Faculty Profiles - OHARA Toshiaki

Papers - OHARA Toshiaki

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Successfully treated pneumatosis cystoides intestinalis with pneumoperitoneum onset in a patient administered α-glucosidase inhibitor. Reviewed International journal

Shunsuke Tanabe, Yasuhiro Shirakawa, Yuko Takehara, Naoaki Maeda, Ryoichi Katsube, Toshiaki Ohara, Kazufumi Sakurama, Kazuhiro Noma, Toshiyoshi Fujiwara

Acta medica Okayama 67 ( 2 ) 123 - 8 2013

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

An 80-year-old woman, who had been administered α-glucosidase inhibitor for diabetes, was brought to the hospital with the sensation of abdominal fullness and pain. Abdominal computed tomography indicated pneumatosis cystoides intestinalis (PCI) in the small intestinal wall, with free air within the abdomen. A blood examination showed no increases in white blood cells or C-reactive protein level. The patient's condition improved with conservative therapy. PCI with pneumoperitoneum induced by α-glucosidase inhibitor is rare, with only 27 cases (excluding the present case) reported in Japan to date. In PCI with pneumoperitoneum, differentiation from gastrointestinal perforation is important and following the clinical symptoms over time is vital.

DOI： 10.18926/AMO/49672

頭頸部表在癌のESDにおける工夫

田辺俊介, 白川靖博, 前田直見, 大原利章, 櫻間教文, 野間和広, 藤原俊義

耳鼻咽喉科展望 55 ( 4 ) 262 - 263 2012.8

小細胞癌成分を含む食道癌肉腫の1切除例

田辺俊介, 白川靖博, 前田直見, 大原利章, 野間和広, 櫻間教文, 柳井広之, 山辻知樹, 猶本良夫, 藤原俊義

岡山医学会雑誌 124 ( 2 ) 145 - 148 2012.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：岡山医学会

73歳男。58歳時、早期胃癌にて幽門側胃切除・Billroth I法再建を施行した。食餌摂取時のつかえ感を自覚し、上部消化管内視鏡検査で胸部食道に隆起性病変を認めた。上部消化管内視鏡検査では、上切歯列より33cmに後壁主体の5cm大の1型病変を認めた。腫瘍は食道内腔をほぼ占拠していた。原発巣の生検で、小細胞癌成分を伴った食道癌肉腫と診断した。肺小細胞癌に準じて、CDDP+VP-16を施行し、原発巣は著明に縮小した。化学療法を繰り返す治療のみでは、副作用にて治療の継続が困難になると判断し、初回治療開始後から約2ヵ月後に手術を施行した。切除術、再建術と二期的に分割して手術を施行後、術後療養ののち、退院した。さらなる術後助化学療法として術前と同様の化学療法を1コース施行したが、肺炎を発症し、1コースのみにて補助療法終了し、その後外来通院中である。現在のところ術後3年が経過しているが無再発生存中である。

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Oral administration of FAK inhibitor TAE226 inhibits the progression of peritoneal dissemination of colorectal cancer. Reviewed International journal

Hui-fang Hao, Munenori Takaoka, Xiao-hong Bao, Zhi-gang Wang, Yasuko Tomono, Kazufumi Sakurama, Toshiaki Ohara, Takuya Fukazawa, Tomoki Yamatsuji, Toshiyoshi Fujiwara, Yoshio Naomoto

