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1Minimally invasive surgery for gastric cancer: A comparison between robotic, laparoscopic and open surgery显示文摘AIM To investigate the role of minimally invasive surgery for gastric cancer and determine surgical, clinical, and oncological outcomes.METHODS This is a propensity score-matched case-control study, comparing three treatment arms: robotic gastrectomy(RG), laparoscopic gastrectomy(LG), open gastrectomy(OG). Data collection started after sharing a specific study protocol. Data were recorded through a tailored and protected web-based system. Primary outcomes: harvested lymph nodes, estimated blood loss, hospital stay, complications rate. Among the secondary outcomes, there are: operative time, R0 resections, POD of mobilization, POD of starting liquid diet and soft solid diet. The analysis includes the evaluation of type and grade of postoperative complications. Detailed information of anastomotic leakages is also provided.RESULTS The present analysis was carried out of 1026 gastrectomies. To guarantee homogenous distribution of cases, patients in the RG, LG and OG groups were 1:1:2 matched using a propensity score analysis with a caliper = 0.2. The successful matching resulted in a total sample of 604 patients(RG = 151; LG = 151; OG = 302). The three groups showed no differences in all baseline patients characteristics, type of surgery(P = 0.42) and stage of the disease(P = 0.16). Intraoperative blood loss was significantly lower in the LG(95.93 ± 119.22) and RG(117.91 ± 68.11) groups compared to the OG(127.26 ± 79.50, P = 0.002). The mean number of retrieved lymph nodes was similar between the RG(27.78 ± 11.45), LG(24.58 ± 13.56) and OG(25.82 ± 12.07) approach. A benefit in favor of the minimally invasive approaches was found in the length of hospital stay(P < 0.0001). A similar complications rate was found(P = 0.13). The leakage rate was not different(P = 0.78) between groups.CONCLUSION Laparoscopic and robotic surgery can be safely performed and proposed as possible alternative to open surgery. The main highlighted benefit is a faster postoperative functional recovery.Amilcare Parisi Daniel Reim Felice Borghi Ninh T Nguyen Feng Qi Andrea Coratti Fabio Cianchi Maurizio Cesari Francesca Bazzocchi Orhan Alimoglu Johan Gagnière Graziano Pernazza Simone D'Imporzano Yan-Bing Zhou Juan-Santiago Azagra Olivier Facy Steven T Brower Zhi-Wei Jiang Lu Zang Arda Isik Alessandro Gemini Stefano Trastulli Alexander Novotny Alessandra Marano Tong Liu Mario Annecchiarico Benedetta Badii Giacomo Arcuri Andrea Avanzolini Metin Leblebici Denis Pezet Shou-Gen Cao Martine Goergen Shu Zhang Giorgio Palazzini Vito D'Andrea Jacopo Desiderio 2017World Journal of Gastroenterology2017,23,13:17
2Bacterial biota in reflux esophagitis and Barrett's esophagus显示文摘AIM: To identify the bacterial flora in conditions such as Barrett's esophagus and reflux esophagitis to determine if they are similar to normal esophageal flora.METHODS: Using broad-range 16S rDNA PCR,esophageal biopsies were examined from 24 patients [9with normal esophageal mucosa, 12 with gastroesophageal reflux disease (GERD), and 3 with Barrett's esophagus].Two separate broad-range PCR reactions were performed for each patient, and the resulting products were cloned.In one patient with Barrett's esophagus, g9 PCR clones were analyzed.RESULTS: Two separate clones were recovered from each patient (total = 48), representing 24 different species, with 14 species homologous to known bacteria,5 homologous to unidentified bacteria, and 5 were not homologous (<97% identity) to any known bacterial 16S rDNA sequences. Seventeen species were found in the reflux esophagitis patients, 5 in the Barrett's esophagus patients, and 10 in normal esophagus patients.Further analysis concentrating on a single biopsy from an individual with Barrett's esophagus revealed the presence of 21. distinct bacterial species. Members of four phyla were represented, including Bacteroidetes,Firmicutes, Proteobacteria, and Actinobacteria.Microscopic examination of each biopsy demonstrated bacteria in intimate association with the distal esophageal epithelium, suggesting that the presence of these bacteria is not transitory.CONCLUSION: These findings provide evidence for a complex, residential bacterial population in esophageal reflux-related disorders. While much of this biota is present in the normal esophagus, more detailed comparisons may help identify potential disease associations.Zhiheng Pei Liying Yang Richard M Peek Jr Steven M Levine David T Pride Martin J Blaser 2005World Journal of Gastroenterology2005,11,46:11
