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1Helicobacter pylori associated chronic gastritis,clinical syndromes,precancerous lesions,and pathogenesis of gastric cancer development显示文摘Helicobacter pylori(H.pylori)infection is well known to be associated with the development of precancerous lesions such as chronic atrophic gastritis(AG),or gastric intestinal metaplasia(GIM),and cancer.Various molecular alterations are identified not only in gastric cancer(GC)but also in precancerous lesions.H.pylori treatment seems to improve AG and GIM,but still remains controversial.In contrast,many studies,including meta-analysis,show that H.pylori eradication reduces GC.Molecular markers detected by genetic and epigenetic alterations related to carcinogenesis reverse following H.pylori eradication.This indicates that these changes may be an important factor in the identification of high risk patients for cancer development.Patients who underwent endoscopic treatment of GC are at high risk for development of metachronous GC.A randomized controlled trial from Japan concluded that prophylactic eradication of H.pylori after endoscopic resection should be used to prevent the development of metachronous GC,but recent retrospective studies did not show the tendency.Patients with precancerous lesions(molecular alterations)that do not reverse after H.pylori treatment,represent the'point of no return'and may be at high risk for the development of GC.Therefore,earlier H.pylori eradication should be considered for preventing GC development prior to the appearance of precancerous lesions.Jiro Watari Nancy Chen Peter S Amenta Hirokazu Fukui Tadayuki Oshima Toshihiko Tomita Hiroto Miwa Kheng-Jim Lim Kiron M Das 2014World Journal of Gastroenterology2014,20,18:60
2Continuous regional arterial infusion therapy with gabexate mesilate for severe acute pancreatitis显示文摘AIM: To evaluate the effi cacy of continuous regional arterial infusion therapy (CRAI) with gabexate mesilate and antibiotics for severe acute pancreatitis (SAP). METHODS: We conducted a prospective study on patients who developed SAP with or without CRAI. Out of 18 patients fulf illed clinical diagnostic criteria for SAP in Japan, 9 patients underwent CRAI, while 9 patients underwent conventional systemic protease inhibitor and antibiotics therapy (non-CRAI). CRAI was initiated within 72 h of the onset of pancreatitis. Gabexate mesilate (2400 mg/d) was continuously administered for 3 to 5 d. The clinical outcome including serum infl ammation-related parameters were examined. RESULTS: The duration of abdominal pain in the CRAI group was 1.9 ± 0.26 d, whereas that in the non-CRAI group was 4.3 ± 0.50. The duration of SIRS in the CRAI group was 2.2 ± 0.22 d, whereas that in the non- CRAI group was 3.2 ± 0.28. Abdominal pain and SIRS disappeared signifi cantly in a short period of time after the initiation of CRAI using gabexate mesilate. The average length of hospitalization signifi cantly differed between the CRAI and non-CRAI groups, 53.3 ± 7.9 d and 87.4 ± 13.9 d, respectively. During the first two weeks, levels of serum CRP and the IL6/IL10 ratio in the CRAI group tended to have a rapid decrease compared to those in the non-CRAI group. CONCLUSION: The present results suggest that CRAI using gabexate mesilate was effective against SAP.Yoshifumi Ino Yoshiyuki Arita Tetsuro Akashi Toshinari Kimura Hisato Igarashi Takamasa Oono Masayuki Furukawa Ken Kawabe Keiichiro Ogoshi Jiro Ouchi Toshihiko Miyahara Ryoichi Takayanagi Tetsuhide Ito 2008World Journal of Gastroenterology2008,14,41:20
