Yuichiro Doki

Osaka City University, Ōsaka, Ōsaka, Japan

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Publications (693)1980.09 Total impact

  • Molecular and Clinical Oncology 01/2015; DOI:10.3892/mco.2015.490
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    ABSTRACT: Cell cycle-arrested cancer cells are resistant to conventional chemotherapy that acts on the mitotic phases of the cell cycle, although the molecular mechanisms involved in halting cell cycle progression remain unclear. Here, we demonstrated that RFPL4A, an uncharacterized ubiquitin ligase, induced G1 retention and thus conferred decreased sensitivity to chemotherapy in the human colorectal cancer cell line, HCT116. Long-term time-lapse observations in HCT116 cells bearing a fluorescence ubiquitin-based cell cycle indicator (Fucci) identified a characteristic population that is viable but remains in the G1 phase for an extended period of time (up to 56 h). Microarray analyses showed that expression of RFPL4A was significantly upregulated in these G1-arrested cells, not only in HCT116 cells but also in other cancer cell lines, and overexpression of RFPL4A increased the G1 population and decreased sensitivity to chemotherapy. However, knockdown of RFPL4A expression caused the cells to resume mitosis and induced their susceptibility to anti-cancer drugs in vitro and in vivo. These results indicate that RFPL4A is a novel factor that increases the G1 population and decreases sensitivity to chemotherapy, and thus may be a promising therapeutic target for refractory tumor conditions. Copyright © 2015, The American Society for Biochemistry and Molecular Biology.
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    ABSTRACT: Although pre-operative chemoradiotherapy appears to be a promising treatment for patients with pancreatic ductal adenocarcinoma, there have been no reports of the feasibility of pre-operative chemoradiotherapy in pancreatic ductal adenocarcinoma patients with renal impairment. The aim of this study was to evaluate retrospectively the feasibility of pre-operative chemoradiotherapy in pancreatic ductal adenocarcinoma patients with renal impairment. Twelve patients with resectable pancreatic ductal adenocarcinoma and a creatinine clearance of <60 ml/min were enrolled in this study. Gemcitabine-based pre-operative chemoradiotherapy was performed, followed by surgery. The feasibility of the treatment was evaluated in terms of clinical outcome and adverse events in the patients. All 12 patients completed gemcitabine-based pre-operative chemoradiotherapy without worsening of renal function. Restaging after the therapy revealed radiologically unresectable disease in two patients. Among the remaining 10 patients who underwent laparotomy, curative resection was performed in eight patients. After curative resection, five patients out of the eight completed post-operative adjuvant therapy. The 1- and 3-year survival rates after the start of chemoradiotherapy in the 12 patients were 80.8 and 36.9%, respectively. Our findings suggest that gemcitabine-based pre-operative chemoradiotherapy may be a safe and effective treatment for pancreatic ductal adenocarcinoma in patients with renal impairment. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
    Japanese Journal of Clinical Oncology 01/2015; DOI:10.1093/jjco/hyu224 · 1.75 Impact Factor
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    ABSTRACT: Tumour targeting nanotechnology has recently made therapeutic progress and several therapeutic nanoparticles have been approved for clinical application. However, an ideal nanotechnology based therapeutic for solid tumours, particularly for systemic administration, still remains a challenge in clinical cancer therapy. We previously reported a pH sensitive in vivo delivery system of doxorubicin, or microRNA, using carbonate apatite (CA) nanoparticles. To further explore utility of CA in cancer therapy, we attempted to transport excess glucose into tumour cells by conjugating glucose (Glc) to the nanoparticle. Despite the non-toxicity of CA and Glc, the complex (CA-[Glc]) exhibited an unexpected anti-cancer effect in vitro and in vivo. CA-[Glc] significantly reduced the growth of colon cancer cell lines. Intravenous injections successfully suppressed solid tumour growth. In mice and monkeys, intravenously injected CA-[Glc] complex resulted in no serious abnormalities in body weight or blood chemistry. Because cancer cells intensively metabolise glucose than normal cells, treatment of cancer using glucose seems paradoxical. However, with the aid of CA, this safe and 'sweet' complex may be a novel anti-cancer reagent.
