Abstract: The newly developed Nikkiso HMS–15 is a miniaturized centrifugal pump. It has an impeller diameter of only 50 mm and a priming volume of only 25 ml. A totally new approach was applied to develop this very small pump. The new pump showed comparable hemolysis with pumps twice as big (e. g., the most widely used coneshaped centrifugal pump [index of hemolysis, 0. 005]). This finding refutes the belief that the pump diameter must be sufficiently large in size. Clinical application for cardiac assist was performed for 48 h without any thrombus formation despite low heparin dosage. Also, the pump showed quite favorable blood trauma when applied as a pump for cardiopulmonary bypass during open heart surgery. The compactness, the high controllability, and the system versatility proved to be very effective for clinical application. This pump is considered very reliable for its highly optimized design.

Heart-Lung Machine

Peristaltic pump

Circulating pump

10.1111/j.1525-1594.1994.tb03396.x

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Citations (15)

An Aged Case of Leiomyosarcoma of the Rectum with Long Term Survival

Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) (1999)

Shinya Tanimura Osamu Yamazaki Masayuki Higashino Yasuhisa Fujimoto Kenji MIZUKAMI

症例は下血を主訴とする80歳の女性。直腸指診で肛門縁より3cmの直腸前壁から左側壁にかけて表面平滑な比較的軟らかい腫瘤を触知し, 大腸内視鏡下生検でleiomyosarcomaと診断された。腹会陰式直腸切断術を施行したところ, 8.0×7.0×5.0cmの管外性に発育する腫瘍で, 空洞を有し瘻孔を介して直腸粘膜と交通していた。なお粘膜面には潰瘍形成がみられた。病理組織学的所見では紡錘形の腫瘍細胞が束状配列をなして粘膜下層から固有筋層を越えて増殖しており, 細胞密度が高く核異型も著明で核分裂像も散見された。本例は術後5年経過した現在, 無再発生存中であり, 特に高齢者の予後不良な本疾患では稀な症例と考えられた。

10.4030/jjcs1979.24.6_892

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Prognostic Factors of Thoracic Esophageal Cancer with 1 or 2 Metastasized Nodes

Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) (2002)

Harushi Osugi Masashi Takemura Masayuki Higashino Nobuyasu Takada Sigeru Lee

リンパ節転移の少ない胸部食道癌例における予後関連因子を検討した。当科で3領域郭清施行胸部食道癌254例を対象に予後と関連する臨床病理学的因子をCox比例ハザードモデルを用いて検討した。術後観察期間中央値は76カ月であった。対象254例における最も予後と関連する因子は転移リンパ節個数であった。転移リンパ節0個, 1, 2個, 3個以上の例の予後には有意 (p＜0.001) な差がみられた。転移リンパ節1, 2個の66例の3年, 5年生存率は67%, 56%で, 組織分化度 (p=0.020), 浸潤・増殖形式 (p=0.011) が予後と関与していた。現時点では根治切除が適応となる胸部食道癌例では, 術前診断による再発リスクの予測は困難であるため, 広範囲リンパ節郭清を含む食道切除を行い, 転移リンパ節が1, 2個と少ない例でも, 組織分化度が低く, 浸潤性増殖を示す例では血行性再発に対する予防対策が必要と思われた。

10.4030/jjcs1979.27.5_738

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Duodenogastric reflux eradicates Helicobacter pylori after distal gastrectomy.

PubMed (2004)

Kenichiro Fukuhara Harushi Osugi Nobuyasu Takada Masashi Takemura Shiegru Lee

Patients who undergo distal gastrectomy often develop duodenogastric reflux and preoperative H. pylori infection is eradicated spontaneously after distal gastrectomy in some patients. However, whether a causal relationship exists has not yet been studied. This report examines the correlation between H. pylori eradication and the amount of duodenogastric reflux following distal gastrectomy.Among 72 consecutive patients who underwent curative distal gastrectomy with radical lymphadenectomy for gastric cancer, 37 patients had H. pylori infection preoperatively and were included in this study. The period of bile reflux (percent time) into the gastric remnant was measured with the Bilitec 2000 under standardized conditions on the 14th day after the surgery. Endoscopic examination was performed to determine the presence of H. pylori infection on week 12 after surgery.The percent time was higher in patients whose H. pylori infection had been eradicated after distal gastrectomy (58.1+/-9.2%) than in patients who had H. pylori infection after distal gastrectomy (33.8+/-5.7%).Duodenogastric reflux correlates with spontaneous eradication of H. pylori infection following distal gastrectomy.

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Citations (27)

[The effectiveness of CDDP in metastatic adenocarcinoma with unknown origin].

