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| 1 | Management and associated factors of delayed perforation after gastric endoscopic submucosal dissection显示文摘AIM: To identify the actual clinical management and associated factors of delayed perforation after gastric endoscopic submucosal dissection(ESD).METHODS: A total of 4943 early gastric cancer(EGC) patients underwent ESD at our hospital between January 1999 and June 2012. We retrospectively assessed the actual management of delayed perforation. In addition, to determine the factors associated with delayed perforation, after excluding 123 EGC patients with perforations that occurred during the ESD procedure, we analyzed the following clinicopathological factors among the remaining 4820 EGC patients by comparing the ESD cases with delayed perforation and the ESD cases without perforation: age, sex, chronological periods, clinical indications for ESD, status of the stomach, location, gastric circumference, tumor size, invasion depth, presence/absence of ulceration, histological type, type of resection, and procedure time.RESULTS: Delayed perforation occurred in 7(0.1%) cases. The median time until the occurrence of delayed perforation was 11 h(range, 6-172 h). Three(43%) of the 7 cases required emergency surgery, while four were conservatively managed without surgical intervention. Among the 4 cases with conservative management, 2 were successfully managed endoscopically using the endoloop-endoclip technique. The median hospital stay was 18 d(range, 15-45 d). There were no delayed perforation-related deaths. Based on a multivariate analysis, gastric tube cases(OR = 11.0; 95%CI: 1.7-73.3; P = 0.013) were significantly associated with delayed perforation.CONCLUSION: Endoscopists must be aware of not only the identified factors associated with delayed perforation, but also how to treat this complicationeffectively and promptly. | Haruhisa Suzuki Ichiro Oda Masau Sekiguchi Seiichiro Abe Satoru Nonaka Shigetaka Yoshinaga Takeshi Nakajima Yutaka Saito | 2015 | World Journal of Gastroenterology2015，21，44： | 21 |
| 2 | Can endoscopic submucosal dissection be safely performed in a smaller specialized clinic?显示文摘AIM:To investigate whether endoscopic submucosal dissection(ESD) can be safely performed at small clinics,such as the Shirakawa Clinic.METHODS:One thousand forty-seven ESDs to treat gastrointestinal tumors were performed at the Shirakawa Clinic from April 2006 to March 2011.The efficacy,technical feasibility and associated complications of the procedures were assessed.The ESD procedures were performed by five endoscopists.Sedation was induced with propofol for esophagogastorduodenal ESD.RESULTS:One thousand forty-seven ESDs were performed to treat 64 patients with esophageal cancer(E),850 patients with gastric tumors(G:764 patients with cancer,82 patients with adenomas and four others),four patients with duodenal cancer(D) and 129 patients with colorectal tumors(C:94 patients with cancer,21 patients with adenomas and 14 others).The en bloc resection rate was 94.3%(E:96.9%,G:95.8%,D:100%,C:79.8%).The median operation time was 46 min(range:4-360 min) and the mean size of the resected specimens was 18 mm(range:2-150 mm).No mortal complications were observed in association with the ESD procedures.Perforation occurred in 12 cases(1.1%,E:1 case,G:9 cases,D:1 case,C:1 case) and postoperative bleeding occurred in 53 cases(5.1%,G:51 cases,D:1 case,C:1 case);however,no case required either emergency surgery or blood transfusion.All of the perforations and postperative bleedings were resolved by endoscopic clipping or hemostasis.The other problematic complication observed was pneumonia,which was treated with conservative therapy.CONCLUSION:ESD can be safely performed in a clinic with established therapeutic methods and medical services to address potential complications. | Naondo Sohara Satoshi Hagiwara Riki Arai Haruhisa Iizuka Yasuhiro Onozato Satoru Kakizaki | 2013 | World Journal of Gastroenterology2013，19，4： | 15 |
