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| 1 | Importance of adequate immunosuppressive therapy for the recovery of patients with 'life-threatening' severe exacerbation of chronic hepatitis B显示文摘AIM: Hepatitis B virus (HBV) re-activation often occurs spontaneously or after withdrawal of immunosuppressive therapy in patients with chronic hepatitis B. Severe exacerbation, sometimes developing into fulminant hepatic failure, is at high risk of mortality. The efficacy of corticosteroid therapy in 'clinically severe' exacerbation of chronic hepatitis B has not been well demonstrated. In this study we evaluated the efficacy of early introduction of high-dose corticosteroid therapy in patients with lifethreatening severe exacerbation of chronic hepatitis B.METHODS: Twenty-two patients, 14 men and 8 women,were defined as 'severe' exacerbation of chronic hepatitis B using uniform criteria and enrolled in this study. Eleven patients were treated with corticosteroids at 60 mg or more daily with or without anti-viral drugs within 10 d after the diagnosis of severe disease ('early high-dose'group) and 11 patients were either treated more than 10 d or untreated with corticosteroids ('non-early high-dose'group).RESULTS: Mean age, male-to-female ratio, mean prothrombin time (PT) activity, alanine transaminase (ALT)level, total bilirubin level, positivity of HBeAg, mean IgMHBc titer, and mean HBV DNA polymerase activity did not differ between the two groups. Ten of 11 patients of the 'early high-dose' group survived, while only 2 of 11 patients of the 'non-early high-dose' group survived (P<0.001). During the first 2 wk after the introduction of corticosteroids, improvements in PT activities and total bilirubin levels were observed in the 'early high-dose'group. Both ALT levels and HBV DNA polymerase levels fell in both groups.CONCLUSION: The introduction of high-dose corticosteroid can reverse deterioration in patients with 'clinically lifethreatening' severe exacerbation of chronic hepatitis B,when used in the early stage of illness. | Keiichi Fujiwara Osamu Yokosuka Hiroshige Kojima Tatsuo Kanda Hiromitsu Saisho Hiroyuki Hirasawa Hiroshi Suzuki | 2005 | World Journal of Gastroenterology2005，11，8： | 20 |
| 2 | Management of thrombocytopenia due to liver cirrhosis:A review显示文摘Thrombocytopenia is a common complication in liver disease and can adversely affect the treatment of liver cirrhosis,limiting the ability to administer therapy and delaying planned surgical/diagnostic procedures because of an increased risk of bleeding.Multiple factors,including splenic sequestration,reduced activity of the hematopoietic growth factor thrombopoietin,bone marrow suppression by chronic hepatitis C virus infection and anti-cancer agents,and antiviral treatment with interferon-based therapy,can contribute to the development of thrombocytopenia in cirrhotic patients.Of these factors,the major mechanisms for thrombocytopenia in liver cirrhosis are(1)platelet sequestration in the spleen;and(2)decreased production of thrombopoietin in the liver.Several treatment options,including platelet transfusion,interventional partial splenic embolization,and surgical splenectomy,are now available for severe thrombocytopenia in cirrhotic patients.Although thrombopoietin agonists and targeted agents are alternative tools for noninvasively treating thrombocytopenia due to liver cirrhosis,their ability to improve thrombocytopenia in cirrhotic patients is under investigation in clinical trials.In this review,we propose a treatment approach to thrombocytopenia according to our novel concept of splenic volume,and we describe the current management of thrombocytopenia due to liver cirrhosis. | Hiromitsu Hayashi Toru Beppu Ken Shirabe Yoshihiko Maehara Hideo Baba | 2014 | World Journal of Gastroenterology2014，20，10： | 19 |
