Graduate School of Medicine „ Medical Sciences
„ Surgery(Gastroenterological,Transplantation)



Professor: Shinichi MIYAGAWA
Associate Professor: Akira KOBAYASHI, Toshihiko IKEGAMI, Naohiko KOIDE
Senior Assistant Professor: Takenari NAKATA
Assistant Professor: Atsuyoshi MITA, Takahide YOKOYAMA, Satoshi ISHIZONE, Akira SHIMIZU, Takahumi SUZUKI

Summary of Activity
The gastrointestinal surgery team clinically treats patients with carcinomas of the esophagus, stomach, colorectum, and the other neoplasms of the GI tract including stromal tumors, and furthermore treats patients with inflammatory or functional disorders of the GI tract. We have provided less invasive laparoscopic and/or thoracoscopic surgery for these patients, whenever possible.
By the end of June 2010, a total of 277 living donor liver transplantation (LDLT) have been performed with a 5-year and 10-year survival rates of 84 and 80% respectively. The Division performed the third successful LDLT in Japan in June 1990 and pioneered the application of LDLT to adult patients in 1993.
Liver resection for hepatocellular carcinoma totaled up to 520 cases by the end of Dec. 2009 with mortality rate of 0.6 % and 5-year survival rate of nearly 60 %. For patients with biliary malignancies, we have performed 30 major liver resections concomitant with pancreatoduodenectomy with zero mortality. We have provided laparoscopic surgery for liver or pancreatic neoplasms and inguinal hernia since 2008.
We have offered the best possible care with safer way for patients with cancer and/or end staged liver disorders.


Research Projects

Division of Gastrointestinal Surgery
@Esophagus
(1)Invasion and metastasis of esophageal cancer including Barrettfs adenocarcinoma as well as squamous cell carcinoma.
(2)Minimally invasive surgery for esophageal cancer patients with severe co-morbidities.
(3)Treatment and outcome of special types of esophageal cancer including basaloid-squamous cell carcinoma or endocrine carcinoma (small cell type).
@Stomach
(1)Relationship between gastric cancer and H. pyroli infection of the stomach.
(2)Biologic and clinicopathologic analyses of carcinoma of the esophagogastric junction, especially Siewertfs Type-II adenocarcinoma.
(3)Chemotherapy for gastric cancer patients, especially with locally advanced tumors or postoperative recurrent tumors, using S-1+ƒΏ.
(4)Changes of gastric mucins after chemotherapy for patients with gastric or colorectal cancers.
(5)Biologic and clinicopathologic analyses of neuroendocrine carcinomas of the stomach @Colon and Rectum
(1)Chemotherapy for colorectal cancer patients using FOLFOX or FOLFIRI.
(2)Biologic and clinicopathologic analyses, and multimodality-treatment for patients with poorly differentiated adenocarcinoma and signet ring cell carcinoma of the colon and rectum.
(3)Treatment for neoplasm of the anorectum including carcinoma and melanoma.

Division of Liver transplantation
(1)Fibrosis progression and its role in acute and chronic rejection
(2)Pathogenesis of sinusoidal obstruction syndrome or veno-occlusive diseas
(3)Mechanisms of hepatic regeneration
(4)Biology of Epstein Barr virus infection and its impact on PTLD
(5)Molecular biology of hepatitis C in liver transplant recipients

Division of Hepato-Biliary-Pancreatic Surgery
(1)Liver organogenesis from murine embryonic stem cells
(2)Tergeting therapy using biopanning for Hepatocellular carcinoma
(3)Bone Marrow-derived cells fuse with hepatic oval cells but are not involved in hepatic tumorigenesis in the Choline-deficient Ethionine-supplemented diet rat model
(4)Transdifferentiation of hepatic cells into functional insulin-producing cells
(5)Identification of hepatic cancer stem cell
(6)Relation between cancer metastasis and inflammation
(7)Expresssion of adrenomedullin and its receptor in hepatocellular carcinoma
(8)Expression of integrins and extracellular matrix in massive hepatic necrosis
(9)Expression of growth associated factors in regenerative and non-regenerative regions of the liver in patients with fulminant hepatic failure

References

Published Articles

Division of Gastrointestinal Surgery

  1. Komatsu D, Koide N, Hiraga R, Furuya N, Akamatsu T, Uehara T, Miyagawa S Gastric schwannoma exhibiting increased fluorodeoxyglucose uptake..Gastric Cancer. 2009;12:225-8.