PubMed (1991)

Tanetoshi Hara Michio Ogawa Takayuki Mukai Yutaka Watanabe Manabu Ishii

A 28-year-old man with inoperable metastatic adenocarcinoma in the retroperitoneum was referred to our hospital for a further evaluation for its origin. The tumor was measured 80 x 107 mm by abd. U.S. and showed papillary adenocarcinoma, histologically. Chemotherapy with intravenous administration of CDDP at the dose of 80 mg/m2 for 6 times at 2-3 week intervals was started, and CDDP concentration of binding-form and free-form in serum and urine were measured in time course. The tumor has reduced for 29 weeks after the discontinuance of CDDP. Free-CDDP, which was thought to have an anticancerous effect, immediately went up high levels in serum and rapidly excreted to urine, while total-CDDP in serum remained in high concentration for more than 10 weeks. Thus it was suggested that anticancerous effect of CDDP could not be contributed only to free-CDDP and the mechanism of CDDP will be clarified by the elucidation of metabolism of both free and total CDDP, especially in the tumor tissue.

Metastatic adenocarcinoma

Papillary adenocarcinoma

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Permanent Pacemaker Implantation via the Iliac Vein: An Alternative in 4 Cases with Contraindications to the Pectoral Approach

Journal of Arrhythmia (2010)

Koji Tsutsumi Kenichi Hashizume Naritaka Kimura Shinichi Taguchi Yoshito Inoue

Pectoral muscle

Axillary vein

10.1016/s1880-4276(10)80037-7

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Citations (4)

Prophylactic Use of Intra‐Aortic Balloon Pumps in Open Heart Surgery

Artificial Organs (2012)

Shinichi Taguchi Koji Tsutsumi Masahiko Okamoto Ichiro Kashima

Abstract During a 1‐year period, intra‐aortic balloon pumps (IABPs) were used in open heart surgery on 57 patients. Indications were prophylactic usage for coronary artery bypass grafting (CABG) in 52 patients, prophylactic usage for valve replacement in three patients, and cardiopulmonary bypass (CPB) weaning during valve replacement in two patients. The 52 CABG patients comprised 94.5% of all CABG procedures during the period. Sheathless 8 Fr IABPs were used in all cases. The 57 patients using IABPs were analyzed. The mean duration of IABP use was 41.7 h. Morbidity was not associated with using IABPs. There was one case of balloon rupture. Hemostasis was performed easily after removing IABP catheters by compressing the groin for approximately 15 min. The lowest blood pressure during anastomosis or cardiac arrest was also assessed. The lowest peak pressure was 55.9 ± 17.3 mm Hg for patients with IABP still turned on, and the lowest mean pressure was 34.7 ± 6.5 mm Hg for patients with IABP temporarily turned off. Peak blood pressure after CPB was 73.8 ± 17.8 mm Hg. During open heart surgery under anesthesia with the low blood pressure presented by this series, use of IABPs enabled patients to tolerate the procedure. In conclusion, aggressive use of IABPs is easy, safe, and effective with no related morbidity.

Groin

10.1111/j.1525-1594.2012.01505.x

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Citations (2)

Technique for Using Pedicled Latissimus Dorsi Muscle Flaps to Wrap Prosthetic Grafts in an Infected Thoracic Aorta

Annals of Vascular Surgery (2013)

Shinichi Taguchi Atsuo Mori Ryo Suzuki Osamu Ishida

Latissimus dorsi muscle

Mycotic aneurysm

10.1016/j.avsg.2013.04.009

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Citations (12)

[Resection of esophageal cancer infiltrating the left main bronchus following complete response to preoperative radiochemotherapy--a case report].

PubMed (2003)

Masashi Takemura Harushi Osugi Shigeru Lee Shinichi Taguchi Masahiro Kaneko

We report a case of esophageal cancer infiltrating the left main bronchus in which radical esophagectomy with clear surgical margins could be performed after preoperative radiochemotherapy. The patient was a 57-year-old man, who was found to have esophageal squamous cell carcinoma of the middle thoracic esophagus during a work-up of dysphagia. Bronchoscopy revealed an elevated region protruding into the lumen of the left main bronchus. After radiochemotherapy (liniac irradiation + low-dose FP therapy), the esophageal and bronchial lesion became smaller. The case was evaluated as a clinically complete response. Bronchoscopic ultrasonography showed a clear boundary between the membranous portion of the trachea and the esophageal wall. Based on these findings, the lesion was considered resectable and radical surgery, including 3-field lymph node dissection, was performed. The resected esophageal specimen had residual cancer cells in the muscularis propria covered with normal mucosa. However, the patient is currently healthy with no evidence of disease. The indication for surgical resection in cases of esophageal cancer with contiguous spread, and a good response to preoperative radiochemotherapy, is controversial. It is necessary to verify the effectiveness of surgical resection, as a secondary treatment, by accumulating data on cases such as the present one.

Esophagectomy

Main Bronchus

Chemoradiotherapy

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