Katsumi Makita

Chigasaki Rehabilitation College

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Takemasa Midorikawa

San-ikukai Hospital

Hidefumi Yagi

San-ikukai Hospital

Kunitoshi Aita

Showa University Fujigaoka Hospital

Yasuro Fujiwara

Michio Sakamoto

Showa General Hospital

Kouji Maezawa

Showa University Fujigaoka Hospital

Kazuyoshi Ishibashi

Showa University Fujigaoka Hospital

Yutaka Sanada

Showa University Fujigaoka Hospital

Kiyoshi Miyakawa

Asahikawa Medical College Hospital

Shigeki Kadokura

Showa University Fujigaoka Hospital

Cooperative Institutions

Showa University Fujigaoka Hospital

Showa University

The University of Tokyo

Kyoto Tachibana University

Kyoto University

Job Performance Systems (United States)

Toho University

San-ikukai Hospital

Chigasaki Rehabilitation College

Showa General Hospital

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Two Cases of Non-Occlusive Mesenteric Ischemia with Different Outcomes

Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) (2013)

Katsumi Makita Takemasa Midorikawa Hidefumi Yagi Kunitoshi Aita Michio Sakamoto

転帰の異なる２例の非閉塞性腸管虚血症を経験したので報告する．症例１は78歳の女性で左下腹部痛を主訴に来院．54時間後，腹膜刺激症状が出現し開腹手術，全小腸の虚血と広範な結腸の壊死のためその切除と人工肛門を造設した．３日後，腸管壊死が強く疑われ再開腹を行った．残存結腸，全小腸および胆囊の壊死所見がみられその切除を行った．集中治療を行ったが状態悪化し術後６日に失った．症例２は81歳の女性で嘔吐，腹痛を主訴に来院．25時間後，腹膜刺激症状のため緊急開腹手術，上行結腸～S状結腸および小腸の一部に壊死を認め，その切除と小腸瘻を造設した．長期管理を要したが術後約１年で退院した．自験２例および過去の報告例より，発症から手術までの時間と腹部所見は重要で，腸管壊死が疑われる症例には開腹による早期の確定診断と切除が必要で，術後は腸管の再壊死を高率に併発するため再開腹を念頭においた管理が重要と考えられた．

Occlusive

Mesenteric Ischemia

10.4030/jjcs.38.1022

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Case Report of a Patient with a Favorable Prognosis Following Excision of a Metastatic Inguinal Sac Tumor Originating from Cecum Cancer

The Showa University Journal of Medical Sciences (2005)

Takahiro Umemoto Takemasa Midorikawa Kazuyoshi Ishibashi Kiyoshi Miyakawa Toshiyuki Hatakeyama

A 69-year-old man with a right inguinal mass was admitted on January 23, 2002. He underwent an ileocecal excision for treatment of cecum cancer (pT3 N1 M0) in December 2000. The mass contained a cystic component and had a saccular tumor protruding from the inner wall. The operative findings revealed that the mass extruded from the external inguinal ring, and a modified Bassini's operation was performed on February 1, 2002. The cystic component was completely separated from the peritoneal cavity, and was found to contain high levels of CEA and CA19-9. Pathological examination revealed that this saccular tumor was an adenocarcinoma similar to that seen in cecum cancer. Saccular tumors originating from cecum cancer are very rare and the prognosis is usually poor. However, the prognosis for the case reported in this study was favorable, and recurrence was still not seen 33 months after surgery. The possibility of peritoneal metastasis should be considered in inguinal hernia patients with a history of intraperitoneal malignancy.

Cecum

10.15369/sujms1989.17.163

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Citations (2)

[Cavernous hemangioma of the liver in a high risk group of liver cancer].