  2. Komatsu D, Kato M, Nakayama J, Miyagawa S, Kamata T.Oncogene. NADPH oxidase 1 plays a critical mediating role in oncogenic Ras-induced vascular endothelial growth factor expression. 2008 ;27:4724-32.

  3. Yanagisawa Y, Maruta F, Iinuma N, Ishizone S, Koide N, Nakayama J, Miyagawa S. Modified Irinotecan/5FU/Leucovorin therapy in advanced colorectal cancer and predicting therapeutic efficacy by expression of tumor-related enzymes. Scand J Gastroenterol 2007; 42: 477-84.

  4. Koide N, Saito H, Suzuki A, Sato T, Koiwai K, Nakamura N, Miyagawa S. Clinicopathologic features and histochemical analyses of proliferative activity and angiogenesis in small cell carcinoma of the esophagus. J Gastroenterol 2007; 42: 932-8.

  5. Suzuki K, Hayama M, Nakamura M, Yamauchi K, Maruta F, Miyagawa S, Ota H: Trefoil factor 2 in gland mucous cell mucin in the mucous gel covering normal or damaged gastric mucosa using the Mongolian gerbil model. Scand J Gastroenterol 2006; 41: 1390-7.

  6. Akita N, Maruta F, Seymour LW, Kerr DJ, Parker AL, Asai T, Oku N, Nakayama J, Miyagawa S: Identification of oligopeptides binding to peritoneal tumors of gastric cancer. Cancer Sci 2006; 97: 1075-81.

  7. Ishizone S, Maruta F, Saito H, Koide N, Sugiyama A, Nakayama J, Miyagawa S. Efficacy of S-1 for patients with peritoneal metastasis of gastric cancer. Chemotherapy 2006; 52: 301-7.

  8. Ishizone S, Yamauchi K, Kawa S, Suzuki T, Shimizu F, Harada O, Sugiyama A, Miyagawa S, Fukuda M, Nakayama J. Clinical utility of quantitative RT-PCR targeted to alpha1,4-N-acetylglucosaminyltransferase mRNA for detection of pancreatic cancer. Cancer Sci 2006; 97: 119-26.

  9. Saito H, Yamaoka Y, Ishizone S, Maruta F, Sugiyama A, Graham DY, Yamauchi K, Ota H, Miyagawa S. Roles of virD4 and cagG genes in the cag pathogenicity island of Helicobacter pylori using a Mongolian gerbil model. Gut 2005; 54: 584-90.

  10. Koide N, Nishio A, Sato T, Sugiyama A, Miyagawa S. Significance of macrophage chemoattractant protein-1 expression and macrophage infiltration in squamous cell carcinoma of the esophagus. Am J Gastroenterol 2004; 99: 1667-74.

Division of Liver transplantation

  1. Ikegami T, Masuda Y, Ohno Y, Mita A, Kobayashi A, Urata K, Nakazawa Y, Miwa S, Hashikura Y, Miyagawa S.Prognosis of adult patients transplanted with liver grafts < 35% of their standard liver volume. Liver Transpl. 2009 ;15:1622-30.

  2. Ikegami T, Masuda Y, Ohno Y, Urata K, Nakazawa Y, Miwa S, Hashikura Y, Miyagawa S.Arterial reconstruction in a case of subintimal dissection of celiac arterial tributaries in living donor liver transplantation: Transplant Proc. 2008 ;40:3794-6.

  3. Ikegami T, Hashikura Y, Nakazawa Y, Urata K, Mita A, Ohno Y, Terada M, Miyagawa S, Kushima H, Kondoh S. Risk factors contributing to hepatic artery thrombosis following living-donor liver transplantation. J Hepatobiliary Pancreat Surg. 2006;13(2):105-9.

  4. Hashikura Y, Ikegami T, Nakazawa Y, Urata K, Mihara M, Mita A, Sakon M, Miyagawa S, Ikeda S. Domino liver transplantation in living donors. Transplant Proc. 2005 Mar;37(2):1076-8.

  5. Mita A, Hashikura Y, Tagawa Y, Nakayama J, Kawakubo M, Miyagawa S. Expression of Fas ligand by hepatic macrophages in patients with fulminant hepatic failure. Am J Gastroenterol. 2005 Nov;100(11):2551-9.