Biochemical and biophysical research communications 423 ( 4 ) 744 - 9 2012.7

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Peritoneal dissemination is one of the most terrible types of colorectal cancer progression. Focal adhesion kinase (FAK) plays a crucial role in the biological processes of cancer, such as cell attachment, migration, proliferation and survival, all of which are essential for the progression of peritoneal dissemination. Since we and other groups have reported that the inhibition of FAK activity exhibited a potent anticancer effect in several cancer models, we hypothesized that TAE226, a novel ATP-competitive tyrosine kinase inhibitor designed to target FAK, can prevent the occurrence and progression of peritoneal dissemination. In vitro, TAE226 greatly inhibited the proliferation and migration of HCT116 colon cancer cells, while their adhesion on the matrix surface was minimally inhibited when FAK activity and expression was suppressed by TAE226 and siRNA. In vivo, when HCT116 cells were intraperitoneally inoculated in mice, the cells could attach to the peritoneum and begin to grow within 24 h regardless of the pretreatment of cells with TAE226 or FAK-siRNA, suggesting that FAK is not essential, at least for the initial integrin-matrix contact. Interestingly, the treatment of mice before and after inoculation significantly suppressed cell attachment to the peritoneum. Furthermore, oral administration of TAE226 greatly reduced the size of disseminated tumors and prolonged survival in tumor-bearing mice. Taken together, a possible strategy for inhibiting peritoneal dissemination by targeting FAK with TAE226 appears to be applicable through anti-proliferative and anti-invasion/anti-migration mechanisms.

DOI： 10.1016/j.bbrc.2012.06.030

A Case of Adenosquamous Carcinoma of Lower Extrahepatic Bile Duct Reviewed

青木秀樹, 金澤卓, 藤原裕子, 森廣俊昭, 竹原清人, 清田正之, 大原利章, 荒田尚, 中川仁志, 田中屋宏爾, 竹内仁司

癌と化学療法 39 ( 1 ) 131 - 133 2012.1

Language：Japanese Publishing type：Research paper (scientific journal)

We report a 83-year-old female with bile duct cancer who underwent subtotal stomach preserving pancreatoduodenectomy. Pathologically, her tumor was diagnosed as adenosquamous carcinoma of the lower extrahepatic bile duct with final stage IVb[pT3pN3M(-)].The prognosis of patients with adenosquamous carcinoma of the bile duct is very poor, and the reason is thought to be its tendency to invade the pancreas.Although she was an aged patient, we performed adjuvant chemotherapy using gemcitabine.No recurrence has occurred until this day, 30 months after the operation.This is thought to be an effect of the adjuvant chemotherapy, considering its poor prognosis.

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当科における後期高齢者食道癌手術症例に対する術式選択の検討

白川靖博, 前田直見, 大原利章, 田辺俊介, 野間和広, 櫻間教文, 藤原俊義

日本消化器外科学会雑誌 44 ( Suppl.2 ) 267 - 267 2011.10

冠動脈バイパス術後横隔膜ヘルニアの1例 Reviewed

大原利章, 竹原清人, 中西将元, 田中屋宏爾, 青木秀樹, 竹内仁司

日本臨床外科学会雑誌 72 ( 9 ) 2257 - 2260 2011.9

Authorship：Lead author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本臨床外科学会

症例は81歳,男性.2日前から続く発熱,心窩部痛を主訴に近医より紹介受診となった.既往歴として8ヵ月前にオフポンプ冠動脈バイパス手術(3枝)を受けていた.胸部レントゲン検査では心陰影に重なり,ニボー像が認められた.CT検査では胸骨右背側の横隔膜を穿破して心嚢内に腸管の脱出が認められた.横隔膜ヘルニアと考えられ,手術目的に入院となった.開腹すると肝前面に横行結腸を認め,大網と合わせて横隔膜内への陥入が認められた.横行結腸を用手的に引き戻し,大網は心嚢内で心臓と癒着していたため切離し,半吸収性メッシュにてヘルニア門を修復した.半吸収性メッシュは臓器癒着を予防し,収縮率が低いとされ,腹壁瘢痕ヘルニアでは有用性が報告されている.横隔膜ヘルニアの修復に半吸収性メッシュを用いた本邦報告例はない.冠動脈バイパス手術後の横隔膜ヘルニアは,胃大網動脈をグラフト血管として用いた場合は報告されているが,その他のグラフト血管での報告は極めて稀である.冠動脈バイパス手術後には,グラフトの種類に関わらず横隔膜ヘルニアが起こる可能性を念頭に置くことが肝要と考えられた.(著者抄録)