3Fusobacterium 's link to colorectal neoplasia sequenced: A systematic review and future insights显示文摘AIM To critically evaluate previous scientific evidence on Fusobacterium's role in colorectal neoplasia development.METHODS Two independent investigators systematically reviewed all original scientific articles published between January,2000,and July,2017,using Pub Med,EMBASE,and MEDLINE. A total of 355 articles were screened at the abstract level. Of these,only original scientific human,animal,and in vitro studies investigating Fusobacterium and its relationship with colorectal cancer(CRC) were included in the analysis. Abstracts,review articles,studies investigating other colonic diseases,and studies written in other languages than English were excluded from our analysis. Ninety articles were included after removing duplicates,resolving disagreements between the two reviewers,and applying the above criteria.RESULTS Studies have consistently identified positive associations between Fusobacterium,especially Fusobacterium nucleatum(F. nucleatum),and CRC. Stronger associations were seen in CRCs proximal to the splenic flexure and Cp G island methylator phenotype(CIMP)-high CRCs. There was evidence of temporality and a biological gradient,with increased F. nucleatum DNA detection and quantity along the traditional adenoma-carcinoma sequence and in CIMP-high CRC precursors. Diet may have a differential impact on colonic F. nucleatum enrichment;evidence suggests that high fiber diet may reduce the risk of a subset of CRCs that are F. nucleatum DNA-positive. Data also suggest shorter CRC and disease-specific survival with increased amount of F. nucleatum DNA in CRC tissue. The pathophysiology of enrichment of F. nucleatum and other Fusobacterium species in colonic tissue is unclear;however,the virulence factors and changes to the local colonic environment with disruption of the protective mucus layer may contribute. The presence of a host lectin(Gal-Gal NAc) in the colonic epithelium may also mediate F. nucleatum attachment to CRC and precursors through interaction with an F. nucleatum protein,fibroblast activation protein 2(FAP2). The clinical significance of detection or enrichment of Fusobacterium in colorectal neoplasia is ambiguous,but data suggest a procarcinogenic effect of F. nucleatum,likely due to activation of oncogenic and inflammatory pathways and modulation of the tumor immune environment. This is hypothesized to be mediated by certain F. nucleatum strains carrying invasive properties and virulence factors such as Fad A and FAP.CONCLUSION Evidence suggests a potential active role of Fusobacterium,specifically F. nucleatum,in CRC. Future prospective and experimental human studies would fill an important gap in this literature.Hisham Hussan Steven K Clinton Kristen Roberts Michael T Bailey 2017World Journal of Gastroenterology2017,23,48:9
4Gastroenteropancreatic neuroendocrine tumours显示文摘Irvin M Modlin Kjell Oberg Daniel C Chung Robert T Jensen Wouter W de Herder Rajesh V Thakker Martyn Caplin Gianfranco Delle Fave Greg A Kaltsas Eric P Krenning Steven F Moss Ola Nilsson Guido Rindi Ramon Salazar Philippe Ruszniewski Anders Sundin 2008Lancet Oncology2008,,1:8
5Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria显示文摘Bruno Dubois Howard H Feldman Claudia Jacova Harald Hampel José Luis Molinuevo Kaj Blennow Steven T DeKosky Serge Gauthier Dennis Selkoe Randall Bateman Stefano Cappa Sebastian Crutch Sebastiaan Engelborghs Giovanni B Frisoni Nick C Fox Douglas Galasko Ma 2014Lancet Neurology2014,,6:7
6Crohn’s and colitis in children and adolescents显示文摘Crohn's disease and ulcerative colitis can be grouped as the inflammatory bowel diseases(IBD).These conditions have become increasingly common in recent years,including in children and young people.Although much is known about aspects of the pathogenesis of these diseases,the precise aetiology is not yet understood,and there remains no cure.Recent data has illustrated the importance of a number of genes-several of these are important in the onset of IBD in early life,including in infancy.Pain,diarrhoea and weight loss are typical symptoms of paediatric Crohn's disease whereas bloody diarrhoea is more typical of colitis in