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| 1 | Clinicopathological characteristics of clinical early gastric cancer in the upper-third stomach显示文摘AIM: To elucidate the clinicopathological characteristics of clinically early gastric cancer in the upper-third stomach and to clarify treatment precautions.METHODS: 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 depth.RESULTS: 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 study.CONCLUSION: Clinical early gastric cancer in the upper-third stomach has distinguishable characteristics that increase the risk of a clinical under-diagnosis, especially in patients with larger or undifferentiated tumors. | Daisuke Ichikawa Shuhei Komatsu Toshiyuki Kosuga Hirotaka Konishi Kazuma Okamoto Atsushi Shiozaki Hitoshi Fujiwara Eigo Otsuji | 2015 | World Journal of Gastroenterology2015，21，45： | 6 |
| 2 | Clinical characteristics of hepatoduodenal lymph node metastasis in gastric cancer显示文摘AIM: To assess the clinical features of hepatoduodenal lymph node(HDLN) metastasis and to clarify the optimal indication of HDLN dissection.METHODS: 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 indication.RESULTS: 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,respectively.CONCLUSION: We suggest that HDLN dissection should be indicated for p N1 or p N2 gastric cancers located at the middle or lower stomach. | Taisuke Imamura Shuhei Komatsu Daisuke Ichikawa Toshiyuki Kosuga Kazuma Okamoto Hirotaka Konishi Atsushi Shiozaki Hitoshi Fujiwara Eigo Otsuji | 2015 | World Journal of Gastroenterology2015，21，38： | 4 |
| 3 | Surgery for gastric cancer patients of age 85 and older: Multicenter survey显示文摘AIM To investigate the surgical therapies for gastric cancer(GC) patients of age 85 or older in a multicenter survey.METHODS Therapeutic opportunities for elderly GC patients have expanded in conjunction with extended life expectancy. However, the number of cases encountered in a single institution is usually very small and surgical therapies for elderly GC patients have not yet been standardized completely. In the present study, a total of 134 GC patients of age 85 or older who underwent surgery in 9 related facilities were retrospectively investigated. The relationships between surgical therapies and clinicopathological or prognostic features were analyzed.RESULTS Eighty-nine of the patients(66%) presented with a comorbidity, and 26(19% overall) presented with more than two comorbidities. Radical lymphadenectomy was performed in 59 patients(44%), and no patient received pre- or post-operative chemotherapy. Forty of the patients(30%) experienced perioperative complications, but no surgical or perioperative mortality occurred. Laparoscopic surgery was performed in only 12 of the patients(9.0%). Univariate and multivariate analyses of the 113 patients who underwent R0 or R1 resection identified the factors of p T3/4 and limited lymphadenectomy as predictive of worse prognosis(HR = 4.68, P = 0.02 and HR =2.19, P = 0.05, respectively). Non-cancer-specific death was more common in c Stage Ⅰ patients than in c Stage Ⅱ or Ⅲ patients. Limited lymphadenectomy correlated with worse cancer-specific survival(P = 0.01), particularly in c Stage Ⅱ patients(P < 0.01). There were no relationships between limited lymphadenectomy and any comorbidities, except for cerebrovascular disease(P = 0.07). CONCLUSION N o n- c a n c e r- s p e c i f i c d e a t h w a s n o t n e g l i g i b l e, particularly in c Stage Ⅰ, and gastrectomy with radical lymphadenectomy appears to be an effective treatment for cS tage Ⅱ elderly GC patients. | Hirotaka Konishi Daisuke Ichikawa Hiroshi Itoh Kenichiro Fukuda Naoki Kakihara Manabu Takemura Kaori Okugawa Kiyoshi Uchiyama Masashi Nakata Hiroshi Nishi Toshiyuki Kosuga Shuhei Komatsu Kazuma Okamoto Eigo Otsuji | 2017 | World Journal of Gastroenterology2017，23，7： | 4 |
