Masaki Kunizaki

University of Nagasaki · Department of Surgical Oncology

Background The prognostic value of the lymphocyte-to-monocyte ratio (LMR) has been reported for various cancers, including colorectal cancer (CRC). Insertion of self-expanding metallic stents (SEMS) is considered effective for patients with surgically indicated obstructive CRC, but LMR can vary depending on factors such as inflammation associated w...

Background We have been trying to produce scaffold-free structures for airway regeneration using a bio-3D-printer with spheroids, to avoid scaffold-associated risks such as infection. Previous studies have shown that human umbilical vein endothelial cells (HUVECs) play an important role in such structures, but HUVECs cannot be isolated from adult h...

[This corrects the article DOI: 10.1371/journal.pone.0211339.].

Various strategies have been attempted to replace esophageal defects with natural or artificial substitutes using tissue engineering. However, these methods have not yet reached clinical application because of the high risks related to their immunogenicity or insufficient biocompatibility. In this study, we developed a scaffold-free structure with...

Individual data of the structures and esophagus of rats. (DOCX)

Introduction: Tracheal adenoid cystic carcinoma (ACC) is rare and accounts for <1% of all lung cancers. Although ACC is classified as a low-grade tumor, metastases are frequently identified in the late period. Extrapulmonary metastases are rare, and their resection has rarely been reported. Presentation of case: Case 1: A 77-year-old man underwe...

A 65-year-old man presented with muscle pain and finger swelling, and was given a diagnosis of anti-MDA5 antibody-positive dermatomyositis and interstitial pneumonia. Colonoscopy, as a detailed examination for malignancy detected descending colon cancer (cStage IIIa), and laparoscopic left hemicolectomy was performed. On postoperative day 4, hypoxe...

Background/aim: Identifying useful biomarkers is central to selecting optimal therapeutic strategies for esophageal squamous cell carcinoma (ESCC). Serum p53 antibody (S-p53Ab), squamous cell carcinoma antigen (SCC-Ag), and carcinoembryonic antigen (CEA) were investigated to evaluate the significance of single and combined tumor markers in determi...

The aim of the present study was to investigate the prognostic value of the C-reactive protein-to-albumin ratio (CAR) and compare it with other inflammation-based prognostic scores (Glasgow prognostic score, modified Glasgow prognostic score, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, prognostic nutritional index and prognostic i...

Serum tumor markers in patients with cancer assist with establishing diagnosis, estimating prognosis, monitoring treatment, and detecting tumor recurrence. Changes in the p53 tumor suppressor gene are the most common genetic abnormalities in many different human malignancies. Several studies have demonstrated that serum p53 antibodies (S-p53Ab) com...

Background: 5-Aminolevulinic acid is a precursor of photosensitizing protoporphyrin IX and has been applied for photodynamic diagnosis of brain and bladder tumors with few side effects. Although most upper gastrointestinal tumors can be detected during photodynamic diagnosis, some tumors containing signet-ring cells cannot be visualized. Here, we...

Background: The aim of this retrospective study was to evaluate the clinical relevance of serum p53 antibody (S-p53Ab) as a biomarker and to investigate whether its diagnostic value could be improved when combined with other biomarkers of gastric cancer (GC). Patients and methods: Serum samples were obtained preoperatively from 208 patients with...

Introduction: Multiple primary neoplasms are relatively rare, but their incidence has increased because of aging and improvements in diagnostic imaging. Presentation of case: A 67-year-old man presented with epigastric pain. On upper gastrointestinal endoscopy, an ulcer was seen at the gastric angle, and biopsy showed moderately differentiated a...

Introduction: Single-incision laparoscopic surgery has been reported to be a safe and feasible technique for colorectal cancer. However, the technique needs skill due to the limitations of the device. An organ retractor is a new grasp device that has the potential to overcome these limitations. Presentation of case: A 63-year-old woman with a tu...

Introduction: Meckel's diverticulum (MD) is a congenital true diverticulum that is residual yolk duct tissue, and some cases with complications require surgery. It has been reported that laparoscopic surgery is effective for patients with an MD. Presentation of case: A 79-year-old man with melena visited our hospital. Upper gastrointestinal seri...

Background: Ulcerative colitis (UC) typically develops in the rectum and progresses proximally. Segmental UC is a rare condition that is often difficult to diagnose. We present a case of segmental UC mimicking colon cancer that developed in the transverse colon. Case presentation: An 83-year-old woman with abdominal pain visited our hospital. Total...