children.However,atypical symptoms may occur in both conditions:these include isolated impairment of linear growth or presentation with extra-intestinal manifestations such as erythema nodosum.Growth and nutrition are commonly compromised at diagnosis in both Crohn's disease and colitis.Consideration of possible IBD and completion of appropriate investi-gations are essential to ensure prompt diagnosis,thereby avoiding the consequences of diagnostic delay.Patterns of disease including location and progression of IBD in childhood differ substantially from adultonset disease.Various treatment options are available for children and adolescents with IBD.Exclusive enteral nutrition plays a central role in the induction of remission of active Crohn's disease.Medical and surgical therapies need to considered within the context of a growing and developing child.The overall management of these chronic conditions in children should include multi-disciplinary expertise,with focus upon maintaining control of gut inflammation,optimising nutrition,growth and quality of life,whilst preventing disease or treatment-related complications.Andrew S Day Oren Ledder Steven T Leach Daniel A Lemberg 2012World Journal of Gastroenterology2012,18,41:4
7Adherence to surveillance endoscopy following hospitalization for index esophageal variceal hemorrhage显示文摘AIM To investigate patient adherence to surveillance endoscopy after index esophageal variceal hemorrhage and the extent to which adherence influences outcomes.METHODS We reviewed the records of patients with cirrhosis admitted to the medical intensive care unit between 2000 and 2014 for first time esophageal variceal hemorrhage treated with endoscopic variceal ligation who were subsequently discharged and scheduled for surveillance endoscopy at our medical center. Demographic and clinical data were obtained through the medical records, including etiology of cirrhosis, completion of variceal obliteration, attendance at surveillance endoscopy, zip code of primary residence, distance from home to hospital, insurance status, rehospitalization for variceal hemorrhage, beta-blocker at discharge, pharmacologically treated psychiatric disorder, and transplant free survival. RESULTS Of 99 consecutive survivors of esophageal variceal bleeding, the minority(33) completed variceal obliteration and fewer(12) adhered to annual surveillance. Completion of variceal obliteration was associated with fewer rehospitalizations for variceal rebleeding(27% vs 56%, P = 0.0099) and when rehospitalizations occurred, they occurred later in those who had completed obliteration(median 259 d vs 207 d, P = 0.0083). Incomplete adherence to endoscopic surveillance was associated with more rehospitalizations for variceal rebleeding compared to those fully adherent to annual endoscopic surveillance(51% vs 17%, P = 0.0328). Those adherent to annual surveillance were more likely to be insured privately or through Medicare compared to those who did not attend post-hospital discharge endoscopy(100% vs 63%, P = 0.0119).CONCLUSION Most patients do not complete variceal obliteration after index esophageal variceal hemorrhage and fewer adhere to endoscopic surveillance, particularly the uninsured and those insured with Medicaid.Brendan T Everett Steven D Lidofsky 2018World Journal of Gastrointestinal Surgery2018,10,4:4
8Heart Disease and Stroke Statistics—2009 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee显示文摘Donald Lloyd-Jones Robert Adams Mercedes Carnethon Giovanni De Simone T Bruce Ferguson Katherine Flegal Earl Ford Karen Furie Alan Go Kurt Greenlund Nancy Haase Susan Hailpern Michael Ho Virginia Howard Brett Kissela Steven Kittner Daniel Lackland Lynda L 2009Circulation2009,,3:4
9Clinical classification of symptomatic heterotopic pancreas of the stomach and duodenum:A case series and systematic literature review显示文摘BACKGROUND Heterotopic pancreas(HP)is an aberrant anatomic malformation that occurs most commonly in the upper gastrointestinal tract.While the majority of heterotopic pancreatic lesions are asymptomatic,many manifest severe clinical symptoms which require surgical or endoscopic intervention.Understanding of the clinical manifestations and symptoms of HP is limited due to the lack of large volume studies in the literature.The purpose of this study is to review symptomatic cases at a single center and compare these to a systematic review of the literature in order to characterize