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World Journal of Gastroenterology 2006年第17期12卷 2793-2797页

作者： chouhei sakakura Akeo Hagiwara Koji Soga Koji Miyagawa Susumu Nakashima Tetsuji Yoshikawa Shuichi Kin Yuenn Nakase Nobuki Yamaoka Yoshihiko Sagara Hisakazu Yamagishi Department of Digestive Surgery Kyoto Prefectural University of Medicine Kawaramachi-doriKamigyokuKyoto 602-0841Japan

Constitutive activation of KIT receptor tyrosine kinase is a critical factor in the pathogenesis of gastrointestinal stromal tumors （GISTs）. But there is little information on whether combination of imatinib mesylate （IM） and surgical treatment can prolong survival in the cases with unresectable multiple liver metastases. We report a case of postoperative recurrence of GIST treated by the tyrosine kinase inhibitor IN and surgical treatment. The initial complete response （CR） to treatment continued for 18 mo, but single liver metastasis showed regrowth in the left hepatic lobe during IN treatment. After partial resection of the recurrent tumor, postoperative course was uneventful and the patient has survived without recurrence for 24 too. Currently, imatinib is the first- line therapy for non-resectable GISTs, but a single agent therapy often leads to tumor resistance. Even if tolerance to imatinib occurs, a combination of imatinib and surgical treatment can prolong survival in some cases as reported here. However, further studies on a large number of cases of recurrent GIST are necessary to evaluate the effectiveness of IN treatment combined with surgery.

关键词： GIST Imatinib mesylate Liver metastases

Laparoscopic transhiatal approach for resection of an adenocarcinoma in long-segment Barrett's esophagus

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World Journal of Gastroenterology 2015年第29期21卷 8974-8980页

作者： Atsushi Shiozaki Hitoshi Fujiwara Hirotaka Konishi Osamu Kinoshita Toshiyuki Kosuga Ryo Morimura Yasutoshi Murayama Shuhei Komatsu Yoshiaki Kuriu Hisashi Ikoma Masayoshi Nakanishi Daisuke Ichikawa Kazuma Okamoto chouhei sakakura Eigo Otsuji Division of Digestive Surgery Department of Surgery Kyoto Prefectural University of Medicine

Barrett's esophagus(BE) is a precursor of esophageal adenocarcinoma and is associated with gastroesophageal reflux disease, which is often preceded by a hiatal hernia. We describe a case of esophageal adenocarcinoma arising in long-segment BE(LSBE) associated with a hiatal hernia that was successfully treated with a laparoscopic transhiatal approach(LTHA) without thoracotomy. The patient was a 42-year-old male who had previously undergone laryngectomy and tracheal separation to avoid repeated aspiration pneumonitis. An ulcerative lesion was found in a hiatal hernia by endoscopy and superficial esophageal cancer was also detected in the lower thoracic esophagus. The histopathological diagnosis of biopsy samples from both lesions was adenocarcinoma. There were difficulties with the thoracic approach because the patient had severe kyphosis and muscular contractures from cerebral palsy. Therefore, we performed subtotal esophagectomy by LTHA without thoracotomy. Using hand-assisted laparoscopic surgery, the esophageal hiatus was divided and carbon dioxide was introduced into the mediastinum. A hernial sac was identified on the cranial side of the right crus of the diaphragm and carefully separated from the surrounding tissues. Abruption of the thoracic esophagus was performed up to the level of thearch of the azygos vein via LTHA. A cervical incision was made in the left side of the permanent tracheal stoma, the cervical esophagus was divided, and gastric tube reconstruction was performed via a posterior mediastinal route. The operative time was 175 min, and there was 61 m L of intra-operative bleeding. A histopathological examination revealed superficial adenocarcinoma in LSBE. Our surgical procedure provided a good surgical view and can be safely applied to patients with a hiatal hernia and kyphosis.

关键词： Laparoscopic transhiatal approach Barrett'sesophageal carcinoma Hiatal hernia

Optimal duration of the early and late recurrence of hepatocellular carcinoma after hepatectomy

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World Journal of Gastroenterology 2015年第4期21卷 1207-1215页

作者： Yusuke Yamamoto Hisashi Ikoma Ryo Morimura Hirotaka Konishi Yasutoshi Murayama Shuhei Komatsu Atsushi Shiozaki Yoshiaki Kuriu Takeshi Kubota Masayoshi Nakanishi Daisuke Ichikawa Hitoshi Fujiwara Kazuma Okamoto chouhei sakakura Toshiya Ochiai Eigo Otsuji Division of Digestive Surgery Department of SurgeryKyoto Prefectural University of MedicineKyoto 6028566Japan Department of Surgery North Medical CenterKyoto Prefectural University of MedicineKyoto 6028566Japan

