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| 1 | Preoperative evaluation of colorectal cancer using CT colonography, MRI, and PET/CT显示文摘Imaging studies are a major component in the evaluation of patients for the screening,staging and surveillance of colorectal cancer.This review presents commonly encountered findings in the diagnosis and staging of patients with colorectal cancer using computed tomography(CT)colonography,magnetic resonance imaging(MRI),and positron emission tomography(PET)/CT colonography.CT colonography provides important information for the preoperative assessment of T staging.Wall deformities are associated with muscular or subserosal invasion.Lymph node metastases from colorectal cancer often present with calcifications.CT is superior to detect calcified metastases.Three-dimensional CT to image the vascular anatomy facilitates laparoscopic surgery.T staging of rectal cancer by MRI is an established modality because MRI can diagnose rectal wall laminar structure.N staging in patients with colorectal cancer is still challenging using any imaging modality.MRI is more accurate than CT for the evaluation of liver metastases.PET/CT colonography isvaluable in the evaluation of extra-colonic and hepatic disease.PET/CT colonography is useful for obstructing colorectal cancers that cannot be traversed colonoscopically.PET/CT colonography is able to localize synchronous colon cancers proximal to the obstruction precisely.However,there is no definite evidence to support the routine clinical use of PET/CT colonography. | Shigeyoshi Kijima Takahiro Sasaki Koichi Nagata Kenichi Utano Alan T Lefor Hideharu Sugimoto | 2014 | World Journal of Gastroenterology2014，20，45： | 46 |
| 2 | A case of invasive hemolymphangioma of the pancreas显示文摘Hemolymphangioma of the pancreas is a very rare benign tumor. There were only five reports of this disease until March 2008. Herein, we report a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to duodenal invasion. A 53-year-old man had been admitted a referral hospital because of severe anemia due to gastrointestinal bleeding in December 2005. He was then transferred to our institute with a diagnosis of a tumor of the head of the pancreas with duodenal invasion in January 2006. No abnormalities were revealed except for anemia in laboratory data including CEA and CA19-9. Gastrointestinal endoscopy revealed bleeding at the duodenum. Computed tomography also demonstrated a heterogenous mass at the pancreatic head and suspected invasion to the duodenal wall. Ultrasonography showed a huge mass at the pancreatic head with a mixture of high and low echoic areas. Pylorous-preserving pancreatoduodenectomy was performed. The pancreatic tumor was soft and had invaded to the duodenum. The pathological diagnosis was a hemolymphangioma of the pancreas invaded to the duodenum. His postoperative course was uneventful and he was discharged on the 26th d after surgery. Hemolymphangioma of the pancreas is a very rare benign tumor. In a literature review until March 2008, we found five case reports. Major symptoms are abdominal pain and distension due to the enlarged tumor. However, we experienced a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to invasion to the duodenum. This disease is a very rare entity, but should be considered when patients have gastrointestinal bleeding. | Yoshikazu Toyoki Kenichi Hakamada Shunji Narumi Masaki Nara Daisuke Kudoh Keinosuke Ishido Mutsuo Sasaki | 2008 | World Journal of Gastroenterology2008，14，18： | 26 |
| 3 | Clinical benefit of radiation therapy and metallic stenting for unresectable hilar cholangiocarcinoma显示文摘AIM:To determine the efficacy of external beam radiotherapy(EBRT),with or without intraluminal brachytherapy(ILBT),in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS:We analyzed 64 patients with locally advanced hilar cholangiocarcinoma,including 25 who underwent resection(17 curative and 8 non-curative),28 treated with radiotherapy,and 11 who received best supportive care(BSC).The radiotherapy group received EBRT(50 Gy,30 fractions),with 11 receiving an additional 24 Gy(4 fractions) ILBT by iridium-192 with remote after loading.ILBT was performed using percutaneous transhepatic biliary drainage(PTBD) route.Uncovered metallic stents(UMS) were inserted into nonresected patients with obstructive jaundice,with