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Featured researches published by Etsuji Shimada.


Journal of Experimental & Clinical Cancer Research | 2008

Association of MUTYH Gln324His and APEX1 Asp148Glu with colorectal cancer and smoking in a Japanese population

Mayumi Kasahara; Kayo Osawa; Kana Yoshida; Aiko Miyaishi; Yasunori Osawa; Natsuko Inoue; Akimitsu Tsutou; Yoshiki Tabuchi; Kenichi Tanaka; Masahiro Yamamoto; Etsuji Shimada; Juro Takahashi

BackgroundGenetic polymorphisms of DNA repair enzymes may lead to genetic instability and colorectal cancer carcinogenesis. Our objective was to measure the interactions between polymorphisms of repair genes and tobacco smoking in colorectal cancer.MethodsThe case-control study involved sixty-eight colorectal cancer patients and 121 non-cancer controls divided into non-smokers and smokers according to pack-years of smoking. The genetic polymorphisms of DNA repair enzymes,OGG1 Ser326Cys, MUTYH Gln324His, APEX1 Asp148Glu and XRCC1 Arg399Gln, were examined using PCR-RFLP.ResultsThe MUTYH Gln324His showed strong significant associations with a risk of colorectal cancer (crude odds ratio [OR] 3.30, 95% confidence interval [95%CI] 1.44–7.60, p = 0.005; adjusted OR3.53, 95%CI 1.44–8.70, p = 0.006). The ORs for the APEX1 Asp148Glu were statistically significant (crude OR 2.69, 95%CI 1.45–4.99, p = 0.002; adjusted OR 2.33, 95%CI 1.21–4.48, p = 0.011). The ORs for the MUTYH Gln324His and the APEX1 Asp148Glu were statistically significant for colon cancer (adjusted OR 3.95, 95%CI 1.28–12.20, p = 0.017 for MUTYH Gln324His ; adjusted OR 3.04, 95%CI 1.38–6.71, p = 0.006 for APEX1 Asp148Glu). The joint effect of tobacco exposure and the MUTYH Gln324His showed a significant association with colorectal cancer risk in non-smokers (adjusted OR 4.08, 95%CI 1.22–13.58, p = 0.022) and the APEX1 Asp148Glu was significantly increased in smokers (adjusted OR 5.02, 95%CI 1.80–13.99, p = 0.002). However, the distributions of OGG1 Ser326Cys and XRCC1 Arg399Gln were not associated with a colorectal cancer risk.ConclusionOur findings suggest that the MUTYH Gln324His and the APEX1 Asp148Glu constitutes an increased risk of colorectal cancer, especially colon cancer. The MUTYH Gln324His is strongly associated with colorectal cancer susceptibility in never smoking history, whereas the APEX1 Asp148Glu genotype constitutes an increased risk of colorectal cancer when accompanied by smoking exposure.


Surgical Endoscopy and Other Interventional Techniques | 2015

Cranial-to-caudal approach for radical lymph node dissection along the surgical trunk in laparoscopic right hemicolectomy

Takeru Matsuda; Takeshi Iwasaki; Masaaki Mitsutsuji; Kenro Hirata; Yoko Maekawa; Tomoko Tanaka; Etsuji Shimada; Yoshihiro Kakeji

Complete mesocolic excision with central vascular ligation is considered to contribute to superior oncological outcomes after colon cancer surgery [1]. For advanced right-sided colon cancer, this surgery sometimes requires lymph node (LN) dissection along the superior mesenteric vein (SMV), with division of the middle colic vessels, or their right branches, at origin [2]. Here, we present cranially approached radical LN dissection along the surgical trunk during laparoscopic right hemicolectomy. The omental bursa is first opened wide, and the gastrocolic trunk of Henle is exposed, using the right gastroepiploic vessels and the accessory right colic vein (ARCV) as landmarks. After division of ARCV, SMV and middle colic vein (MCV) are identified. After dividing MCV at its root, LN dissection along SMV is conducted in a cranial-to-caudal manner. Concurrently, the middle colic artery, or its right branch, is exposed and divided at origin. The transverse colon is then raised ventrally, and LN dissection along SMV using a cranial-to-caudal approach is again performed. The ileocolic and right colic vessels are divided at origin. The ascending and transverse mesocolon, including the pedicles, are then separated from the retroperitoneal tissues, pancreatic head, and duodenum, using a medial approach. The key characteristics in this procedure consist of easy access to pancreas, early division of ARCV and middle colic vessels at origin, and easy dissection along SMV. We performed a laparoscopic colectomy using this approach for 18 patients with right-sided colon cancer. The mean operative time and blood loss were 288 min and 83 ml, respectively. The mean number of harvested LNs was 24. There were 6 cases with positive LN metastasis. There were no recurrent cases at a median follow-up period of 24 months. We consider this approach to be safe and useful for radical LN dissection along SMV for right-sided colon cancers.


