WorldCat Identities

Fujiwara, Michitaka

Works: 7 works in 7 publications in 1 language and 7 library holdings
Publication Timeline
Most widely held works by Michitaka Fujiwara
Nutritional predictors for postoperative short-term and long-term outcomes of patients with gastric cancer( )

1 edition published in 2016 in English and held by 1 WorldCat member library worldwide

Abstract : Abstract: Evidence indicates that impaired immunocompetence and nutritional status adversely affect short-term and long-term outcomes of patients with cancer. We aimed to evaluate the clinical significance of preoperative immunocompetence and nutritional status according to Onodera's prognostic nutrition index (PNI) among patients who underwent curative gastrectomy for gastric cancer (GC). This study included 260 patients with stage II/III GC who underwent R0 resection. The predictive values of preoperative nutritional status for postoperative outcome (morbidity and prognosis) were evaluated. Onodera's PNI was calculated as follows: 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm 3 ). The mean preoperative PNI was 47.8. The area under the curve for predicting complications was greater for PNI compared with the serum albumin concentration or lymphocyte count. Multivariate analysis identified preoperative PNI < 47 as an independent predictor of postoperative morbidity. Moreover, patients in the PNI < 47 group experienced significantly shorter overall and disease-free survival compared with those in the PNI ≥ 47 group, notably because of a higher prevalence of hematogenous metastasis as the initial recurrence. Subgroup analysis according to disease stage and postoperative adjuvant treatment revealed that the prognostic significance of PNI was more apparent in patients with stage II GC and in those who received adjuvant chemotherapy. Preoperative PNI is easy and inexpensive to determine, and our findings indicate that PNI served as a significant predictor of postoperative morbidity, prognosis, and recurrence patterns of patients with stage II/III GC
Stapling an extracorporeal Billroth‐I anastomosis by the complete double stapling technique after laparoscopy‐assisted distal gastrectomy( )

1 edition published in 2017 in English and held by 1 WorldCat member library worldwide

Abstract: Introduction: Laparoscopy‐assisted distal gastrectomy is one of the major treatments for early stage gastric cancer, particularly in the East Asia. In this method, extracorporeal anastomosis is performed via a small laparotomy wound, but excessive tissue traction may be encountered during the anastomotic procedure. Therefore, we developed an original procedure for extracorporeal Billroth‐I reconstruction: end‐to‐end stapling gastroduodenostomy with complete double stapling technique. This procedure aims to reduce the problems related to maneuvers through a small laparotomy. Methods: An end‐to‐end anastomosis is constructed on the transection line using a circular stapler inserted from the distal end of the greater curvature of the remnant stomach. Short‐term outcomes were reviewed in 218 consecutive patients who underwent complete double stapling technique reconstruction after laparoscopy‐assisted distal gastrectomy between 2002 and 2012. Findings from GI endoscopy were reviewed in 110 patients. Results: The mean operative time was 216min, and mean blood loss was 163mL. There was no conversion to the open surgery and no operative death. Eight patients (3.6%) had anastomosis‐related postoperative complications. In follow‐up endoscopic examinations 1year after surgery, grade 3 or higher residual food was seen in 17.2% of patients. Gastritis extending to the entire remnant stomach was observed in 8.2% of patients, and grade 3 gastritis was seen in 2.7%. Los Angeles classification grade A or higher reflux esophagitis was found in 10.9%. Conclusions: Billroth‐I reconstruction by the complete double stapling technique is a safe and feasible procedure. This method provides satisfactory short‐term outcomes, including the incidence of reflex remnant gastritis and esophagitis
Expression of membrane complement regulators, CD46, CD55 and CD59, in mesothelial cells of patients on peritoneal dialysis therapy( )

1 edition published in 2015 in English and held by 1 WorldCat member library worldwide

Highlights Membrane complement regulators abundantly express in peritoneal mesothelial cells. Mesothelial expression of CD55 was related to sC5b-9 level in peritoneal dialysate. Decrease of CD55 expression might enhance complement activation in mesothelial cells. Peritoneal dialysis therapy may modify expression of CD55 in peritoneum. Expression of CD55 in mesothelium may be a surrogate marker of peritoneal function
An application of cascaded 3D fully convolutional networks for medical image segmentation( )

1 edition published in 2018 in English and held by 1 WorldCat member library worldwide

Highlights: Recent advances in 3D fully convolutional networks (FCN) have made it feasible to produce dense voxel-wise predictions of volumetric images. This enables accurate and automatic multi-organ organ segmentation from 3D radiological scans, important yet challenging problem for medical image analysis. We propose a two-stage, coarse-to-fine approach that will first use a 3D FCN to roughly define a candidate region, which will then be used as input to a second 3D FCN. Quantitative experimentation and evaluation is performed on over 700 clinical CT images from three different data collections. While we focus on abdominal CT, our approach could provide an efficient and practical solution to multi-organ that should be transferable to many other use cases in medical image segmentation. Abstract: Recent advances in 3D fully convolutional networks (FCN) have made it feasible to produce dense voxel-wise predictions of volumetric images. In this work, we show that a multi-class 3D FCN trained on manually labeled CT scans of several anatomical structures (ranging from the large organs to thin vessels) can achieve competitive segmentation results, while avoiding the need for handcrafting features or training class-specific models. To this end, we propose a two-stage, coarse-to-fine approach that will first use a 3D FCN to roughly define a candidate region, which will then be used as input to a second 3D FCN. This reduces the number of voxels the second FCN has to classify to ∼10% and allows it to focus on more detailed segmentation of the organs and vessels. We utilize training and validation sets consisting of 331 clinical CT images and test our models on a completely unseen data collection acquired at a different hospital that includes 150 CT scans, targeting three anatomical organs (liver, spleen, and pancreas). In challenging organs such as the pancreas, our cascaded approach improves the mean Dice score from 68.5 to 82.2%, achieving the highest reported average score on this dataset. We compare with a 2D FCN method on a separate dataset of 240 CT scans with 18 classes and achieve a significantly higher performance in small organs and vessels. Furthermore, we explore fine-tuning our models to different datasets. Our experiments illustrate the promise and robustness of current 3D FCN based semantic segmentation of medical images, achieving state-of-the-art results. 1
Visual and tactile feedback for a direct‐manipulating tactile sensor in laparoscopic palpation( )