AIM: To determine the best cut-off value between the early and late recurrence periods after the initial recurrence of hepatocellular carcinoma(HCC).METHODS: The clinical records of 404 patients who underwent macroscopic curative hepatectomy for HCC between 1980 and 2010 were retrospectively examined. We divided the 252 patients experienced a recurrence of HCC into two groups, the early and late recurrence groups using the "minimum P-value" approach. Factors for early recurrence were investigated using all 404 patients, and factors related to late recurrence were investigated in the patients who were confirmed to be recurrence free at the end of the early recurrence ***: For the 252 patients who experienced a recurrence, the optimal cut-off value for differentiating early and late recurrence based on the overall survival after initial recurrence was 17 mo(5-year overall survival after initial recurrence: 15.4% vs 36.3%, P = 0.000018). Cox proportional hazard analysis identified early recurrence(P = 0.003) as one of the independent prognostic factors associated with overall survival after initial recurrence. A logistic regression model showed that an alpha-fetoprotein level > 100 ng/m L(P < 0.001), multiple HCC(P < 0.001), serosal invasion(P = 0.031), and microvascular invasion(P = 0.012) were independent factors associated with early recurrence, whereas the only independent factor related to late recurrence was liver cirrhosis(P = 0.002).CONCLUSION: Seventeen months after hepatectomy is a useful cut-off value between early and late recurrence of HCC based on the prognosis and different etiologies.

关键词： Early recurrence Late recurrence Hepatocellular ca

Post-hepatectomy survival in advanced hepatocellular carcinoma with portal vein tumor thrombosis

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World Journal of Gastroenterology 2015年第1期21卷 246-253页

作者： Yusuke Yamamoto Hisashi Ikoma Ryo Morimura Katsutoshi Shoda Hirotaka Konishi Yasutoshi Murayama Shuhei Komatsu Atsushi Shiozaki Yoshiaki Kuriu Takeshi Kubota Masayoshi Nakanishi Daisuke Ichikawa Hitoshi Fujiwara Kazuma Okamoto chouhei sakakura Toshiya Ochiai Eigo Otsuji Division of Digestive Surgery Department of SurgeryKyoto Prefectural University of MedicineKyoto 6028566Japan Department of Surgery North Medical Center Kyoto Prefectural University of MedicineKyoto 6028566Japan

AIM: To analyze hepatocellular carcinoma(HCC) patients with portal vein tumor thrombosis(PVTT) using the tumor-node-metastasis(TNM) staging ***: We retrospectively analyzed 372 patients with HCC who underwent hepatectomy between 1980 and *** studied the outcomes of HCC patients with PVTT to evaluate the American Joint Committee on Cancer TNM staging system(7th edition) for stratifying and predicting the prognosis of a large cohort of HCC patients after hepatectomy in a *** vein invasion(vp) 1 was defined as an invasion or tumor thrombus distal to the second branch of the portal vein,vp2 as an invasion or tumor thrombus in the second branch of the portal vein,vp3 as an invasion or tumor thrombus in the first branch of the portal vein,and vp4 as an invasion or tumor thrombus in the portal trunk or extending to a branch on the contralateral ***: The cumulative 5-year overall survival(5yr OS) and 5-year disease-free survival(5yr DFS) rates of the 372 patients were 58.3% and 31.3%,*** 5yr DFS and 5yr OS of vp3-4 patients(n = 10) were 20.0%,and 30.0%,respectively,which was comparable with the corresponding survival rates of vp1-2 patients(P = 0.466 and 0.586,respectively).In the subgroup analysis of patients with macroscopic PVTT(vp2-4),the OS of the patients who underwent preoperative transarterial chemoembolization was comparable to that of patients who did not(P = 0.747).There was a significant difference in the DFS between patients with stage Ⅰ HCC and those with stage Ⅱ HCC(5yr DFS 39.2% vs 23.1%,P 100 mg/dL was independently associated with ***: Hepatectomy for vp3-4 HCC results in a survival rate similar to hepatectomy for *** stratified the stage Ⅱ-Ⅲ HCC patients according to prognosis.