Introduction: Abdominoperineal resection is performed using laparoscopic techniques at many institutions. Few institutions construct the terminal stoma using the extraperitoneal route, mainly because of the difficulty of this approach. However, the extraperitoneal route for terminal stoma might be associated with a lower rate of complications when...

Purpose: The aim of this retrospective study was to evaluate inflammation-based scoring as a prognostic factor for operable non-small-cell lung cancer (NSCLC) in elderly patients. Methods: We collected preoperative data from 108 patients aged above 80 years with NSCLC. Inflammation-based scoring systems, including the C-reactive protein to album...

High-age patients have higher rates of comorbidity that are associated with a poor prognosis. It is important to correctly evaluate their preoperative status to avoid mortality. The aim of this study was to clarify whether the Charlson comorbidity index (CCI) was useful for predicting postoperative outcomes. This retrospective study collected data...

Background: Serum p53 antibody (s-p53Ab), carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9) were investigated to evaluate the significance of these singly and combined tumor markers in the diagnosis and prognosis of colorectal cancer (CRC). Patients and methods: Preoperative serum samples were obtained from 170 patients with...

Gastrointestinal cancer is the leading cause of cancer deaths in developed countries. The incidence of gastroinetestinal cancer has been increasing dramatically in Japan and has attracted worldwide attention. Despite the introduction of new postoperative chemotherapy regimens and the progress in endoscopic surgery techniques, overall survival is st...

Introduction: Surgeons often perform surgery for patients who are critically ill. Intensive care unit (ICU)-acquired weakness (ICUAW) is a condition in which systemic and prolonged muscle weakness occurs and causes worse short-term and long-term outcomes. Presentation of case: A 60-year-old woman with sudden nausea and vomiting presented to our...

Purpose: The aim of this study was to clarify whether a surgical-specific risk scoring system estimating the physiologic ability and surgical stress (E-PASS) score was useful for prediction of postoperative morbidity and mortality. Methods: The E-PASS score consists of the preoperative risk score (PRS), surgical stress score (SSS), and the compr...

Background/aims: To clarify improvement of hepatic resection in the recent years, we examined surgical records of 544 patients who underwent hepatectomy in 3 periods between 1994 and 2011 at a single academic institute. Methodology: Subjects were divided into 3 groups: group 1 (1994-1999, n = 156), group 2 (2000-2006, n = 228) and group 3 (2007-...

Photodynamic diagnosis (PDD) is an imaging technology that is based on the fundamental biological features of cancer cells. Five-aminolevulinic acid (ALA), a precursor of photosensitizing protoporphyrin IX (PpIX) has been applied. In fact, ALA-mediated PDD provides good visualization for certain tumors. However, there have been few studies on clini...

The present study was designed to define the clinicopathological characteristics of multiple cancers (MC) in 597 patients with hepatobiliary and pancreas (HBP) malignancies who underwent curative resection, in order to clarify risk factors and prognostic significance. Patients' demographics, clinicopathological parameters and survival rates were co...

Background/aims: Oldest-old patients generally have several comorbidities, and laparoscopic-assisted colectomy (LAC) has not been performed on these patients. However, the surgical technique of LAC has improved, and its indications have been extended. The aim of this study was to evaluate the safety and effectiveness of LAC for patients over 85 ye...

Radiation-induced leiomyosarcoma is a very rare complication following irradiation of primary malignancies. In the chest wall, it is usually secondary to radiotherapy for breast cancer or lymphoma. Esophageal malignancy is a radiation dose-related complication of radiotherapy for breast cancer, but its absolute risk is low. A 61-year-old woman pres...

OBJECTIVES The number of elderly lung cancer patients requiring surgery has been increasing due to the ageing society and less invasive perioperative procedures. Elderly people usually have various comorbidities, but there are few simple and objective tools that can be used to determine prognostic factors for elderly patients with clinical stage I...

We compared each vessel-sealing device to evaluate safety and efficacy for controlling surgical results in 200 patients undergoing pancreatectomy. Sixty-seven patients applied the hemostatic devices (VS group) consisted of LigaSure™ (LS) or the Harmonic ultrasonic dissector (USD). Results were compared with that of a historical control group (n=134...

To clarify parameters associated with postoperative surgical site infection (SSI) after pancreatectomy, we examined clinicopathological and surgical records in 186 patients who underwent pancreatectomy at a single academic institute. Patient demographics, liver functional parameters, histological findings, surgical records and post-hepatectomy outc...

Background: Prognostic influences of hepatic transection by an anterior approach using the liver hanging maneuver (LHM) has not been fully clarified. Methods: We examined 233 patients who underwent major hepatectomy with the LHM (n = 75; hepatocellular carcinoma (HCC) in 35, colorectal liver metastasis (CLM) in 10, intrahepatic cholangiocarcinoma (...

