Publications by authors named "Fujisaki J"

Stem cells reside in specialized microenvironments, termed niches, at several different locations in tissues. The differential functions of heterogeneous stem cells and niches are important given the increasing clinical applications of stem-cell transplantation and immunotherapy. Whether hierarchical structures among stem cells at distinct niches exist and further control aspects of immune tolerance is unknown.

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Background And Study Aim: Endoscopic resection (ER) of esophageal squamous cell carcinoma (ESCC) is an organ-preserving treatment; however, heterochronic carcinomas are often encountered. Most patients are treated using ER; however, for some, this is inadequate and requires additional treatment. We sought to identify the characteristics and frequency of lesions at high risk of metastasis during surveillance based on Lugol-voiding lesion (LVL) grading and esophagogastroduodenoscopy (EGD) intervals.

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Article Synopsis
  • This study aimed to evaluate the effectiveness of artificial intelligence (AI) in helping endoscopists detect esophageal squamous cell carcinoma (ESCC) in a clinical trial, as previous studies were only retrospective.
  • In this randomized controlled trial, high-risk patients were assigned to either an AI-supported group or a control group, with endoscopists utilizing different monitors during screening procedures.
  • Results showed no significant difference in ESCC detection rates between the AI group and the control group, suggesting that the AI system did not improve detection for either non-experts or experts in a clinical setting.
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Background: Little is known about prognostic factors for patients 85 years or older undergoing endoscopic submucosal dissection for early gastric cancer. Therefore, this study aimed to identify such prognostic factors.

Methods: We retrospectively evaluated the long-term outcomes and prognostic factors of 143 patients 85 years or older undergoing endoscopic submucosal dissection for early gastric cancer at a single-center between October 2005 and September 2020.

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Unlabelled: Herein, we report a case of myocarditis in a 27-year-old male with long-term follow-up using longitudinal peak systolic strain (LPSS) measurements with transthoracic echocardiography (TTE) and late gadolinium enhancement (LGE) in cardiovascular magnetic resonance imaging (CMR). On admission, a predominant decrease was observed in the LPSS in the posterolateral segments of the TTE. After a period of two weeks, the values of the LPSS observed in the posterolateral segments were still slightly reduced, which is consistent with the LGE results in CMR.

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  • Accurate localization of tumors is crucial for successful gastric cancer surgery, and the study evaluated the effectiveness of near-infrared fluorescent clips for this purpose.
  • In a clinical trial with 20 patients undergoing laparoscopic gastrectomy, fluorescent clips were placed near tumors and detected during surgery using specialized equipment.
  • Results showed a 75% detection rate for the clips with no related complications, demonstrating the method's safety and feasibility in surgical practice.
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Background: The incidence of Barrett's esophageal adenocarcinoma (BEA) is increasing, and endoscopic submucosal dissection (ESD) has been frequently performed for its treatment. However, the differences between the characteristics and ESD outcomes between short- and long-segment BEA (SSBEA and LSBEA, respectively) are unclear. We compared the clinicopathological characteristics and short- and long-term outcomes of ESD between both groups.

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Introduction: Gastric cancer with fusion genes involving the Rho GTPase-activating protein domain (RhoGAP-GC) is mainly included in the genomically stable type of The Cancer Genome Atlas classification. Clinical implications and histological characteristics of RhoGAP-GC in the early phase remain unclear.

Methods: We analyzed 878 consecutive pT1b GCs for RhoGAP and its partner genes using fluorescence in situ hybridization assay.

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Article Synopsis
  • The study focuses on managing Barrett's esophageal adenocarcinoma in Japan, highlighting the need for risk stratification of multifocal cancer after endoscopic submucosal dissection.
  • Researchers retrospectively analyzed data from 97 patients to identify significant risk factors for multifocal cancer using Cox regression analysis.
  • Findings revealed that the lengths of Barrett's esophagus were strong predictors of multifocal cancer risk, with lower incidences observed in patients with shorter lengths, suggesting the need for further research to confirm the results.
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  • This study investigates long-term surveillance for gastric cancer, particularly focusing on cases diagnosed 10 or more years after initial treatment.
  • It analyzes 377 patients across 14 institutions, revealing that invasive cancers diagnosed after 10 years tend to be more aggressive and have a higher pathological stage compared to those diagnosed sooner.
  • The findings emphasize the importance of ongoing surveillance for all patients, regardless of mucosal atrophy, especially after 10 years post-eradication.
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Although magnifying endoscopy with narrow-band imaging is the standard diagnostic test for gastric cancer, diagnosing gastric cancer using this technology requires considerable skill. Artificial intelligence has superior image recognition, and its usefulness in endoscopic image diagnosis has been reported in many cases. The diagnostic performance (accuracy, sensitivity, and specificity) of artificial intelligence using magnifying endoscopy with narrow band still images and videos for gastric cancer was higher than that of expert endoscopists, suggesting the usefulness of artificial intelligence in diagnosing gastric cancer.