关键词： Hepatocellular carcinoma Hepatectomy Portal vein t

Foreign body granulomas mimic peritoneal dissemination caused by incarcerated femoral hernia perforation:A case report

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World Journal of Clinical Oncology 2021年第11期12卷 1083-1088页

作者： Shinpei Ogino Tatsuya Matsumoto Yosuke Kamada Noriaki Koizumi Hiroshi Fujiki Kenji Nakamura Takeshi Yamano chouhei sakakura Department of Surgery Akashi City HospitalAkashi 673-8501HyogoJapan Department of Pathology Akashi City HospitalAkashi 673-8501HyogoJapan

BACKGROUND Foreign body granuloma(FBG)is a well-known type of granulomatous formation,and intraabdominal FBG(IFBG)is primarily caused by surgical *** IFBGs caused by gastrointestinal perforation is an extremely rare and interesting clinicopathological condition that resembles peritoneal ***,we present a case of IFBGs mimicking peritoneal dissemination caused by bowel perforation and describe the value of intraoperative pathological examinations for rapid IFBG *** SUMMARY An 86-year-old woman with an incarcerated femoral hernia was admitted to the hospital and underwent *** the operation,the incarcerated ileum was perforated during repair due to hemorrhage necrosis,and a small volume of enteric fluid leaked from the *** incarcerated ileum was resected,and the femoral hernia was repaired without *** months later,a second operation was performed for an umbilical incisional *** the second operation,multiple small,white nodules were observed throughout the abdominal cavity,resembling peritoneal *** results of peritoneal washing cytology in Douglas’pouch and the examination of frozen nodule sections were compatible with IFBG diagnosis,and incisional hernia repair was *** IFBGs can mimic *** pathological examinations and operation history are valuable for the rapid diagnosis to avoid excessive treatments.

关键词： Foreign body granuloma Peritoneal dissemination Peritoneal seeding Perforation Operation Case report

Ultralow-loss geometric phase and polarization shaping by ultrafast laser writing in silica glass

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Light(Science & Applications) 2020年第1期9卷 1860-1869页

作者： Masaaki sakakura Yuhao Lei Lei Wang Yan-Hao Yu Peter G.Kazansky Optoelectronics Research Centre University of SouthamptonSouthampton SO171BJUK

Polarization and geometric phase shaping via a space-variant anisotropy has attracted considerable interest for fabrication of flat optical elements and generation of vector beams with applications in various areas of science and *** the methods for anisotropy patterning,imprinting of self-assembled nanograting structures in silica glass by femtosecond laser writing is promising for the fabrication of space-variant birefringent optics with high thermal and chemical durability and high optical damage ***,a drawback is the optical loss due to the light scattering by nanograting structures,which has limited the ***,we report a new type of ultrafast laser-induced modification in silica glass,which consists of randomly distributed nanopores elongated in the direction perpendicular to the polarization,providing controllable birefringent structures with transmittance as high as 99% in the visible and near-infrared ranges and >90% in the UV range down to 330 *** observed anisotropic nanoporous silica structures are fundamentally different from the femtosecond laser-induced nanogratings and conventional nanoporous silica.A mechanism of nanocavitation via interstitial oxygen generation mediated by multiphoton and avanlanche defect ionization is *** demonstrate ultralow-loss geometrical phase optical elements,including geometrical phase prism and lens,and a vector beam convertor in silica glass.

关键词： polarization silica phase

Efficient ultrafast laser writing with elliptical polarization

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Light(Science & Applications) 2023年第4期12卷 605-612页

作者： Yuhao Lei Gholamreza Shayeganrad Huijun Wang Masaaki sakakura Yanhao Yu Lei Wang Dmitrii Kliukin Linards Skuja Yuri Svirko Peter G.Kazansky Optoelectronics Research Centre University of SouthamptonSouthampton SO171BJUK Institute of Solid State Physics University of Latvia8 Kengaraga StrasseRiga LV-1063Latvia Institute of Photonics Department of Physics and MathematicsUniversity of Eastern FinlandFI-80101 JoensuuFinland

Photosensitivity in nature is commonly associated with stronger light *** is also believed that artificial optical anisotropy to be the strongest when created by light with linear *** to intuition,ultrafast laser direct writing with elliptical polarization in silica glass,while nonlinear absorption is about 2.5 times weaker,results in form birefringence about twice that of linearly polarized ***,a larger concentration of anisotropic nanopores created by elliptically polarized light pulses is *** phenomenon is interpreted in terms of enhanced interaction of circularly polarized light with a network of randomly oriented bonds and hole polarons in silica glass,as well as efficient tunneling ionization produced by circular *** to multiplexed optical data storage and birefringence patterning in silica glass are demonstrated.