| 3 | Stratifying the risk of lymph node metastasis in undifferentiated-type early gastric cancer显示文摘AIM:To study how lymph node metastasis(LNM) risk is stratified in undifferentiated-type early gastric cancer(undiff-EGC) dependent on combinations of risk factors.METHODS:Five hundred and sixty-seven cases with undiff-EGC undergoing gastrectomy with lymphadenectomy were examined retrospectively.Using clinicopathological factors of patient age,location,size,an endoscopic macroscopic tumor form,ulceration,depth,histology,lymphatic involvement(LI) and venous involvement(VI),LNM risk was examined and stratified by conventional statistical analysis and datamining analysis.RESULTS:LNM was positive in 44 of 567 cases(7.8%).Univariate analysis revealed > 2 cm,protrusion,submucosal(sm),mixed type,LI and VI as significant prognostic factors and > 2 cm and LI-positive were independent factors by multivariate analysis.In preoperatively evaluable factors excluding LVI,sm and > 2 cm were independent factors.According to the depth and size,cases were categorized into the low-risk group [m and ≤ 2 cm,0%(LNM incidence)],the moderaterisk group(m and > 2 cm,5.6%; and sm and ≤ 2 cm,6.0%),and the high-risk group(sm and > 2 cm,19.3%).On the other hand,LNM occurred in 1.4% in all LI-negative cases,greatly lower than 28.2% in all LI-positive cases,and LNM incidence was low in LInegative cases even in the moderate- and high-risk groups.CONCLUSION:LNM-related factors in undiff-EGC were depth and size preoperatively while those were LI and size postoperatively.Among these factors,LI was the most significantly correlated factor. | Yukiko Asakawa Masahiko Ohtaka Shinya Maekawa Mitsuharu Fukasawa Yasuhiro Nakayama Tatsuya Yamaguchi Taisuke Inoue Tomoyoshi Uetake Minoru Sakamoto Tadashi Sato Yoshihiko Kawaguchi Hideki Fujii Kunio Mochizuki Masao Hada Toshio Oyama Tomotaka Yasumura Kosaku Omata Atsushi Nishiyama Keiichi Naito Hideo Hata Yoshiaki Haba Kazuyuki Miyata Haruhisa Saitoh Yoichi Yamadera Kazuo Miura Akira Kawaoi Tohru Abe Hajime Tsunoda Yuji Honda Masayuki Kurosaki Nobuyuki Enomoto | 2015 | World Journal of Gastroenterology2015，21，9： | 8 |
| 4 | Complications of Gastric Endoscopic Submucosal Dissection显示文摘 | Ichiro Oda Haruhisa Suzuki Satoru Nonaka Shigetaka Yoshinaga | 2013 | Digestive Endoscopy2013，，： | 7 |
| 5 | Dehiscence following successful endoscopic closure of gastric perforation during endoscopic submucosal dissection显示文摘Gastric perforation is one of the most serious complications that can occur during endoscopic submucosal dissection(ESD).In terms of the treatment of such perforations,we previously reported that perforations immediately observed and successfully closed with endoclips during endoscopic resection could be managed conservatively.We now report the first case in our medical facility of a gastric perforation during ESD that was ineffectively treated conservatively even after successful endoscopic closure.In December 2006,we performed ESD on a recurrent early gastric cancer in an 81-year-old man with a medical history of laparotomy for cholelithiasis.A perforation occurred during ESD that was immediately observed and successfully closed with endoclips so that ESD could be continued resulting in an en-bloc resection.Intensive conservative management was conducted following ESD,however,an endoscopic examination five days after ESD revealed dehiscence of the perforation requiring an emergency laparotomy. | Masau Sekiguchi Haruhisa Suzuki Ichiro Oda Shigetaka Yoshinaga Satoru Nonaka Makoto Saka Hitoshi Katai Hirokazu Taniguchi Ryoji Kushima Yutaka Saito | 2012 | World Journal of Gastroenterology2012，18，31： | 7 |
| 6 | Endoscopic submucosal dissection for large laterally spreading tumors involving the ileocecal valve and terminal ileum显示文摘Endoscopic submucosal dissection is a challenging technique that enables en-bloc resection for large colorectal tumors, as laterally spreading tumors, particularly difficult, if the ileocecal valve and terminal ileum is involved. Herein, we report on one of 4 cases. The procedures, using a bipolar needle knife (B-Knife) to reduce the perforation risk and carbon dioxide instead of conventional air insufflation for patient comfort, achieved curative resections without any complications. | Gustavo Kishimoto Yutaka Saito Hajime Takisawa Haruhisa Suzuki Taku Sakamoto Takeshi Nakajima Takahisa Matsuda | 2012 | World Journal of Gastroenterology2012，18，3： | 5 |