  6. Ogawa S, Tagawa Y, Kamiyoshi A, Suzuki A, Nakayama J, Hashikura Y, Miyagawa S. Crucial roles of mesodermal cell lineages in a murine embryonic stem cell-derived in vitro liver organogenesis system. Stem Cells. 2005 ;23(7):903-13.

  7. Suzuki F, Hashikura Y, Ise H, Ishida A, Nakayama J, Takahashi M, Miyagawa S, Ikeda U. MCI-186 (edaravone), a free radical scavenger, attenuates hepatic warm ischemia-reperfusion injury in rats. Transpl Int. 2005 Jul;18(7):844-53.

  8. Yazaki M, Hashikura Y, Takei Y, Ikegami T, Miyagawa S, Yamamoto K, Tokuda T, Kobayashi K, Saheki T, Ikeda S. Feasibility of auxiliary partial orthotopic liver transplantation from living donors for patients with adult-onset type II citrullinemia. Liver Transpl. 2004 Apr;10(4):550-4.

  9. Hashikura Y, Ikegami T, Nakazawa Y, Urata K, Ogino S, Terada M, Miyagawa S, Kawasaki S, Takei Y, Ikeda S. Delayed domino liver transplantation: use of the remnant liver of a recipient of a temporary auxiliary orthotopic liver transplant as a liver graft for another patient. Transplantation. 2004 Jan 27;77(2):324.

  10. Nakazawa Y, Chisuwa H, Mita A, Ikegami T, Hashikura Y, Terada M, Nakayama J, Kawasaki S. Life-threatening veno-occlusive disease after living-related liver transplantation. Transplantation. 2003 Mar 15;75(5):727-30.

Division of Hepato-Biliary-Pancreatic Surgery

  1. Kobayashi A, Miwa S, Nakata T, Miyagawa S Disease recurrence patterns after R0 resection of hilar cholangiocarcinoma.Br J Surg. 2010 ;97:56-64.

  2. Nakata T, Kobayashi A, Miwa S, Soeda J, Uehara T, Miyagawa S.Clinical and pathological features of primary carcinoma of the cystic duct.J Hepatobiliary Pancreat Surg. 2009;16:75-82.

  3. Kobayashi A, Miyagawa S, Miwa S, Nakata T.Prognostic impact of anatomical resection on early and late intrahepatic recurrence in patients with hepatocellular carcinoma.J Hepatobiliary Pancreat Surg. 2008;15:515-21.

  4. Miwa S, Kobayashi A, Akahane Y, Nakata T, Mihara M, Kusama K, Ogawa S, Soeda J, Miyagawa S. Is major hepatectomy with pancreatoduodenectomy justified for advanced biliary malignancy? J Hepatobiliary Pancreat Surg. 2007;14(2):136-41.

  5. Shimizu A, Maruta F, Akita N, Miwa S, Seymour LW, Kerr DJ, Parker AL, Miyagawa S. Identification of an oligopeptide binding to hepatocellular carcinoma. Oncology. 2006;71(1-2):136-45.

  6. Nakata T, Kobayashi A, Miwa S, Soeda J, Miyagawa S. Impact of tumor spread to the cystic duct on the prognosis of patients with gallbladder carcinoma. World J Surg. 2007 Jan;31(1):155-61; discussion 162-3.

  7. Kobayashi A, Kawasaki S, Miyagawa S, Miwa S, Noike T, Takagi S, Iijima S, Miyagawa Y. Results of 404 hepatic resections including 80 repeat hepatectomies for hepatocellular carcinoma. Hepatogastroenterology. 2006 Sep-Oct;53(71):736-41.

  8. Miwa S, Miyagawa S, Kobayashi A, Akahane Y, Nakata T, Mihara M, Kusama K, Soeda J, Ogawa S. Predictive factors for intrahepatic cholangiocarcinoma recurrence in the liver following surgery. J Gastroenterol. 2006 Sep;41(9):893-900.

  9. Misawa R, Ise H, Takahashi M, Morimoto H, Kobayashi E, Miyagawa S, Ikeda U. Development of liver regenerative therapy using glycoside-modified bone marrow cells. Biochem Biophys Res Commun. 2006 Apr 7;342(2):434-40. Epub 2006 Feb 9.

  10. Ichikawa E, Hida S, Omatsu Y, Shimoyama S, Takahara K, Miyagawa S, Inaba K, Taki S. Defective development of splenic and epidermal CD4+ dendritic cells in mice deficient for IFN regulatory factor-2. Proc Natl Acad Sci U S A. 2004 Mar 16;101(11):3909-14.