    Scientific Reports 01/2015; 5:7742. DOI:10.1038/srep07742 · 5.08 Impact Factor
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    ABSTRACT: Purpose This study aimed to assess the efficacy of daikenchuto (DKT), a commonly prescribed, traditional Japanese herbal medicine, on postoperative intestinal dysfunction after gastric cancer surgery. Methods Patients with gastric cancer scheduled for a total gastrectomy were randomly assigned before surgery to receive either no treatment (n = 40; control group) or DKT (7.5 g/day, t.i.d.) for 3 months (n = 41) postoperatively. We examined gastrointestinal motility, stool attributes, the quantity of bowel gas, the quality of life, and the incidence of postoperative ileus. Results During the hospital stay, significant differences were observed between the DKT group and controls in the number of stools per day (1.1 ± 0.6 vs 0.8 ± 0.4, respectively; P = 0.037) and stool consistencies (Bristol scale ratings were 3.7 ± 0.8 vs 3.1 ± 0.8, respectively; P = 0.041). The DKT group showed significant reductions in gas volume scores, calculated from abdominal radiographs, at 7 days, 1 month, and 3 months after surgery. The groups did not show significant differences in quality of life scores (based on the Gastrointestinal Symptom Rating Scale) or in the incidence of postoperative ileus. Conclusion DKT improved bowel movements, stool properties, and bowel gas. These results suggested that DKT promoted early postoperative bowel functions after total gastrectomy.
    Journal of Gastrointestinal Surgery 01/2015; 19(3). DOI:10.1007/s11605-014-2730-y · 2.39 Impact Factor
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    ABSTRACT: Conducting clinical trials to establish evidence of the benefits of adjuvant treatment for resectable esophagogastric junction (EGJ) cancer is difficult because it is a very rare disease compared with gastric or esophageal cancer. In the West, where esophageal cancer occurs more frequently than gastric cancer, a phase III trial (the CROSS trial) demonstrated the efficacy of preoperative chemoradiotherapy using carboplatin plus paclitaxel for patients with esophageal or EGJ cancer. Thus, this preoperative regimen is considered to be the standard adjuvant treatment for resectable EGJ cancer in the West. On the other hand, the Western evidence is not widely accepted in Asia because there are many differences in surgical techniques, particularly in the field of lymph node dissection, between the West and Asia. The standard adjuvant treatment for resectable EGJ cancer in Asia is postoperative chemotherapy using S-1 alone or capecitabine plus oxaliplatin based on the results of two large-scale phase III trials in gastric cancer conducted in East Asia. The incidence of EGJ cancer has recently increased in Japan, and nationwide studies to develop more effective adjuvant treatment for resectable EGJ cancer should be conducted in the near future.
    Nippon Geka Gakkai zasshi 01/2015; 116(1):50-4.
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    ABSTRACT: Right non-recurrent inferior laryngeal nerve is a rare nerve anomaly that communicates the right vagal nerve trunk to the laryngeal nerve directly in the neck, and is usually accompanied by an aberrant right subclavian artery. We report a case of thoracic esophagectomy with intraoperative neuromonitoring undertaken in a patient with these abnormalities. This case report concerns a 66-year-old man with thoracic esophageal carcinoma who was referred to our hospital. An aberrant right subclavian artery that gave us a prediction of a right non-recurrent inferior laryngeal nerve was detected preoperatively using computed tomography, and identified visually with intraoperative neuromonitoring. Identification of this nerve anomaly during cervical lymph node dissection was considered important to avoid unexpected neural injuries. For a successful esophagectomy with lymph node dissection in patients with this anomaly, intraoperative neuromonitoring for the non-recurrent inferior laryngeal nerve may provide a useful contribution to surgical safety.
    Esophagus 01/2015; DOI:10.1007/s10388-015-0493-5 · 0.74 Impact Factor
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    ABSTRACT: Purpose Patients with resectable thoracic esophageal squamous cell cancer (TESCC) and positron emission tomography (PET)-positive lymph nodes (PET-N positive) are likely to have ≥3 pathological lymph node metastases (pLNMs) and show a higher rate of postoperative recurrence despite curative resection than PET-N-negative TESCC patients. We examined the prognostic significance of 18F-fluorodeoxyglucose uptake into lymph node metastases after neoadjuvant chemotherapy (NAC) for PET-N positive TESCC and aimed to propose the optimal NAC response criteria for these patients. Methods Fifty-one patients with PET-N positive TESCC underwent two courses of NAC followed by surgery. Metabolic responses of primary tumors and LNs were prospectively evaluated and associations with clinicopathological data and patient survival assessed by univariate and multivariate analyses. Results After NAC, 21 patients were post-treatment (post-) PET-N positive and 30 post-PET-N negative. A significantly (p p = 0.015) independent of the primary tumor response. Conclusions PET-N negative status predicts ≤2 pLNMs and longer RFS in resectable TESCC patients even after NAC. Therefore, post-PET-N status, not the effects on the primary tumor, is a critical NAC treatment response criterion for evaluating prognosis and guiding subsequent treatment.
