1.Essential anatomy for lateral lymph node dissection
Yuichiro YOKOYAMA ; Hiroaki NOZAWA ; Kazuhito SASAKI ; Koji MURONO ; Shigenobu EMOTO ; Hiroyuki MATSUZAKI ; Shinya ABE ; Yuzo NAGAI ; Yuichiro YOSHIOKA ; Takahide SHINAGAWA ; Hirofumi SONODA ; Daisuke HOJO ; Soichiro ISHIHARA
Annals of Coloproctology 2023;39(6):457-466
In Western countries, the gold-standard therapeutic strategy for rectal cancer is preoperative chemoradiotherapy (CRT) following total mesorectal excision (TME), without lateral lymph node dissection (LLND). However, preoperative CRT has recently been reported to be insufficient to control lateral lymph node recurrence in cases of enlarged lateral lymph nodes before CRT, and LLND is considered necessary in such cases. We performed a literature review on aspects of pelvic anatomy associated with rectal surgery and LLND, and then combined this information with our experience and knowledge of pelvic anatomy. In this review, drawing upon research using a 3-dimensional anatomical model and actual operative views, we aimed to clarify the essential anatomy for LLND. The LLND procedure was developed in Asian countries and can now be safely performed in terms of functional preservation. Nonetheless, the longer operative time, hemorrhage, and higher complication rates with TME accompanied by LLND than with TME alone indicate that LLND is still a challenging procedure. Laparoscopic or robotic LLND has been shown to be useful and is widely performed; however, without a sufficient understanding of anatomical landmarks, misrecognition of vessels and nerves often occurs. To perform safe and accurate LLND, understanding the landmarks of LLND is essential.
2.Pupillometer-Based Neurological Pupil Index Differential: A Potential Predictor of Post-Stroke Delirium
Kotaro NODA ; Tomotaka TANAKA ; Soichiro ABE ; Ryo USUI ; Misa MATSUMOTO ; Yoshito ARAKAKI ; Hiroyuki KIDA ; Ryoma INUI ; Kaoru KOHAMA ; Kazuo WASHIDA ; Sonu M. M. BHASKAR ; Masatoshi KOGA ; Kazunori TOYODA ; Masafumi IHARA
Journal of Stroke 2024;26(2):321-324
3.A Report on an Annual Kampo Medicine Conference Held by Medical Students in the Hokkaido and Tohoku Areas
Shohei OKADA ; Fumiya OMATA ; Takafumi TOGASHI ; Takahisa OKUDA ; Tesshin MIYAMOTO ; Miho OOSUGA ; Kohei TANAKA ; Mami ISHIYAMA ; Aiseio AISO ; Hiromichi YASUI ; Minoru YAEGASHI ; Kahori KUBO ; Soichiro KANEKO ; Tetsuharu KAMIYA ; Natsumi SAITO ; Ryutaro ARITA ; Hidekazu WATANABE ; Hitoshi NISHIKAWA ; Yuka IKENO ; Junichi TANAKA ; Minoru OHSAWA ; Akiko KIKUCHI ; Takehiro NUMATA ; Hitoshi KURODA ; Michiaki ABE ; Shin TAKAYAMA ; Tadashi ISHII
Kampo Medicine 2017;68(1):72-78
Since students who would like to study Kampo medicine more have no opportunity to communicate each other in Northern Japanese Universities, we newly started joint study conferences held by medical students in 2013. The objectives of this paper are to report on these annually held student-based Kampo study conferences in the Hokkaido and Tohoku areas, and the ways each university studies Kampo medicine. In the conference, the students reported on their club activities. Then they studied the history of Kampo medicine and simulation of abdominal diagnosis, and performed group work on case reports together. The number of student participants in these conferences has tripled over 3 years from 18 to 58 (for a total of 111 participants). All members were satisfied with the content. And this reflects medical students' need for a wider perception of Kampo medicine, rather than a limited one gained in their university club activities. We hope this conference will play a major role in other nationwide student-based Kampo study conferences in the years to come.
4.Neuroendocrine carcinoma associated with chronic ulcerative colitis: a case report and review of the literature
Yumi YOKOTA ; Hiroyuki ANZAI ; Yuzo NAGAI ; Hirofumi SONODA ; Takahide SHINAGAWA ; Yuichiro YOSHIOKA ; Shinya ABE ; Yuichiro YOKOYAMA ; Hiroyuki MATSUZAKI ; Shigenobu EMOTO ; Koji MURONO ; Kazuhito SASAKI ; Hiroaki NOZAWA ; Tetsuo USHIKU ; Soichiro ISHIHARA
Annals of Coloproctology 2024;40(Suppl 1):S32-S37
Adenocarcinoma is a common histological type of ulcerative colitis-associated cancer (UCAC), whereas neuroendocrine carcinoma (NEC) is extremely rare. UCAC is generally diagnosed at an advanced stage, even with regular surveillance colonoscopy. A 41-year-old man with a 17-year history of UC began receiving surveillance colonoscopy at the age of 37 years; 2 years later, dysplasia was detected in the sigmoid colon, and he underwent colonoscopy every 3 to 6 months. Approximately 1.5 years thereafter, a flat adenocarcinoma lesion occurred in the rectum. Flat lesions with high-grade dysplasia were found in the sigmoid colon and surrounding area. The patient underwent laparoscopic total proctocolectomy and ileal pouch-anal anastomosis with ileostomy. Adenocarcinoma was diagnosed in the sigmoid colon and NEC in the rectum. One year postoperation, recurrence or metastasis was not evident. Regular surveillance colonoscopy is important in patients with long-term UC. A histological examination of UCAC might demonstrate NEC.