the exception of four patients who received percutaneous transhepatic biliary drainage only.UMS were placed endoscopically or percutaneously,depending on the initial drainage procedure.The primary endpoints were patient death or stent occlusion.Survival time of patients in the radiotherapy group was compared with that of patients in the resection and BSC groups.Stent patency was compared in the radiotherapy and BSC groups.RESULTS:No statistically significant differences in patient characteristics were found among the resection,radiotherapy,and BSC groups.Three patients in the radiotherapy group and one in the BSC group did not receive UMS insertion but received PTBD alone;cholangitis occurred after endoscopic stenting,and patients were treated with PTBD.A total of 16 patients were administered additional systemic chemotherapy(5-fluorouracil-based regimen in 9,S-1 in 6,and gemcitabine in 1).Overall survival varied significantly among groups,with median survival times of 48.7 mo in the surgery group,22.1 mo in the radiotherapy group,and 5.7 mo in the BSC group.Patients who underwent curative resection survived significantly longer than those who were not candidates for surgery(P = 0.0076).Cumulative survival in the radiotherapy group was significantly longer than in the BSC group(P = 0.0031),but did not differ significantly from those in the non-resection group.Furthermore,the median survival time of patients in the radiotherapy group who were considered for possible resection(excluding the seven patients who were not candidates for surgery due to comorbid disease or age) was 25.9 mo.Stent patency was evaluated only in the 24 patients who received a metallic stent.Stent patency was significantly longer in the radiotherapy than in the BSC group(P = 0.0165).Biliary drainage was not eliminated in any patient.To determine the efficacy of ILBT,we compared survival time and stent patency in the EBRT alone and EBRT plus ILBT groups.However,we found no significant difference in survival time between groups or for stent patencies.Hemorrhagic gastroduodenal ulcers were observed in 5 patients(17.9%),three in the EBRT plus ILBT group and two in the EBRT alone group.Ulcers occurred 5 mo,7 mo,8 mo,16 mo,and 29 mo following radiotherapy.All patients required hospitalization,but blood transfusions were unnecessary.All 5 patients recovered following the administration of anti-ulcer medication.CONCLUSION:Radiotherapy improved patient prognosis and the patency of uncovered metallic stents in patients with locally advanced hilar cholangiocarcinoma,but ILBT provided no additional benefits. | Hiroyuki Isayama Takeshi Tsujino Yousuke Nakai Takashi Sasaki Keiichi Nakagawa Hideomi Yamashita Taku Aoki Kazuhiko Koike | 2012 | World Journal of Gastroenterology2012，18，19： | 24 |
| 4 | Irinotecan, a key chemotherapeutic drug for metastatic colorectal cancer显示文摘Irinotecan hydrochloride is a camptothecin derivative that exerts antitumor activity against a variety of tumors. SN-38 produced in the body by carboxylesterase is the active metabolite of irinotecan. After irinotecan was introduced for the treatment of metastatic colorectal cancer(CRC) at the end of the last century,survival has improved dramatically. Irinotecan is now combined with 5-fluorouracil,oxaliplatin and several molecularly-targeted anticancer drugs,resulting in the extension of overall survival to longer than 30 mo. Severe,occasionally life-threatening toxicity occurs sporadically,even in patients in relatively good condition who have a low risk of chemotherapyinduced toxicity,often causing the failure of irinotecanbased chemotherapy. Clinical pharmacological studies have revealed that such severe toxicity is related to exposure to SN-38 and genetic polymorphisms in UDPglucuronosyltransferase 1A1 gene. The large interand intra-patient variability in systemic exposure to SN-38 is determined not only by genetic factors but also by physiological and environmental factors. This review first summarizes the roles of irinotecan in chemotherapy for metastatic CRC and then discusses the optimal dosing of irinotecan based on the aforementioned factors affecting systemic exposure to SN-38,with the ultimate goal of achieving personalized irinotecan-based chemotherapy. | Ken-ichi Fujita Yutaro Kubota Hiroo Ishida Yasutsuna Sasaki | 2015 | World Journal of Gastroenterology2015，21，43： | 22 |