| 4 | Laparoscopic and endoscopic co-operative surgery for nonampullary duodenal tumors显示文摘AIM To assess the safety and feasibility of laparoscopic and endoscopic co-operative surgery(LECS) for early nonampullary duodenal tumors.METHODS Twelve patients with a non-ampullary duodenal tumor underwent LECS at our hospital. One patient had two mucosal lesions in the duodenum. The indication for this procedure was the presence of duodenal tumors with a low risk for lymph node metastasis. In particular, the tumors included small(less than 10 mm) submucosal tumors(SMT) and epithelial mucosal tumors, such as mucosal cancers or large mucosal adenomas with malignant suspicion. The LECS procedures, such as full-thickness dissection for SMT and laparoscopic reinforcement after endoscopic submucosal dissection(ESD) for epithelial tumors, were performed for the 13 early duodenal lesions in 12 patients. Here we present the short-term outcomes and evaluate the safety and feasibility of this new technique.RESULTS Two SMT-like lesions and eleven superficial epithelial tumor-like lesions were observed. Seven and Six lesions were located in the second and third parts of the duodenum, respectively. All lesions were successfully resected en bloc. The defect in the duodenal wall was manually sutured after resection of the duodenal SMT. For epithelial duodenal tumors, the ulcer bed was laparoscopically reinforced via manual suturing after ESD. Intraoperative perforation occurred in two out of eleven epithelial tumor-like lesions during ESD; however, they were successfully laparoscopically repaired. The median operative time and intraoperative estimated blood loss were 322 min and 0 mL, respectively. Histological examination of the tumors revealed one adenoma with moderate atypia, ten adenocarcinomas, and two neuroendocrine tumors. No severe postoperative complications(Clavien-Dindo classification grade Ⅲ or higher) were reported in this series, but minor leakage secondary to pancreatic fistula occurred in one patient.CONCLUSION LECS can be a safe and minimally invasive treatment option for non-ampullary early duodenal tumors. | Daisuke Ichikawa Shuhei Komatsu Osamu Dohi Yuji Naito Toshiyuki Kosuga Kazuhiro Kamada Kazuma Okamoto Yoshito Itoh Eigo Otsuji | 2016 | World Journal of Gastroenterology2016，22，47： | 3 |
| 5 | Prognostic Significance of Complications after Curative Surgery for Gastric Cancer显示文摘 | Takeshi Kubota Naoki Hiki Takeshi Sano Shogo Nomura Souya Nunobe Koshi Kumagai Susumu Aikou Ryohei Watanabe Toshiyuki Kosuga Toshiharu Yamaguchi | 2014 | Annals of Surgical Oncology2014，，3： | 2 |
| 6 | High-temperature formation phases and crystal structure of hot-pressed thermoelectric compounds with chalcopyrite-type structure显示文摘In this study, we introduced the temperaturedependent formation phases and crystallographic parameters of hot-pressed silver gallium telluride AgGaTe_2 and copper gallium telluride CuGaTe_2 with chalcopyrite structure from 300 to 800 K. These two compounds are potential thermoelectric materials in the intermediate temperature range; however, the temperature-dependent formation phases and crystallographic parameters of hotpressed samples have not yet been analyzed in detail. The crystal structure analysis based on synchrotron X-ray diffraction(SXRD) measurements clarifies that impurity phases such as Te and Ag_2 Te in the AgGaTe_2 matrix and Te and CuTe in the CuGaTe_2 matrix appear at some temperature regions above 300 K. The existence of such impurity phases could be correlated with the increases of the electrical resistivity and Seebeck coefficient of the samples after multiple measurement cycles of the