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Inhibition of mTOR by temsirolimus contributes to prolonged survival of mice with pleural dissemination of non-small-cell lung cancer cells. Reviewed International journal

Toshiaki Ohara, Munenori Takaoka, Shinichi Toyooka, Yasuko Tomono, Toshio Nishikawa, Yasuhiro Shirakawa, Tomoki Yamatsuji, Noriaki Tanaka, Toshiyoshi Fujiwara, Yoshio Naomoto

Cancer science 102 ( 7 ) 1344 - 9 2011.7

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL

Temsirolimus (CCI-779), a recently synthesized analogue of rapamycin, specifically inhibits mTOR and has been approved for clinical use in renal cell carcinoma. Recent reports have indicated the growth inhibitory effect of temsirolimus in some cancers including non-small-cell lung carcinoma (NSCLC). In this study, we aimed to explore the potential therapeutic use of temsirolimus as a treatment for NSCLC. Using cultured NSCLC cells (A549, H1299, and H358), we determined the effect of temsirolimus on cell proliferation and its antitumor effects on subcutaneous tumors, as well as its contribution to the survival of mice having pleural dissemination of cancer cells, mimicking advanced NSCLC. Temsirolimus suppressed proliferation of NSCLC cells in a dose-dependent manner, with an IC(50) of <1 nM. Western blot analysis revealed that temsirolimus treatment specifically inhibited the phosphorylation of mTOR and its downstream effectors in 1 h, accompanied by an increased cell population in the G(0) /G(1) phase, but according to flow cytometry, the cell population did not increase in the sub-G(0) phase. When NSCLC subcutaneous tumor-bearing mice were treated with temsirolimus, tumor volume was significantly reduced (tumor volume on day 35: vehicle vs temsirolimus = 1239 vs 698 cm(3) ; P < 0.05). Furthermore, prolonged survival was observed in pleural disseminated tumor-bearing mice with temsirolimus treatment (median survival: vehicle vs temsirolimus = 53.5 vs 72.5 days; P < 0.05). These results suggest that temsirolimus could be useful for NSCLC treatment, due to its antiproliferative effect, and could be a potential treatment for advanced NSCLC, giving prolonged survival.

DOI： 10.1111/j.1349-7006.2011.01967.x

魚骨肝穿破による胃壁,肝,横隔膜下膿瘍の1例 Reviewed

大原利章, 青木秀樹, 中西将元, 清田正之, 田中屋宏爾, 竹内仁司

日本臨床外科学会雑誌 72 ( 6 ) 1611 - 1615 2011.6

Authorship：Lead author Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本臨床外科学会

症例は81歳,男性.食欲不振,39.3度の発熱を認めたため当院救急外来を受診した.CT検査にて胃壁,肝,横隔膜下に膿瘍と考えられる低吸収域と内部を貫通して魚骨と考えられる線状の石灰化陰影が認められた.上部消化管内視鏡検査では,胃角部小彎側に粘膜下病変を認め,魚骨の刺入部と考えられたため,生検用鉗子にて粘膜を開窓したところ,内部より膿汁の流出が認められた.入院後第3病日に再度,上部消化管内視鏡検査を施行し,魚骨の摘出を試みたが見当たらず,内視鏡的な摘出を断念し,第5病日手術を施行した.横隔膜下の膿瘍を開窓すると,内部に肝臓を穿破した魚骨を認めた.魚骨を摘出し,肝内異物除去術および腹腔内洗浄ドレナージ術を施行した.摘出された魚骨は長さが5.2cmであり,鯖の骨と考えられた.魚骨が肝臓を穿破して横隔膜下に膿瘍を作った報告はわれわれが検索した範囲では,文献的に英文も含め自験例のみであった.(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J03156&link_issn=&doc_id=20110706200055&doc_link_id=10.3919%2Fjjsa.72.1611&url=https%3A%2F%2Fdoi.org%2F10.3919%2Fjjsa.72.1611&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