| 7 | Analysis of colonoscopic perforations at a local clinic and a tertiary hospital显示文摘AIM:To define the clinical characteristics,and to assess the management of colonoscopic complications at a local clinic.METHODS:A retrospective review of the medical records was performed for the patients with iatrogenic colon perforations after endoscopy at a local clinic between April 2006 and December 2010.Data obtained from a tertiary hospital in the same region were also analyzed.The underlying conditions,clinical presentations,perforation locations,treatment types(operative or conservative) and outcome data for patients at the local clinic and the tertiary hospital were compared.RESULTS:A total of 10 826 colonoscopies,and 2625 therapeutic procedures were performed at a local clinic and 32 148 colonoscopies,and 7787 therapeutic procedures were performed at the tertiary hospital.The clinic had no perforations during diagnostic colonoscopy and 8(0.3%) perforations were determined to be related to therapeutic procedures.The perforation rates in each therapeutic procedure were 0.06%(1/1609) in polypectomy,0.2%(2/885) in endoscopic mucosal resection(EMR),and 3.8%(5/131) in endoscopic submucosal dissection(ESD).Perforation rates for ESD were significantly higher than those for polypectomy or EMR(P < 0.01).All of these patients were treated conservatively.On the other hand,three(0.01%) perforation cases were observed among the 24 361 diagnostic procedures performed,and these cases were treated with surgery in a tertiary hospital.Six perforations occurred with therapeutic endoscopy(perforation rate,0.08%;1 per 1298 procedures).Perforation rates for specific procedure types were 0.02%(1 per 5500) for polypectomy,0.17%(1 per 561) for EMR,2.3%(1 per 43) for ESD in the tertiary hospital.There were no differences in the perforation rates for each therapeutic procedure between the clinic and the tertiary hospital.The incidence of iatrogenic perforation requiring surgical treatment was quite low in both the clinic and the tertiary hospital.No procedure-related mortalities occurred.Performing closure with endoscopic clipping reduced the C-reactive protein(CRP) titers.The mean maximum CRP titer was 2.9 ± 1.6 mg/dL with clipping and 9.7 ± 6.2 mg/dL without clipping,respectively(P < 0.05).An operation is indicated in the presence of a large perforation,and in the setting of generalized peritonitis or ongoing sepsis.Although we did not experience such case in the clinic,patients with large perforations should be immediately transferred to a tertiary hospital.Good relationships between local clinics and nearby tertiary hospitals should therefore be maintained.CONCLUSION:It was therefore found to be possible to perform endoscopic treatment at a local clinic when sufficient back up was available at a nearby tertiary hospital. | Toshihiko Sagawa Satoru Kakizaki Haruhisa Iizuka Yasuhiro Onozato Naondo Sohara Shinichi Okamura Masatomo Mori | 2012 | World Journal of Gastroenterology2012，18，35： | 5 |
| 8 | Short- and long-term outcomes of endoscopic submucosal dissection for undifferentiated early gastric cancer显示文摘 | Seiichiro Abe Ichiro Oda Haruhisa Suzuki Satoru Nonaka Shigetaka Yoshinaga Tomoyuki Odagaki Hirokazu Taniguchi Ryoji Kushima Yutaka Saito | 2013 | Endoscopy2013，，09： | 5 |