An 81-year-old man was admitted to a primary care hospital due to bloody diarrhea. The findings of abdominal computed tomography indicated ischemic colitis, so conservative therapy was started. On the 4th hospital day, the patient was transferred to our hospital because of renal dysfunction. Physical examination showed clouding of consciousness and...

Endoscopic submucosal dissection (ESD) is a standard treatment for early gastric cancer, but it is not generally used for colorectal lesions because of its high risk of adverse events. An unanticipated adverse event of rectal ESD is reported. A 71-year-old man was found to have a laterally spreading tumor at the upper rectum. ESD was performed. Dur...

Desmoplastic small round cell tumor (DSRCT) is an uncommon, poor prognostic tumor which is found mainly in young adults. A 23-year-old woman was admitted to our hospital with a complaint of anal pain. Pelvic CT revealed a 50-mm tumor in the anal and swollen lymph nodes in the bilateral inguinal region. DSRCT was diagnosed by biopsy, and Mile's oper...

In this retrospective study, the effects of cystic duct (C) tube use on the incidence of post-hepatectomy bile leak were assessed. The subjects were 550 patients who underwent a hepatectomy during 1990-2011, with (n = 83) and without (n = 467) C tube drainage. The use of a C tube was based on the surgeon's choice. Bile leakage was observed in 44 (8...

Background/aims: Despite recent advances in surgical techniques, blood loss is an important factor associated with postoperative outcomes in pancreatectomy. It is useful to identify risk factors of increased blood loss. Methodology: The clinical records of 161 patients who underwent an elective pancreatectomy for peripancreatic diseases between...

In era of systemic chemotherapy for colorectal liver metastasis (CLM), role of hepatic intraarterial infusion chemotherapy (HAIC) remains important. We examined treatment effects of HAIC in 36 patients with non-resectable CLM using 5-FU or CPT-11. Tumor response was complete response (CR) in 4, partial response (PR) in 19, stable disease (SD) in 6,...

Background Acinar cell carcinoma (ACC) is a very rare malignancy and represents only 1% to 2% of pancreatic exocrine carcinomas. At the time of diagnosis, 75% of ACC are resectable. Reliable data concerning effective adjuvant chemotherapy has not been established. Case presentation A 30-mm tumor in the pancreatic tail was incidentally discovered by...

Purpose: Arterial enhancement of intrahepatic cholangiocarcinoma (ICC) has been noted. To precisely identify the characteristics of tumor enhancement patterns, we examined the relationship between CT attenuation in the tumor and clinicopathological parameters or prognosis. Methods: Subjects were 42 ICC patients who had undergone hepatectomy. mic...

The efficacy of adjuvant photodynamic therapy (PDT) using the new photosensitizer, talaporfin sodium (TPS), was assessed in 7 patients with bile duct carcinoma (BDC). The 664-nm semiconductor laser (100 J/cm(2)) was applied through endoscopy to the tumor lesion within 6 h after injection of TPS. Cases included three non-resectable and 4 resected BD...

Purpose: Despite recent advances in surgical techniques, blood loss can still determine the postoperative outcome of hepatectomy. Thus, the preoperative identification of risk factors predicting increased blood loss is important. Methods: We studied retrospectively the clinical records of 482 patients who underwent elective hepatectomy for liver...

Background/aims: Surgical resection is a radical treatment option for gallbladder carcinoma (GBC); however, it is still difficult to cure and patient prognosis is poor. An assessment of the surgical results and chemotherapy options may elucidate effective treatments. Methodology: We retrospectively examined the demographics, surgical records and...

Efficacy of fibrin glue to prevent biliary or pancreas fistula at the resected edge of the liver or pancreas is controversial. We examined surgical results of fibrin glue use in patients who underwent hepatectomy or pancreatectomy to assess the efficacy of its use. Subjects were divided into two groups; the fibrin glue group in hepatectomy (n=228)...

To identify the clinical significance of the omental wrapping (OW) technique after left hepatectomy to reduce bile leakage and delayed gastric emptying. We examined clinical and surgical parameters after left hepatectomy with or without biliary reconstruction in 79 patients. This was a retrospective study of data from 14 patients undergoing OW comp...

Surgical resection is a radical treatment option for pancreatic carcinoma (PC); however, it is still difficult to cure and patient prognosis is poor at this stage. We examined the demographics, surgical records and outcome in 64 patients with hilar PC undergoing surgical resection. Pancreatoduodenectomy (PD) was carried out in 48 patients, distal p...