    Annals of Surgical Oncology 12/2014; DOI:10.1245/s10434-014-4299-9 · 3.94 Impact Factor
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    ABSTRACT: Recent advances in diagnostic techniques have allowed the diagnosis of gastric cancer (GC) at an early stage. Due to the low incidence of lymph node metastasis and favorable prognosis in early GC, function-preserving surgery which improves postoperative quality of life may be possible. Pylorus-preserving gastrectomy (PPG) is one such function-preserving procedure, which is expected to offer advantages with regards to dumping syndrome, bile reflux gastritis, and the frequency of flatus, although PPG may induce delayed gastric emptying. Proximal gastrectomy (PG) is another function-preserving procedure, which is thought to be advantageous in terms of decreased duodenogastric reflux and good food reservoir function in the remnant stomach, although the incidence of heartburn or gastric fullness associated with this procedure is high. However, these disadvantages may be overcome by the reconstruction method used. The other important problem after PG is remnant GC, which was reported to occur in approximately 5% of patients. Therefore, the reconstruction technique used with PG should facilitate postoperative endoscopic examinations for early detection and treatment of remnant gastric carcinoma. Oncologic safety seems to be assured in both procedures, if the preoperative diagnosis is accurate. Patient selection should be carefully considered. Although many retrospective studies have demonstrated the utility of function-preserving surgery, no consensus on whether to adopt function-preserving surgery as the standard of care has been reached. Further prospective randomized controlled trials are necessary to evaluate survival and postoperative quality of life associated with function-preserving surgery.
    World Journal of Gastroenterology 12/2014; 20(46):17297-17304. DOI:10.3748/wjg.v20.i46.17297 · 2.43 Impact Factor
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    ABSTRACT: Background:Circulating tumour DNA (ctDNA) is an emerging candidate biomarker for malignancies and may be useful for monitoring the disease status of gastric cancer.Methods:We performed targeted deep sequencing of plasma cell-free DNA (cfDNA) by massively parallel sequencing in patients with tumours harbouring TP53 mutations. The quantitative values of TP53-ctDNA during the clinical course were compared with the tumour status.Results:Three out of ten patients with TP53 mutations in primary tumours showed detectable TP53 mutation levels in preoperative cfDNA. Although the cfDNA concentrations were not always reflective of the disease course, the ctDNA fraction correlated with the disease status.Conclusions:ctDNA may serve as a useful biomarker to monitor gastric cancer progression and residual disease.British Journal of Cancer advance online publication 9 December 2014; doi:10.1038/bjc.2014.609 www.bjcancer.com.
    British Journal of Cancer 12/2014; DOI:10.1038/bjc.2014.609 · 4.82 Impact Factor
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    ABSTRACT: In low anterior resections, anastomosis continues to present major problems. Although the single-stapling technique (SST) is considered to be superior to the double-staple technique (DST) in terms of leakage and stenosis, SST requires suturing, which is particularly difficult during laparoscopic surgery. A simpler and safer method of anastomosis is needed. In this study, we developed a pre-ligation SST (L-SST) that does not require suturing and evaluated the usefulness of L-SST in an ex vivo and an in vivo porcine model. Porcine rectums were ligated using SurgiTie™ and sharply resected instead of using a linear stapler. The burst pressures of the closed rectums after using a linear stapler and SurgiTie™ (each group; n = 5) and the burst pressures of the anastomoses performed with L-SST and DST (each group; n = 4) were measured. During in vivo porcine laparoscopic surgery, we performed and evaluated the feasibility of L-SST. After completing the anastomosis with L-SST, the ligated portion using SurgiTie™ was completely removed. The stump closed using SurgiTie™ was much stronger than that closed using a stapler (131.2 and 25.6 mmHg, respectively; P = 0.01). The average burst pressure of the anastomoses performed with L-SST was 33.8 mmHg, whereas that performed with DST was 30.5 mmHg. We did not find significant difference between these two groups (P = 0.88). We also confirmed the feasibility of L-SST in an in vivo porcine laparoscopic surgery model. We developed a novel SST, the L-SST. We were able to perform L-SST successfully using an ex vivo porcine rectum and during in vivo porcine laparoscopic surgery.