| 3 | Optimal treatment for Siewert type Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction: A retrospective cohort study with long-term follow-up显示文摘AIM To determine the optimal treatment strategy for Siewert type Ⅱ and?Ⅲ?adenocarcinoma of the esophagogastric junction.METHODS We retrospectively reviewed the medical records of 83 patients with Siewert type?Ⅱ?and?Ⅲ?adenocarcinoma of the esophagogastric junction and calculated both an index of estimated benefit from lymph node dissection for each lymph node(LN) station and a lymph node ratio(LNR: ratio of number of positive lymph nodes to the total number of dissected lymph nodes). We used Cox proportional hazard models to clarify independent poor prognostic factors. The median duration of observation was 73 mo.RESULTS Indices of estimated benefit from LN dissection were as follows, in descending order: lymph nodes(LN) along the lesser curvature, 26.5; right paracardial LN, 22.8; left paracardial LN, 11.6; LN along the left gastric artery, 10.6. The 5-year overall survival(OS) rate was 58%. Cox regression analysis revealed that vigorous venous invasion(v2, v3)(HR = 5.99; 95%CI: 1.71-24.90) and LNR of > 0.16(HR = 4.29, 95%CI: 1.79-10.89) were independent poor prognostic factors for OS.CONCLUSION LN along the lesser curvature, right and left paracardial LN, and LN along the left gastric artery should be dissected in patients with Siewert type?Ⅱ?or?Ⅲ?adenoca rcinoma of the esophagogastric junction. Patients with vigorous venous invasion and LNR of > 0.16 should be treated with aggressive adjuvant chemotherapy to improve survival outcomes. | Kei Hosoda Keishi Yamashita Hiromitsu Moriya Hiroaki Mieno Masahiko Watanabe | 2017 | World Journal of Gastroenterology2017，23，15： | 19 |
| 4 | Effect of Clostridium butyricum on fecal flora in Helicobacter pylori eradication therapy显示文摘AIM: To investigate the effect of probiotic bacterium,Clostridium butyricum MIYAIRI 588 strain (CBM) on the changes of the fecal flora in Helicobacter pylori(H pylori)treatment.METHODS: Thirty-five patients with gastric or duodenal ulcers positive for Hpylori were randomized either to 1 wk amoxicillin, clarithromycin, lansoprazole (Group 1) or to the same regimen supplemented with CBM 7 dahead of the triple therapy (Group 2). Stool samples were collected before and 2, 4, 7, 15, and 22 d after the starting eradication therapy, and were examined intestinal flora. Patients were required to keep a diary record of their condition. RESULTS: Obligate anaerobes decreased significantly on d 2, 4, 8 and 15 in Group 1. On the other hand, they did not decrease significantly in Group 2. The Escherichiacoli was dominant bacterium in Enterobacteriaceae, butthat was replaced by other species such as Klebsiella and Enterobacter after eradication in Group 1. The change was suppressed in Group 2. Abdominal symptoms were less frequent in Group 2 than in Group 1.CONCLUSION: The combined use of CBM reduced the changes in the intestinal flora and decreased the incidence of gastrointestinal side effects. | Izumi Shimbo Taketo Yamaguchi Takeo Odaka Kenichi Nakajima Akinori Koide Hidehiko Koyama Hiromitsu Saisho | 2005 | World Journal of Gastroenterology2005，11，47： | 18 |
| 5 | Long-term survival after resection of pancreatic cancer:A single-center retrospective analysis显示文摘AIM: To retrospectively analyze factors affecting the long-term survival of patients with pancreatic cancer who underwent pancreatic resection.METHODS: From January 2000 to December 2011,195 patients underwent pancreatic resection in our hospital.The prognostic factors after pancreatic resection were analyzed in all 195 patients.After excluding the censored cases within an observational period,the clinicopathological characteristics of 20 patients who survived ≥ 5(n = 20) and < 5(n = 76) years were compared.For this comparison,we analyzed the patients who underwent surgery before June 2008 and were observed for more than 5 years.For statistical analyses,the log-rank test was used to compare the cumulative survival rates,and the χ2 and Mann-Whitney tests were used to compare the two groups.The CoxHazard model was used for a multivariate analysis,and P values less than 0.05 were considered significant.A multivariate analysis was conducted on the factors that were significant in the univariate analysis.RESULTS: The median survival for all patients was 27.1 months,and the 5-year actuarial survival rate was 34.5%.The median observational