In locally advanced pancreatic body cancers, cancer infiltrates major vessels such as the celiac axis, common hepatic artery and superior mesenteric artery or vein, which is the borderline of resectability. Patients also suffer severe abdominal pain. Kondo and Hirano et al. developed a radical operation called "distal pancreatectomy with en bloc ce...

Introduction: Hepatocellular carcinoma (HCC) is a major cause of cancer-related deaths around the world. Nearly half of patients with HCC display metastatic disease at the time of initial diagnosis, frequently involving the liver, bone, brain, lungs, and adrenal glands, but gastrointestinal involvement is rare. Melena occurring secondary to a meta...

In advanced cancers of hepatobiliary and pancreatic lesions, major vascular resection and reconstruction are necessary to accomplish curative resection. Stenosis of vascular anastomosis is a concern in case of portal or superior mesenteric venous anastomosis with different vascular calibers. We attempted to apply parachute anastomosis in such a sit...

Background/aims: Surgical resection is a radical treatment option for hilar bile duct carcinoma (HBDC); however, it is still difficult to cure and postoperative morbidity is high at this stage. Methodology: We examined the demographics, surgical records and outcome in 38 patients with hilar cholangiocarcinoma undergoing operation. Results: Fiv...

Using endoscopic biopsies, gastric mucosal expression levels of interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor-alpha (TNF-α) messenger RNA (mRNA) and microRNAs (miRNAs) that were differentially expressed in association with Helicobacter pylori were assessed by quantitative reverse-transcriptase polymerase chain reaction. Among the H. py...

The emphasis in anticancer drug discovery has always been on finding a drug with great antitumor potential but few side-effects. This can be achieved if the drug is specific for a molecular site found only in tumor cells. Here, we find the enhancer of zeste homolog 2 (EZH2) to be highly overexpressed in lung and other cancers, and show that EZH2 is...

A 77-year-old woman with a history of coronary artery bypass grafting 5 years earlier presented with anemia and was diagnosed with advanced gastric cancer involving the pylorus. Preoperative angiography revealed that the right gastroepiploic artery (RGEA) graft was patent. Multidetector-row computed tomography showed the running pattern of the RGEA...

Esophageal squamous cell carcinoma (ESCC) is often diagnosed at later stages until they are incurable. MicroRNA (miR) is a small, non-coding RNA that negatively regulates gene expression mainly via translational repression. Accumulating evidence indicates that deregulation of miR is associated with human malignancies including ESCC. The aim of this...

To improve diagnostic accuracy of intraoperative ultrasonography (IOUS), we investigated the usefulness of new contrast medium of microbubble agent, Sonazoid as a preliminary study. We examined IOUS in 50 patients with liver tumors who underwent hepatectomy. Sonazoid was administrated intravenously and Kupffer-phase images of the tumor were observe...

Morphologically, liver metastases from colorectal carcinoma usually form as nodular tumor masses, whereas intraductal papillary growth in the bile duct is rare. A 65-year-old man underwent right hemicolectomy for advanced colon carcinoma, and histology of the primary carcinoma confirmed moderately differentiated adenocarcinoma with subserosal invas...

症例は43歳，女性．1型糖尿病にて治療中．便秘と腹痛を主訴に前医受診し，左下腹部に強い圧痛を認めたため消化管穿孔が疑われ当院紹介．腹部CTにてfree airは認めず，S状結腸を先端として糞便塊を大量に含んだ著明な結腸の拡張を認めた．内科的治療に奏効せず，大腸内視鏡施行し粘土状の糞便を洗浄や鉗子にて破砕を試みると，周囲の腸管が全周性に深い潰瘍を形成していた．また，腹満による呼吸苦が出現したため緊急手術を施行した．開腹すると拡張したS状結腸は一部白苔を伴い，肛門側は虚脱していた．内視鏡にて潰瘍部を確認し，その肛門側にて腸管を切離．約1.6kgの便塊を押し出し，潰瘍形成した腸管を切除後，ハルトマン手術とした．術後経過は良好で，術後4カ月目に再入院し人工肛門閉鎖術を施行した．糞便性イレウスは透析患...