| 5 | Safe and minimally invasive laminoplastic laminotomy using an ultrasonic bone curette for spinal surgery: technical note显示文摘 | Ito K Ishizaka S Sasaki T Miyahara T Horiuchi T Sakai K Shigeta H Hongo K | 2009 | 中国神经肿瘤杂志2009，7，1： | 21 |
| 6 | Association of glypican-3 expression with growth signaling molecules in hepatocellular carcinoma显示文摘AIM:To clarify the association of glypican-3(GPC3)expression with Wnt and other growth signaling molecules in hepatocellular carcinoma(HCC). METHODS:Expression of GPC3,Wnt,matrix metalloproteinases(MMPs),sulfatase(SULF)1,SULF2,and other growth signaling molecules was analyzed in HCC cell lines and tissue samples by real-time reverse transcriptionpolymerase chain reaction,immunoblotting,and/or immunostaining.Expression of various genes in GPC3 siRNA-transfected HCC cells was analyzed. RESULTS:GPC3 was overexpressed in most HCCs at mRNA and protein levels and its serum levels weresignificantly higher in patients with HCC than in non- HCC subjects(P<0.05).Altered expressions of various MMPs and growth signaling molecules,some of which were correlated with GPC3 expression,were observed in HCCs.Down-regulation of GPC3 expression by siRNA in GPC3-overexpressing HCC cell lines resulted in a significant decrease in expressions of MMP2,MMP14,fibroblast growth factor receptor 1,insulin-like growth factor 1 receptor.GPC3 expression was significantly correlated with nuclear/cytoplasmic localization ofβ-catenin. CONCLUSION:These results suggest that GPC3,in conjunction with MMPs and growth signaling molecules, might play an important role in the progression of HCC. | Noriyuki Akutsu Hiroyuki Yamamoto Shigeru Sasaki Hiroaki Taniguchi Yoshiaki Arimura Kohzoh Imai Yasuhisa Shinomura | 2010 | World Journal of Gastroenterology2010，16，28： | 20 |
| 7 | Nonalcoholic fatty liver disease and hepatic cirrhosis: comparison with viral hepatitis-associated steatosis显示文摘Nonalcoholic fatty liver disease(NAFLD) including nonalcoholic steatohepatitis(NASH) is globally increasing and has become a world-wide health problem. Chronic infection with hepatitis B virus or hepatitis C virus(HCV) is associated with hepatic steatosis. Viral hepatitis-associated hepatic steatosis is often caused by metabolic syndrome including obesity,type 2 diabetes mellitus and/or dyslipidemia. It has been reported that HCV genotype 3 exerts direct metabolic effects that lead to hepatic steatosis. In this review,the differences between NAFLD/NASH and viral hepatitis-associated steatosis are discussed. | Yuki Haga Tatsuo Kanda Reina Sasaki Masato Nakamura Shingo Nakamoto Osamu Yokosuka | 2015 | World Journal of Gastroenterology2015，21，46： | 20 |
| 8 | Short term results of endoscopic submucosal dissection in superficial esophageal squamous cell neoplasms显示文摘AIM: To evaluate the efficacy of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms. METHODS: Between July 2007 and March 2009, 27 consecutive superficial esophageal squamous cell neoplasms in 25 enrolled patients were treated by endoscopic submucosal dissection. The therapeutic efficacy, complications, and follow-up results were assessed. RESULTS: The mean size of the lesions was 21 ± 13 mm (range 2-55 mm); the mean size of the resection specimens was 32 ± 12 mm (range 10-70 mm). The enblock resection rate was 100% (27/27), and en block resection with tumor-free lateral/basal margins was 88.9% (24/27). Perforation occurred in 1 patient who was managed by conservative medical treatments. None of the patients developed local recurrence or distant metastasis in the follow-up period. CONCLUSION: Endoscopic submucosal dissection is applicable to superficial esophageal squamous cell neoplasms with promising results. | Kouichi Nonaka Shin Arai Keiko Ishikawa Masamitsu Nakao Yousuke Nakai Osamu Togawa Koji Nagata Michio Shimizu Yutaka Sasaki Hiroto Kita | 2010 | World Journal of Gastrointestinal Endoscopy2010，2，2： | 19 |