| 9 | Association of polymorphic alleles of CTLA4 with inflammatory bowel disease in the Japanese显示文摘AIM: To examine an association between the cytotoxic T-lymphocyte antigen 4 (CTLA4) gene that plays a role in downregulation of T-cell activation and inflammatory bowel disease consisting of ulcerative colitis (UC) and Crohn's disease (CD) in the Japanese.METHODS: We studied 108 patients with UC, 79 patients with CD, and 200 sex-matched healthy controls, with respect to three single nucleotide polymorphisms (SNPs)in CTLA4, such as C-318T in the promoter region, A+49G in exon 1 and G+6230A in the 3' untranslated region (3'-UTR) by a PCR-restriction fragment length polymorphism method, and to an (AT)n repeat polymorphism in 3'-UTR by fragment analysis with fluorescence-labeling on denaturing sequence gels. Frequency of alleles and genotypes and their distribution were compared statistically between patients and controls and among subgroups of patients, using χ2 and Fisher exact tests.RESULTS: The frequency of 'A/A' genotype at the G+6230A SNP site was statistically lower in UC patients than in controls (3.7% vs 11.0%, P= 0.047, odds ratio (OR) = 0.311). Moreover, the frequency of'G/G' genotype at the A+49G SNP site was significantly higher in CD patients with fistula (48.6%) than those without it (26.2%)(P = 0.0388, OR=2.67).CONCLUSION: The results suggest that CTLA4 located at 2q33 is a determinant of UC and responsible for fistula formation in CD in the Japanese. | Haruhisa Machida Kazuhiro Tsukamoto Chun-Yang Wen Yukiko Narumi Saburou Shikuwa Hajime Isomoto Fuminao Takeshima Yohei Mizuta Norio Niikawa Ikuo Murata Shigeru Kohno | 2005 | World Journal of Gastroenterology2005，11，27： | 4 |
| 10 | Crohn's disease in Japanese is associated with a SNP-haplotype of N-acetyltransferase 2 gene显示文摘AIM: To investigate the frequency and distribution of N-acetyltransferase 2 (NAT2) and uridine 5′-diphosphate (UDP)-glucuronosyltransferase 1A7 (UGT1A7) genes in patients with ulcerative colitis (UC) and Crohn's disease (CD).METHODS: Frequencies and distributions of NAT2 and UGT1A7SNPs as well as their haplotypes were investigated in 95 patients with UC, 60 patients with CD, and 200gender-matched, unrelated, healthy, control volunteers by PCR-restriction fragment length polymorphism (RFLP),PCR-denaturing high-performance liquid chromatography (DHPLC), and direct DNA sequencing.RESULTS: Multiple logistic regression analysis revealed that the frequency of haplotype, NAT2*7B, significantly increased in CD patients, compared to that in controls (P= 0.0130, OR = 2.802, 95%CI = 1.243-6.316). However,there was no association between NAT2 haplotypes and UC, or between any UGT1A7haplotypes and inflammatory bowel disease (IBD).CONCLUSION: It is likely that the NAT2 gene is one of the determinants for CD in Japanese. Alternatively, a new CD determinant may exist in the 8p22 region, whereNAT2is located. | Haruhisa Machida Kazuhiro Tsukamoto Chun-Yang Wen Saburou Shikuwa Hajime Isomoto Yohei Mizuta Fuminao Takeshima Kunihiko Murase Naomichi Matsumoto Ikuo Murata Shigeru Kohno Chen-Yang Wen | 2005 | World Journal of Gastroenterology2005，11，31： | 3 |
| 11 | Inflammatory pseudotumor of the liver and peripheral eosinophilia in autoimmune pancreatitis显示文摘AIM: Inflammatory pseudotumor (IPT) of the liver is a rare benign lesion, the etiology of which remains obscure.It is not associated with any particular diseases apart from phlebitis and Crohn's disease.METHODS: A middle-aged male with hepatic IPT and peripheral eosinophilia associated with autoimmune pancreatitis (AIP) was selected for this study and review of literature.RESULTS: A 59-year-old male was admitted with obstructive jaundice, marked eosinophilia (1 343/mm3)and hypergammaglobulinemia (4 145 mg/dL). Imaging techniques revealed dilatation of the intrahepatic bile duct,stenosis of the common bile duct with diffuse wall thickening, gallbladder wall thickening, irregular narrowing of the pancreatic duct, and swelling of the pancreatic parenchyma. Multiple liver masses were also demonstrated and diagnosed as IPT by biopsy specimens. Six months later, the abnormal features of the biliary tree remarkably improved by the oral administration of prednisolone, and the liver masses disappeared. The swelling of the pancreatic head also improved. The peripheral eosinophil count normalized. IPT associated with AIP, as we know,has not been reported in the literature. The clinical features of the present case mimicked those of pancreatic cancer with liver metastasis. This case deserves to be documented to prevent misdiagnosis of similar cases. | Naoki Sasahira Takao Kawabe Akira Nakamura Kenji Shimura Haruhisa Shimura Ei Itobayashi Manabu Asada Yasushi Shiratori Masao Omata | 2005 | World Journal of Gastroenterology2005，11，6： | 2 |