3Clinical outcomes and risk factors for perforation in gastric endoscopic submucosal dissection: A prospective pilot study显示文摘AIM: To evaluate clinical outcomes and risk factors for endoscopic perforation during endoscopic submucosal dissection (ESD) in a prospective study. METHODS: We investigated the clinical outcomes and risk factors for the development of perforation in 98 consecutive gastric neoplasms undergoing ESD regarding. Demographic and clinical parameters including patient-, tumor-, and treatment-related factors, clinical parameters, and duration of hospital stay were analyzed for risk factors for perforation. In subgroup analysis, we also compared the clinical outcomes between perforation and 'silent' free air without endoscopically visible perforation detected only by computed tomography.RESULTS: Perforation was identified in 8.2% of patients. All patients were managed conservatively by the administration of antibiotics. The mean procedure time was significantly longer in patients with endoscopic perforation than in those without. According to the receiver-operating characteristic analysis, the resulting cutoff value of the procedure time for perforation was 115 min (87.5% sensitivity, 56.7% specificity). Prolonged procedure time (≥ 115 min) was associated with an increased risk of perforation (odds ratio 9.15; 95%CI: 1.08-77.54; P = 0.04). Following ESD, body temperature and C-reactive protein level were significantly higher in patients with perforation than in those without (P = 0.02), whereas there was no difference between these patient groups on the starting day of oral intake or of hospitalization. In subgroup analysis, the post-ESD clinical course was not different between endoscopic perforation and silent free air. CONCLUSION: Only prolonged procedure time (≥ 115 min) was significantly associated with perforation. The clinical outcomes of perforation are favorable and are comparable to those of patients with or without silent free air.Jiro Watari Toshihiko Tomita Fumihiko Toyoshima Jun Sakurai Takashi Kondo Haruki Asano Takahisa Yamasaki Takuya Okugawa Hisatomo Ikehara Tadayuki Oshima Hirokazu Fukui Hiroto Miwa 2013World Journal of Gastrointestinal Endoscopy2013,5,6:17
4Fucoidan enhances intestinal barrier function by upregulating the expression of claudin-1显示文摘AIM:To evaluate the protective effects of fucoidan on oxidative stress-induced barrier disruption in human intestinal epithelial cells.METHODS:In Caco-2 cell monolayer models,the disruption of barrier function by oxidative stress is mediated by H2O2.The integrity of polarized Caco-2 cell monolayers was determined by measuring the transepithelial resistance(TER)and permeability was estimated by measuring the paracellular transport of FITC-labeled4-kDa dextran(FD4).The protective effects of fucoidan on epithelial barrier functions on polarized Caco-2 cell monolayers were evaluated by TER and FD4 flux.The expression of tight junction(TJ)proteins was assessed using reverse-transcription polymerase chain reaction(RT-PCR)and immunofluorescence staining.RESULTS:Without H2O2treatment,fucoidan significantly increased the TER compared to control(P<0.05),indicating a direct enhancement of intestinal epithelial barrier function.Next,H2O2disrupted the epithelial barrier function in a time-dependent manner.Fucoidan prevented the H2O2-induced destruction in a dosedependent manner.Fucoidan significantly decreased H2O2-induced FD4 flux(P<0.01),indicating the prevention of disruption in paracellular permeability.RTPCR showed that Caco-2 cells endogenously expressed claudin-1 and-2,and occludin and that H2O2reduced the mRNA expression of these TJ proteins.Treatment with fucoidan attenuated the reduction in the expressions of claudin-1 and claudin-2 but not occludin.Immunofluorescence staining revealed that the expression of claudin-1 was intact and high on the cell surface.H2O2disrupted the integrity of claudin-1.Treatment with fucoidan dramatically attenuated the expression of claudin-1.CONCLUSION:Fucoidan enhanced intestinal epithelial barrier function by upregulating the expression of claudin-1.Thus,fucoidan may be an appropriate therapy for the treatment of inflammatory bowel diseases.Atsushi Iraha Hiroshi Chinen Akira Hokama Takumi Yonashiro Tetsu Kinjo Kazuto Kishimoto Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Futoshi Higa Masao Tateyama Fukunori Kinjo Jiro Fujita 2013World Journal of Gastroenterology2013,19,33:15