The establishment of a new mouse model with orthotopic esophageal cancer showing the esophageal stricture. Reviewed International journal

Toshiaki Ohara, Munenori Takaoka, Kazufumi Sakurama, Kaori Nagaishi, Haruo Takeda, Yasuhiro Shirakawa, Tomoki Yamatsuji, Takeshi Nagasaka, Junji Matsuoka, Noriaki Tanaka, Yoshio Naomoto

Cancer letters 293 ( 2 ) 207 - 12 2010.7

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER IRELAND LTD

We established a promising new experimental animal model with an orthotopic xenograft of esophageal cancer that successfully represents poor oral intake, a major clinical feature of esophageal cancer. The advantage of this model is that no surgical technique is required, only the injection of a cell suspension by a needle and syringe via the esophageal lumen from the mouth, which provides a high reproducibility of tumor implantation and a rapid progress of outcome. We propose that this model is useful to study cancer-related outcomes and for developing new therapies for esophageal cancer, and we expect it to make a contribution to clinical practice.

DOI： 10.1016/j.canlet.2010.01.017

手術回数を反映したバスキュラーアクセス開存の指標平均無手術期間について Reviewed

宮崎雅史, 岡良成, 高津成子, 宇野太, 大原利章, 近藤喜太, 丸山昌伸, 松田浩明

腎と透析 69 ( 別冊アクセス2010 ) 158 - 160 2010.7

Language：Japanese Publisher：(株)東京医学社

20年間に透析治療を行った609例を対象に、バスキュラーアクセス開存の指標として無手術期間を検討した。無手術期間は、観察期間内の全アクセス関連手術施行回数に1を加えた数字で観察期間を除した値とした。609例中477例は何らかのアクセス関連手術を行っており、手術総数は905件であった。内訳は内シャント造設術540件、人工血管移植術154件、シャント修復術211件(自家血管51件・人工血管160件)、PTA 14件で、手術回数10回以上は8例であった。現在透析中の患者199例のうち、観察期間5年以上の102例は平均観察期間13.42年、手術回数2.70回、無手術期間7.95年、観察期間5年未満の97例はそれぞれ2.62年、1.14回、2.04年であった。また、観察期間20年の32例では平均手術回数2.91回、無手術期間9.05年で、5年以上観察を行った275例の最終5年間での平均手術回数は0.81回、無手術期間3.80年であった。5年累積二次開存率は自家血管56.9%、人工血管45.6%であった。

RAD001 offers a therapeutic intervention through inhibition of mTOR as a potential strategy for esophageal cancer. Reviewed International journal

Zhi Gang Wang, Takuya Fukazawa, Toshio Nishikawa, Nobuyuki Watanabe, Kazufumi Sakurama, Takayuki Motoki, Shinji Hatakeyama, Osamu Omori, Toshiaki Ohara, Shunsuke Tanabe, Yasuhiro Fujiwara, Munenori Takaoka, Yasuhiro Shirakawa, Tomoki Yamatsuji, Noriaki Tanaka, Yoshio Naomoto

Oncology reports 23 ( 4 ) 1167 - 72 2010.4

Language：English Publishing type：Research paper (scientific journal) Publisher：SPANDIDOS PUBL LTD

