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Yoko Kubuki,Kotaro Shide,Takuro Kameda,Takumi Yamaji,Masaaki Sekine,Ayako Kamiunten,Keiichi Akizuki,Haruko Shimoda,Yuki Tahira,Kenichi Nakamura,Hiroo Abe,Tadashi Miike,Hisayoshi Iwakiri,Yoshihiro Taha 대한진단검사의학회 2017 Annals of Laboratory Medicine Vol.37 No.2
Dear Editor, Essential thrombocythemia (ET) is a myeloproliferative neoplasm (MPN) that primarily involves the megakaryocytic lineage, and is characterized by increased numbers of large, mature megakaryocytes in bone marrow as well as sustained thrombocytosis. Mutations in JAK2 or calreticulin (CALR) are present in about 50% and 25% of patients with ET, respectively, and these mutations are thought to drive MPN [1]. CALR and JAK2 mutations are mutually exclusive in MPNs [1]. Compared with patients with JAK2-mutated ET, patients with CALR-mutated ET have lower Hb levels and lower numbers of granulocytes, but higher numbers of platelets [2-6]. The CALR-mutated patients also have a lower incidence of thrombosis during their clinical course. Genetic background such as race may influence the risk of thrombosis, and recent study reported that Japanese ET patients with JAK2 mutation had a higher cumulative incidence of thrombosis than those with CALR mutations, although the differences were not significant [6]. Therefore, we analyzed the impact of JAK2 and CALR mutations on clinical features and thrombotic events in Japanese patients with ET.
Ida, Satoshi,Hiki, Naoki,Ishizawa, Takeaki,Kuriki, Yugo,Kamiya, Mako,Urano, Yasuteru,Nakamura, Takuro,Tsuda, Yasuo,Kano, Yosuke,Kumagai, Koshi,Nunobe, Souya,Ohashi, Manabu,Sano, Takeshi The Korean Gastric Cancer Association 2018 Journal of gastric cancer Vol.18 No.2
Purpose: Postoperative pancreatic fistula is a serious and fatal complication of gastrectomy for gastric cancer. Blunt trauma to the parenchyma of the pancreas can result from an assistant's forceps compressing and retracting the pancreas, which in turn may result in pancreatic juice leakage. However, no published studies have focused on blunt trauma to the pancreas during laparoscopic surgery. Our aim was to investigate the relationship between compression of the pancreas and pancreatic juice leakage in a swine model. Materials and Methods: Three female pigs were used in this study. The pancreas was gently compressed dorsally for 15 minutes laparoscopically with gauze grasped with forceps. Pancreatic juice leakage was visualized by fluorescence imaging after topical administration of chymotrypsin-activatable fluorophore in real time. Amylase concentrations in ascites collected at specified times was measured. In addition, pancreatic tissue was fixed with formalin, and the histology of the compressed sites was evaluated. Results: Fluorescence imaging enabled visualization of pancreatic juice leaking into ascites around the pancreas. Median concentrations of pancreatic amylase in ascites increased from 46 U/L preoperatively to 12,509 U/L 4 hours after compression. Histological examination of tissues obtained 4 hours after compression revealed necrotic pancreatic acinar cells extending from the surface to deep within the pancreas and infiltration of inflammatory cells. Conclusions: Pancreatic compression by the assistant's forceps can contribute to pancreatic juice leakage. These findings will help to improve the procedure for lymph node dissection around the pancreas during laparoscopic gastrectomy.
Satoshi Ida,Naoki Hiki,Takeaki Ishizawa,Yugo Kuriki,Mako Kamiya,Yasuteru Urano,Takuro Nakamura,Yasuo Tsuda,Yosuke Kano,Koshi Kumagai,Souya Nunobe,Manabu Ohashi,Takeshi Sano 대한위암학회 2018 Journal of gastric cancer Vol.18 No.2
Purpose: Postoperative pancreatic fistula is a serious and fatal complication of gastrectomy for gastric cancer. Blunt trauma to the parenchyma of the pancreas can result from an assistant's forceps compressing and retracting the pancreas, which in turn may result in pancreatic juice leakage. However, no published studies have focused on blunt trauma to the pancreas during laparoscopic surgery. Our aim was to investigate the relationship between compression of the pancreas and pancreatic juice leakage in a swine model. Materials and Methods: Three female pigs were used in this study. The pancreas was gently compressed dorsally for 15 minutes laparoscopically with gauze grasped with forceps. Pancreatic juice leakage was visualized by fluorescence imaging after topical administration of chymotrypsin-activatable fluorophore in real time. Amylase concentrations in ascites collected at specified times was measured. In addition, pancreatic tissue was fixed with formalin, and the histology of the compressed sites was evaluated. Results: Fluorescence imaging enabled visualization of pancreatic juice leaking into ascites around the pancreas. Median concentrations of pancreatic amylase in ascites increased from 46 U/L preoperatively to 12,509 U/L 4 hours after compression. Histological examination of tissues obtained 4 hours after compression revealed necrotic pancreatic acinar cells extending from the surface to deep within the pancreas and infiltration of inflammatory cells. Conclusions: Pancreatic compression by the assistant's forceps can contribute to pancreatic juice leakage. These findings will help to improve the procedure for lymph node dissection around the pancreas during laparoscopic gastrectomy.