5Diagnosis of intestinal tuberculosis using a monoclonal antibody to Mycobacterium tuberculosis显示文摘AIM:To investigate the utility of immunohistochemical(IHC) staining with an antibody to Mycobacterium tuberculosis(M.tuberculosis) for the diagnosis of intestinal tuberculosis(TB).METHODS:We retrospectively identified 10 patients(4 males and 6 females;mean age = 65.1 ± 13.6 years) with intestinal TB.Clinical characteristics,including age,gender,underlying disease,and symptoms were obtained.Chest radiograph and laboratory tests,including sputum Ziehl-Neelsen(ZN) staining,M.tuberculosis culture,and sputum polymerase chain reaction(PCR) for tubercle bacilli DNA,as well as Tuberculin skin test(TST) and QuantiFERON-TB gold test(QFT),were examined.Colonoscopic records recorded on the basis of Sato's classification were also reviewed,in addition to data from intestinal biopsies examined for histopathological findings,including hematoxylin and eosin staining,and ZN staining,as well as M.tuberculosis culture,and PCR for tubercle bacilli DNA.For the present study,archived formalin-fixed paraffin-embedded(FFPE) intestinal tissue samples were immunohistochemically stained using a commercially available species-specific monoclonal antibody to the 38-kDa antigen of the M.tuberculosis complex.These sections were also stained with the pan-macrophage marker CD68 antibody.RESULTS:From the clinical data,we found that no patients were immunocompromised,and that the main symptoms were diarrhea and weight loss.Three patients displayed active pulmonary TB,six patients(60%) had a positive TST,and 4 patients(40%) had a positive QFT.Colonoscopic findings revealed that all patients had type 1 findings(linear ulcers in a circumferential arrangement or linear ulcers arranged circumferentially with mucosa showing multiple nodules),all of which were located in the right hemicolon and/or terminal ileum.Seven patients(70%) had concomitant healed lesions in the ileocecal area.No acid-fast bacilli were detected with ZN staining of the intestinal tissue samples,and both M.tuberculosis culture and PCR for tubercle bacilli DNA were negative in all samples.The histopathological data revealed that tuberculous granulomas were present in 4 cases(40%).IHC staining in archived FFPE samples with anti-M.tuberculosis monoclonal antibody revealed positive findings in 4 patients(40%);the same patients in which granulomas were detected by hematoxylin and eosin staining.M.tuberculosis antigens were found to be mostly intracellular,granular in pattern,and primarily located in the CD68 + macrophages of the granulomas.CONCLUSION:IHC staining with a monoclonal antibody to M.tuberculosis may be an efficient and simple diagnostic tool in addition to classic examination methods for the diagnosis of intestinal TB.Yasushi Ihama Akira Hokama Kenji Hibiya Kazuto Kishimoto Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Haley L Cash Futoshi Higa Masao Tateyama Fukunori Kinjo Jiro Fujita 2012World Journal of Gastroenterology2012,18,47:12
6Cytokines in adipose-derived mesenchymal stem cells promote the healing of liver disease显示文摘Adipose-derived mesenchymal stem cells(ADSCs) are a treatment cell source for patients with chronic liver injury. ADSCs are characterized by being harvested from the patient's own subcutaneous adipose tissue, a high cell yield(i.e., reduced immune rejection response), accumulation at a disease nidus, suppression of excessive immune response, production of various growth factors and cytokines, angiogenic effects, antiapoptotic effects, and control of immune cells via cellcell interaction. We previously showed that conditioned medium of ADSCs promoted hepatocyte proliferation and improved the liver function in a mouse model of acute liver failure. Furthermore, as found by many other groups, the administration of ADSCs improved liver tissue fibrosis in a mouse model of liver cirrhosis. A comprehensive protein expression analysis by liquid chromatography with tandem mass spectrometry showed that the various cytokines and chemokines produced by ADSCs promote the healing of liver disease. In this review, we examine the ability of expressed protein components of ADSCs to promote healing in cell therapy for liver disease. Previous studies demonstrated that ADSCs are a treatment cell source for patients with chronic liver injury. This review describes the various cytokines and chemokines produced by ADSCs that promote the healing of liver disease.Saifun Nahar Yoshiki Nakashima Chika Miyagi-Shiohira Takao Kinjo Zensei Toyoda Naoya Kobayashi Issei Saitoh Masami Watanabe Hirofumi Noguchi Jiro Fujita 2018World Journal of Stem Cells2018,10,11:11
