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Atsushi Nanashima,Masahide Hiyoshi,Naoya Imamura,Koichi Yano,Takeomi Hamada,Rouko Hamada,Kenzo Nagatomo,Makoto Ikenoue,Shuichi Tobinaga,Takeshi Nagayasu 한국간담췌외과학회 2019 Annals of hepato-biliary-pancreatic surgery Vol.23 No.2
Backgrounds/Aims: Preoperative nutritional status has been reported to influence patient outcomes after pancreatectomy. The Prognostic Nutritional Index (PNI) is a useful parameter to reflect the outcomes of patients undergoing gastrointestinal surgery. Therefore, the relationship between the PNI and clinicopathological factors, surgical data, and postoperative morbidity were retrospectively evaluated at two academic institutes in a cohort study. Methods: Curative pancreatectomy was performed on 222 patients at the University of Nagasaki between 1995 and March 2015, and 101 at the University of Miyazaki between April 2015and March 2018. The PNI was calculated using preoperative albumin and total cholesterol levels. Results: The mean PNI in our series was 39.2±5.4 and the prevalence of PNIs less than 40 was observed in 134 patients (44%). The PNI was not significantly different between normal, hard, and fatty architecture of the pancreatic parenchyma. The PNIs were significantly negatively correlated with higher age (p<0.01), but not with gender, co-morbidity, or habits. The PNI was significantly correlated with levels of hemoglobin, prothrombin activity, choline esterase, total protein, albumin and cholesterol (p<0.01), and with postoperative total protein and albumin levels (p<0.05). Although the preoperative PNI tended to be lower in patients with total postoperative complications, no significant differences for each complication were observed. Conclusions: Although the preoperative PNIs reflect the perioperative nutritional status, its predictive usefulness for postoperative complications could not be significantly confirmed.
Atsushi Nanashima,Masahide Hiyoshi,Naoya Imamura,Koichi Yano,Takeomi Hamada,Takashi Wada,Takahiro Nishida,Kazuyo Tsuchiya,Fumiaki Kawano,Shinsuke Takeno,Takuto Ikeda 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.4
Backgrounds/Aims: The present study analyzed the postoperative outcomes in patients who underwent hepatectomy or pancreatectomy, with a history of intra-abdominal surgery involving other organs, to elucidate surgical efficacy. Methods: We examined the perioperative parameters in 28 patients who underwent hepatectomy (n=12) and pancreatectomy (n=16) after receiving prior abdominal organ resection (esophagectomy, n=2; gastrectomy, n=5; resection of small intestine, n=2; appendectomy, n=5; colorectal resection, n=9; hepatectomy, n=1; cholecystectomy, n=3; splenectomy, n=2, pancreatectomy ,right adrenectomy, nephrectomy and myoma uteri, n=1 each). Results: Age, gender, a history of comorbidities, and primary diseases were not significantly different between the groups. The present operation was predominantly indicated for liver metastases in all patients undergoing hepatectomy. Several diseases were detected in pancreaticoduodenectomy (PD) patients. Laboratory data were not significantly different between groups. Although operating time and blood loss during hepatectomy did not differ significantly between the groups, the operating time was significantly longer in patients undergoing PD compared with distal pancreatectomy (p<0.05). Red cell blood transfusion was most frequently used in patients who underwent major hepatectomy and PD (p<0.05). The prevalence of postoperative complications was not significantly different between groups. Hospital death was not observed and the period of hospital stay did not differ between groups. Conclusions: Carefully scheduled hepatectomy or pancreatectomy is safe even in cases with prior abdominal surgery under the present strategy.