period was 595 d.With the univariate analysis,the UICC stage was significantly associated with survival time,and the CA19-9 ≤ 200 U/m L,DUPAN-2 ≤ 180 U/m L,t u m o r s i ze ≤ 2 0 m m,R 0 re s e c t i o n,a b s e n c e o f lymph node metastasis,absence of extrapancreatic neural invasion,and absence of portal invasion were favorable prognostic factors.The multivariate analysis showed that tumor size ≤ 20 mm(HR = 0.40; 95%CI: 0.17-0.83,P = 0.012) and negative surgical margins(R0 resection)(HR = 0.48; 95%CI: 0.30-0.77,P = 0.003) were independent favorable prognostic factors.Among the 96 patients,20 patients survived for 5 years or more,and 76 patients died within 5 years after operation.Comparison of the 20 5-year survivors with the 76 non-survivors showed that lower concentrations of DUPAN-2(79.5 vs 312.5 U/mL,P = 0.032),tumor size ≤ 20 mm(35% vs 8%,P = 0.008),R0 resection(95% vs 61%,P = 0.004),and absence of lymph nodemetastases(60% vs 18%,P = 0.036) were significantly associated with the 5-year survival.CONCLUSION: Negative surgical margins and a tumor size ≤ 20 mm were independent favorable prognostic factors.Histologically curative resection and early tumor detection are important factors in achieving long-term survival. | Takehito Yamamoto Shintaro Yagi Hiromitsu Kinoshita Yusuke Sakamoto Kazuyuki Okada Kenji Uryuhara Takeshi Morimoto Satoshi Kaihara Ryo Hosotani | 2015 | World Journal of Gastroenterology2015，21，1： | 18 |
| 6 | Treatment of gastric remnant cancer post distal gastrectomy by endoscopic submucosal dissection using an insulation-tipped diathermic knife显示文摘AIM: To evaluate the effectiveness of endoscopic submucosal dissection using an insulation-tipped diathermic knife (IT-ESD) for the treatment of patients with gastric remnant cancer. METHODS: Thirty-two patients with early gastric cancer in the remnant stomach, who underwent distal gastrectomy due to gastric carcinoma, were treated with endoscopic mucosal resection (EMR) or ESD at Sumitomo Besshi Hospital and Shikoku Cancer Center in the 10-year period from January 1998 to December 2007, including 17 patients treated with IT-ESD. Retrospectively, patient backgrounds, the one-piece resection rate, complete resection (CR) rate, operation time, bleeding rate, and perforation rate were compared between patients treated with conventional EMR and those treated with IT-ESD. RESULTS: The CR rate (40% in the EMR group vs 82% in the IT-ESD group) was significantly higher in the IT-ESD group than in the EMR group; however, the operation time was significantly longer for the IT- ESD group (57.6 ± 31.9 min vs 21.1 ± 12.2 min). No significant differences were found in the rate of underlying cardiopulmonary disease (IT-ESD group, 12% vs EMR group, 13%), one-piece resection rate (100% vs 73%), bleeding rate (18% vs 6.7%), and perforation rate (0% vs 0%) between the two groups. CONCLUSION: IT-ESD appears to be an effective treatment for gastric remnant cancer post distal gastrectomy because of its high CR rate. It is useful for histological confirmation of successful treatment. Thelong-term outcome needs to be evaluated in the future. | Shoji Hirasaki Hiromitsu Kanzaki Minoru Matsubara Kohei Fujitav Shuji Matsumura Seiyuu Suzuki | 2008 | World Journal of Gastroenterology2008，14，16： | 18 |
| 7 | Role of microRNAs in gastric cancer显示文摘Although gastric cancer(GC)is one of the leading causes of cancer-related death,major therapeutic advances have not been made,and patients with GC still face poor outcomes.The prognosis of GC also remains poor because the molecular mechanisms of GC progression are incompletely understood.MicroRNAs(miRNAs)are noncoding RNAs that are associated with gastric carcinogenesis.Studies investigating the regulation of gene expression by miRNAs have made considerable progress in recent years,and abnormalities in miRNA expression have been shown to be associated with the occurrence and progression of GC.miRNAs contribute to gastric carcinogenesis by altering the expression of oncogenes and tumor suppressors,affecting cell proliferation,apoptosis,motility,and invasion.Moreover,a number of miRNAs have been shown to be