7Endoscopic and radiographic features of gastrointestinal involvement in vasculitis显示文摘Vasculitis is an inflammation of vessel walls,followed by alteration of the blood flow and damage to the dependent organ.Vasculitis can cause local or diffuse pathologic changes in the gastrointestinal (GI) tract.The variety of GI lesions includes ulcer,submucosal edema,hemorrhage,paralytic ileus,mesenteric ischemia,bowel obstruction,and life-threatening perforation.The endoscopic and radiographic features of GI involvement in vasculitisare reviewed with the emphasis on small-vessel vasculitis by presenting our typicalcases,including Churg-Strauss syndrome,HenochSch nlein purpura,systemic lupus erythematosus,and Beh et's disease.Important endoscopic features are ischemic enterocolitis and ulcer.Characteristic computed tomographic findings include bowel wall thickening with the target sign and engorgement of mesenteric vessels with comb sign.Knowledge of endoscopic and radiographic GI manifestations can help make an early diagnosis and establish treatment strategy.Akira Hokama Kazuto Kishimoto Yasushi Ihama Chiharu Kobashigawa Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Futoshi Higa Masao Tateyama Fukunori Kinjo Kunitoshi Iseki Seiya Kato Jiro Fujita 2012World Journal of Gastrointestinal Endoscopy2012,4,3:9
8What types of early gastric cancer are indicated for endoscopic ultrasonography staging of invasion depth?显示文摘AIM To clarify the diagnostic efficacy and limitations of endoscopic ultrasonography(EUS) and the characteristics of early gastric cancers(EGCs) that are indications for EUS-based assessment of cancer invasion depth.METHODS We retrospectively investigated the cases of 153 EGC patients who underwent conventional endoscopy(CE) and EUS(20 MHz) before treatment.RESULTS We found that 13.7% were 'inconclusive' cases with low-quality EUS images, including all nine of the cases with protruded(0-I)-type EGCs. There was no significant difference in the diagnostic accuracybetween CE and EUS. Two significant independent risk factors for misdiagnosis by EUS were identified-ulcer scarring [UL(+); odds ratio(OR) = 4.49, P = 0.003] and non-indication criteria for endoscopic resection(ER)(OR = 3.02, P = 0.03). In the subgroup analysis, 23.1% of the differentiated-type cancers exhibiting SM massive invasion(SM2) invasion(submucosal invasion ≥ 500 μm) by CE were correctly diagnosed by EUS, and 23.1% of the undifferentiated-type EGCs meeting the expanded-indication criteria for ER were correctly diagnosed by EUS.CONCLUSION There is no need to perform EUS for UL(+) EGCs or 0-I-type EGCs, but EUS may enhance the pretreatment staging of differentiated-type EGCs with SM2 invasion without UL or undifferentiated-type EGCs revealed by CE as meeting the expanded-indication criteria for ER.Jiro Watari Shigemitsu Ueyama Toshihiko Tomita Hisatomo Ikehara Kazutoshi Hori Ken Hara Takahisa Yamasaki Takuya Okugawa Takashi Kondo Tomoaki Kono Katsuyuki Tozawa Tadayuki Oshima Hirokazu Fukui Hiroto Miwa 2016World Journal of Gastrointestinal Endoscopy2016,8,16:8
9Double-balloon endoscopy in the diagnosis and management of GI tract diseases:Methodology,indications,safety,and clinical impact显示文摘AIM: To prospectively evaluate the indications, method-ology, safety, and clinical impact of double-balloon en-doscopy.METHODS: A total of 60 patients with suspected or documented small- or large-bowel diseases were investi-gated by double balloon endoscopy. A total of 103 proce-dures were performed (42 from the oral route, 60 from the anal route, and 1 from the stoma route). The main outcome measurements were the time of insertion and the entire examination, complications, diagnostic yields, and the ability to successfully perform treatment.RESULTS: Observation of the entire small intestine was possible in 10 (40%) of 25 patients with total enteros-copy. The median insertion time was 122 min (range, 74-199 min). Observation of the entire colon was possi-ble in 13 (93%) of 14 patients after failure of total colo-noscopy