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Clinicopathological characteristics of clinical early gastric cancer in the upper-third stomach

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World Journal of Gastroenterology 2015年第45期21卷 12851-12856页

作者： Daisuke Ichikawa Shuhei Komatsu Toshiyuki Kosuga hirotaka Konishi Kazuma Okamoto Atsushi Shiozaki Hitoshi Fujiwara Eigo Otsuji Division of Digestive Surgery Department of Surgery Kyoto Prefectural University of Medicine

AIM: To elucidate the clinicopathological characteristics of clinically early gastric cancer in the upper-third stomach and to clarify treatment ***: A total of 683 patients with clinical early gastric cancer were enrolled in this retrospective study, 128 of whom had gastric cancer in the upper-third stomach(U group). All patients underwent a double contrast barium examination, endoscopy, and computed tomography(CT), and were diagnosed preoperatively based on the findings obtained. The clinicopathological features of these patients were compared with those of patients with gastric cancer in the middle- and lower-third stomach(ML group). We also compared clinicopathological factors between accurate-diagnosis and under-diagnosis groups in order to identify factors affecting the accuracy of a preoperative diagnosis of tumor ***: Patients in the U group were older(P = 0.029), had a higher ratio of males to females(P = 0.015), and had more histologically differentiated tumors(P = 0.007) than patients in the ML group. A clinical under-diagnosis occurred in 57 out of 683 patients(8.3%), and was more frequent in the U group than in the ML group(16.4% vs 6.3%, P < 0.0001). Therefore, the rates of lymph node metastasis and lymphatic invasion were slightly higher in the U group than in the ML group(P = 0.071 and 0.082, respectively). An under-diagnosis was more frequent in histologically undifferentiated tumors(P = 0.094) and in those larger than 4 cm(P = 0.024). The medianfollow-up period after surgery was 56 mo(range, 1-186 mo). Overall, survival and disease-specific survival rates were significantly lower in the U group than in the ML group(P = 0.016 and 0.020, respectively). However, limited operation-related cancer recurrence was not detected in the U group in the present ***: Clinical early gastric cancer in the upper-third stomach has distinguishable characteristics that increase the risk of a clinical under-diagnosis, especially i

关键词： Upper-third stomach Diagnosis Gastric cancer

A case of mucin producing liver metastases with intrabiliary extension

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World Journal of Gastroenterology 2006年第30期12卷 4918-4921页

作者： hirotaka Tokai Yujo Kawashita Susumu Eguchi Yukio Kamohara Mitsuhisa Takatsuki Sadayuki Okudaira Yoshitsugu Tajima Tomayoshi Hayashi Takashi Kanematsu Department of Transplantation and Digestive Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan Department of Pathology Nagasaki University Hospital. Nagasaki Japan

A 75-year-old man was admitted to our hospital with a diagnosis of liver metastases from colon cancer. He underwent right hemicolectomy for cecal cancer eight years ago, and had a metastatic liver tumor in segment 8 （S8）, which was surgically resected about 4 years after the initial operation. Histopathological examination of the resected specimens from both operations revealed a well-differentiated adenocarcinoma with mucinous carcinoma. Four months after the second operation, computed tomography demonstrated a low-density lesion at the cut surface of the remnant liver. Although it was considered to be a postoperative collection of inflammatory fluid, it formed a cystic configuration and increased in size to approximately 5 cm in diameter. With a tentative diagnosis of a recurrence of metastatic cancer, partial hepatectomy of S8 was performed. Histological examination of the resected specimens also revealed mucinous adenocarci- noma, which had invaded into the biliary ducts, replacing and extending along its epithelium. Immunohistochemi-cally, the tumor cells were positive for cytokeratin （CK） 20, but negative for CK7. Therefore, the tumor was diagnosed as a metastatic adenocarcinoma from colonic cancer. Liver metastases of colorectal adenocarcinoma sometimes invade the Glisson＇s triad and grow along the biliary ducts.

关键词： Liver metastases Mucin Intrabiliary extension Cytokeratin 7, Cytokeratin 20

Development of Evaluation Method of Daylighting Duct System Considering Inner Light Flux

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Computer Aided Drafting,Design and Manufacturing 2015年第4期25卷 1-7页

作者： TOMINAGA Akihiro SUZUKI hirotaka Graduate School of Engineering Kobe University

Currently, daylighting ducts system is widely used as a daylighting device. Generally, daylighting duct system efficiently takes light from outside during the day, and conveys daylight to required location through light duct manufactured by high reflectance mirror. Daylighting duct system can convey daylight to underground space that has no windows opening to external space. Daylighting system is composed of light collection part, light guide part and light emission part. Efficiency of daylighting system is depending on type of each part used in the system. However, it is very difficult to estimate exact light flow in the system considering type of the parts. Authors performed measurement experiments to make clear the light flow with real-size model and miniature model of daylighting duct system. We discussed effect of type of the parts on efficiency of daylighting duct system.