associated with tumor type,tumor stage,and patient survival and therefore may be developed as novel diagnostic or prognostic markers.In this review,we discuss the involvement of miRNAs in GC and the mechanisms through which they regulate gene expression and biological functions.Then,we review recent research on the involvement of miRNAs in GC prognosis,their potential use in chemotherapy,and their effects on Helicobacter pylori infections in GC.A greater understanding of the roles of miRNAs in gastric carcinogenesis could provide insights into the mechanisms of tumor development and could help to identify novel therapeutic targets. | Hideyuki Ishiguro Masahiro Kimura Hiromitsu Takeyama | 2014 | World Journal of Gastroenterology2014，20，19： | 15 |
| 8 | Treatment of over 20 mm gastric cancer by endoscopic submucosal dissection using an insulation-tipped diathermic knife显示文摘AIM: To evaluate the effectiveness of endoscopic submucosal dissection using an insulation-tipped diathermic knife (IT-ESD) for the treatment of patients with over 20 mm early gastric cancer (EGC). METHODS: A total of 112 patients with over 10 mm EGC were treated with IT-ESD at Sumitomo Besshi Hospital and Shikoku Cancer Center in the 5 year period from January 2002 to December 2006, including 40 patients with over 20 mm EGC. We compared patient backgrounds, the one-piece resection rate, complete resection (CR) rate, operation time, bleeding rate, perforation rate between patients with over 20 mm EGC [over 20 mm group (21-40 mm)] and the remaining patients (under 20 mm group). RESULTS: We found no significant difference in the rate of underlying cardiopulmonary disease (over 20 mm group vs under 20 mm group, 5.0% vs 5.6%), one- piece resection rate (95% vs 96%), CR rate (85% vs 89%), operation time (72.3 min vs 66.5 min), bleeding rate (5% vs 4.2%), and perforation rate (0% vs 1.4%) between the 2 groups. Three patients in each group had submucosal invasion and two in each groups underwent additional surgery. CONCLUSION: There was no significant difference in the outcome resulting from IT-ESD between the 2 groups. Our study proves that IT-ESD is a feasible treatment for patients with over 20 mm mucosal gastric cancer although the long-term outcome should be evaluated in the future. | Shoji Hirasaki Hiromitsu Kanzaki Minoru Matsubara Kohei Fujita Fusao Ikeda Hideaki Taniguchi Eiichiro Yumoto Seiyuu Suzuki | 2007 | World Journal of Gastroenterology2007，13，29： | 13 |
| 9 | Pink-color sign in esophageal squamous neoplasia, and speculation regarding the underlying mechanism显示文摘AIM:To investigate the reasons for the occurrence of the pink-color sign of iodine-unstained lesions. METHODS:In chromoendoscopy, the pink-color sign of iodine-unstained lesions is recognized as useful for the diagnosis of esophageal squamous cell carcinoma. Patients with superficial esophageal neoplasms treated by endoscopic resection were included in the study. Areas of mucosa with and without the pink-color sign were evaluated histologically. The following histologic features that were possibly associated with the pinkcolor sign were evaluated. The keratinous layer and basal cell layer were classified as present or absent. Cellular atypia was classified as high grade, moderate grade or low grade, based on nuclear irregularity, mitotic figures, loss of polarity, chromatin pattern and nuclear/cytoplasmic ratio. Vascular change was assessed based on dilatation, tortuosity, caliber change and variability in shape. Vessels with these four findings were classified as positive for vascular change. Endoscopic images of the lesions were captured immediately after iodine staining, 2-3 min after iodine staining and after complete fading of iodine staining. Quantitative analysis of color changes after iodine staining was also performed. RESULTS:A total of 61 superficial esophageal neoplasms in 54 patients were included in the study. The lesions were located in the cervical esophagus in one case, the upper thoracic esophagus in 10 cases, the mid-thoracic esophagus in 33 cases, and the lower thoracic esophagus in 17 cases. The median diameter of the lesions was 20 mm (range:2-74 mm). Of the 61 lesions, 28 were classified as pink-color sign positive and 33 as pink-color sign negative. The histologic diagnosis was high-grade intraepithelial neoplasia (HGIN) or cancer invading into the lamina propria in 26 of the 28 pink-color sign positive lesions. There was a significant association between pink-color sign positive epithelium and HGIN or invasive cancer (P = 0.0001). Univariate analyses found that absence of the keratinous layer and cellular atypia were significantly associated with the pink-color sign. After Bonferroni correction, there were no significant associations between the pink-color sign and presence of the basal membrane or vascular change. Multivariate analyses found that only absence of the keratinous layer was independently associated with the pink-color sign (OR = 58.8, 95%CI:5.5-632).Quantitative analysis was performed on 10 superficial esophageal neoplasms with both pink-color sign positive and negative areas in 10 patients. Pink-color sign positive mucosa had a lower mean color value in the late phase (pinkish color) than in the early phase (yellowish color), and had similar mean color values in the late and final phases. These findings suggest that pinkcolor positive mucosa underwent color fading from the color of the iodine (yellow) to the color of the mucosa (pink) within 2-3 min after iodine staining. Pink-color sign negative mucosa had similar mean color values in the late and early phases (yellowish color), and had a lower mean color value in the final phase (pinkish color) than in the late phase. These findings suggest that pink-color sign negative mucosa did not undergo color fading during the 2-3 min after iodine staining, and underwent color fading only after spraying of sodium thiosulfate. CONCLUSION:The pink-color sign was associated with absence of the keratinous layer. This sign may be caused by early fading of iodine staining. | Ryu Ishihara Hiromitsu Kanzaki Hiroyasu Iishi Kengo Nagai Fumi Matsui Takeshi Yamashina Noriko Matsuura Takashi Ito Mototsugu Fujii Sachiko Yamamoto Noboru Hanaoka Yoji Takeuchi Koji Higashino Noriya Uedo Masaharu Tatsuta Yasuhiko Tomita Shingo Ishiguro | 2013 | World Journal of Gastroenterology2013，19，27： | 10 |
| 10 | Consensus of primary care in acute pancreatitis in Japan显示文摘在日本的尖锐胰腺炎的发生正在增加并且每百万张人口从 187 ~ 347 个盒子。盒子命运是 0.2% 为对温和中等,并且 9.0% 为在在 2003 的日本的严重尖锐胰腺炎。在日本的胰腺炎的专家做了与尖锐胰腺炎在病人的早管理集中于实际方面的这个文件。尖锐胰腺炎和严厉层化的正确诊断应该为尖锐胰腺炎的诊断用标准在所有病人被做并且多,因素得分系统尽早由胰的难处理的疾病的研究委员会求婚了。与尖锐胰腺炎诊断的所有病人应该在医院里被管理。血压监视,脉搏和呼吸率,体温,时时尿的体积,和血氧饱和水平在如此的病人的管理是必要的。早精力旺盛的静脉内的水和具有最前的重要性稳定循环动力学。有鸦片剂的足够的疼痛地势也是重要的。在严重尖锐胰腺炎,在一个早阶段的抗菌素的预防静脉内的管理被推荐。一旦尖锐胰腺炎的诊断被证实,朊酶禁止者的管理应该被开始。如果没有肠塞痛并且胃肠的流血的清楚的症状,从早舞台用非肠道的营养喂的肠内的联合被推荐。有严重尖锐胰腺炎的病人应该尽早被转移到 ICU 执行象朊酶的连续地区性的动脉的注入那样的特殊措施禁止者和抗菌素,和连续牙齿过敏过滤。日本政府为难处理的疾病作为关于措施的研究的工程之一为严重尖锐胰腺炎盖住医疗保健开销。 | Makoto Otsuki Masahiko Hirota Shinju Arata Masaru Koizumi Shigeyuki Kawa Terumi Kamisawa Kazunori Takeda Toshihiko Mayumi Motoji Kitagawa Tetsuhide Ito Kazuo Inui Tooru Shimosegawa Shigeki Tanaka Keisho Kataoka Hiromitsu Saisho Kazuichi Okazaki Yosikazu Kuroda Norio Sawabu Yoshifumi Takeyama | 2006 | World Journal of Gastroenterology2006，12，21： | 9 |
| 11 | Doppler study of hepatic vein in cirrhotic patients:Correlation with liver dysfunction and hepatic hemodynamics显示文摘AIM: To elucidate the significance of Doppler measurements of hepatic vein in cirrhotic patients and to correlate with liver dysfunction and hepatic hemodynamics. METHODS: One hundred patients with liver cirrhosis and 60 non-cirrhotic controls were studied. Doppler waveforms were obtained from right hepatic vein and flow velocity measured during quiet respiration. Doppler measurements were also obtained from portal trunk, right portal vein and proper hepatic artery. RESULTS: Hepatic vein waveforms were classified into three classical patterns. Flat waveform was uncommon. Mean hepatic vein velocity was significantly higher in cirrhotic patients (12.7 ± 6.4 vs 5.1 ± 2.1 and 6.2 ± 3.2 cm/s; P < 0.0001). The poorer the grade of cirrhosis, the higher was the mean velocity. Maximum forward velocity was never greater than 40 cm/s in controls. Degree of