Esophageal cancer is one of the most frequently occurring cancers in the world. Targeting therapy strategy of cancer with specific inhibitors is developing and has showed promising antitumor efficacy. It is known that mTOR is an important controller of cell growth. RAD001 (everolimus) is a specific inhibitor of mTOR that can block the mTOR signaling pathway. The purposes of this study was to explore the inhibitory effects of RAD001 on mTOR signaling and the mechanism of cell growth suppression by RAD001. We examined both the expression of mTOR, p70S6K and S6 in SEG-1 esophageal cancer cells and KOB-13 normal esophageal epithelial cells and the efficacy of RAD001 against SEG-1 esophageal cancer cells. mTOR, p70S6K and S6 were overexpressed in SEG-1 esophageal cancer cells compared with KOB-13 normal esophageal epithelial cells. SEG-1 esophageal cancer cells were sensitive to RAD001. The survival rate of the cells treated with RAD001 over 0.33 microM was significantly different compared with that of control (P<0.01). RAD001 inhibited the phosphorylation of mTOR (Ser2448) and S6 (Ser240/244) in different grades and the expressions of mTOR, p70S6K and S6. As a result, RAD001 induced a dose-dependent decrease in cell proliferation, G1/S arrest and damage of cell shape. Taken together, these data showed that RAD001 can inhibit mTOR signaling and proliferation in SEG-1 esophageal cancer cells in vitro. It offers a therapeutic intervention through inhibition of mTOR as a potential strategy for esophageal cancer.

DOI： 10.3892/or_00000747

Dual tyrosine kinase inhibitor for focal adhesion kinase and insulin-like growth factor-I receptor (TAE226) leads to apoptosis in esophageal cancer by inhibiting AKT-mTOR survival signaling Reviewed

Huifang Hao, Zhigang Wang, Xiaohong Bao, Nobuyuki Watanabe, Kazufumi Sakurama, Yasuko Tomono, Takuya Fukazawa, Shinji Hatakeyama, Osamu Omori, Seishi Nishitani, Toshiaki Ohara, Munenori Takaoka, Yasuhiro Shirakawa, Tomoki Yamatsuji, Junji Matsuoka, Masakiyo Sakaguchi, Noriaki Tanaka, Yoshio Naomoto

CANCER RESEARCH 69 2009.5

活動性SLEを伴う進行食道癌の一例根治切除後4年間無再発生存例の検討 Invited

元木崇之, 猶本良夫, 藤原康宏, 白川靖博, 山辻知樹, 高岡宗徳, 田邊俊介, 大原利章, 松岡順治, 田中紀章

外科治療 100 ( 3 ) 315 - 318 2009.3

Language：Japanese Publishing type：Part of collection (book) Publisher：(株)永井書店

42歳女。下腿の浮腫、全身倦怠感、嚥下困難、38℃をこえる発熱で近医を受診し、Systemic lupus Erythematosus(SLE)と診断された。上部消化管内視鏡で下部食道から胃噴門部に2型病変を認め、生検より食道扁平上皮癌と診断され当院入院となった。貧血、血小板数低下と低アルブミン血症を認め、上部消化管内視鏡で右壁中心に胃噴門部へ浸潤する高い隆起性病変を認め、腹部造影CTで#7リンパ節の腫大、胸腹水、脾腫を認めた。以上よりEsophageal cancer、AeG Type2、T3N2M0 StageIIIと術前診断した。SLEは強い活動性を示したためSLEの治療を先行し、ステロイドパルス療法とPSL維持療法により術前準備を行った。縫合不全の合併症のリスクを考慮して分割手術として開腹・頸部・経横隔膜操作による食道・胃噴門部切除、胃管皮下経路再建(未吻合)・胆嚢摘出術を行い、術後10ヵ月目に食道・胃管吻合を施行した。初回術後の大量の胸水に対して、胸腔腹腔間にデンバーシャントを留置して胸水の減量と胸水に含まれ漏出した蛋白の腹腔内での再吸収により血中の蛋白濃度が改善できた。I期目手術後4年経過した現在、再発もなく社会復帰した。

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Establishment of a lymph node metastasis model from subcutaneous tumors of gastrointestinal stromal tumor model cells. Reviewed International journal