PubMed (1987)

Y Itai Toshiaki Kokubo Shiho Ohnishi Michio Imawari Takashi Ishikawa

Liver Cancer

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A Case with a Diagnosis of Omental Hemorrhage before Surgery

The Japanese Journal of Gastroenterological Surgery (2009)

Katsumi Makita Takemasa Midorikawa Hidefumi Yagi Yasuro Fujiwara Kunitoshi Aita

症例は61歳の男性で，平成19年3月，腹部全体の痛みと腹部膨満を主訴に当院受診．血液検査でHb 9.5 g/dlと貧血を認め，腹部超音波検査および腹部CTで腹腔内貯留液を認め，腹腔内出血を疑った．腹部造影CT（CT angio）を行ったところ，左上腹部大網上に腫瘤性病変と動脈相にて左胃大網動脈と連続する血管から造影剤の漏出がみられ，左側大網出血と診断した．全身状態が安定していたため経過を見ていたが，その2時間後，血圧の低下傾向，Hb 8.7 g/dlと低下，腹部超音波検査で腹腔内貯留液が増量していたため，緊急手術を施行した．術前診断同様，左側大網動脈からの動脈性出血を確認，大網部分切除術を行い止血した．本邦での特発性大網出血，大網血腫の論文報告は17例，うち術前診断がなされた症例は5例，疑診2例であり，本例のごとく術前CT angioにより出血部位を確認しえた症例はこれまで報告されていない．

10.5833/jjgs.42.1466

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Effect of Selective Portal Vein Occlusion on Hepatic Reduced Glutathione and Lipid Peroxidation Expression in Regeneration and Atrophy of Hepatic Lobes

The Showa University Journal of Medical Sciences (2005)

Takemasa Midorikawa Shigeki Kadokura Yutaka Sanada Hiroaki Kikuchi Gaku Kigawa

This study aimed to clarify the mechanisms by which selective portal vein occlusion can result in hypertrophy of the remnant liver and atrophy of the liver to be resected. The association between hepatic reduced glutathione (GSH) and malondialdehyde (MDA) in lobes supplied by branches of the portal vein that had been occluded (LPVO) or not occluded (LPVNO) were evaluated in rats. Changes in liver function in both groups were determined before and after portal vein occlusion (PVO) . Transaminase showed significantly higher levels in the PVO group than in the sham operation group on days 1 and 3, and the levels of prothrombin activity in the PVO group were significantly lower than in the sham group on day 1. GSH in the LPVNO increased significantly during the first 3 days in comparison to the sham group, and reached a peak on the 3rd day. In the LPVO, the levels of GSH decreased gradually relative to the sham group on days 3, 5, and 7 MDA levels in both LPVNO and LPVO were significantly higher on the first day than in the sham group. From the third day. MDA levels in the LPVNO were less than the lowest level in the sham group, while those in the LPVO continued to increase linearly throughout the observation period. The correlations between GSH and MDA levels in the LPVO were negatively significant. The regeneration in LPVNO was preceded by a temporary increase in MDA and a subsequent increase in GSH production, whereas LPVO showed atrophic changes with a continuous decrease in GSH and an increase in MDA.

Malondialdehyde

Liver function

Liver Regeneration

10.15369/sujms1989.17.33

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Usefullness of Closed Drainage for the Patients Undergoing Digestive Surgery

Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) (2005)

Katsumi Makita Takemasa Midorikawa Kazuyoshi Ishibashi Kiyoshi Miyakawa Kouji Maezawa

[目的] 消化管手術における開放型, 閉鎖型ドレーンの逆行性感染の頻度をretrospectiveに比較し, 閉鎖型ドレーンの意義を検討した。[方法] 1997年から1999年に当科で手術した消化器癌138例を対象とし, 胃切除術, 結腸・直腸切除術, 腹会陰式直腸切断術 (Miles'手術) に分類し, 閉鎖型ドレーン群 (Cl群), 開放型ドレーン群 (Op群) の感染頻度を比較検討した。[結果] 結腸・直腸切除術においてCl群の感染頻度はOp群に比して有意に低率であった。特にMRSA感染率が有意に低率であった。結腸・直腸切除術症例の術後入院期間はCl群で有意な短縮を認めた。[考察] 結腸・直腸切除術症例において, 閉鎖型ドレーンは感染の防御に有用と考えられた。しかし, 内因性感染と考えられる症例や内腔閉塞の問題もあるため, その管理には注意を要するものと思われる。

10.4030/jjcs1979.30.1_7

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A Case of Retroperitoneal Dedifferentiated Liposarcoma Presented as a Swelling Mass in Left Inguinal Area