| 9 | Laparoscopic appendectomy for acute appendicitis: How to discourage surgeons using inadequate therapy显示文摘Acute appendicitis(AA) develops in a progressive and irreversible manner, even if the clinical course of AA can be temporarily modified by intentional medications. Reliable and real-time diagnosis of AA can be made based on findings of the white blood cell count and enhanced computed tomography. Emergent laparoscopic appendectomy(LA) is considered as the first therapeutic choice for AA. Interval/delayed appendectomy at 6-12 wk after disease onset is considered as unsafe with a high recurrent rate during the waiting time. However, this technique may have some advantages for avoiding unnecessary extended resection in patients with an appendiceal mass. Nonoperative management of AA may be tolerated only in children. Postoperative complications increase according to the patient's factors, and temporal avoidance of emergent general anesthesia may be beneficial for high-risk patients. The surgeon's skill and cooperation of the hospital are important for successful LA. Delaying appendectomy for less than 24 h from diagnosis is safe. Additionally, a semi-elective manner(i.e., LA within 24 h after onset of symptoms) may be paradoxically acceptable, according to the factors of the patient, physician, and institution. Prompt LA is mandatory for AA. Fortunately, the Japanese government uses a universal health insurance system, which covers LA. | tomohide hori takafumi machimoto yoshio kadokawa toshiyuki hata tatsuo ito shigeru kato daiki yasukawa yuki aisu yusuke kimura maho sasaki yuichi takamatsu taku kitano shigeo hisamori tsunehiro yoshimura | 2017 | World Journal of Gastroenterology2017，23，32： | 18 |
| 10 | 新型导电胶的研究 (Ⅲ)导电胶中铜表面的防氧化研究显示文摘低价格、耐金属迁移的铜粉或镀银铜粉导电胶研究和开发越来越受到工业界重视,但铜粉或裸露铜表面的易氧化性却是制约其应用的一大难题。本实验以球磨镀银铜粉为原料,用具有给电子性的胺类化合物为络合剂与镀银铜粉表面裸露的铜部分络合,同时添加电子受体化合物,形成电荷转移络合物,这样得到的导电粉不仅初期导电性高且耐湿性好。 | 路庆华 Sasaki Akihiro | 1998 | 功能材料1998，29，4： | 18 |
| 11 | The Sendai Framework for Disaster Risk Reduction: Renewing the Global Commitment to People’s Resilience, Health,and Well-being显示文摘The Sendai Framework for Disaster Risk Reduction 2015–2030(SFDRR) is the first global policy framework of the United Nations’ post-2015 agenda. It represents a step in the direction of global policy coherence with explicit reference to health, development, and climate change. To develop SFDRR, the United Nations Office for Disaster Risk Reduction(UNISDR) organized and facilitated several global, regional, national, and intergovernmental negotiations and technical meetings in the period preceding the World Conference on Disaster Risk Reduction(WCDRR) 2015 where SFDRR was adopted. UNISDR also worked with representatives of governments, UN agencies, and scientists to develop targets and indicators for SFDRR and proposed them to member states for negotiation and adoption as measures of progress and achievement in protecting lives and livelihoods. The multiple efforts of the health community in the policy development process, including campaigning for safe schools and hospitals, helped to put people’s mental and physicalhealth, resilience, and well-being higher up the disaster risk reduction(DRR) agenda compared with the Hyogo Framework for Action 2005–2015. This article reviews the historical and contemporary policy development process that led to the SFDRR with particular reference to the development of the health theme. | Amina Aitsi-Selmi Shinichi Egawa Hiroyuki Sasaki Chadia Wannous Virginia Murray | 2015 | International Journal of Disaster Risk Science2015，6，2： | 17 |
| 12 | 轴心受压方钢管混凝土短柱的性能研究:Ⅱ分析显示文摘利用三维非线性有限元方法编制的计算机程序,对试验结果进行了分析、比较,并探讨了方钢管混凝土截面受力机理和破坏机制.对截面尺寸和材料强度在较大范围内变化的方钢管混凝土短柱进行了模拟试验,通过参数分析、回归得到方钢管混凝土短柱的承载力计算公式. | 余勇 吕西林 Tanaka Kiyoshi Sasaki Satoshi | 2000 | 建筑结构2000，30，2： | 17 |
| 13 | Activation of hypoxia-inducible factor 1 attenuates periapical inflammation and bone loss显示文摘Hypoxia(low oxygen level) is an important feature during infections and affects the host defence mechanisms. The host has evolved specific responses to address hypoxia, which are strongly dependent on the activation of hypoxia-inducible factor 1(HIF-1).Hypoxia interferes degradation of HIF-1 alpha subunit(HIF-1α), leading to stabilisation of HIF-1α, heterodimerization with HIF-1 beta subunit(HIF-1β) and subsequent activation of HIF-1 pathway. Apical periodontitis(periapical lesion) is a consequence of endodontic infection and ultimately results in destruction of tooth-supporting tissue, including alveolar bone. Thus far, the role of HIF-1 in periapical lesions has not been systematically examined. In the present study, we determined the role of HIF-1 in a wellcharacterised mouse periapical lesion model using two HIF-1α-activating