Kazufumi Sakurama, Yoshio Naomoto, Toshiaki Ohara, Nobuyuki Watanabe, Munenori Takaoka, Hitoshi Nagatsuka, Yasuko Tomono, Toru Tanida, Kazuhiro Noma, Shunsuke Tanabe, Yasuhiro Fujiwara, Takayuki Motoki, Yasuhiro Shirakawa, Tomoki Yamatsuji, Seiichi Hirota, Takahiro Taguchi, Noriaki Tanaka

Oncology reports 21 ( 2 ) 407 - 11 2009.2

Language：English Publishing type：Research paper (scientific journal)

There is currently no suitable animal model of metastasis using cultured human gastrointestinal stromal tumor cells even though the molecular mechanisms of c-KIT-mediated progression and metastasis should be clarified. Ba/F3 murine lymphocyte cells transduced with mutant c-KIT have been utilized to analyze some molecular mechanisms related to a constitutively activated c-KIT signaling and to assess the efficacy of molecular-targeted inhibitors. Using this cellular system, we coincidentally discovered the development of axillary and inguinal lymph node swelling three weeks after subcutaneous injection of Ba/F3 cells with c-KIT mutation into nude mice. Mutation-specific PCR detected c-KIT mutation in the swollen lymph nodes but not in unmetastasized normal lymph nodes, indicating that the lymph nodes contain tumor cells which should come from a primary subcutaneous tumor. Microscopic observation revealed tumor cells infiltrating through lymphatic follicles with Ki-67-positive staining to distinguish them from lymphocytes. The significance of this model is helpful to understand the molecular mechanisms of c-KIT-mediated metastasis and is useful for assessments of molecular therapeutics and in vivo imaging.

TAE226, a dual inhibitor for FAK and IGF-IR, has inhibitory effects on mTOR signaling in esophageal cancer cells. Reviewed International journal

Zhi Gang Wang, Takuya Fukazawa, Toshio Nishikawa, Nobuyuki Watanabe, Kazufumi Sakurama, Takayuki Motoki, Munenori Takaoka, Shinji Hatakeyama, Osamu Omori, Toshiaki Ohara, Shunsuke Tanabe, Yasuhiro Fujiwara, Yasuhiro Shirakawa, Tomoki Yamatsuji, Noriaki Tanaka, Yoshio Naomoto

Oncology reports 20 ( 6 ) 1473 - 7 2008.12

Language：English Publishing type：Research paper (scientific journal)

Esophageal cancer is one of the most aggressive cancers in the world. Novel preventive and therapeutic strategies tend to target the key molecules involved in the signaling transduction pathways for cell growth. It is known that FAK and mTOR are important controllers of cell growth. TAE226, a novel small molecule compound, is a potent ATP competitive inhibitor of FAK and IGF-IR. TAE226 can block FAK and IGF-IR signaling pathways. The purpose of this study was to explore the inhibitory effects on mTOR signaling and the mechanism of cell growth suppression by TAE226. We examined the expression of mTOR and S6 in esophageal cancer cells (SEG-1) and normal esophageal epithelial cells (KOB-13) and the efficacy of TAE226 against SEG-1 cells. mTOR and S6 were overexpressed in SEG-1 cells compared with KOB-13 cells. TAE226 inhibited the expression of mTOR, Akt, p70S6K and S6 as well as the phosphorylation of mTOR (Ser2448), Akt (Ser473), p70S6K (Thr389) and S6 (Ser240/244). As a result, TAE226 induced a dose-dependent decrease in cell growth (number) and damage in the cell shape. Together, these data show that TAE226 has potent inhibitory effects on mTOR signaling and esophageal cancer cell growth indicating that TAE226 has potential application in esophageal cancer treatment.