1 edition published in 2017 in English and held by 1 WorldCat member library worldwide

Abstract: Background: A surgeon's tactile sense can contribute to intraoperative tumor detection, but it is limited by laparoscopic surgery. Methods: We have developed a simple and biocompatible tactile sensor. This study aimed to design and evaluate visual and tactile feedback from the sensor for laparoscopic tumor detection. A line graph was offered through a monitor as the visual feedback. A normal force was presented to the user's foot as the tactile feedback. Twelve novices conducted a task of detecting a phantom tumor under 4 conditions (no feedback, visual feedback, tactile feedback and a combination of both types of feedback). Results: The visual feedback was significantly more effective in detection than no feedback. Moreover, both visual and tactile feedback led to safer manipulation with significantly smaller load and lower scanning speed, respectively. Conclusions: The results suggest that visual and tactile feedback can be useful for laparoscopic palpation; however, their effects depend on the means in which they are presented
The significance of relative dose intensity in adjuvant chemotherapy of pancreatic ductal adenocarcinoma—including the analysis of clinicopathological factors influencing relative dose intensity( )

1 edition published in 2016 in English and held by 1 WorldCat member library worldwide

Abstract : Abstract: Recently, it has been reported that the relative dose intensity (RDI) of adjuvant chemotherapy (AC) influences survival in various cancers, but there are very few reports about RDI in pancreatic ductal adenocarcinoma (PDAC). The optimal timing for initiation of AC for PDAC also remains unknown. The aim of this study was to identify the significance of RDI and the time interval between surgery and initiation of AC on survival of patients with PDAC. Clinicopathological factors that affect RDI were also investigated. A total of 311 consecutive PDAC patients who underwent curative resection between May 2005 and January 2015 were enrolled. Patients who underwent neoadjuvant chemoradiation, had UICC stage IV disease, or had early recurrences within 6 months were excluded, and the remaining 168 cases were analyzed. Patients with RDIs ≥80% (n = 79) showed significantly better overall survival (OS) compared to patients with RDIs <80% (n = 55) (median survival time (MST): 45.6 months, 26.0 months, P  < 0.001). Patients with no AC (n = 34) showed the worst OS (MST: 20.8 months). Whether the AC was initiated earlier or later than 8 weeks after surgery did not influence survival, either in patients with RDIs ≥80% ( P  = 0.79) or in those with <80% ( P  = 0.73). Patients in the S-1 monotherapy group (n = 49) showed significantly better OS than patients in the gemcitabine monotherapy group (n = 51) (MST: 95.0 months, 26.0 months, respectively; P  = 0.001). Univariate analysis conducted after adjusting for the chemotherapeutic drug used identified several prognostic factors; male gender ( P  = 0.01), intraoperative blood transfusion ( P  = 0.005), lymph node metastasis ( P  = 0.03), and postoperative WBC count ( P  = 0.03). Multivariate analysis identified intra-plus postoperative blood transfusion ( P  = 0.002) and high postoperative platelet-to-lymphocyte ratios (PLR) ( P  = 0.04) as independent predictors of poor RDI. Efforts to maintain RDI had a greater impact on survival than the struggle to start AC early after surgery. Intra-plus postoperative blood transfusion and a high postoperative PLR could be predictive markers of reduced RDI in AC of PDAC patients. Avoidance of perioperative blood transfusions where possible and nutritional support during the perioperative period could maintain adequate RDI and may lead to improved long-term outcome. Abstract : Supplemental Digital Content is available in the text
Clinical Implication of Inflammation-Based Prognostic Score in Pancreatic Cancer( )

1 edition published in 2016 in English and held by 1 WorldCat member library worldwide

Abstract : Abstract: A variety of systemic inflammation-based prognostic scores have been explored; however, there has been no study to clarify which score could best reflect survival in resected pancreatic cancer patients. Between 2002 and 2014, 379 consecutive patients who underwent curative resection of pancreatic cancer were enrolled. The Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), prognostic index (PI), and prognostic nutritional index (PNI) scores for each patient were calculated. Survival of each score was evaluated, and correlations between the score selected on the basis of the prognostic significance and various clinicopathological factors were analyzed. In the analysis of the GPS, the median survival time (MST) was 28.1 months for score 0, 25.6 for score 1, and 17.0 for score 2. As for mGPS, the MST was 25.8 months for score 0, 27.7 for score 1, and 17.0 for score 2. Both scores were found to be significant. On the contrary, there were no statistical differences in MST between various scores obtained using the NLR, PLR, PI, or PNI. Multivariate analysis revealed that lymph node metastasis, positive peritoneal washing cytology, and a GPS score of 2 were significant prognostic factors. There was also statistically significant correlation between the GPS score and tumor location (head), tumor size (≥2.0 cm), bile duct invasion, and duodenal invasion. Our study demonstrated that the GPS could be an independent predictive marker and was superior to other inflammation-based prognostic scores in patients with resected pancreatic cancer. Abstract : Supplemental Digital Content is available in the text
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