Surgical Endoscopy and Other Interventional Techniques | 2015

Surgical outcomes of intracorporeal circular-stapled esophagojejunostomy using modified over-and-over suture technique in laparoscopic total gastrectomy

Takeru Matsuda; Takeshi Iwasaki; Masaaki Mitsutsuji; Kenro Hirata; Yoko Maekawa; Daisuke Tsugawa; Yutaka Sugita; Etsuji Shimada; Yoshihiro Kakeji

AbstractBackground Esophagojejunostomy in laparoscopic total gastrectomy (LTG) is a technically demanding procedure. Although several methods have been reported to date, none is considered consistently reliable. We developed a simple method for intracorporeal circular-stapled esophagojejunostomy using a modified over-and-over suture technique. The surgical outcomes of our technique were evaluated in comparison with those of open total gastrectomy (OTG).MethodsFrom April 2012 to August 2014, reconstruction using this method in LTG was performed for 21 consecutive patients with gastric cancer (LTG group). Their surgical outcomes were compared with those of 27 patients with gastric cancer who underwent OTG without splenectomy (OTG group) between January 2011 and April 2014.ResultsEstimated blood loss was significantly lower, and the postoperative hospital stay was significantly shorter in the LTG group than in the OTG group. The operating time and the number of harvested lymph nodes were similar between the two groups. The incidence of overall complications did not differ significantly between the two groups. Anastomotic leakage developed in one of the 21 patients in the LTG group and in two of the 27 patients in the OTG group. Anastomotic stenosis was observed in one patient in the LTG group.ConclusionsWe consider this method as simple and feasible for most laparoscopic surgeons with basic laparoscopic suturing skills. This method might help LTG to become an accepted standard surgical option for treatment of patients with gastric cancer.


Surgery Today | 2010

Fish bone penetration of the duodenum extending into the pancreas: Report of a case

Takashi Yasuda; Shiro Kawamura; Etsuji Shimada; Shuichi Okumura

We report a case of fish bone penetration of the duodenum extending into the pancreatic head, which was successfully treated by surgery. A 73-year-old woman was admitted with upper abdominal dull pain that had persisted for 3 days. Computed tomography showed a linear calcified body, which appeared to penetrate the posterior wall of the duodenal bulb into the pancreatic head. A laparotomy was performed based on the preoperative diagnosis of localized peritonitis caused by penetration of the duodenum into the pancreas by an ingested foreign body. The foreign body was safely removed from both the pancreas and duodenum and was found to be a fish bone, measuring 4 cm in length. Neither an abscess nor hematoma was detected at the site of the pancreatic head. The postoperative course was uneventful. This case demonstrates an unusual presentation of fish bone penetration of the duodenum with a migration to the pancreas.


Asian Pacific Journal of Cancer Prevention | 2012

Association between polymorphisms in UDP-glucuronosyltransferase 1A6 and 1A7 and colorectal cancer risk.

Kayo Osawa; Chiaki Nakarai; Minami Akiyama; Ryuta Hashimoto; Akimitsu Tsutou; Juro Takahashi; Yuko Takaoka; Shiro Kawamura; Etsuji Shimada; Kenichi Tanaka; Masaya Kozuka; Masahiro Yamamoto; Yoshiaki Kido

Genetic polymorphisms of uridine diphosphate-glucuronosyltransferases 1A6 (UGT1A6) and 1A7 (UGT1A7) may lead to genetic instability and colorectal cancer carcinogenesis. Our objective was to measure the interaction between polymorphisms of these repair genes and tobacco smoking in colorectal cancer (CRC). A total of 68 individuals with CRC and 112 non-cancer controls were divided into non-smoker and smoker groups according to pack-years of smoking. Genetic polymorphisms of UGT1A6 and UGT1A7 were examined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). We found a weak association of UGT1A6 polymorphisms with CRC risk (crude odds ratio [OR], 1.65; 95% confidence interval [95%CI], 0.9-3.1, P=0.107; adjusted OR 1.95, 95%CI 1.0-3.8, P=0.051). The ORs for the UGT1A7 polymorphisms were statistically significant (crude OR: 26.40, 95%CI: 3.5-198.4, P=0.001; adjusted OR: 21.52, 95%CI: 2.8-164.1, P=0.003). The joint effect of tobacco exposure and UGT1A6 polymorphisms was significantly associated with colorectal cancer risk in non-smokers (crude OR, 2.11; 95%CI, 0.9-5.0, P=0.092; adjusted OR 2.63, 95%CI 1.0-6.7, P=0.042). In conclusion, our findings suggest that UGT1A6 and UGT1A7 gene polymorphisms are associated with CRC risk in the Japanese population. In particular, UGT1A6 polymorphisms may strongly increase CRC risk through the formation of carcinogens not associated with smoking.