ascites was found to be highly correlated with mean velocity. “Very high” group (≥ 20 cm/s) presented clinically with moderate to massive ascites. Correlations between right portal flow and mean velocity was significant (P < 0.0001, r = 0.687). CONCLUSION: Doppler waveforms of hepatic vein, which is independent of liver dysfunction, should be obtained during normal respiration. Mean hepatic vein velocity reflects the change in hepatic circulation associated with progression of liver cirrhosis. It can be used as a new parameter in the assessment of liver cirrhosis. | KC Sudhamshu Shoiichi Matsutani Hitoshi Maruyama Taro Akiike Hiromitsu Saisho | 2006 | World Journal of Gastroenterology2006，12，36： | 8 |
| 12 | Hepatitis C virus enhances incidence of idiopathic pulmonary fibrosis显示文摘AIM: To investigate the cumulative development incidence and predictive factors for idiopathic pulmonary fibrosis in hepatitis C virus (HCV) positive patients. METHODS: We studied 6150 HCV infected patients who were between 40-70 years old (HCV-group). Another 2050 patients with hepatitis B virus (HBV) were selected as control (HBV-group). The mean observation period was 8.0 ± 5.9 years in HCV-group and 6.3 ± 5.5 years in HBV-group. The primary goal is the development of idiopathic pulmonary fibrosis (IPF) in both groups. The cumulative appearance rate of IPF and independent factors associated with the incidence rate of IPF were calculated using the Kaplan- Meier method and the Cox proportional hazard model. All of the studies were performed retrospectively by collecting and analyzing data from the patient records in our hospital. RESULTS: Fifteen patients in HCV-group developedIPF. On the other hand, none of the patients developed IPF in HBV-group. In HCV-group, the cumulative rates of IPF development were 0.3% at 10th year and 0.9% at 20th year. The IPF development rate in HCV-group was higher than that in HBV-group (P = 0.021). The IPF development rate in patients with HCV or HBV was high with statistical significance in the following cases: (1) patients ≥ 55 years (P < 0.001); (2) patients who had smoking index (package per day × year) of ≥ 20 (P = 0.002); (3) patients with liver cirrhosis (P = 0.042). CONCLUSION: Our results indicate that age, smoking and liver cirrhosis enhance the development of IPF in HCV positive patients. | Yasuji Arase Fumitaka Suzuki Yoshiyuki Suzuki Norio Akuta Masahiro Kobayashi Yusuke Kawamura Hiromi Yatsuji Hitomi Sezaki Tetsuya Hosaka Miharu Hirakawa Satoshi Saito Kenji Ikeda Hiromitsu Kumada | 2008 | World Journal of Gastroenterology2008，14，38： | 8 |
| 13 | A rare case of primary choriocarcinoma in the sigmoid colon显示文摘Primary colorectal choriocarcinoma is an extremely rare neoplasm and is usually associated with a poor prognosis.Only 13 cases of colorectal choriocarcinoma have previously been reported.There is no standard chemotherapeutic regimen for this tumor type.A 68-year-old man presented with melena and was diagnosed with sigmoid colonic adenocarcinoma with multiple liver metastases.He underwent a laparoscopic sigmoidectomy.Pathology revealed choriocarcinoma with a focal component of moderately differentiated adenocarcinoma of colon origin.Based on the collagen gel droplet-embedded culture drug sensitivity test(CD-DST)results,mFOLFOX6 and bevacizumab were administered,which suppressed aggressive tumor growth for 4 mo.The patient died 9 mo after the initial diagnosis.Our study results suggest that the standard chemotherapy regimen for colorectal cancer might have suppressive effects against primary colorectal choriocarcinoma.Moreover,CD-DST may provide,at least in part,therapeutic insight for the selection of appropriate antitumor agents for such patients. | Hiromitsu Maehira Tomoharu Shimizu Hiromichi Sonoda Eiji Mekata Tomoharo Yamaguchi Tohru Miyake Mitsuaki Ishida Tohru Tani | 2013 | World Journal of Gastroenterology2013，19，39： | 6 |
