innate immunity. Regarding the effect of Kampo medicine on cancel of immune suppression by cancer, a few reports have been published including our data that juzentaihoto reduced regulatory T cell ratio in advanced pancreas cancer patients. Interestingly, a certain kind of Kampo medicine has possibility to induce immune tolerance in murine cardiac transplant model through increased regulatory T cells, and to suppress intestinal inflammation by anticancer drug by functioning immune checkpoint (PD-1). We hope that Kampo medicine would be proved to possibly regulate immune function from the viewpoint of immune checkpoint in the near future.