| 12 | Endoscopic submucosal dissection for early gastric cancer in the remnant stomach after gastrectomy显示文摘 | Satoru Nonaka Ichiro Oda Makomo Makazu Shin Haruyama Seiichiro Abe Haruhisa Suzuki Shigetaka Yoshinaga Takeshi Nakajima Ryoji Kushima Yutaka Saito | 2013 | Gastrointestinal Endoscopy2013，，1： | 2 |
| 13 | Bone metastasis from early gastric cancer following non-curative endoscopic submucosal dissection显示文摘A 67-year-old male underwent endoscopic submucosal dissection(ESD)to treat early gastric cancer(EGC)in 2001.The lesion(50 mm × 25 mm diameter)was histologically diagnosed as poorly differentiated adenocarcinoma,with an ulcer finding.Although the tumor was confined to the mucosa with no evidence of lymphovascular involvement,the ESD was regarded as a noncurative resection due to the histological type,tumor size,and existence of an ulcer finding(as indicated by the 2010 Japanese gastric cancer treatment guidelines,ver.3).Despite strong recommendation for subsequent gastrectomy,the patient refused surgery.An alternative follow-up routine was designed,which included five years of biannual clinical examinations to detect and measure serum tumor markers and perform visual assessment of recurrence by endoscopy and computed tomography scan after which the examinations were performed annually.The patient's condition remained stable for eight years,until a complaint of back pain in 2010 prompted further clinical investigation.Bone scintigraphy indicated increased uptake.Histological examination of biopsy specimens taken from the lumbar spine revealed adenocarcinoma resembling the carcinoma cells from the EGC that had been treated previously by ESD,and which was consistent with immunohistochemical findings of gastrointestinal tract cancer.Thus,the diagnosis of bone metastasis from EGC was made.The reported rates of EGC recurrence in surgically resected cases range 1.4%-3.4%,but among these bone metastasis is very rare.To our knowledge,this is the first reported case of bone metastasis from EGC following a non-curative ESD and occurring after an eight-year disease-free interval. | Hiroyuki Kawabata Ichiro Oda Haruhisa Suzuki Satoru Nonaka Shigetaka Yoshinaga Hitoshi Katai Hirokazu Taniguchi Ryoji Kushima Yutaka Saito | 2013 | World Journal of Gastroenterology2013，19，30： | 2 |
| 14 | Subversion of cell signaling pathways by hepatitis C virus nonstructural 5A protein via interaction with Grb2 and P85 phosphatidylinositol 3-kinase显示文摘 | He YP Haruhisa Nakao Tan SL | 2002 | Virol2002，76，18： | 1 |
| 15 | A new glycosphingolipid from the red alga Corallina pilulifera显示文摘 | Ishida Ryoichi Shirahama Haruhisa Matsumoto Takeshi | 1993 | Chem Lett1993，，1： | 1 |
| 16 | Reaction of ketones or aldehydes with 1-alkynes over solid-base catalysts 显示文摘 | Toshihide Baba Hisashi Kizuka Haruhisa Handa | 2000 | Applied Catalysis A : General2000，194，： | 1 |
| 17 | Sugar with nitrogen in the ring isolated from the leaves of Morus bombyc/s 显示文摘 | NAOKI A EMIKO T HARUHISA K | 1994 | Carbohydrate Research1994，253，： | 1 |
| 18 | Sugars with nitrogen in the ring isolated from the leaves of morus bombycis显示文摘 | Naoki Asano Emiko Tomioka Haruhisa Kizu | 1994 | Carbohydrate Research1994，253，： | 1 |
| 19 | Novel aromatics bearing 4-O-methylglucose unit isolated from the oriental crude drug Bombyx batryticatus 显示文摘 | Haruhisa K Nahoko T Yoshiteru O | 2004 | Tetrahedron Lett2004，45，： | 1 |
| 20 | PKA phosphorylates the p75 receptor and regulates its localization to hpid rafts 显示文摘 | Haruhisa H Toshihide Y Hideki Y | 2003 | EMBO J2003，22，8： | 1 |
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