Biomedical subjects

Yoshimi Akamo

Publications and source records attributed to Yoshimi Akamo.

8 recordsLinked to original sources

PubMed2006

A new method for constructing an ileal J pouch without an enterotomy.

The conventional methods of making an ileal J pouch require an enterotomy to introduce a linear stapler. We devised a new surgical technique that removes any need for this enterotomy by using both circular and linear staplers. We applied this method to two patients who underwent a total colectomy for ulcerative colitis and succeeded in making a J pouch without difficulty. This procedure may represent an improved method of making a J pouch.

Colectomy↗

PubMed2006

Limiting vein puncture to three needle passes in subclavian vein catheterization by the infraclavicular approach.

PURPOSE: With central venous catheterization, each additional vein puncture raises the risk of complications. We assessed the rate of failure and complications using a limiting rule whereby the number of needle passes for subclavian vein catheterization was restricted to three. METHODS: A prospective clinical trial was conducted between September 2001 and December 2003 in a university hospital surgical department. Two hundred and thirty-two adult patients were enrolled to undergo subclavian vein catheterization under non-emergency conditions. The patients were subjected to right subclavian vein catheterization by the infraclavicular approach. Vein puncture failure was defined as such if venipuncture was not accomplished after three attempts. Any arterial puncture was judged to be a failure immediately. RESULTS: Vein puncture failure occurred in nine patients (3.9%), and included two arterial punctures (0.9%). No other complications, such as pneumothorax, hemothorax, plexus lesion, mediastinal hematoma or bleeding, or air embolism, were observed. In multivariate analyses, a close to average body mass index (weight in kilograms divided by the square of the height in meters, odds ratio 0.74; 95% confidence interval 0.56-0.97; P = 0.028) was associated with a low risk of failure. CONCLUSION: Limiting the number of needle passes to three may therefore prevent mechanical complications. A low body mass index was predictive of vein puncture failure.

Aged↗

PubMed2005

A novel colonic J-pouch procedure.

The conventional methods for making a J-pouch require a stab wound to introduce a linear stapler. We devised a novel procedure that removes any need for this stab wound. With our method, the bowel is first evaginated and a side-to-side anastomosis is created with a linear stapler and the intestine is then returned to a normal position.

Anastomosis, Surgical↗

PubMed2005

An anti-stray stylet for subclavian catheterization by the infraclavicular approach.

OBJECTIVE: Misplacement of subclavian vein catheters has been reported. We assessed the rate of misplacement of a subclavian vein catheter with and without a novel stylet. METHODS: A prospective, randomized, controlled clinical trial was conducted between September 2001 and June 2003 in a university hospital. Two hundred sixteen adult patients were enrolled to receive subclavian vein catheterization under non-emergency conditions. Patients were randomly assigned to undergo right subclavian vein catheterization with the stylet (n = 109, stylet group) or without the stylet (n = 107, control group). The rate of subclavian vein catheter misplacement was determined and risk factors for failure and complications were analyzed. RESULTS: There was no incidence of catheter misplacement in the stylet group, but this occurred in 12 patients in the control group in whom the catheter was misplaced into the ipsilateral internal jugular vein (0% versus 11.2%, P = 0.0003). In multivariate analyses, use of the stylet (odds ratio = 0.062, 95% confidence interval = 0.008 to 0.495, P = 0.009) and a close to average body mass index (odds ratio = 0.73, 95% confidence interval = 0.54 to 0.98, P = 0.038) were associated with low risks of complications and failure, respectively. CONCLUSIONS: This stylet is useful for decreasing the incidence of misplacement of subclavian vein catheters. Body mass index is predictive of failed vein puncture.

Aged↗

PubMed2003

Keyhole procedure: a new technique for intestinal anastomosis with a large opening and less tissue trauma, using both circular and linear staplers.

BACKGROUND: We designed a new technique, termed the keyhole procedure, that uses a linear stapler to enlarge the anastomotic opening made with a circular stapler. The present study was performed to evaluate this technique in terms of maximum bursting pressure and area of anastomotic opening and compare it with conventional anastomosis using a circular stapler in an animal model. METHODS: Anastomoses were created by the new technique or by the conventional method in swine small intestine. Anastomosis integrity was assessed by the air leakage test. Anastomotic openings were photographed and measured with an image analyzer. RESULTS: It was found that the area of the anastomotic opening obtained with the new technique was more than 3 times that of the control (P <.001). There was no significant difference between the methods in maximum bursting pressure. CONCLUSIONS: The keyhole procedure provides a larger anastomotic opening than conventional anastomosis with a circular stapler, without impairing the integrity of anastomosis.

Anastomosis, Surgical↗

PubMed2002

Solitary intraperitoneal recurrence of alpha-fetoprotein-producing gastric carcinoma: report of a case.

A solitary recurrence of gastric carcinoma in the peritoneal cavity is extremely rare. We herein present a case of solitary intraperitoneal recurrence in a patient with alpha-fetoprotein (AFP)-producing gastric carcinoma. As far as we can determine, this is the first report of such a form of recurrence in a patient with gastric carcinoma who underwent a successful resection. A review of our eight patients who had AFP-producing gastric carcinoma showed a frequent association with hepatic metastasis and a poor prognosis as has been reported previously. Our patient received intra-arterial chemotherapy with low-dose cisplatin and 5-fluorouracil to prevent hepatic recurrence, but eventually developed multiple hepatic metastases after ceasing this therapy. Therefore, adjuvant intra-arterial chemotherapy may have altered the site of first recurrence in this patient.

Adenocarcinoma↗

PubMed2002

[Efficacy of intraperitoneal chemotherapy for advanced Borrmann type IV gastric carcinoma].

We report four patients with advanced Borrmann type IV gastric carcinoma, in whom intraperitoneal chemotherapy with low-dose CDDP and 5-FU plus MMC via a peritoneal port was effective against peritoneal metastasis. However, none of the four patients survived for a long period. During treatment, they were followed on an outpatient basis and received intraperitoneal chemotherapy biweekly with good control of peritoneal metastasis. The ratio of the outpatient follow-up period was more than 50% in all these patients. Intraperitoneal chemotherapy may be effective for controlling peritoneal metastasis of advanced Borrmann type IV gastric carcinoma, and contribute to maintaining the patient's quality of life.

Aged↗

PubMedDate not supplied

Treatment of peritoneal carcinomatosis using carboplatin-loaded hydroxyapatite particles.

UNLABELLED: The anti-tumor effects and tissue distribution of carboplatin (CBDCA) incorporated into hydroxyapatite (HAP) particles was studied. MATERIALS AND METHODS: Seven days after the intraperitoneal (i.p.) implantation of AH130 tumor cells into Donryu rats, the animals were randomized into four groups: group I was treated with saline i.p.; Group II, with CBDCA i.v.; group III with CBDCA i.p.; and group IV with HAP-CBDCA i.p. RESULTS: The survival rate of group IV was better than that of the other groups (p < 0.05). The area under the ascitic platinum concentration-time curve and tissue concentrations of platinum in the omentum after 24 hours of treatment were higher in group IV than in groups II or III (p < 0.05). The platinum concentrations in the kidneys of group IV were lower than in group III (p < 0.05). CONCLUSION: The HAP-CBDCA combination enhances the anti-tumor effects of the drug and reduces the nephrotoxicity in rats with peritoneal carcinomatosis.

Animals↗