    Surgical Endoscopy 12/2014; DOI:10.1007/s00464-014-3960-5 · 3.31 Impact Factor
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    ABSTRACT: Steady pressure automatically controlled endoscopy (SPACE) is a new modality that eliminates on-demand insufflation but enables automatic insufflation in the gastrointestinal tract. Though its use in porcine esophageal ESD was reported to be promising, its applicability and potential effectiveness to gastric procedures have not been evaluated. The aims were (1) to evaluate feasibility and safety of SPACE in the stomach, and (2) to assess its potential advantages over conventional endoscopy in preventing "blind insufflation"-related complications. A multicenter randomized preclinical animal study. Laboratories at three universities. Experiment 1: Gastric ESD was attempted in the swine (n = 17), under either SPACE or manual insufflation. Experiment 2: Gastroscopy was performed for 10 min in the perforated stomach (n = 10) under either SPACE or manual insufflation. Experiment 1: ESD time, energy device activation time, number of forceps exchanges, specimen size, en block resection rate, vital signs and any intraoperative adverse events. Experiment 2: Intra-gastric and intra-abdominal pressures, vital signs, and any adverse events. Experiment 1: Gastric ESD was completed in all animals. ESD time tended to be shorter in SPACE than in the control, though the difference was not significant (p = 0.18). Experiment 2: Although both intra-gastric and intra-abdominal pressures remained within preset values in SPACE, they showed excessive elevation in control. An animal study with small sample size. SPACE is feasible and safe for complicated and lengthy procedures such as gastric ESD, and is potentially effective in preventing serious consequences related to excessive blind insufflation.
    Surgical Endoscopy 12/2014; DOI:10.1007/s00464-014-4001-0 · 3.31 Impact Factor
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    ABSTRACT: Recent studies have suggested that microRNA-29 (miR-29) family members may play important roles in human cancer by regulating cell proliferation, differentiation, apoptosis, migration, and invasion. The present study aimed to investigate the clinical significance and biological function of miR-29b in colorectal cancer (CRC). Real-time polymerase chain reaction was used to quantify miR-29b expression. The association between miR-29b and survival was evaluated in 245 patients with CRC. We transfected an miR-29b mimetic into CRC cells to explore the functional role of miR-29b in vitro, based on a proliferation assay, flow cytometry, and Western blotting. In clinical samples of CRC, miR-29b expression was significantly reduced in tumor tissues compared with normal mucosa (p < 0.012). Multivariate survival analyses indicated that miR-29b expression was an independent prognostic factor for disease-free survival (p = 0.026), lymph node metastasis (p = 0.004), and pathological T classification (p = 0.002). In a multivariate analysis of 5-year overall survival, we found a similar association between lymph node metastasis, pathological T classification, venous invasion, and miR-29b expression (p = 0.013). In vitro, low Ki-67-positive staining showed that administration of the mimic-miR-29b reduced proliferation of CRC cells. An Annexin V apoptosis assay and flow cytometric analysis revealed that miR-29b induced apoptosis and arrested the cell cycle at the G1/S transition. Moreover, miR-29b inhibited the expression of MCL1 and CDK6. Our findings indicated that miR-29b may be a useful, novel, prognostic marker and may play important roles in regulating apoptosis and cell cycle in CRC.
    Annals of Surgical Oncology 12/2014; DOI:10.1245/s10434-014-4255-8 · 3.94 Impact Factor
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    ABSTRACT: Laparoscopic partial gastrectomy has become a common procedure for gastric submucosal tumors because of its accepted feasibility, safety, and oncologic outcomes. However, long-term postoperative outcomes have not been determined, especially based on the location of submucosal tumors. We reviewed 52 consecutive gastric submucosal tumor patients who underwent laparoscopic partial gastrectomy between 1999 and 2009. They were divided into a lesser curvature group (LC group, n = 23) and a greater curvature group (GC group, n = 26) according to tumor location. We compared the following postoperative data about gastric function between the two groups: (i) body weight change during the first postoperative year; (ii) gastrointestinal symptoms (e.g. abdominal pain/discomfort, bloating, heartburn, and dyspepsia); (iii) the amount of food residue at endoscopy; and (iv) the need for medications such as histamine H2 -receptor antagonists, proton pump inhibitors, and prokinetic drugs. Only a few patients - one in the LC group and two in the GC group - showed body weight loss (over 10%). Compared to the GC group (n = 0 in all three categories), the LC group showed significantly higher frequency of prolonged postoperative abdominal symptoms (n = 4, P = 0.042), food residue at endoscopic follow-up (n = 4, P = 0.036), and postoperative medication use (n = 5, P = 0.016). Patients who received laparoscopic partial gastrectomy did not have severe body weight loss, which suggests dysfunction of the gastric remnant. However, patients in the LC group should receive special attention, as they have a higher risk of developing postoperative gastrointestinal symptoms. © 2014 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.