using a conventional colonoscope. Small-intes-tine abnormalities were found in 20 (43%) of 46 patients with indications of suspected or documented small bowel diseases, obscure GI tract bleeding, or a history of ileus. Endoscopic procedures including tattooing (n = 33), bite biopsy (n = 17), radiographic examination (n = 7), EUS (n = 5), hemostasis (n = 1), polypectomy (n = 5), balloon dilatation (n = 1), endoscopic mucosal resection (n = 1) and lithotripsy (n = 1) were all successfully performed. No relevant technical problems or severe complications were encountered.CONCLUSION: Double balloon endoscopy is a feasible technique that allows adequate small and large bowel examination and potentially various endoscopic proce-dures of small-intestinal lesions. It is safe, useful, and also provides a high clinical impact.Kazuya Akahoshi Masaru Kubokawa Masahiro Matsumoto Shingo Endo Yasuaki Motomura Jiro Ouchi Mitsuhide Kimura Atsuhiko Murata Michiaki Murayama 2006World Journal of Gastroenterology2006,12,47:8
10Histological diagnosis of gastric submucosal tumors: A pilot study of endoscopic ultrasonography-guided fine-needle aspiration biopsy vs mucosal cutting biopsy显示文摘AIM: To compare the usefulness of endoscopic ultrasonography-guided fine-needle aspiration biopsy(EUS-FNAB) without cytology and mucosal cutting biopsy(MCB) in the histological diagnosis of gastric submucosal tumor(SMT).METHODS: We prospectively compared the diagnostic yield, feasibility, and safety of EUS-FNAB and those of MCB based on endoscopic submucosal dissection. The cases of 20 consecutive patients with gastric SMT ≥1 cm in diameter. who underwent both EUS-FNAB and MCB were investigated.RESULTS: The histological diagnoses were gastrointestinal stromal tumors(n = 7), leiomyoma(n =6), schwannoma(n = 2), aberrant pancreas(n = 2), and one case each of glomus tumor, metastatic hepatocellular carcinoma, and no-diagnosis. The tumors' mean size was 23.6 mm. Histological diagnosis was made in 65.0% of the EUS-FNABs and 60.0% of the MCBs, a nonsignificant difference. There were no significant differences in the diagnostic yield concerning the tumor location or tumor size between the two methods. However, diagnostic specimens were significantly more frequently obtained in lesions with intraluminal growth than in those with extraluminal growth by the MCB method(P = 0.01). All four SMTs with extraluminal growth were diagnosed only by EUSFNAB(P = 0.03). No complications were found in either method.CONCLUSION: MCB may be chosen as an alternative diagnostic modality in tumors showing the intraluminal growth pattern regardless of tumor size, whereas EUSFNAB should be performed for SMTs with extraluminal growth.Hisatomo Ikehara Zhaoliang Li Jiro Watari Masato Taki Tomohiro Ogawa Takahisa Yamasaki Takashi Kondo Fumihiko Toyoshima Tomoaki Kono Katsuyuki Tozawa Yoshio Ohda Toshihiko Tomita Tadayuki Oshima Hirokazu Fukui Ikuo Matsuda Seiichi Hirota Hiroto Miwa 2015World Journal of Gastrointestinal Endoscopy2015,7,14:7
11Different natural courses of chronic hepatitis B with genotypes B and C after the fourth decade of life显示文摘AIM: To investigate the different impact of genotypes B and C on the development of liver cirrhosis (LC) among different age groups of patients with chronic hepatitis B (CH-B). METHODS: We examined the outcome of 121 patients with CH-B, divided by age and genotype. Univariate analyses were used to compare different groups. The Cox proportional hazard model was employed to evaluate factors affecting the development of LC. RESULTS: In patients < 30 years old, there were no significant predictors for development of LC. However, in patients ≥ 30 years old, genotype C was the only significant predictor. In the genotype C group, 8 of 12 patients who progressed to LC were 30-49 years old at initial diagnosis of chronic hepatitis (7 patients were positive for HBeAg). In the genotype B group, 4 of 8 patients who developed LC were ≥ 50 years old at initial diagnosis and were HBeAg-negative. CONCLUSION: The rate of development of LC was comparable in patients infected with genotypes B and C when CH-B occurred at < 30 years old. However, CH-B patients infected with genotype C showed poor prognosis if they were 30-49 years old and were positive for HBeAg. Age-specific natural course of CH-B should be considered when patients with CH-B are treated with antiviral drugs.Tatsuji Maeshiro Shingo Arakaki Takako Watanabe Hajime Aoyama Joji Shiroma Tsuyoshi Yamashiro Tetsuo Hirata Akira Hokama Fukunori Kinjo Tomofumi Nakayoshi Tomokuni Nakayoshi Masashi Mizokami Jiro Fujita Hiroshi Sakugawa 2007World Journal of Gastroenterology2007,13,34:7