Katsumi Makita Takemasa Midorikawa Hidefumi Yagi Yasuro Fujiwara Kunitoshi Aita

A 6 6yearold male with the mass in his left inguinal lesion came to our hospital on June 2 0 0 3. Com puted tomography(CT)followed up for hepatitis C showed the huge retroperi‑ toneal tumor extended from left inguinal area to surrounding of left kidney.　Retroperitoneal li‑ posarcoma was suspected with imaging studies.　The patient received the surgery of left in‑ guinal hernia and the fatty mass was resected at deep inguinal ring.　The biopsy of retroperito‑ neal tumor was done at the same operation under laparotomy.　Pathological findings of ingui‑ nal mass revealed fatty tissue and the findings of retroperitoneal tumor was definitive in di‑ agnosing well differentiated liposarcoma.　The tumor was removed with the left kidney. How‑ ever the patient had been followed up without adjuvant chemotherapy CT three years after the first surgery showed the mass behind spleen.　The recurrence of liposarcoma was highly suspected.　The tumor with a part of diaphragm pancreatic tail a nd spleen had been re‑ moved.　Pathological findings demonstrated dedifferentiated liposarcoma.　Metastasis had not been occurred up to six months after the second surgery.　The patient died from cerebral hemor‑ rhage on February 2 0 0 7. We w ill report very rare case of a retroperitoneal dedifferentiated li‑ posarcoma found out from left inguinal tumor and had underwent several surgeries.

Diaphragm (acoustics)

Abdominal mass

Retroperitoneal space

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Correlation between total irradiation energy and postoperative course in the cases of laparotomic microwave coagulation therapy

Journal of Microwave Surgery (2001)

Kazuyoshi Ishibashi Takemasa Midorikawa Hiroaki Kikuchi Kiyoshi Miyagawa Mariko Saito

Recently, microwave coagulation therapy (MCT) is performed as minimal invasive treatment for liver tumor, and many studies concerning MCT have been reported. However, the clinical study focusing on the relationship between the accurate amount of microwave irradiation and surgical stress after MCT has not been reported. In this report, we studied the relation between the amount of microwave irradiation and the postoperative results in 30 cases who had been received laparotomic MCT. The amount of irradiation was correlated with the volume of necrosis and postoperative transaminase and LDH concentration. Abscess formation was observed in two cases who had been received high amount of irradiation. However, the amount of irradiation did not correlate to the postoperative hospitalization, the average of which is 21.0 ± 1.0 days in cases which received irradiation less than 160.0 × 103 J. The amount of irradiation would be the useful factor for estimating necrotic volume and surgical stress. Although a lot of irradiation might complicate abscess, it was suggested that MCT was safely executed in appropriate and enough amount of irradiation.

Transaminase

10.3380/jmicrowavesurg.19.85

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A Case of Intestinal Obstruction Due to Eosinophilic Gastroenteritis

The Japanese Journal of Gastroenterological Surgery (2022)

Katsumi Makita Takemasa Midorikawa Murayama Akihiro Toshio Imada Takashi Endo

症例は35歳の男性で，急性発症の腹痛で当院を受診した．腹部CTで小腸壁の著明な肥厚による腸閉塞と診断しイレウス管を挿入し減圧治療を行ったが，腹痛の改善がないため絞扼性腸閉塞と診断し緊急手術を施行した．術中所見では回腸末端より約150 cmの回腸に全周性の腸管壁の肥厚と発赤を伴う約7 cmにわたる狭窄を認め小腸部分切除を行った．切除小腸の病理所見では粘膜下層から漿膜下層にかけて高度の好酸球を主体とする炎症性細胞の浸潤を認めた．臨床経過と病理所見より好酸球性胃腸炎と診断した．好酸球性胃腸炎による腸閉塞の1切除例を経験したので報告する．

Eosinophilic gastroenteritis

10.5833/jjgs.2021.0118

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A Case of CA19-9 Possitive Early Gastric Cancer with Interstitial Pneumonia Reveal the High Level of Serum CA19-9 after Surgery

Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) (2008)

Katsumi Makita Takemasa Midorikawa Hidefumi Yagi Yasuro Fujiwara Kunitoshi Aita

CA19-9

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