    Asian Journal of Endoscopic Surgery 12/2014; 8(1). DOI:10.1111/ases.12145
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    ABSTRACT: Aim: We investigated clinical and dosimetric factors influencing the risk of developing pericardial effusion (PCE) in patients with Stage I esophageal cancer undergoing definitive chemoradiotherapy. Patients and Methods: Sixty-nine patients with Stage I esophageal cancer who underwent definitive chemoradiotherapy were retrospectively analyzed. Treatment comprised of three-dimensional conformal radiotherapy (60 Gy in 30 fractions) with concurrent chemotherapy. Clinical and dosimetric factors associated with PCE development were analyzed. Results: The median follow-up was 37 months (range=8-111 months); the crude PCE incidence rate was 52.2%. Grade 2 and 3 incidence rate was 47.8% and 4.3%, respectively. The median time to PCE onset was 5.7 months after radiotherapy. In multivariate analysis, pericardial V30 ≥41.6%, age ≥66 years, body mass index (BMI) ≥19 and diabetes mellitus (DM) were significant predictors of developing PCE. Conclusion: The present study suggests that higher pericardial V30, advanced age, high BMI and DM are risk factors for developing PCE.
    Anticancer research 12/2014; 34(12-12):7389-7393. · 1.87 Impact Factor
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    ABSTRACT: Background and ObjectiveSPARC (secreted protein acidic and rich in cysteine) is a matricellular glycoprotein that modulates interactions between tumoral cells and the peri-tumoralstroma. SPARC induces proliferation and invasion in vitro, and is a poor prognostic factor in several gastrointestinal cancers. Herein, we evaluated the prognostic value of tumoral and stromal SPARC expression in patients with biliary tract cancer (BTC) after surgery.Methods We examined immunohistochemical patterns of SPARC expression in 110 resected BTC specimens and evaluated the prognostic value using prospectively collected data.ResultsSPARC was expressed in tumoral cells in 46 samples (42%) and inperi-tumoralstromain 65 samples (59%). Tumoral SPARC expression was not related to major patient characteristics. Stromal SPARC expression was related to lymph node metastasis, stage, margin status, and tumor location. Overall survival at 5 years after surgery was 34.2%. Stromal SPARC (P < 0.001) and tumoral SPARC (P = 0.048) were associated with poor prognosis. Multivariate analysis revealed invasion into lymphatic system, residual tumor, and stromal SPARC as independent prognostic factors. The hazard ratio for patients with positive stromal SPARC was 3.20 (P < 0.001).ConclusionSPARC expression inperi-tumoralstroma predicts a poor prognosis for patients with BTC after surgery. J. Surg. Oncol. © 2014 Wiley Periodicals, Inc.