关键词： daylighting daylighting duct system daylighting efficiency light collection part light guide part light emission part measurement experiment

Clinical characteristics of hepatoduodenal lymph node metastasis in gastric cancer

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World Journal of Gastroenterology 2015年第38期21卷 10866-10873页

作者： Taisuke Imamura Shuhei Komatsu Daisuke Ichikawa Toshiyuki Kosuga Kazuma Okamoto hirotaka Konishi Atsushi Shiozaki Hitoshi Fujiwara Eigo Otsuji Division of Digestive Surgery Department of SurgeryKyoto Prefectural University of Medicine

AIM: To assess the clinical features of hepatoduodenal lymph node(HDLN) metastasis and to clarify the optimal indication of HDLN ***: We investigated a total of 276 patients who underwent gastrectomy with extended lymphadenectomy,including HDLN dissection,for gastric cancer between 1999 and 2012. Of these,26 patients(9.4%) had HDLN metastasis. First,we investigated the clinicopathological characteristics,their perioperative clinical outcomes,such as postoperative complications,and prognostic outcomes between patients with and without HDLN metastasis. Second,we detected the prognostic factors,particularly in patients with HDLN metastasis. Third,we assessed the therapeutic value of HDLN dissection to determine its optimal ***: The five-year overall survival rate of the patients with HDLN metastasis was 29%. Univariate and multivariate logistic regression analyses revealed that the tumour location(the middle or lower stomach [P = 0.005,OR = 5.88(95%CI: 1.61-38.1)] and p T category [T3 or T4,P = 0.017,OR = 4.45(95%CI: 1.28-21.3)] were independent risk factors for HDLNmetastasis. Cox proportional hazard analysis identified p N3 as an independent poor prognostic factor in the patients with HDLN metastasis [P = 0.021,HR = 5.17(95%CI: 1.8-292)]. For patients who underwent radical HDLN dissection,HDLN metastasis was a prognostic indicator in p N3 gastric cancer(P < 0.0001),but not p N1-2(P = 0.602). Furthermore,the index of therapeutic value of HDLN dissection for gastric cancer in the middle or lower stomach and the upper stomach was 3.4 and 0.0,***: We suggest that HDLN dissection should be indicated for p N1 or p N2 gastric cancers located at the middle or lower stomach.

关键词： Gastric cancer Hepatoduodenal lymph node D2 lympha

Risk factors to predict severe postoperative pancreatic fistula following gastrectomy for gastric cancer

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World Journal of Gastroenterology 2013年第46期19卷 8696-8702页

作者： Shuhei Komatsu Daisuke Ichikawa Kingo Kashimoto Takeshi Kubota Kazuma Okamoto hirotaka Konishi Atsushi Shiozaki Hitoshi Fujiwara Eigo Otsuji Division of Digestive Surgery Department of SurgeryKyoto Prefectural University of Medicine

AIM:To allow the identification of high-risk postoperative pancreatic fistula(POPF)patients with special reference to the International Study Group on Pancreatic Fistula(ISGPF)***:Between 1997 and 2010,1341 consecutive patients underwent gastrectomy for gastric cancer at the Department of Digestive Surgery,Kyoto Prefectural University of Medicine,*** on the preoperative diagnosis,total or distal gastrectomy and sufficient lymphadenectomy was performed,mainly according to the Japanese guidelines for the treatment of gastric *** these,35 patients(2.6%)were diagnosed with Grade B or C POPF according to the ISGPF classification and were treated *** hospital records of these patients were reviewed ***:Of 35 patients with severe POPF,17(49%)and 18(51%)patients were classified as Grade B and C POPF,*** several clinical factors,the severity of POPF according to the ISGPF classification was significantly correlated with the duration of intensive POPF treatments(P=0.035).Regarding the clinical factors to distinguish extremely severe POPF,older patients(P=0.035,65 years≤vs<65 years old)and those with lower lymphocyte counts at the diagnosis of POPF(P=0.007,<1400/mm3vs 1400/mm3≤)were significantly correlated with Grade C POPF,and a low lymphocyte count was an independent risk factor by multivariate analysis[P=0.045,OR=10.45(95%CI:1.050-104.1)].CONCLUSION:Caution and intensive care are required for older POPF patients and those with lower lymphocyte counts at the diagnosis of POPF.

关键词： Pancreatic fistula International Study Group on Pancreatic Fistula classification Gastric cancer Gas-trectomy Complication

Integration of body-mounted ultrasoft organic solar cell on cyborg insects with intact mobility

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npj Flexible Electronics 2022年第1期6卷 726-734页

作者： Yujiro Kakei Shumpei Katayama Shinyoung Lee Masahito Takakuwa Kazuya Furusawa Shinjiro Umezu hirotaka Sato Kenjiro Fukuda Takao Someya Center for Emergent Matter Science RIKEN2-1 HirosawaWakoSaitama 351-0198Japan Department of Integrative Bioscience and Biomedical Engineering Center for Advanced Biomedical SciencesTWIns Waseda Univerisity2-2 Wakamatsu-choShinjuku-kuTokyo 162-8480Japan Department of Modern Mechanical Engineering Waseda University3-4-1 OkuboShinjuku-kuTokyo 169-8555Japan Department of Applied Chemistry and Food Science Faculty of Environmental and Information SciencesFukui University of Technology3-6-1 GakuenFukui 910-8505Japan School of Mechanical and Aerospace Engineering Nanyang Technological UniversityN3.2-01-2065 Nanyang DriveSingapore 637460Singapore Thin-Film Device Laboratory RIKEN2-1 HirosawaWakoSaitama 351-0198Japan Electrical and Electronic Engineering and Information Systems The University of Tokyo7-3-1 HongoBunkyo-kuTokyo 113-8656Japan