12Safety advantage of endocut mode over endoscopic sphincterotomy for choledocholithiasis显示文摘瞄准:评估一个自动地控制的切割系统(endocut 模式) 是否能与常规混合切割模式相比在 EST 以后减少内视镜的括约肌切开术(EST ) 和浆液血淀粉酶过多的复杂并发症率。方法:从 2001 年 1 月到 2003 年 10 月,有胆总管石病的 134 个病人在括约肌切开术的时候被分到任何一个 endocut 模式组或常规混合切割模式组。二个组回顾地在 EST 和浆液淀粉酶以后为复杂并发症被比较水平在前和在过程以后的 24 h。结果:对待的 134 个病人, 79 被分到常规混合切割模式组, 55 组织到 endocut 模式。在年龄,性别,和在在二个组之间的 EST 前的浆液淀粉酶水平没有有效差量。复杂并发症在 endocut 模式组(9%) 的 5 个病人被发现:血淀粉酶过多(比正常高 5 倍) 在 4 并且在 1 的中等胰腺炎。复杂并发症在常规混合切割模式组(16%) 的 13 个病人被发现:在 12 的血淀粉酶过多和在 1 的中等胰腺炎。浆液淀粉酶层次在两个组被提高在 EST (P<0.02 ) 以后的 24 h。在在常规混合切割模式的 EST 以后的 24 h 组织的平均浆液淀粉酶水平在 endocut 模式组(P<0.05 ) 比那显著地高。结论:Endocut 模式由减少血淀粉酶过多在 EST 以后为胰腺炎在常规混合切割模式上提供一个安全优点。Hirotada Akiho Yorinobu Sumida Kazuya Akahoshi Atsuhiko Murata Jiro Ouchi Yasuaki Motomura Taisuke Toyomasu Mitsuhide Kimura Masaru Kubokawa Masahiro Matsumoto Shingo Endo Kazuhiko Nakamura 2006World Journal of Gastroenterology2006,12,13:6
13胃肠的淀粉样变性病的内视镜、组织病理学说的特征显示文摘 Amyloidosis is a rare disorder, characterized by the extracellular deposition of an abnormal fibrillar protein, which disrupts tissue structure and function. Amyloidosis can be acquired or hereditary, and systemic or localized to a single organ, such as the gastrointestinal (GI) tract. Clinical manifestations may vary from asymptomatic to fatal forms. Primary amyloidosis (monoclonal immunoglobulin light chains, AL) is the most common form of amyloidosis. AL amyloidosis has been associated with plasma cell dyscrasias, such as, mul- tiple myeloma. Secondary amyloidosis is caused by the deposition of fragments of the circulating acute-phase reactant, serum amyloid A protein (SAA). Common causes of AA amyloidosis are chronic inflammatory dis-orders. Although GI symptoms are usually nonspecific, histopathological patterns of amyloid deposition are associated with clinical and endoscopic features. Amyloid deposition in the muscularis mucosae, submucosa, and muscularis propria has been dominant in AL amyloidosis, leading to polypoid protrusions and thickening of the valvulae conniventes, whereas granular amyloid deposition mainly in the propria mucosae has been related to AA amyloidosis, resulting in the fine granular appearance, mucosal friability, and erosions. As a result, AL amyloidosis usually presents with constipation, mechanical obstruction, or chronic intestinal pseudoobstruction while AA amyloidosis presents with diarrhea and malabsorption Amyloidotic GI symptoms are mostly refractory and have a negative impact on quality of life and survival. Diagnosing GI amyloidosis requires high suspicion of evaluating endoscopists. Because of the absence of specific treatments for reducing the abundance of the amyloidogenic precursor protein, we should be aware of certain associations between patterns of amyloid deposition and clinical and endoscopic features.Akira Hokama Kazuto Kishimoto Manabu Nakamoto Chiharu Kobashigawa Tetsuo Hirata Nagisa Kinjo Fukunori Kinjo Seiya Kato Jiro Fujita 2011World Journal of Gastrointestinal Endoscopy2011,3,8:6
14Asian gut microbiome显示文摘Several hundred microbial species inhabit the human gastrointestinal(GI)tract and constitute a complex ecological community that influences the host’s physiology and immunity through their metabolism and interactions with the host[1,2].The composition of the GI microbiota varies among individuals.Multiple intrinsic and extrinsic factors,including host genetics and physiology,drug and disease,and diets and some other living environments。Jiro Nakayama Heping Zhang Yuan-Kun Lee 2017Science Bulletin2017,62,12:5
