Scheduled second-look endoscopy is not recommended after endoscopic submucosal dissection for gastric neoplasms (the SAFE trial): a multicentre prospective randomised controlled non-inferiority trial.

Objective: To clarify the effectiveness of second-look endoscopy (SLE) at preventing bleeding after gastric endoscopic submucosal dissection (ESD).

Design: A multicentre prospective randomised controlled non-inferiority trial was conducted at five referral institutions across Japan. Patients with a solitary gastric neoplasm were enrolled.

Discovery of an uncovered region in fibrin clots and its clinical significance.

Despite the pathological importance of fibrin clot formation, little is known about the structure of these clots because X-ray and nuclear magnetic resonance (NMR) analyses are not applicable to insoluble proteins. In contrast to previously reported anti-fibrin monoclonal antibodies (mAbs), our anti-fibrin clot mAb (clone 102-10) recognises an uncovered region that is exposed only when a fibrin clot forms. The epitope of the 102-10 mAb was mapped to a hydrophobic region on the Bβ chain that interacted closely with a counterpart region on the γ chain in a soluble state.

Dose-escalation study of thoracic radiotherapy in combination with pemetrexed plus Cisplatin followed by pemetrexed consolidation therapy in Japanese patients with locally advanced nonsquamous non-small-cell lung cancer.

Background: Pemetrexed has radiosensitizing potential when evaluated in vitro in combination with platinum-containing compounds and radiation. We determined the recommended dose (RD) of thoracic radiotherapy (TRT) with a concurrent chemotherapy combination of pemetrexed and cisplatin in Japanese patients with nonsquamous non-small-cell lung cancer (NSCLC).

Patients And Methods: Eligible patients were histologically confirmed as having locally advanced nonsquamous NSCLC.

The clinical outcome of non-small cell lung cancer patients with adjacent lobe invasion: the optimal classification according to the status of the interlobar pleura at the invasion point.

Objectives: The aim of this study was to analyse the survival of non-small cell lung cancer (NSCLC) patients with adjacent lobe invasion (ALI) with emphasis on the interlobar fissure status at the tumour invasion point.

Methods: We retrospectively evaluated 2097 consecutive patients with surgically resected NSCLC from July 1993 through April 2006. Of these, 90 (4.

Association between incisional surgical site infection and the type of skin closure after stoma closure.

Purpose: This study was performed to investigate the effect of subcuticular sutures on the incidence of incisional surgical site infection (SSI) after closure of a diverting stoma.

Methods: The study was carried out as a retrospective analysis of prospectively collected data from 51 patients who underwent closure of diverting stoma following resections of lower rectal cancer between January 2008 and December 2008. This study attempted to determine whether there was an association between the type of skin closure and the incidence of incisional SSI.

Clinical impact of intraoperative histological examination of the ductal resection margin in extrahepatic cholangiocarcinoma.

Background: Although ductal resection margin status in extrahepatic cholangiocarcinoma is evaluated by intraoperative histological examination of frozen sections, its clinical relevance remains controversial.

Methods: Material taken from patients who underwent R0 or R1 resection for extrahepatic cholangiocarcinoma with intraoperative histological examination of the final ductal resection margins between 1994 and 2003 were reviewed. The following histological classification was used: insufficient, negative for malignancy (NM), undetermined lesion (UDL) or positive for malignancy (PM).

High expression level of geminin predicts a poor clinical outcome in salivary gland carcinomas.

Aims: To examine the prognostic impact of geminin expression, a negative regulator of DNA replication, in salivary gland carcinomas.

Methods And Results: Tissues from 170 patients with salivary gland carcinoma were assembled in a tissue microarray format, and immunohistochemistry staining for geminin and Ki67 was performed. Patients were categorized into three groups using the tertile values of the labelling index (LI) for each marker as the cut-off points for constructing Kaplan-Meier survival curves.

Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer.

Background: The aim of this retrospective study was to determine the efficacy of complete (R0) resection for pulmonary metastases of colorectal carcinoma, and to clarify prognostic factors for survival that could be used to identify patients likely to benefit most from pulmonary resection.

Methods: Data on 113 patients who underwent R0 resection of pulmonary metastases from colorectal cancer were reviewed. Overall median follow-up was 49 (range 1-140) months.