症例は84歳，男性．心窩部痛を主訴に受診．腹部CT検査では膵全体に多発する嚢胞が指摘され，また膵体部に3cm大の嚢胞に隣接した3cm大の低濃度腫瘍を認めた．内視鏡的逆行性膵管造影検査では膵体部での主膵管の著明な狭窄と尾側膵管の数珠状の拡張を呈していた．超音波内視鏡検査では嚢胞内の結節から膵実質の不整な腫瘍への連続性を認め，膵管内乳頭粘液性腫瘍（IPMN）に由来した膵癌が疑われた．膵体尾部切除術を施行し病理組織学的検査で膵IPMNに由来した膵腺扁平上皮癌の診断を得た．術後経過は良好で術後23カ月無再発生存中である．膵IPMNに由来した膵腺扁平上皮癌の報告はまれであり若干の文献的考察を加えて報告する．

Expert technique and special anatomical or physiological knowledge are needed in the field of pancreatic surgery. The establishment of basic policies and operative techniques for pancreaticoduodenectomy (PD) and stepwise training for young pancreatic surgeons are necessary. We scheduled PD for ampullar, biliary and pancreas carcinoma, and evaluated...

Pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (1CTP) is a sensitive serum marker for metastatic bone carcinomas and may also be associated with invasiveness of various carcinomas. To clarify the significance of 1CTP in hepato-biliary pancreas malignancies, we examined the relationship between clinicopathological features...

Vascular infiltration (VI) is an important prognostic factor for hepatocellular carcinoma (HCC) and predictive parameters are necessary to preoperatively decide treatment strategies in patients with HCC. Relationships between presence and degree of VI in the portal and hepatic veins and bile duct, and post-hepatectomy survival were examined in 271...

This study identified significantly down-regulated microRNAs (miRs) specific for esophageal squamous cell carcinoma (ESCC) cells. Total RNA was extracted from ESCC cell lines (OE21 and TE10) and a non-malignant human esophageal squamous cell line (Het1A), and subjected to microarray analysis. Expression levels of miRs that showed significant down-r...

Cancer death in the early period after hepatectomy remains problematic in patients with hepatocellular carcinoma (HCC). We examined the relationship between clinicopathological parameters' and survival periods in 234 HCC patients who underwent hepatectomy. Patients were divided into four groups: Group 1, survival > 5 years; Group 2, survival for 2-...

It is difficult to diagnose lymph node metastasis in biliary and pancreas carcinomas before surgery. The aim of this study was to assess the utility of the combination of multi-detector computed tomographic (MDCT) findings and serum carbohydrate antigen (CA)19-9 level in the diagnosis of lymph node metastasis in biliary and pancreas carcinomas. The...

Hepatectomy is accepted as the standard therapy in patients with resectable liver metastases. In recent years, the techniques such as microwave coagulation therapy (MCT) and radiofrequency ablation therapy (RFA) have been developed, so we have many options to treat. We evaluated nineteen subjects with cases of liver metastases who underwent thermoa...

The accidental ingestion of a foreign body is not uncommon. However, the presence of a foreign body in the gallbladder is extremely rare. Here, we present a case of cholecystitis due to a fish bone that may have penetrated through the stomach wall and into the gallbladder without causing peritonitis. A laparoscopic cholecystectomy was performed; a...

To achieve complete resection of metastatic colonic carcinoma in the liver and lung, thoracolaparotomy-assisted simultaneous resection was attempted in a 60-year-old male patient who had previously undergone sigmoidectomy for primary sigmoid colon carcinoma. A solitary liver metastasis was observed in segment 7 and a solitary lung metastasis was lo...

Microvessel count (MVC) has been correlated with patient prognosis in hepatocellular carcinoma. We investigated whether MVC assessed by staining with CD34 antibody was associated with disease-free and overall survival in patients with metastatic liver cancer (MLC). We examined relationships between MVC and clinicopathologic factors or postoperative...

Cancer death in the early period after hepatectomy still occurs in patients with colorectal liver metastasis (CLM). We examined the relationship between clinicopathological parameters and survival periods in 130 CLM patients who underwent hepatectomy. Patients were divided into four groups: Group 1 (5-year survivors without tumor relapse), Group 2...

The present study aimed to elucidate the relationship between microvessel count (MVC) according to CD34 expression and prognosis in intrahepatic cholangiocarcinoma (ICC) patients who underwent hepatectomy based on our preliminary study. Relationships between MVC and clinicopathological factors were examined in 37 ICC patients. CD34 expression was a...

Histone methylation is involved in the regulation of gene expression and DNA replication through alteration of chromatin structure. We earlier showed that SMYD3, a histone H3-lysine 4-specific methyltransferase, is frequently upregulated in human colorectal, liver and breast cancer compared to their matched non-cancerous cells, and that its activit...

We previously identified SMYD3 as a histone methyltransferase and showed that its expression was elevated in colorectal, hepatocellular, and breast carcinomas. In the investigation of methyltransferase activity of SMYD3, we have found that vascular endothelial growth factor receptor 1 (VEGFR1) was also methylated by SMYD3. We further identified the...