common clinical manifestations and treatment of this disease.AIM To classify the common clinical manifestations of heterotopic pancreas.METHODS A retrospective review was conducted of pathologic samples containing heterotopic pancreas from 2000-2018.Review was limited to HP of the upper gastrointestinal tract due to the frequency of presentation in this location.Symptomatic patients were identified from review of the medical records and clinical symptoms were tabulated.These were compared to a systematic review of the literature utilizing Pub Med and Embase searches for papers pertaining to heterotopic pancreas.Publications describing symptomatic presentation of HP were selected for review.Information including demographics,symptoms,presentation and treatment were compiled and analyzed.RESULTS Twenty-nine patient were identified with HP at a single center,with six of these identified has having clinical symptoms.Clinical manifestations included,gastrointestinal bleeding,gastric ulceration with/without perforation,pancreatitis,and gastric outlet obstruction.Systemic review of the literature yielded 232 publications detailing symptomatic cases with only 20 studies describing ten or more patients.Single and multi-patient studies were combined to form a cohort of 934 symptomatic patients.The majority of patients presented with abdominal pain(67%)combined with one of the following clinical categories:(1)Dyspepsia,(n=445,48%);(2)Pancreatitis(n=260,28%);(3)Gastrointestinal bleeding(n=80,9%);and(4)Gastric outlet obstruction(n=80,9%).The majority of cases(n=832,90%)underwent surgical or endoscopic resection with 85%reporting resolution or improvement in their symptoms.CONCLUSION Heterotopic pancreas can cause significant clinical symptoms in the upper gastrointestinal tract.Better understanding and classification of this disease may result in more accurate identification and treatment of this malformation.Michael T Le Compte Brandon Mason Keenan J Robbins Motoyo Yano Deyali Chatterjee Ryan C Fields Steven M Strasberg William G Hawkins 2022World Journal of Gastroenterology2022,28,14:3
10Cholangiocarcinoma, gone without the Wnt?显示文摘Cholangiocarcinoma(CCA) is a relatively rare malignancy of the intra- or extra-hepatic bile ducts that is classified according to its anatomical localization as intrahepatic, perihilar or distal. Overall, CCA has a dismal prognosis due to typical presentation at an advanced irresectable stage, lack of effective non-surgical treatments, and a high rate of disease recurrence. CCA frequently arises on a background of chronic liver inflammation and cholestasis. Chronic inflammation is accompanied by enhanced cell turnover with generation of additional inflammatory stimuli, and a microenvironment rich in pro-inflammatory mediators and proliferative factors that enable accumulation of mutations, transformation and expansion of mutated cells. A recent study by Boulter et al implicates the Wnt signaling cascade in cholangiocarcinogenesis. Wnt ligands Wnt7 B and Wnt10 A were found to be highly overexpressed in human CCA tissue. Wnt7 B protein was present throughout the tumor stroma, and often co-localized with a subset of CD68+ macrophages. To address in a direct manner whether Wnt signaling is engaged in development of CCA, Boulter et al explored the Wnt signaling pathway in an experimental model that recapitulates the multi-stage progression of human CCA.Wnt ligands found to be elevated in human CCA were also upregulated during the course of CCA development following thioacetamide treatment. Wnt10 a increased during the(pre-cancerous) regenerative phase, while Wnt7 b induction paralleled tumor growth. Along with upregulation of target genes, the findings demonstrate that the canonical Wnt pathway is progressively activated during cholangio-carcinogenesis. Macrophage depletion,eliminating a major source of Wnt7 b, prevented activation of the canonical Wnt cascade, and resulted in reduced number and volume of tumors in this model. Moreover,specific inhibitors of the canonical Wnt pathway(ICG-001 and C-59) caused reduction of tumor area and number,in xenograft and thioacetamide models of CCA. The aggregated findings show that experimental, and presumably human CCA, is a Wnt-driven tumor. Modulation of Wnt signaling, alone or in combination with surgicalor chemotherapy approaches, holds promise in the management of this fatal malignancy.Anne T R Noll Thorsten Cramer Steven W M Olde Damink Frank G Schaap 2016World Journal of Hepatology2016,8,26:3