15Cytomegalovirus gastritis显示文摘Cytomegalovirus(CMV)has been increasingly recognized as an important common pathogen in an immunocompromised state.The colon and stomach are the most common sites of its gastrointestinal infection. Symptoms of CMV gastritis are usually nonspecific and include epigastric pain,fever,nausea and bleeding. Endoscopic features are quite variable and include macroscopically normal mucosa,diffuse erythema, nodules,pseudotumors,erosions and ulcers.The bioptic detection of intranuclear inclusions is the hallmark of CMV infection.Most gastrointestinal CMV infection responds well to ganciclovir.We present endoscopic and histopathological features of CMV gastritis in a 71 year old woman receiving long-term prednisolone for pemphigus vulgaris.Akira Hokama Kiyohito Taira Yu-ichi Yamamoto Nagisa Kinjo Fukunori Kinjo Kenzo Takahashi Jiro Fujita 2010World Journal of Gastrointestinal Endoscopy2010,2,11:4
16Diagnosis of small intramucosal signet ring cell carcinoma of the stomach by non-magnifying narrow-band imaging: A pilot study显示文摘AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been treated with endoscopic submucosal dissection(ESD) and 14 randomly selected whitish gastric ulcer scars(control). The strength and shape of the SRCs and whitish scars by NM-NBI and white-light imaging(WLI) were assessed with Image J(NIH, Bethesda).RESULTS: NM-NBI findings of SRC showed a clearly isolated whitish area amid the brown color of the surrounding normal mucosa. The NBI index, which indicates the potency of NBI for visualizing SRC, was significantly higher than the WLI index(P = 0.001), indicating SRC was more clearly identified by NM-NBI. Although the NBI index was not significantly different between SRCs and controls, the circle(C)-index, as an index of circularity of tumor shape, was significantly higher in SRCs(P = 0.001). According to the receiveroperating characteristic analysis, the resulting cut-off value of the circularity index(C-index) for SRC was 0.60(85.7% sensitivity, 85.7% specificity). Thus a lesion with a C-index ≥ 0.6 was significantly more likely to be an SRC than a gastric ulcer scar(OR = 36.0; 95%CI: 4.33-299.09; P = 0.0009).CONCLUSION: Small isolated whitish round area by NM-NBI endoscopy is a useful finding of SRCs which is the indication for ESD.Jiro Watari Toshihiko Tomita Hisatomo Ikehara Masato Taki Tomohiro Ogawa Takahisa Yamasaki Takashi Kondo Fumihiko Toyoshima Jun Sakurai Tomoaki Kono Katsuyuki Tozawa Yoshio Ohda Tadayuki Oshima Hirokazu Fukui Seiichi Hirota Hiroto Miwa 2015World Journal of Gastrointestinal Endoscopy2015,7,12:4
17Evaluation of a multiplex PCR assay for detection of cytomegalovirus in stool samples from patients with ulcerative colitis显示文摘AIM: To evaluate a multiplex PCR assay for the detection of bacterial and viral enteropathogens in stool samples from patients with ulcerative colitis(UC). METHODS: We prospectively analyzed 300 individuals, including immunocompetent patients, immunocompromised patients, and patients with UC. Stool samples were collected from the recto-sigmoid region of the colon by endoscopy. The samples were qualitatively analyzed for bacterial and viral enteropathogens with a multiplex PCR assay using a Seeplex® Kit. Additional clinical and laboratory data were collected from the medical records. RESULTS: A multiplex PCR assay detected 397 pathogens(191 bacteria and 206 viruses) in 215 samples(71.7%). The most frequently detected bacteria were Escherichia coli H7, 85(28.3%); followed by Aeromonas spp., 43(14.3%); and Clostridium perfringens, 36(12.0%) samples. The most prevalent viruses were Epstein-Barr virus(EBV), 90(30.0%); followed by human herpes virus-6(HHV-6), 53(17.7%); and cytomegalovirus(CMV), 37(12.3%) samples. The prevalence rate of CMV infection was significantly higher in the immunocompromised group than in the immunocompetent group(P < 0.01). CMV infection was more common in patients with UC(26/71; 36.6%)than in the immunocompetent patients excluding UC(6/188; 3.2%)(P < 0.01). CMV infection was more prevalent in UC active patients(25/58; 43.1%) than in UC inactive patients(1/13; 7.7%)(P < 0.05). Among 4 groups which defined by the UC activity and immunosuppressive drugs, the prevalence rate of CMV infection was highest in the UC active patients with immunosuppressive drugs(19/34; 