temperature-dependent transport properties from 300 to 800 K.The tetragonal lattice parameters a and c, tetragonal lattice volume, thermal expansion coefficients, tetragonal distortion, anion displacement parameter, and isotropic displacement parameter of the hot-pressed AgGaTe_2 and CuGaTe_2 were also analyzed. These crystallographic parameters are expected to substantially affect the thermoelectric properties of AgGaTe_2 and CuGaTe_2. Our results provide prospect of the long-term high-temperature stability and clues of the detailed analysis on the transport properties of hot-pressed AgGaTe_2 and CuGaTe_2, which should aid their development for thermoelectric applications. | Atsuko Kosuga Yosuke Fujii Akito Horie | 2018 | Rare Metals2018，37，4： | 2 |
| 7 | Continuously Frequency Tunable High Power Sub-THz Radiation Source-Gyrotron FU CW VI for 600 MHz DNP-NMR Spectroscopy显示文摘 | Idehara T Kosuga K Agusu L | 2010 | Journal of Infrared Millimeter and Terahertz Waves2010，31，： | 1 |
| 8 | Long-Term (>10 Years) clin- ical outcomes of first-in-human biodegradable poly-l-lactic acid coronary stents: Igaki-Tamai stents 显示文摘 | Nishio S Kosuga K Igaki K | 2012 | Circulation2012，125，19： | 1 |
| 9 | Intravascular ultrasound- guided directional coronary atherectomy for unprotected left main coronary stenoses with distal bifurcation involvement 显示文摘 | HU F B TAMAI H KOSUGA K | 2003 | Am J Cardiol2003，92，8： | 1 |
| 10 | Feasibility and nutritional impact of laparoscopy-assisted subtotal gastrectomy for early gastric cancer in the upper stomach显示文摘 | Kosuga T Hiki N Nunobe S | 2014 | Ann Surg Oncol2014，21，6： | 1 |
| 11 | Initial and long-term results of angioplasty in unprotected left main coronary artery显示文摘 | Kosuga K Tamai H Ueda K | 1999 | Am J Cardiol1999，83，： | 1 |
| 12 | Microstructure of mica-based nanocomposite glass-ceramics显示文摘 | UNO T KOSUGA T NAKAYAMA S | 1993 | J Am Ceram Soc1993，76，2： | 1 |
| 13 | Laparoscopic transhiatal approach for resection of an adenocarcinoma in long-segment Barrett's esophagus显示文摘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. | 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 | 2015 | World Journal of Gastroenterology2015，21，29： | 1 |
| 14 | Long-term (> 10 years) clinical outcomes of first-in-human biodegradable poly-l-lac- tic acid coronary显示文摘 | Nishio S Kosuga K Igaki K | 2012 | Circulation2012，125，19： | 1 |
| 15 | Long-Term (>10 Years) Clinical Outcomes of First-in-Human Biodegradable Poly-l-Lactic Acid Coronary Stents: Igaki-Tamai Stents显示文摘 | Soji Nishio Kunihiko Kosuga Keiji Igaki Masaharu Okada Eisho Kyo Takafumi Tsuji Eiji Takeuchi Yasutaka Inuzuka Shinsaku Takeda Tatsuhiko Hata Yuzo Takeuchi Yoshitaka Kawada Takeshi Harita Junya Seki Shunji Akamatsu Shinichi Hasegawa Nico Bruining Salvator | 2012 | Circulation2012，，19： | 1 |
| 16 | Initial mid longterm results of an gioplasty in unprotected left main coronary artery显示文摘 | KOSUGA K TAMAI H UEDA K | 1999 | Am J Cardiol1999，83，1： | 1 |
| 17 | XB130 as an inde- pendent prognostic factor in human esophageal squamous cell carcinoma显示文摘 | Shiozaki A Kosuga T Ichikawa D | 2013 | Ann Surg Oncol2013，20，9： | 1 |
| 18 | Reduction of c-myc expression by an antisense approach under Cre/Loxp switching induces apoptosis in human liver cancer cells显示文摘 | Ebinuma H Saito H Kosuga M | 2001 | J Cell Physiol2001，188，1： | 1 |
| 19 | Photoelectrochemical study of lanthanide zirconium oxides, Ln2 Zr2 07 ( Ln = La, Ce, Nd and Sm) 显示文摘 | Uno M Kosuga A Okui M | 2006 | J Alloys Compd2006，420，： | 1 |
| 20 | Reduction of c-myc expression by an antisense approach under Cre/loxP switching induces apoptosis in human liver cancer cells显示文摘 | Ebinuma H Saito H Kosuga M | 2001 | J Cell Physiol2001，188，1： | 1 |
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