11Differential flood stress resistance of two tomato genotypes显示文摘Steven T 1989J Amer Sci1989,114,6:2
12Widespread use of gastric acid inhibitors in infants:Are they needed? Are they safe?显示文摘Gastroesophageal reflux is a common phenomenon in infants,but the differentiation between gastro-esophageal reflux and gastroesophageal reflux disease can be difficult.Symptoms are non-specific and there is increasing evidence that the majority of symptoms may not be acid-related.Despite this,gastric acid inhibitors such as proton pump inhibitors are widely and increasingly used,often without objective evidence or investigations to guide treatment.Several studies have shown that these medications are ineffective at treating symptoms associated with reflux in the absence of endoscopically proven oesophagitis.With a lack of evidence for efficacy,attention is now being turned to the potential risks of gastric acid suppression.Previously assumed safety of these medications is being challenged with evidence of potential side effects including GI and respiratory infections,bacterial overgrowth,adverse bone health,food allergy and drug interactions.Mark Safe Wei H Chan Steven T Leach Lee Sutton Kei Lui Usha Krishnan 2016World Journal of Gastrointestinal Pharmacology and Therapeutics2016,7,4:2
13The “Colonial Wig” pancreaticojejunostomy:zero leaks with a novel technique for reconstruction after pancreaticoduodenectomy显示文摘BACKGROUND: Postoperative pancreatic fistula(POPF) remains common and morbid after pancreaticoduodenectomy(PD). A major advance in the study of POPF is the fistula risk score(FRS).METHODS: We analyzed 48 consecutive patients undergoing PD. The 'Colonial Wig' pancreaticojejunostomy(CWPJ) technique was used in the last 22 PDs, we compared 22 CWPJ to 26 conventional PDs. RESULTS: Postoperative morbidity was 49%(27% Clavien grade >2). The median length of hospital stay was 11 days. In the first 26 PDs, the PJ was performed according to standard techniques and the clinically relevant POPF(CR-POPF) rate was 15%, similar to the FRS-predicted rate(14%). In the next 22 PJs, the CWPJ was employed. Although the FRS-predicted rates were similar in these two groups(14% vs 13%), the CRPOPF rate in the CWPJ group was 0(P=0.052).CONCLUSION: Early experience with the CWPJ is encouraging, and this anastomosis may be a safe and effective way to lower POPF rates.Xihua Yang Pouya Aghajafari Naeem Goussous Shirali T Patel Steven C Cunningham 2017Hepatobiliary & Pancreatic Diseases International2017,16,5:2
14Survival after inflammatory bowel disease-associated colorectal cancer in the Colon Cancer Family Registry显示文摘AIM: To investigate the survival of individuals with colorectal cancer (CRC) with inflammatory bowel disease (IBD-associated CRC) compared to that of individuals without IBD diagnosed with CRC. METHODS: Epidemiologic, clinical, and follow-up data were obtained from the Colon Cancer Family Registry (Colon CFR). IBD-associated cases were identified from self-report of physician diagnosis. For a subset of participants, medical records were examined to confirm self-report of IBD. Cox proportional hazards regression was applied to estimate adjusted hazard ratios (aHR) and 95%CI of mortality, comparing IBD-associated to non-IBD-associated CRC, adjusted for age at CRC diagnosis, sex, Colon CFR phase, and number of prior endoscopies. Following imputation to complete CRC stage information, adjustment for CRC stage was examined. RESULTS: A total of 7202 CRC cases, including 250 cases of IBD-associated CRC, were analyzed. Over a twelve year follow-up period following CRC diagnosis, 2013 and 74 deaths occurred among non-IBD associated CRC and IBD-associated CRC patients, respectively. The difference in survival between IBD-associated and non-IBD CRC cases was not statistically significant (aHR = 1.08; 95%CI: 0.85-1.36). However, the assumption of proportional hazards necessary for valid inference from Cox regression was not met over the entire follow-up period, and we therefore limited analyses to within five years after CRC diagnosis when the assumption of proportional hazards was met. Over this period, there was evidence of worse prognosis for IBD-associated CRC (aHR = 1.36; 95%CI: 1.05-1.76). Results were similar when adjusted for CRC stage, or restricted to IBD confirmed in medical records. CONCLUSION: These results support the hypothesis that IBD-associated CRC has a worse prognosis than non-IBD-associated CRC.Scott V Adams Dennis J Ahnen John A Baron Peter T Campbell Steven Gallinger William M Grady Loic LeMarchand Noralane M Lindor John D Potter Polly A Newcomb 2013World Journal of Gastroenterology2013,19,21:2