关键词： polarization laser polarized

Recurrent chromosomal rearrangements at bands 8q24 and 11q13 in gastric cancer as detected by multicolor spectral karyotyping

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World Journal of Gastroenterology 2005年第33期11卷 5129-5135页

作者： Yasuhide Yamashita Kazuhiro Nishida Takashi Okuda Kenichi Nomura Yosuke Matsumoto Shoji Mitsufuji Shigeo Horiike Hiroyuki Hata Chohei sakakura Akio Hagiwara Hisakazu Yamagishi Masafumi Taniwaki Department of Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Kyoto 602-8566 Japan Department of Hematology and Oncology Kyoto Prefectural University of Medicine Kyoto 602-8566 Japan Second Department of Internal Medicine Kumamoto University School of Medicine Kumamoto 860-8555 Japan Department of Digestive Surgery Kyoto Prefectural University of Medicine Kyoto 602-8566 Japan Department of Clinical Molecular Genetics and Laboratory Medicine Kyoto Prefectural University of Medicine Kyoto 602-8566 Japan

AIM: To identify chromosomal translocations specific to gastric cancer (GC), spectral karyotyping (SKY) analysis was performed on established cell lines and cancerous ascitic ***: SKY analysis of 10 established cell lines and seven cancerous ascitic fluid samples identified recurrent chromosomal breakpoints and translocations in GC,several of which involved chromosomal loci of oncogenes or tumor suppressor ***: A total of 630 chromosomal breaks were identified. Chromosome no.8 was the most frequently involved in rearrangements (65 breaks), followed by chromosomes no. 11 (53), no. 1 (49), no. 7 (46), no. 13 (37), no. 3 (36), no. 17 (33), and no. 20 (29). Frequent breakpoints were detected in 8q24.1 (30 breaks), 11q13 (29), 13q14 (16), 20q11.2 (14), 7q32 (13), 17q11.2 (13),18q21 (12), 17q23 (9), 18q11.2 (9). SKY analysis identified a total of 242 chromosomal rearrangements including 190 reciprocal and non-reciprocal translocations. The recurrent combinations of chromosomal bands involved in translocations were 8q24.1 and 13q14 (3 cases), 8q24.1 and 11q13 (3), 11q13 and 17q11.2 (2), and 18q11.2 and 20q11.2 (2). Our study validated the ability of SKY to characterize in detail the chromosomal rearrangements in solid tumors and derived cell lines. Moreover,fluorescence in situ hybridization helped to identify the insertions, translocations, and homogeneously staining regions of MYCand CCND1 gene ***: The non-random co-localization of certain cytogenetic bands suggests the importance of chromosomal translocations in gastric carcinogenesis, by serving as landmarks for the cloning of GC causing genes.

关键词： Gastric cancer SKY FISH Chromosomaltranslocation

Picosecond burst pulse machining with temporal energy modulation

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Chinese Optics Letters 2020年第12期18卷 87-91页

作者： Akinao Nakamura Tomoki Mizuta Yasuhiko Shimotsuma Masaaki sakakura Tomohito Otobe Masahiro Shimizu Kiyotaka Miura Department of Material Chemistry Graduate School of Engineering Kyoto University National Institutes for Quantum and Radiological Science and Technology Kansai Photon Science Institute

Suppression of stress and crack generation during picosecond laser processing in transparent brittle materials such as glass was successfully demonstrated by a picosecond laser pulse with temporal energy modulation. The origin of deterioration in processing accuracy could be interpreted in terms of the discontinuous movement of plasma in the vicinity of the focus. To reveal the effectiveness of the temporal energy modulation for smooth machining, such plasma motion was simulated by the finite-difference time-domain method. Furthermore, photoinduced birefringence was observed using a high-speed polarization camera.

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Picosecond burst pulse machining with temporal energy modulation [Invited]

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Chinese Optics Letters 2020年第12期18卷 83-87页

作者： Akinao Nakamura Tomoki Mizuta Yasuhiko Shimotsuma Masaaki sakakura Tomohito Otobe Masahiro Shimizu Kiyotaka Miura Department of Material Chemistry Graduate School of EngineeringKyoto UniversityKyoto 615-8510Japan National Institutes for Quantum and Radiological Science and Technology Kansai Photon Science InstituteKyoto 619-0215Japan

Suppression of stress and crack generation during picosecond laser processing in transparent brittle materials such as glass was successfully demonstrated by a picosecond laser pulse with temporal energy *** origin of deterioration in processing accuracy could be interpreted in terms of the discontinuous movement of plasma in the vicinity of the *** reveal the effectiveness of the temporal energy modulation for smootli machining,such plasma motion was simulated by the fiidtc-d ifference time-domain method.F urt her more,photoinduced birefringence was observed using a high-speed polarization camera.

关键词： picosecond laser energy modulation burst pulse material processing stress distribution