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Background: We previously developed a Japan Esophageal Society Barrett's Esophagus (JES-BE) magnifying endoscopic classification for superficial BE-related neoplasms (BERN) and validated it in a nationwide multicenter study that followed a diagnostic flow chart based on mucosal and vascular patterns (MP, VP) with nine diagnostic criteria. Our present post hoc analysis aims to further simplify the diagnostic criteria for superficial BERN.

Methods: We used data from our previous study, including 10 reviewers' assessments for 156 images of high-magnifying narrow-band imaging (HM-NBI) (67 dysplastic and 89 non-dysplastic histology).

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Background: The effect of Helicobacter pylori (H.pylori) eradication therapy on mixed-histological-type gastric cancer remains unclear. This study aimed to clarify the effect of H.

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Objectives: This study aimed to extract endoscopic findings for diagnosing colorectal neoplasia associated with sessile serrated lesions (SSLs), which are of significant interest.

Methods: To compare the magnifying narrow-band imaging (NBI) findings with microscopic morphology, we classified SSLs into two groups: Group A SSLs included the majority of uniform SSLs and any dysplasia other than that classified as group B SSLs. Group B SSLs included SSLs with intramucosal and invasive carcinoma.

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Objectives: Distinguishing between intramucosal cancer and submucosal invasive cancer is vital for optimal treatment selection for patients with superficial nonampullary duodenal adenocarcinoma (SNADAC); however, standard diagnostic systems for diagnosing invasion depth are as yet undetermined.

Methods: Of 205 patients with SNADAC who underwent treatment at our institution between 2006 and 2022, 188 had intramucosal cancer and 17 had submucosal invasive cancer. The clinical, endoscopic, and pathological features used in the preoperative diagnosis of invasion depth and the diagnostic performance of endoscopic ultrasonography (EUS) were retrospectively analyzed in 85 patients.

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Since the indications for endoscopic submucosal dissection have been expanded to include undifferentiated-type early gastric cancers, improvements in preoperative diagnostic ability have been an area of research. There are also concerns about the impact on the diagnosis of infection. Based on our previous studies, in undifferentiated-type early gastric cancers, magnifying endoscopy with narrow-band imaging is useful for delineating the demarcation regardless of the tumor size.

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Patients with malignant esophageal fistulas often experience dysphagia and infection, resulting in poor prognoses. Self-expandable metallic stent (SEMS) placement is a palliative treatment option; however, its efficacy and safety are unclear. We aimed to determine the efficacy and safety of SEMS placement for malignant esophageal fistulas.

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Purpose: Duplex ultrasound (DUS)-measured peak systolic velocity ratios (PSVRs) are commonly used to evaluate arterial stenosis in lower extremity artery disease (LEAD). However, these measurement methods have not yet been standardized. This study aimed to reveal the influence of measuring methods on PSVR values.

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Objectives: Optimal management of type 1 gastric neuroendocrine tumors (T1-GNETs) remains unknown, with few reports on their long-term prognosis. This study investigated the clinical characteristics and long-term prognosis of T1-GNETs.

Methods: We reviewed the medical records of patients diagnosed with T1-GNET during 1991-2019 at 40 institutions in Japan.

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Article Synopsis
  • * A study at a hospital between 2005 and 2018 documented nine cases, where argon plasma coagulation (APC) was used for treatment.
  • * APC effectively stopped bleeding in eight patients, while one required surgical resection due to high-risk factors like liver cirrhosis.
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Background And Aim: () eradication has become popular as it prevents the development of gastric cancer. There have been no comprehensive studies on advanced gastric cancer (AGC) after eradication; thus, the clinical characteristics remain unclear. This study aimed to compare the characteristics of AGC after eradication and with current infection and evaluate the esophagogastroduodenoscopy (EGD) follow-up after eradication.

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Objectives: Endoscopists' abilities to diagnose early gastric cancers (EGCs) vary, especially between specialists and nonspecialists. We developed an artificial intelligence (AI)-based diagnostic support tool "Tango" to differentiate EGCs and compared its performance with that of endoscopists.

Methods: The diagnostic performances of Tango and endoscopists (34 specialists, 42 nonspecialists) were compared using still images of 150 neoplastic and 165 non-neoplastic lesions.

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We herein report two cases of early esophageal adenocarcinoma derived from non-Barrett's columnar epithelium. Both patients, a 65-year-old woman and 60-year-old man, had elevated lesions on white-light imaging. Magnifying endoscopy revealed slightly irregular surface and vessel patterns, and both patients were successfully treated with endoscopic submucosal dissection.

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Article Synopsis
  • * A study retrospectively analyzed 259 patients who underwent LECS for gastric GIST between 2006 and 2020, achieving a high completion rate of 99.1% with few complications (2.8%), most commonly delayed gastric emptying.
  • * The three-year survival rates for patients who completed LECS were impressive, with 99% overall survival and 100% disease-specific survival, indicating that LECS is a safe and feasible option for
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Helicobacter pylori (HP) is a major etiologic driver of diffuse-type gastric cancer (DGC). However, improvements in hygiene have led to an increase in the prevalence of HP-naïve DGC; that is, DGC that occurs independent of HP. Although multiple genomic cohort studies for gastric cancer have been conducted, including studies for DGC, distinctive genomic differences between HP-exposed and HP-naïve DGC remain largely unknown.

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