strategies, dimethyloxalylglycine(DMOG) and adenovirusinduced constitutively active HIF-1α(CA-HIF1 A). Both DMOG and CA-HIF1 A attenuated periapical inflammation and tissue destruction. The attenuation in vivo was associated with downregulation of nuclear factor-κappa B(NF-κB) and osteoclastic gene expressions. These two agents also suppressed NF-κB activation and subsequent production of proinflammatory cytokines by macrophages. Furthermore, activation of HIF-1α by DMOG specifically suppressed lipopolysaccharide-stimulated macrophage differentiation into M1 cells, increasing the ratio of M2 macrophages against M1 cells. Taken together, our data indicated that activation of HIF-1 plays a protective role in the development of apical periodontitis via downregulation of NF-κB, proinflammatory cytokines, M1 macrophages and osteoclastogenesis. | Kimito Hirai Hisako Furusho Kiichi Hirota Hajime Sasaki | 2018 | International Journal of Oral Science2018，10，2： | 16 |
| 14 | Acute pancreatitis successfully diagnosed by diffusion-weighted imaging: A case report显示文摘Diffusion-weighted imaging (DWI) is an established diagnostic method of acute stroke. The latest advances in magnetic resonance imaging (MRI) technology have greatly expanded the utility of DWI in the examination of various organs. Recent studies have revealed the usefulness of DWI for imaging of the liver, kidney, ovary, and breast. We report a patient with acute pancreatitis detected by DWI and discussed the efficacy of DWI in diagnosing acute pancreatitis. A 50-year old man presented with a primary complaint of abdominal pain. We performed both DWI and computed tomography (CT) for this patient. The signal intensity in a series of DWI was measured and the apparent diffusion coefficient (ADC) values were calculated to differentiate inflammation from normal tissue. Two experienced radiologists evaluated the grade of acute pancreatitis by comparing the CT findings. Initially, the pancreas and multiple ascites around the pancreas produced a bright signal and ADC values were reduced on DWI. As the inflammation decreased, the bright signal faded to an iso-signal and the ADC values returned to their normal level. There was no difference in the abilities of DWI and CT images to detect acute pancreatitis. However, our case indicates that DWI can evaluate the manifestations of acute pancreatitis using no enhancement material andhas the potential to replace CT as a primary diagnostic strategy for acute pancreatitis. | Satoshi Shinya Takamitsu Sasaki Yoshifumi Nakagawa Zhang Guiquing Fumio Yamamoto Yuichi Yamashita | 2008 | World Journal of Gastroenterology2008，14，35： | 16 |
| 15 | Contrast enhanced ultrasound of hepatocellular carcinoma显示文摘Sonazoid(Daiichi Sankyo,Tokyo,Japan),a secondgeneration of a lipid-stabilized suspension of a perfluorobutane gas microbubble contrast agent,has been used clinically in patients with liver tumors and for harmonic gray-scale ultrasonography(US)in Japan since January 2007.Sonazoid-enhanced US has two phases of contrast enhancement:vascular and late.In the late phase of Sonazoid-enhanced US,we scanned the whole liver using this modality at a low mechanical index(MI)without destroying the microbubbles, and this method allows detection of small viable hepatocellular carcinoma(HCC)lesions which cannot be detected by conventional US as perfusion defects in the late phase.Re-injection of Sonazoid into an HCC lesion which previously showed a perfusion defect in the late phase is useful for confirming blood flow intothe defects.High MI intermittent imaging at 2 frames per second in the late phase is also helpful in differentiation between necrosis and viable hypervascular HCC lesions.Sonazoid-enhanced US by the coded harmonic angio mode at a high MI not only allows clear observation of tumor vessels and tumor enhancement, but also permits automatic scanning with Sonazoidenhanced three dimensional(3D)US.Fusion images combining US with contrast-enhanced CT or contrastenhanced MRI have made it easy to detect typical or atypical HCC lesions.By these methods,Sonazoidenhanced US can characterize liver tumors,grade HCC lesions histologically,recognize HCC dedifferentiation, evaluate the efficacy of ablation therapy or transcatheter arterial embolization,and guide ablation therapy for unresectable HCC.This article reviews the current developments and applications of Sonazoid-enhanced US and Sonazoid-enhanced 3D US for diagnosing and treating hepatic lesions,especially HCC. | Kazushi Numata Manabu Morimoto Masaaki Kondo Yosuke Kunishi Tomohiko Sasaki Akito Nozaki Katsuaki Tanaka | 2010 | World Journal of Radiology2010，2，2： | 15 |