Cyborg insects have been proposed for applications such as urban search and ***-mounted energy-harvesting devices are critical for expanding the range of activity and functionality of cyborg ***,their power outputs are limited to less than 1 mW,which is considerably lower than those required for wireless locomotion *** area and load of the energy harvesting device considerably impair the mobility of tiny ***,we describe the integration of an ultrasoft organic solar cell module on cyborg insects that preserves their motion *** quantified system design strategy,developed using a combination of ultrathin film electronics and an adhesive-nonadhesive interleaving structure to perform basic insect motion,successfully achieved the fundamental locomotion of traversing and *** body-mounted ultrathin organic solar cell module achieves a power output of 17.2 *** demonstrate its feasibility by displaying the recharging wireless locomotion control of cyborg insects.

关键词： mounted harvesting considerably

Hyperplastic polyposis associated with two asynchronous colon cancers

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World Journal of Gastroenterology 2007年第23期13卷 3255-3258页

作者： Masaya Kurobe Kuniko Abe Naoe Kinoshita Masanobu Anami hirotaka Tokai Yoshinori Ryu Chun Yang Wen Takashi Kanematsu Tomayoshi Hayashi Department of Pathology Nagasaki University Hospital Nagasaki 852-8501 Japan Department of Transplantation and Digestive Surgery Nagasaki University Graduate School of Biomedical Science Nagasaki 852-8501 Japan Department of Digestive Disease Center Bei Hua University 3999 Huashan Road Jilin 132013 Jilin Province China

We report a patient with hyperplastic polyposis who had two asynchronous colon cancers, a combined adenoma-hyperplastic polyp, a serrated adenoma, and tubular adenomas. Hyperplastic polyposis is thought to be a precancerous lesion; and adenocarcinoma arises from hyperplastic polyposis through the hyperplastic polyp-adenoma-carcinoma sequence. Most polyps in patients with hyperplastic polyposis present as bland- looking hyperplastic polyps, which are regarded as non- neoplastic lesions; however, the risk of malignancy should not be underestimated. In patients with multiple hyperplastic polyps, hyperplastic polyposis should be identified and followed up carefully in order to detect malignant transformation in the early stage.

关键词： Hyperplastic polyposis Hyperplastic polyp Adenocarcinoma Serrated adenoma Multiple cancer

possible role of soluble fibrin monomer complex after gastroenterological surgery

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World Journal of Gastroenterology 2017年第12期23卷 2209-2216页

作者： Masatoshi Kochi Manabu Shimomura Takao Hinoi Hiroyuki Egi Kazuaki Tanabe Yasuyo Ishizaki Tomohiro Adachi hirotaka Tashiro Hideki Ohdan Department of Gastroenterological and Transplant Surgery Applied Life SciencesInstitute of Biomedical and Health SciencesHiroshima University Department of Surgery National Hospital Organization Higashihiroshima Medical Center Department of Surgery Institute for Clinical ResearchNational Hospital Organization Kure Medical Center and Chu-goku Cancer Center Department of Surgery National Hospital Organization Hiroshima-nishi Medical Center

AIM To examine the role of soluble fibrin monomer complex(SFMC) in the prediction of hypercoagulable state after gastroenterological *** We collected data on the clinical risk factors and fibrin-related makers from patients who underwent gastroenterological surgery at Hiroshima University Hospital between April 1, 2014 and March 31, 2015. We investigated the clinical significance of SFMC, which is known to reflect the early plasmatic activation of coagulation, in the view of these fibrin related *** A total of 123 patients were included in the present study. There were no patients with symptomatic VTE. Thirty-five(28%) patients received postoperative anticoagulant therapy. In the multivariate analysis, a high SFMC level on POD 1 was independently associated with D-dimer elevation on POD 7(OR = 4.31, 95%CI: 1.10-18.30, P = 0.03). The cutoff SFMC level was 3.8 μg/ml(AUC = 0.78, sensitivity, 63%, specificity, 89%). The D-dimer level on POD 7 was significantly reduced in high-SFMC patients who received anticoagulant therapy in comparison to highSFMC patients who did *** The SFMC on POD 1 strongly predicted the hypercoagulable state after gastroenterological surgery than the clinical risk factors and the other fibrin related markers.

关键词： Hypercoagulable state Gastroenterological surgery Soluble fibrin monomer complex Venous thromboembolism Anticoagulant therapy

A Proposal of a Method for Evaluation of Graphic and Spatial Information Processing in Terms of Conversion Ability of Projection Method——A Mental Test Presuming Isometric Projection Drawing from Orthogonal Projection Drawing Making Use of Combination o

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A Proposal of a Method for Evaluation of Graphic and Spatial...