European Journal of Gastroenterology & Hepatology | 2012

Eosinophilic gastroenteritis associated with multiple gastric cancer.

Yasunori Otowa; Masaaki Mitsutsuji; Takeshi Urade; Teruhiro Chono; Haruki Morimoto; Kunio Yokoyama; Kenro Hirata; Shiro Kawamura; Etsuji Shimada; Masayuki Fujita

Eosinophilic gastroenteritis (EG) is an inflammation of the digestive tract that is characterized by eosinophilic infiltration. There are no specific symptoms, and are related to the layer in which eosinophilic infiltration is observed. A 69-year-old Japanese man presented to our hospital with a history of general malaise, diarrhea, and dysgeusia. Esophagogastroduodenoscopy showed reddish elevated lesions that were edematous all over the gastric mucosa. In addition, three tumors were also observed. The biopsies of the reddish elevated mucosa revealed eosinophilic infiltration and tubular adenocarcinoma from the tumors. Colonoscopy showed abnormal reddish elevated mucosa. The biopsies from the reddish elevated mucosa showed eosinophilic infiltration. From the abdominal contrast computed tomography scan, tumor stain was seen in the anterior wall of the gastric body. No ascites, intestinal wall thickening, or lymph node swelling were found. A slight elevation in the serum immunoglobulin E (IgE), 480 IU/ml, was found from the laboratory test results; other laboratory results were within normal limits including the number of peripheral eosinophils. No specific allergen was found from the multiple antigen simultaneous test and from the skin patch test. The parasitic immunodiagnosis was negative. He was diagnosed with EG associated with gastric cancer and underwent total gastrectomy, regional lymph node dissection with reconstruction by a Roux-en-Y method. He was prescribed prednisolone after the operation and showed a good clinical response. There are many case reports on EG, but none of them were associated with cancer. We encountered a case of EG associated with multiple gastric cancer; the patient underwent total gastrectomy.


The Journal of Thoracic and Cardiovascular Surgery | 2010

Acute torsion of the left lower lobe caused by chronic traumatic hernia of the diaphragm

Yugo Tanaka; Wataru Nishio; Daisuke Hokka; Shiro Kawamura; Etsuji Shimada; Shuuichi Okumura

best of our knowledge, there are only 3 other reports of an accessory chordae tendinae located in the left atrium, with one report describing a prolapsing chordae through the mitral aperture and a fibrous band tethering the anterior mitral leaflet to the edge of the fossa ovalis. We present an unusual case of an accessory left atrial chordae tendinae associated with a partial cleft of the anterior mitral leaflet.


Asian Pacific Journal of Cancer Prevention | 2007

Association of CYP1A1, CYP1A2, GSTM1 and NAT2 Gene Polymorphisms with Colorectal Cancer and Smoking

Kana Yoshida; Kayo Osawa; Mayumi Kasahara; Aiko Miyaishi; Keiko Nakanishi; Saori Hayamizu; Yasunori Osawa; Akimitsu Tsutou; Yoshiki Tabuchi; Etsuji Shimada; Kenichi Tanaka; Masahiro Yamamoto; Juro Takahashi


Langenbeck's Archives of Surgery | 2015

Cranially approached radical lymph node dissection around the middle colic vessels in laparoscopic colon cancer surgery

Takeru Matsuda; Takeshi Iwasaki; Masaaki Mitsutsuji; Kenro Hirata; Yoko Maekawa; Daisuke Tsugawa; Yutaka Sugita; Yasuo Sumi; Etsuji Shimada; Yoshihiro Kakeji


Jpn J Gastroenterol Surg, Nihon Shokaki Geka Gakkai zasshi | 1988

Surgical management of primary gastric lymphoma; A retrospective study of 10 cases.

Etsuji Shimada; Michio Kato; Masato Funasaka; Keizo Kikkawa; Takeshi Nakamura; Yoichi Saitoh

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