| 16 | Decreased levels of plasma adiponectin associated with increased risk of colorectal cancer显示文摘AIM:To investigate the association between adiponectin levels and risk of colorectal adenoma and cancer (early and advanced).METHODS: A cross-sectional study in a cohort of hospital-based patients was conducted between January 2004 and March 2006 at Yamagata University Hospital. Male subjects, who had colorectal tumors detected by endoscopic examination, were enrolled according to inclusion and exclusion criteria. Based on the T factor of the TNM system, intraepithelial carcinoma and submucosally invasive carcinoma were def ined as early cancer, and invasion into the muscularis propria or deeper was defined as advanced cancer. The plasma levels of glucose, insulin, total cholesterol, triglyceride, high sensitivity C-reactive protein, insulin like growth factor (IGF)-1, IGF binding protein-3, adiponectin, leptin, and resistin were measured. Each factor level was designated low or high, and the risk of adenoma or cancer was estimated by univariate and multivariate logistic regression analysis.RESULTS: We enrolled 124 male subjects (47 with adenoma, 34 with early cancer, 17 with advanced cancer, and 26 without tumors as controls). In patients with adenoma, high triglyceride and low adiponectin were associated with a significant increase in the odds ratio (OR) by univariate analysis. Only a low adiponectin level was related to increased adenoma risk, with an adjusted OR for low level (<11 μg/mL) to high (≥11 μg/mL) of 5.762 (95% confidence interval (CI):1.683-19.739, P=0.005). In the patients with early cancer, high body mass index, high triglyceride, and low adiponectin were associated with a significant increase in OR in univariate analysis. Imultivariate analysis, only low adiponectin was significantly associated with early cancer, with an adjusted OR of 4.495 (95% CI:1.090-18.528, P=0.038). However, in patients with advanced cancer, low adiponectin was not recognized as a significant risk factor for advanced cancer.CONCLUSION: A decreased level of adiponectin is strongly associated with an increased risk of colorectal adenoma and early cancer. These data call for further investigation, including a controlled prospective study. | Sayaka Otake Hiroaki Takeda Shoichiro Fujishima Tadahisa Fukui Tomohiko Orii Takeshi Sato Yu Sasaki Shoichi Nishise Sumio Kawata | 2010 | World Journal of Gastroenterology2010，16，10： | 14 |
| 17 | 妊娠期口腔疾病患者的治疗显示文摘随着医疗保健知识的普及,很多人认识到牙周炎等感染性疾病可致胎儿发育异常甚至流产。目前,越来越多的准备怀孕的女性主动到口腔诊室进行潜在牙病处理及口腔保健。怀孕后发生的一系列生理变化,可引发或加剧口腔疾患,并在妊娠各时期出现。对于孕妇的常规口腔疾病治疗,国内传统观点与国外最新观点在检查、治疗、预防宣教等多方面存在不同。口腔医生如何评价孕妇和胎儿的生理指标?在保证孕妇和胎儿安全前提下,如何提供口腔疾病的有效救治?本期争鸣栏目邀请以下几位专家,就妊娠期患者口腔疾病治疗时机的选择、诊疗方案的确定以及孕婴生理指标的评价进行探讨。 | 何平 叶金梅 郭芳 王洪涛 Keiichi Sasaki 洪光 Kostas Zygogiannis 包崇云 刘寅冬 王了 | 2014 | 国际口腔医学杂志2014，41，5： | 12 |
| 18 | Endoscopic ultrasonography guided-fine needle aspirationfor the diagnosis of solid pancreaticobiliary lesions:Clinicalaspects to improve the diagnosis显示文摘Endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA) has been applied to pancreaticobiliary lesions since the 1990 s and is in widespread use throughout the world today. We used this method to confirm the pathological evidence of the pancreaticobiliary lesions and to perform suitable therapies. Complications of EUS-FNA are quite rare, but some of them are severe. Operators should master conventional EUS observation and experience a minimum of 20-30 cases of supervised EUS-FNA on non-pancreatic and pancreatic lesions before attempting solo EUSFNA. Studies conducted on pancreaticobiliary EUSFNA have focused on selection of suitable instruments(e.g., needle selection) and sampling techniques(e.g., fanning method, suction level, with or without a stylet, optimum number of passes). Today, the diagnostic ability of EUS-FNA is still improving; the detection of pancreatic cancer(PC) currently has a sensitivity of 90%-95% and specificity of 95%-100%. In addition to PC, a variety of rare pancreatic tumors can be discriminated by conducting immunohistochemistry on the