Atsushi Nanashima,Masahide Hiyoshi,Naoya Imamura,Koichi Yano,Takeomi Hamada,Kengo Kai,Takahiro Nishida,Yukako Uchise,Risa Sakamoto,Mayu Inomata 한국간담췌외과학회 2021 Annals of hepato-biliary-pancreatic surgery Vol.25 No.4
Backgrounds/Aims: It is known that preoperative nutritional status can influence patient outcomes after hepatectomy. Prognostic Nutritional Index (PNI) is a useful parameter to reflect patient outcomes undergoing gastro-intestinal surgery. The aim of this study was to retrospectively evaluate relationships of nutritional parameters, demographics, and surgical records with postoperative outcomes in a cohort study. Methods: Curative hepatectomy was performed for 182 patients at the University of Miyazaki between 2015 and 2018. Each preoperative level of albumin, prealbumin, lymphocyte, total cholesterol, or the comprehensively calculated Onodera’s PNI was examined as a nutritional parameter. Results: The mean PNI was 39.6 ± 5.1, with PNI below 40 observed in 91 (50.0%) patients. Nutritional parameters were not different among patients with various liver diseases. Serum albumin or prealbumin level was significantly correlated with each hepatic parameter (p < 0.01). Prealbumin and total cholesterol levels were significantly correlated with postoperative prothrombin activity (p < 0.05). Albumin or prealbumin levels and PNI were significantly lower in patients with posthepatectomy complications, particularly bile leakage in comparison those without such complications (p < 0.05). Multiple logistic analysis showed that albumin level was an independent risk factor for complications after hepatectomy (risk ratio [RR]: 1.33) and that lymphocyte count was an independent risk factor for bile leakage (RR: 1.28) (p < 0.05). The cut-off level of albumin was approximately 3.8 mg/dL and that of lymphocyte count was 1,320/㎣. Conclusions: Preoperative PNI reflected perioperative liver functional status. It was a predictive parameter for postoperative complications, particularly biliary leakage.
Efficacy of Endoscopic Submucosal Dissection of Esophageal Neoplasms under General Anesthesia
Koichi Hamada,Koichiro Kawano,Atsushi Yamauchi,Ryota Koyanagi,Yoshinori Horikawa,Shinya Nishida,Yoshiki Shiwa,Noriyuki Nishino,Michitaka Honda 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.3
Background/Aims: Evidence that general anesthesia (GA) reduces the operative time of esophageal endoscopic submucosal dissection(ESD) is currently insuffcient. This study aims to evaluate the effcacy and safety of esophageal ESD under GA. Methods: A total of 227 lesions from 198 consecutive patients with superficial esophageal neoplasms treated by ESD at 3 Japaneseinstitutions between April 2011 and September 2017 were included in this retrospective study. For ESD, GA and deep sedation (DS)were used in 102 (51.5%, GA group) and 96 patients (48.5%, DS group), respectively. Results: There were no statistically significant differences in age, sex, or comorbidities between the groups. In the GA group, the tumorsize was larger (21 [3–77] mm vs. 14 [3–63] mm, p<0.001), luminal circumference was larger (≥2/3; 13.9% vs. 5.4%, p=0.042), proceduretime was shorter (28 [5–202] min vs. 40 [8–249] min, p<0.001), and submucosal dissection speed was faster (25.2 [7.8–157.2] mm2 /minvs. 16.2 [2.4–41.3] mm2 /min, p<0.001). The rates of intraoperative perforation and aspiration pneumonia were lower in the GA group,but the difference did not achieve statistical significance (p=0.242 and p=0.242). Conclusions: GA shortens the procedure time of esophageal ESD.
Muniyappan Rajiv Gandhi,Manabu Yamada,Yoshihiko Kondo,Atsushi Shibayama,Fumio Hamada 한국공업화학회 2015 Journal of Industrial and Engineering Chemistry Vol.30 No.-
p-Sulfonatothiacalix[6]arene was impregnated onto commercial polymeric resins. The platinum groupmetals sorption experiments were carried and maximum PGM sorption was observed at pH 4 in 180 min. The 1-loaded IRA-400, IRA-411, and XAD-7 showed Pd SCs of 279, 265, and 135 mg/g, respectively. ThePGM SCs of 1-loaded IRA-400, IRA-411 are found to be Pd > Pt > Rh. All the impregnated resins followedFreundlich isotherm and Pd sorption was exothermic. The kinetic studies demonstrate that Pd sorptionfollows pseudo-second order and intraparticle diffusion models. 1-Loaded XAD-7 selectively adsorbs ofPd ions from an automotive catalyst residue leached solution.
STANDARD SPECIFICATION FOR CONCRETE STRUCTURES, -2001 “MAINTENANCE”
Toyoaki Miyagawa,Hidenori Morikawa,Nobuaki Otsuki,Ayaho Miyamoto,Kazuo Eguchi,Hidenori Hamada,Atsushi Hattori,Tetsuo Harada,Susumu Inoue,Yuichi Kaneko,Yasushi Kamihigashi,Kenji Kawai,Masaru Kawamura,Y 대한토목학회 2003 대한토목학회 학술대회 Vol.2003 No.10