15Community-level physiological profiles of bacteria and fungi: plate type and incubation temperature influences on contrasting soils显示文摘Aimée T Classen Sarah I Boyle Kristin E Haskins Steven T Overby Stephen C Hart FEMS Microbiology Ecology0,,:2
16Artificial intelligence applications in inflammatory bowel disease:Emerging technologies and future directions显示文摘Inflammatory bowel disease(IBD)is a complex and multifaceted disorder of the gastrointestinal tract that is increasing in incidence worldwide and associated with significant morbidity.The rapid accumulation of large datasets from electronic health records,high-definition multi-omics(including genomics,proteomics,transcriptomics,and metagenomics),and imaging modalities(endoscopy and endomicroscopy)have provided powerful tools to unravel novel mechanistic insights and help address unmet clinical needs in IBD.Although the application of artificial intelligence(AI)methods has facilitated the analysis,integration,and interpretation of large datasets in IBD,significant heterogeneity in AI methods,datasets,and clinical outcomes and the need for unbiased prospective validations studies are current barriers to incorporation of AI into clinical practice.The purpose of this review is to summarize the most recent advances in the application of AI and machine learning technologies in the diagnosis and risk prediction,assessment of disease severity,and prediction of clinical outcomes in patients with IBD.John Gubatan Steven Levitte Akshar Patel Tatiana Balabanis Mike T Wei Sidhartha R Sinha 2021World Journal of Gastroenterology2021,27,17:2
17Endothelin-1 activation in pediatric patients undergoing surgical coarctation of the aorta repair显示文摘AIM To determine endothelin-1(ET-1)concentration before and after surgical coarctectomy and evaluate its association with left ventricular geometric change.METHODSA prospective,cohort study of 24 patients aged 2 d to 10years with coarctation of the aorta undergoing surgical repair.A sub-cohort of patients with age<1 mo was classified as'neonates'.Echocardiograms were performed just prior to surgery and in the immediate post-op period to assess left ventricle mass index and relative wall thickness(RWT).Plasma ET-1 levels were assessed at both time points.Association between ET-1 levels and ventricular remodeling was assessed.RESULTSPatients<1 year demonstrated higher pre-op ET-1 than post-op(2.8 pg/m L vs 1.9 pg/m L,P=0.02).Conversely,patients>1 year had no change in ET-1 concentration before and after surgery(1.1 vs 1.4,NS).Pre-op,patients<1 year demonstrated significantly higher ET-1 than older children(2.8 vs 1.1,P=0.001).Post-op there was no difference between the age groups(1.9 vs 1.4,NS).Neither RWT nor left ventricle mass index(LVMI)varied from pre-op to post-op.The subset of neonates showed a strong positive correlation between pre-op ET-1 and RWT(r=0.92,P=0.001).Patients with ET-1>2 pg/m L preop demonstrated higher LVMI(65.7 g/m^(2.7) vs 38.5 g/m^(2.7),P=0.004)and a trend towards higher RWT(45%vs39%,P=0.07)prior to repair than those with lower ET-1concentration.CONCLUSIONET-1 concentration is significantly variable in the perioperative period surrounding coarctectomy.Older children and infants have different responses to surgical repair suggesting different mechanisms of activation.Benjamin Steven Frank Tracy T Urban Suhong Tong Courtney Cassidy Max B Mitchell Christopher S Nichols Jesse A Davidson 2017World Journal of Cardiology2017,9,12:2
18Adipocyte iron regulates adiponectin and insulin sensitivity显示文摘Gabrielsen J Scott Gao Yan Simcox Judith A Huang Jingyu Thorup David Jones Deborah Cooksey Robert C Gabrielsen David Adams Ted D Hunt Steven C Hopkins Paul N Cefalu William T McClain Donald A 2012EN2012,,10:2
19Analysis of air gap flux current and vibration signals as a function of the combination of static and dynamic air-gap eccentricity in 3-phase induction motors显示文摘David G Dorrell William T Thomson Steven Roach 1997IEEE Transactions on Industry Applications1997,33,1:1
20Endotoxin as a grug target显示文摘Steven M Opal MD Gluck T 2003Crit Care Med2003,,:1
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