FNA materials. A flexible, large caliber needle has been used to obtain a large piece of tissue, which can provide sufficient histological information to be helpful in classifying benign pancreatic lesions. EUSFNA can supply high diagnostic yields even for biliary lesions or peri-pancreaticobiliary lymph nodes. This review focuses on the clinical aspects of EUS-FNA in the pancreaticobiliary field, with the aim of providing information that can enable more accurate and efficient diagnosis. | Hiroyuki Matsubayashi Toru Matsui Yohei Yabuuchi Kenichiro Imai Masaki Tanaka Naomi Kakushima Keiko Sasaki Hiroyuki Ono | 2016 | World Journal of Gastroenterology2016，22，2： | 12 |
| 19 | Condyloma acuminatum of the anal canal,treated with endoscopic submucosal dissection显示文摘Condyloma acuminatum(CA) is a common sexually transmitted disease caused by human papilloma virus infection. Not all individuals develop persistent, progressive disease, but careful follow up is required with moderate-to-severe dysplasia to prevent progression to malignancy. Standard therapies include surgical treatments(trans-anal resection and transanal endoscopic microsurgery) and immunotherapeutic and topical methods(topical imiquimod); however, local recurrence remains a considerable problem. Here, we report a case with superficial CA of the anal canal, treated with endoscopic submucosal dissection(ESD). A 28-year-old man presented with a chief complaint of hematochezia. Digital exam did not detect a tumor. Screening colonoscopy revealed 10-mm long, whitish condyles extending from the anal canal to the lower rectum. The lesion covered almost the whole circumference, and only a small amount of normal mucosa remained. Magnifying endoscopy with narrow band imaging showed brownish hairpin-shaped, coiled capillaries. Although histopathological diagnosis by biopsy revealed CA, accurate histological differentiation between CA, papilloma, and squamous cell carcinoma can be difficult with a small specimen. Therefore, weperformed diagnostic ESD, which provides a complete specimen for precise histopathological evaluation. The pathological diagnosis was CA, with moderate dysplasia(anal intraepithelial neoplasia 2). There was no recurrence at 16 mo after the initial ESD. Compared to surgical treatment, endoscopic diagnosis and resection could be performed simultaneously and the tumor margin observed clearly with a magnifying chromocolonoscopy, resulting in less recurrence. These findings suggest that endoscopic resection may be an alternative method for CA that prevents recurrence. | Akiko Sasaki Takeshi Nakajima Hideto Egashira Kotaro Takeda Shinnosuke Tokoro Chikamasa Ichita Sakue Masuda Haruki Uojima Kazuya Koizumi Takeshi Kinbara Taku Sakamoto Yutaka Saito Makoto Kako | 2016 | World Journal of Gastroenterology2016，22，8： | 11 |
| 20 | DOG1 is useful for diagnosis of KIT-negative gastrointestinal stromal tumor of stomach显示文摘Approximately 80%-95%of gastrointestinal stromal tumors(GISTs)show positive staining for KIT,while the other 5%-20%show negative staining.If the tumor is negative for KIT,but is positive for CD34,a histological diagnosis is possible.However,if the tumor is negative for KIT,CD34,S-100,and SMA,a definitive diagnosis is often challenging.Recently,Discovered on GIST-1(DOG1)has received considerable attention as a useful molecule for the diagnosis of GIST.DOG1,a membrane channel protein,is known to be overexpressed in GIST.Because the sensitivity and specificity of DOG1 are higher than those of KIT,positive staining for DOG1has been reported,even in KIT-negative GISTs.KITnegative GISTs most commonly arise in the stomach and are mainly characterized by epithelioid features histologically.We describe our experience with a rare case of a KIT-negative GIST of the stomach that was diagnosed by positive immunohistochemical staining for DOG1 in a patient who presented with severe anemia.Our findings suggest that immunohistochemical staining for DOG1,in addition to gene analysis,is useful for the diagnosis of KIT-negative tumors that are suspected to be GISTs. | Takuya Wada Satoshi Tanabe Kenji Ishido Katsuhiko Higuchi Tohru Sasaki Chikatoshi Katada Mizutomo Azuma Akira Naruke Myunguchul Kim Wasaburo Koizumi Tetsuo Mikami | 2013 | World Journal of Gastroenterology2013，19，47： | 11 |
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