Sirolimus ameliorated post lung transplant chylothorax in lymphangioleiomyomatosis. Reviewed International journal

Toshiaki Ohara, Takahiro Oto, Kentaro Miyoshi, Hiroyuki Tao, Masaomi Yamane, Shinichi Toyooka, Megumi Okazaki, Hiroshi Date, Yoshifumi Sano

The Annals of thoracic surgery 86 ( 6 ) e7-8 - 8 2008.12

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

We report a successful case of sirolimus treatment for chylous pleural and peritoneal effusions of lymphangioleiomyomatosis after lung transplantation. A 32-year-old woman underwent living donor lung transplantation. Persistent chylous pleural and peritoneal effusions were seen postoperatively. Pleurodesis by intrathoracic injection of OK-432, minomycin, and somatostatine analog failed to control chylous effusions. However, sirolimus treatment reduced the amount of chylous drainage and improved both chylous pleural and peritoneal effusions.

DOI： 10.1016/j.athoracsur.2008.07.062

骨シンチグラフィーで腫瘍に骨外集積を認めた肺原発多形癌の1例 Reviewed

大原利章, 木村幸男

肺癌 47 ( 4 ) 333 - 336 2007.8

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(NPO)日本肺癌学会

背景。肺原発多形癌は稀な腫瘍であり、術前診断は困難なことが多い。症例。67歳女性。左下胸部痛あり近医受診し、翌日精査加療目的にて当院へ紹介となった。胸部CTにて左下葉に径5.5cm大の腫瘤を認め、左下葉肺癌cT2N0M0の疑いにて手術を施行した。術中針生検による迅速病理診断では腺癌の診断であり、左下葉切除とリンパ節郭清を施行した。術後病理診断にて多形癌と診断された。なお、本症例では術前骨シンチグラフィーにて、腫瘍に一致して骨外集積が認められた。結論。骨シンチグラフィーにて腫瘍に一致した骨外集積を伴う肺多形癌の1例を経験した。肺多形癌と骨シンチグラフィー骨外集積との関係を解明していくことが必要と考えられた。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2007&ichushi_jid=J01244&link_issn=&doc_id=20070913160005&doc_link_id=%2Fec7jaluc%2F2007%2F004704%2F005%2F0333-0336%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fec7jaluc%2F2007%2F004704%2F005%2F0333-0336%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Pleomorphic carcinoma with extra-skeletal uptake on bone scintigraphy

Ohara, T., Kimura, Y.

Japanese Journal of Lung Cancer 47 ( 4 ) 2007

A Case of Perforated Refractory Ulcer in the Gastric Tube after Esophageal Cancer Reviewed

39 ( 3 ) 289 - 293 2006.3

Language：Japanese Publishing type：Research paper (scientific journal)

A 66-year-old man who had undergone esophagectomy for intrathoracic esophageal cancer developed a peptic epithelial ulcer and edema on the anterior aspect of the reconstructed gastric tube while undergoing regular follow-up examinations. On admission, he received ulcer therapy, but the ulcer didn’t heal and the gastric
tube was partialy resectioned under local anesthesia. The ulcer recurred twice, and we conducted a thorough
investigation. A detailed history revealed that he had been treated of the shoulder with NSAIDS and longterm steroid therapy, and they were thought to be factors contributing to formation of the ulcers. A secretin
test was performed to rule out the Zollinger-Ellison syndrome, but it was negative because the patients’
plasma gastrin level was continuously high（1,210～1,620pgml ）and there was no paradoxical response. The
plasma gastrin level was much higher than in other cases reported in Japan, and we attempted to find the
cause. Parietal cell antibody（PCA）was negative. The patient was positive for urophanic and serum antibodies to Helicobacter pylori, but the gastric tube resection specimens were negative, and the cause remained unclear. Because of the generally long-term survival after esophageal cancer surgery, patient education is necessary to prevent the development of gastric tube ulcers.

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2006&ichushi_jid=J01117&link_issn=&doc_id=20060314040003&doc_link_id=10.5833%2Fjjgs.39.289&url=https%3A%2F%2Fdoi.org%2F10.5833%2Fjjgs.39.289&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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