Relationship between MVD and meshed-capillaries using magnifying NBI colonoscopy in colorectal precursor lesions.

Background/aims: To prospectively investigate differences in angiogenesis between low-grade dysplasia (LGD) and hyperplastic polyps, as well as the relationship between microvessel density (MVD) as identified by histological analysis and meshed-capillary (MC) vessels visualized using magnifying narrow band imaging (NBI) colonoscopy.

Methodology: Immunohistochemical analysis of MVD was performed using monoclonal antibody against CD31. The number and thickness of vessels were investigated for 45 LGD and 25 hyperplastic polyps.

Vinorelbine plus gemcitabine followed by docetaxel versus carboplatin plus paclitaxel in patients with advanced non-small-cell lung cancer: a randomised, open-label, phase III study.

Background: Platinum-containing two-drug combinations improve survival and cancer-related symptoms in patients with advanced non-small-cell lung cancer (NSCLC). However, survival benefit is modest and platinum-containing regimens cause substantial toxic effects. We did a prospective randomised open-label phase III study to compare an experimental platinum-free, triplet, sequential regimen of vinorelbine plus gemcitabine followed by docetaxel with the standard platinum-containing, doublet regimen paclitaxel plus carboplatin in patients with advanced NSCLC.

Problems in the current diagnostic standards of clinical N1 non-small cell lung cancer.

Background: Although clinical N1 (cN1) non-small cell lung cancer (NSCLC) is considered to be locoregional, the postoperative outcome is disappointing, with a 5 year survival of less than 50%. One possible reason may be that cN1disease diagnosed by current standard imaging modalities often contains unexpected N2 disease. This study was conducted to evaluate the surgical and pathological results of patients with cN1 NSCLC.

Detection and treatment of early cancer in high-risk populations.

In this paper we describe how to more efficiently detect and treat early gastric cancer (EGC) in high-risk populations. For detection, we first assess the value of known risk factors from the viewpoint of availability for cancer screening. Serum pepsinogen appears to be the most useful and realistic of the factors examined, although its adequacy needs to be assessed in high-risk populations other than those in Japan.

Contrast enhancement patterns of hepatic tumours during the vascular phase using coded harmonic imaging and Levovist to differentiate hepatocellular carcinoma from other focal lesions.

The purpose of the study was to assess contrast enhancement patterns of hepatic tumours during the vascular phase using contrast-enhanced ultrasound and Levovist to differentiate hepatocellular carcinoma from other hepatic tumours. 89 hepatic tumours in 82 consecutive patients were evaluated using coded harmonic ultrasound imaging. The procedure used a phase inversion harmonic technique and coded technology.

Deep circumflex iliac perforator flap with iliac crest for mandibular reconstruction.

The deep circumflex iliac myocutaneous perforator (DCIP) flap with iliac crest was used to reconstruct oromandibular defects in 10 patients. In seven of the patients a dominant perforator was found preoperatively using a Doppler flowmeter; in five of these seven patients a DCIP flap was successfully transferred. In two of the seven patients the dominant perforators were too narrow: one patient underwent a standard osteocutaneous flap transfer and one patient underwent a second flap transfer.

Clinicopathological differences between colonic and rectal carcinomas: are they based on the same mechanism of carcinogenesis?

Background: There is a difference in the location of colorectal mucosal lesions and invasive cancers.

Aims: To ascertain whether the location of colorectal neoplasms reflects the carcinogenesis pathway.

Methods: The subject material consisted of 4147 neoplastic lesions that had been resected endoscopically or surgically from 5025 patients.

Intracranial metastases of hepatocellular carcinoma: CT and MRI.

We report clinical characteristics and CT and MRI in 16 patients with brain metastases due to hepatocellular carcinoma (HCC). Eight of these 16 patients presented with apoplexy-like symptoms (50%). Pulmonary metastases were found in 13 cases (81.

Effects of sedation produced by thiopentone on responses to nasal occlusion in female adults.

To test the hypothesis that full wakefulness is an important factor in the control of the route of breathing in adult humans, we have studied the responses to nasal occlusion before and during sedation with thiopentone in 14 female subjects. A tightly fitting partitioned face mask separated the nasal and oral breathing routes. Nasal and oral breathing were identified from changes in carbon dioxide concentration and airway pressure in the different compartments of the face mask.