| 14 | Effect of lamivudinein in BeAg-positive chronic hepatitis B: Discordant effect on HBeAg and HBV DNA according to pretreatment ALT level显示文摘AIM: To clarify differences in antiviral effect of the drug in patients with different ALT levels, we examined the changes in HBV markers in patients with high or low ALT levels with or without lamivudine treatment. METHODS: Thirty-seven HBeAg-positive patients were studied. Ten patients with ALT levels higher than 200 IU/L (group 1) and 8 patients with ALT below 200 IU/L (group 2) were treated orally with 100 mg/d of lamivudine. As untreated control, 9 patients with ALT above 200 IU/L (group 3) and 10 patients with ALT below 200 IU/L (group 4) were examined. ALT level, HBeAg/HBeAb status, and HBV DNA level were examined monthly for 11.9±0.4 mo.RESULTS: The ALT level normalized in all 10 patients of group 1, 7/8 of group 2, 4/9 of group 3, and 1/10 of group 4 within 6 mo (groups 1 vs 2, P = NS; groups 1 vs 3, P = 0.002; groups 1vs 4, P<0.0001). HBV DNA fell below the detection limit in all 10 patients of group 1, 7/8 of group 2, 0/9 of group 3, and 0/10 of group 4 within 6 mo (groups 1 vs 2, P = NS). HBeAg became seronegative in 7/10 patients of group 1, 1/8 of group 2, 3/9 of group 3, and 0/10 of group 4 within 12 mo (groups 1 vs2, P= 0.02;groups 1 vs 3, P = NS).CONCLUSION: Our data suggest that HBeAg-positive patients with higher ALT levels can be considered good candidates for lamivudine therapy, probably because lamivudine accelerates the natural seroconversion of HBeAg, accompanied by HBV DNA loss, in these patients. | Tomoko Kurihara Fumio Imazeki Osamu Yokosuka Kenichi Fukai Tatsuo Kanda Shigenobu Kawai Hiromitsu Saisho | 2005 | World Journal of Gastroenterology2005，11，22： | 5 |
| 15 | Phase III study of sorafenib after transarterial chemoembolisation in Japanese and Korean patients with unresectable hepatocellular carcinoma显示文摘 | Masatoshi Kudo Kazuho Imanaka Nobuyuki Chida Kohei Nakachi Won-Young Tak Tadatoshi Takayama Jung-Hwan Yoon Takeshi Hori Hiromitsu Kumada Norio Hayashi Shuichi Kaneko Hirohito Tsubouchi Dong Jin Suh Junji Furuse Takuji Okusaka Katsuaki Tanaka Osamu Matsui | 2011 | European Journal of Cancer2011，，14： | 5 |
| 16 | Giant primary angiosarcoma of the small intestine showing severe sepsis显示文摘Primary malignant tumors of the small intestine are rare,comprising less than 2%of all gastrointestinal tumors.An 85-year-old woman was admitted with fever of 40℃ and marked abdominal distension.Her medical history was unremarkable,but blood examination showed elevated inflammatory markers.Abdominal computed tomography showed a giant tumor with central necrosis,extending from the epigastrium to the pelvic cavity.Giant gastrointestinal stromal tumor of the small intestine communicating with the gastrointestinal tract or with superimposed infection was suspected.Because no improvement occurred in response to antibiotics,surgery was performed.Laparotomy revealed giant hemorrhagic tumor adherent to the small intestine and occupying the peritoneal cavity.The giant tumor was a solid tumor weighing 3490 g,measuring24 cm×17.5 cm×18 cm and showing marked necrosis.Histologically,the tumor comprised spindle-shaped cells with anaplastic large nuclei.Immunohistochemical studies showed tumor cells positive for vimentin,CD31,and factorⅧ-related antigen,but negative for c-kit and CD34.Angiosarcoma was diagnosed.Although no postoperative complications occurred,the patient experienced enlargement of multiple metastatic tumors in the abdominal cavity and died 42 d postoperatively.The prognosis of small intestinal angiosarcoma is very poor,even after volume-reducing palliative surgery. | Mizuna Takahashi Masanori Ohara Noriko Kimura Hiromitsu Domen Takumi Yamabuki Kazuteru Komuro Takahiro Tsuchikawa Satoshi Hirano Nozomu Iwashiro | 2014 | World Journal of Gastroenterology2014，20，43： | 5 |