55.8%). EpsteinBarr virus(EBV) infection was more common in the immunocompromised patients excluding UC(18/41; 43.9%) than in the immunocompetent patients excluding UC(47/188; 25.0%)(P < 0.05). The simultaneous presence of CMV and EBV and/or HHV6 in UC active patients(14/58; 24.1%) was greater than in immunocompromised patients excluding UC(5/41; 12.2%)(P < 0.05). CONCLUSION: The multiplex PCR assay that was used to analyze the stool samples in this study may serve as a non-invasive approach that can be used to exclude the possibility of CMV infection in patients with active UC who are treated with immunosuppressive therapy.Saifun Nahar Atsushi Iraha Akira Hokama Ayako Uehara Gretchen Parrott Tetsuya Ohira Masatoshi Kaida Tetsu Kinjo Takeshi Kinjo Tetsuo Hirata Nagisa Kinjo Jiro Fujita 2015World Journal of Gastroenterology2015,21,44:4
18Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection显示文摘AIM:To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis(S.stercoralis)hyperinfection. METHODS:Over a period of 23 years(1984-2006),we investigated 25 patients withS.stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis.The clinical and endoscopic findings were analyzed retrospectively. RESULTS:Twenty-four(96%)of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1(HTLV-1)infection.The abnormal endoscopic findings,mainly edematous mucosa,white villi and erythematous mucosa,were observed in 23(92%) patients.The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy.The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative(Endoscopic severity score:4.86±2.47vs 2.71 ±1.38,P<0.05). CONCLUSION:Our study clearly demonstrates that,in addition to stool analysis,endoscopic observation and biopsies are very important.We also emphasize that S.stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions.Kazuto Kishimoto Akira Hokama Tetsuo Hirata Yasushi Ihama Manabu Nakamoto Nagisa Kinjo Fukunori Kinjo Jiro Fujita 2008World Journal of Gastroenterology2008,14,11:4
19Efficacy and adverse events of cold vs hot polypectomy: A meta-analysis显示文摘AIM: To compare previously reported randomized controlled studies(RCTs) of cold and hot polypectomy, we systematically reviewed and clarify the utility of cold polypectomy over hot with respect to efficacy and adverse events.METHODS: A meta-analysis was conducted to evaluate the predominance of cold and hot polypectomy for removing colon polyps. Published articles and abstracts from worldwide conferences were searched using the keywords 'cold polypectomy'. RCTs that compared either or both the effects or adverse events of cold polypectomy with those of hot polypectomy were collected. The patients' demographics, endoscopic procedures, No. of examined lesions, lesion size, macroscopic and histologic findings, rates of incomplete resection, bleeding amount, perforation, and length of procedure were extracted from each study. A forest plot analysis was used to verify the relative strength of the effects and adverse events of each procedure. A funnel plot was generated to assess the possibility of publication bias.RESULTS: Ultimately, six RCTs were selected. No significant differences were noted in the average lesion size(less than 10 mm) between the cold and hot polypectomy groups in each study. Further, the rates of complete resection and adverse events, including delayed bleeding, did not differ markedly between cold and hot polypectomy. The average procedural time in the cold polypectomy group was significantly shorter than in the hot polypectomy group.CONCLUSION: Cold polypectomy is a time-saving procedure for removing small polyps with markedly similar curability and safety to hot polypectomy.Mikihiro Fujiya Hiroki Sato Nobuhiro Ueno Aki Sakatani Kazuyuki Tanaka Tatsuya Dokoshi Shugo Fujibayashi Yoshiki Nomura Shin Kashima Takuma Gotoh Junpei Sasajima Kentaro Moriichi Jiro Watari Yutaka Kohgo 2016World Journal of Gastroenterology2016,22,23:3
20普旋过程中旋轮道次的制定对产品的影响显示文摘本文讨论了为获得最小产品高度而对轨迹形状及其它工作条件对数学参数进行选择的方法,提出了获得一定产品高度的合理方程,并指出了选择最优的旋轮进给速度和道次间距的方法。根据文中描述的规律,可容易地获得所希望的筒形零件高度,本文中的计算机模拟程序可望应用于复杂形状的零件。Masu jiro Hayama 王强 1989锻压技术1989,14,5:3
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