    Journal of Surgical Oncology 12/2014; 110(8). DOI:10.1002/jso.23767 · 2.84 Impact Factor
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    ABSTRACT: We report the response to pre-operative gemcitabine-based chemoradiotherapy for pancreatic adenocarcinoma. Thirty-five consecutive patients with borderline resectable pancreatic adenocarcinoma of UICC Stage II or III with portal vein invasion or tumor abutment of artery received radiotherapy (twice daily fractions of 1.5 Gy, 5 days/week, total dose: 36 Gy; 30 Gy for Phase I Level 1) with weekly intravenous infusions of gemcitabine (400, 600 and 800 mg/m(2)) at Days 1 and 8 for Phase I and 800 mg/m(2) for Phase II. Restaging was repeated after completion of chemoradiotherapy. Twenty-six of the 35 (74.3%) patients underwent resection. The dose-limiting toxicities were Grade 4 neutropenia and thrombocytopenia. The recommended regimen was total radiation dose of 36 Gy with gemcitabine 800 mg/m(2). Surgical resection was conducted in 11 of the 15 (73.3%) patients in Phase I study and 15 of the 20 (75.0%) in Phase II. After recommended dose chemoradiotherapy and surgical resection, the median disease-free survival was 17.4 months (5-year survival rate = 14.3%). The median overall survival time and 5-year survival rate were 41.2 months and 28.6%, respectively, for the 21 patients who underwent resection and 10.0 months and 0%, respectively, for those 5 who did not (P = 0.004). Our pre-operative gemcitabine-based chemoradiotherapy was well tolerated and safe. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
    Japanese Journal of Clinical Oncology 12/2014; 44(12):1172-80. DOI:10.1093/jjco/hyu143 · 1.75 Impact Factor
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    ABSTRACT: It is controversial whether the treatment strategy for gastric cancer should be different for elderly patients. We herein evaluated the feasibility of gastrectomy and the risk factors for postoperative complications in octogenarians with gastric cancer. We retrospectively collected data on 441 consecutive patients who underwent total or subtotal gastrectomy for gastric cancer. We divided all of the patients into two groups: the octogenarian group (n = 47), consisting of patients aged 80-89 years, and the younger group (n = 394), consisting of patients under 80 years of age. The postoperative complication rate was 23.1 % (91/394) in the younger group and 36.2 % (17/47) in the octogenarian group (P = 0.049). Octogenarian patients had significantly lower preoperative serum albumin levels (P < 0.001) and higher ASA scores (P < 0.001). Although the rate of each major complication was similar between the two groups, there was a trend toward a higher rate of other miscellaneous complications, mostly non-surgical complications, in the octogenarian group (P = 0.077). A multivariate analysis of the patients in the octogenarian group revealed that only total gastrectomy was a significant risk factor for postoperative complications (P = 0.035). Octogenarian patients with gastric cancer experienced more complications than younger patients. Therefore, closer monitoring is needed for octogenarian patients who will receive total gastrectomy.
    Surgery Today 11/2014; DOI:10.1007/s00595-014-1087-x · 1.21 Impact Factor
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    ABSTRACT: We previously generated induced pluripotent stem cells by reprograming adipose stem cells through the introduction of microRNAs targeting four transcription factors (Oct3/4, Sox2, c-Myc, and Klf4). In this study, we aimed to reprogram cancer cells using microRNAs to explore their therapeutic potential.
    Annals of Surgical Oncology 11/2014; DOI:10.1245/s10434-014-4217-1 · 3.94 Impact Factor
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    ABSTRACT: IntroductionPurposeThese guidelines are intended for doctors who are engaged in the diagnosis and treatment of esophageal carcinoma, for the following purposes: (1) to present the standard practice for the diagnosis and treatment of esophageal carcinoma with a high regard for the principles of evidence-based medicine (EBM); (2) to improve the safety and results of treatment, thereby reducing the difference in treatment results among different institutions; (3) to reduce unnecessary costs and efforts; (4) help enable people to undergo treatment without anxiety.These guidelines provide only guidance on the indications for treatment and do not restrict or prohibit the use of any treatment deviating from those described herein.ResponsibilitiesThe Japan Esophageal Society assumes responsibility for the content described in these guidelines.However, responsibility for the treatment results should be borne by the doctor providing the treatment and shall not rest with the Japan Esophageal Soci ...
    Esophagus 11/2014; 12(1):1-30. DOI:10.1007/s10388-014-0465-1 · 0.74 Impact Factor

Publication Stats

7k Citations
1,980.09 Total Impact Points


  • 2000–2015
    • Osaka City University
      • • Department of Gastroenterological Surgery
      • • Graduate School of Medicine
      Ōsaka, Ōsaka, Japan
  • 1998–2015
    • Osaka University
      • • Department of Surgery
      • • Division of Gastroenterological Surgery
      • • Graduate School of Medicine
      Suika, Ōsaka, Japan
  • 2011–2013
    • Kyushu University
      • • Division of Surgery
      • • Medical Institute of Bioregulation - MIB Hospital
      Fukuoka-shi, Fukuoka-ken, Japan
  • 2000–2008
    • Osaka Medical Center for Cancer and Cardiovascular Diseases
      Ōsaka, Ōsaka, Japan
  • 2004
    • Okayama University
      Okayama, Okayama, Japan
  • 1995–1997
    • Columbia University
      • College of Physicians and Surgeons
      New York City, NY, United States
    • Kyoto University
      Kioto, Kyōto, Japan
  • 1996
    • Weizmann Institute of Science