| 17 | Significance of a novel sucrose permeability test using serum in the diagnosis of early gastric cancer显示文摘AIM: To investigate the usefulness of sucrose permeability test using serum in the diagnosis of gastric diseases, with special reference to early gastric cancer (EGC).METHODS: A total of 63 subjects, including 11patients with gastric ulcer, 20 patients with gastric cancer (13, early; 7, advanced) and 32 healthy controls,were studied. Blood and urine samples were collected repeatedly for 5 h before and after the sucrose loading.Sucrose levels were measured by a newly developed enzymatic method.RESULTS: Serum sucrose levels started to increase15 min after loading, and peaked at 60 min in the gastric disease groups. The levels for gastric ulcer, EGC and advanced gastric cancer (AGC) at 60 min were significantly higher than that in the healthy controls(26.9±2.4, 34.4±5.0, and 71.8±15.6 vs 7.9±0.7 mol/L,respectively, P<0.01). The cut-off level set at 15.4 mol/L(60 min) offered the best distinction between EGC patients and healthy controls; and the sensitivity and specificity were 92.3% and 93.8%, respectively, while those of the urine method were 76.9% and 93.8%,respectively.CONCLUSIONS: The gastric permeability test using serum is reliable for the detection of EGC, and this test can provide results much earlier than the conventional urine method. This test may offer a useful alternative to more invasive tests for EGC. | Tadayuki Shishido Taketo Yamaguchi Takeo Odaka Masanori Seimiya Hiromitsu Saisho Fumio Nomura | 2005 | World Journal of Gastroenterology2005，11，44： | 5 |
| 18 | Cap polyposis refractory to Helicobacter pylori eradication treated with endoscopic submucosal dissection显示文摘Cap polyposis is a rare intestinal disorder. Characteristic endoscopic findings are multiple inflammatory polypoid lesions covered by caps of fibrous purulent exudate. Although a specific treatment has not been established, some studies have suggested that eradication therapy for Helicobacter pylori(H. pylori) is effective. We report a case of a 20-year-old man with cap polyposis presenting with hematochezia. Colonoscopy showed the erythematous polyps with white caps from the sigmoid colon to rectum. Histopathological findings revealed elongated, tortuous, branched crypts lined by hyperplastic epithelium with a mild degree of fibromusculosis in the lamina propria. Although H. pylori eradication was instituted, there was no improvement over six months. We then performed en bloc excision of the polyps by endoscopic submucosal dissection(ESD), which resulted in complete resolution of symptoms. ESD may be a treatment option for cap polyposis refractory to conservative treatments. We review the literature concerning treatment for cap polyposis and clinical outcomes. | Masaki Murata Mitsushige Sugimoto Hiromitsu Ban Taketo Otsuka Toshiro Nakata Masahide Fukuda Osamu Inatomi Shigeki Bamba Ryoji Kushima Akira Andoh | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，10： | 5 |
| 19 | Strategies for gastric cancer in the modern era显示文摘Gastric cancer is one of the most common neoplasms in Japan, and it is also the second leading cause of cancer-related deaths worldwide. Nowadays, infection with Helicobacter pylori (H. pylori) is a known risk factor for the development of gastric cancer. Therefore, gastric cancer should be considered as an infectious disease, and in fact, prophylactic eradication of H. pylori may prevent the development of metachronous gastric carcinoma. Before the role of H. pylori was understood, a different approach was used. Recently even after the cancer has developed, some newer therapeutic approaches have been pursued. These newer treatments have been summarized as 'minimally invasive therapies' and use endoscopic or laparoscopic techniques. In addition, robotic approaches are being developed that seem to hold a great potential to change the surgical approach. Since basic understanding and treatment of the disease have both changed signif icantly over the last decade, we present a review of current advances in gastric cancer research and therapy. | Satoru Takayama Takehiro Wakasugi Hitoshi Funahashi Hiromitsu Takeyama | 2010 | World Journal of Gastrointestinal Oncology2010，2，9： | 5 |
| 20 | Long‐term entecavir treatment reduces hepatocellular carcinoma incidence in patients with hepatitis B virus infection显示文摘 | Tetsuya Hosaka Fumitaka Suzuki Masahiro Kobayashi Yuya Seko Yusuke Kawamura Hitomi Sezaki Norio Akuta Yoshiyuki Suzuki Satoshi Saitoh Yasuji Arase Kenji Ikeda Mariko Kobayashi Hiromitsu Kumada | 2013 | Hepatology2013，，： | 5 |
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