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1Risk factors for bleeding after endoscopic submucosal dissection for gastric lesions显示文摘AIM:To assess risk factors for bleeding after gastric endoscopic submucosal dissection(ESD) and to develop preventive measures.METHODS:This retrospective study was performed in a tertiary referral center.A total of 328 patients underwent ESD for 398 gastric neoplasms between July 2007 and June 2009.The main outcome was association between post-ESD bleeding and the following:age;sex;comorbidities;daily use of medicine potentially related to gastric injury/bleeding;location,size,and histological depth of lesions;ulceration;experience of operator coagulating the ulcer floor,and duration of operation.We also determined the relationship between the location of post-ESD bleeding and risk factors for hemorrhage.RESULTS:Univariate analysis revealed significant risk factors:tumor location [odds ratio(OR),2.86;95% CI:1.21-6.79,P=0.024],coagulator experience(OR,4.29;95% CI:1.43-12.86,P=0.009),and medicine potentially related to gastric injury/bleeding(OR,2.80;95% CI:1.14-6.90,P=0.039).Multivariate logistic regression analysis confirmed significant,independent risk factors:tumor in lower third of stomach(OR,2.47;95% CI:1.02-5.96,P=0.044),beginner coagulator(OR,3.93;95% CI:1.29-11.9,P=0.016),and medicine(OR,2.76;95% CI:1.09-6.98,P=0.032).We classif ied cases of post-ESD bleeding into two groups(bleeding at the ulcer margin vs bleeding at the center) and found that bleeding at the margin occurred more frequently with beginner coagulators compared with experts(OR,16.00;95% CI:1.22-210.59,P=0.040).CONCLUSION:Beginner coagulators,tumor in the antrum,and medicines were significant risk factors for post-ESD bleeding.Bleeding at the ulcer margin frequently occurred with beginner operators.Yosuke Tsuji Ken Ohata Takafumi Ito Hideyuki Chiba Tomohiko Ohya Toshiaki Gunji Nobuyuki Matsuhashi 2010World Journal of Gastroenterology2010,16,23:60
2Gastric adenocarcinoma of the fundic gland(chief cell-predominant type): A review of endoscopic and clinicopathological features显示文摘Gastric adenocarcinoma of the fundic gland(chief cellpredominant type, GA-FG-CCP) is a rare variant of welldifferentiated adenocarcinoma, and has been proposed to be a novel disease entity. GA-FG-CCP originates from the gastric mucosa of the fundic gland region without chronic gastritis or intestinal metaplasia. The majority of GA-FG-CCPs exhibit either a submucosal tumor-like superficial elevated shape or a flat shape on macroscopic examination. Narrow-band imaging with endoscopic magnification may reveal a regular or an irregular microvascular pattern, depending on the degree of tumor exposure to the mucosal surface. Pathological analysis of GA-FG-CCPs is characterized by a high frequency of submucosal invasion, rare occurrences of lymphatic and venous invasion, and low-grade malignancy. Detection of diffuse positivity for pepsinogen-I by immunohistochemistry is specific for GA-FG-CCP. Careful endoscopic examination and detailed pathological evaluation are essential for early and accurate diagnosis of GA-FG-CCP. Nearly all GA-FG-CCPs are treated by endoscopic resection due to their small tumor size and low risk of recurrence or metastasis.Masaki Miyazawa Mitsuru Matsuda Masaaki Yano Yasumasa Hara Fumitaka Arihara Yosuke Horita Koichiro Matsuda Akito Sakai Yatsugi Noda 2016World Journal of Gastroenterology2016,22,48:26
3Bleeding after endoscopic submucosal dissection: Risk factors and preventive methods显示文摘Endoscopic submucosal dissection(ESD) has become widely accepted as a standard method of treatment for superficial gastrointestinal neoplasms because it enables en block resection even for large lesions or fibrotic lesions with minimal invasiveness, and decreases the local recurrence rate. Moreover, specimens resected in an en block fashion enable accurate histological assessment. Taking these factors into consideration, ESD seems to be more advantageous than conventional endoscopic mucosal resection(EMR), but the associated risks of perioperative adverse events are higher than in EMR. Bleeding after ESD is the most frequent among these adverse events. Although post-ESD bleeding can be controlled by endoscopic hemostasis in most cases, it may lead to serious conditions including hemorrhagic shock. Even with preventive methods including administration of acid secretion inhibitors and preventive hemostasis, post-ESD bleeding cannot be completely prevented. In addition high-risk cases for post-ESD bleeding, which include cases with the use of antithrombotic agents or which require large resection, are increasing. Although there have been many reports about associated risk factors and methods of preventing post-ESD bleeding, many issues remain unsolved. Therefore, in this review, we have overviewed risk factors and methods of preventing post-ESD bleeding from previous studies. Endoscopists should have sufficient knowledge of these risk factors and preventive methods when performing ESD.Yosuke Kataoka Yosuke Tsuji Yoshiki Sakaguchi Chihiro Minatsuki Itsuko Asada-Hirayama Keiko Niimi Satoshi Ono Shinya Kodashima Nobutake Yamamichi Mitsuhiro Fujishiro Kazuhiko Koike 2016World Journal of Gastroenterology2016,22,26:16
4Gastric adenocarcinoma of fundic gland type: Five cases treated with endoscopic resection显示文摘Recently,a new disease entity termed gastric adenocarcinoma of fundic gland type(GA-FG) was proposed.We treated five cases of GA-FG with endoscopic submucosal dissection.All tumors were small and located in the upper third of the stomach.Four tumors were macroscopically identified as 0-IIa and one was identified as 0-Ⅱb.Narrow-band imaging with magnifying endoscopy showed an irregular microvascular pattern in 2 cases and a regular microvascular pattern in the remainder.All tumors arose from the deep layer of the lamina propria mucosae and showed submucosal invasion.Lymphatic invasion was seen only in one case,while no venous invasion was recognized.All tumors were positive for pepsinogen-Ⅰ and MUC6 by immunohistochemistry.None showed p53 overexpression,and the labeling index of Ki-67 was low in all cases.All cases have been free from recurrence or metastasis.Herein,we discussed the clinicopathological features of GA-FG in comparison with past reports.Masaki Miyazawa Mitsuru Matsuda Masaaki Yano Yasumasa Hara Fumitaka Arihara Yosuke Horita Koichiro Matsuda Akito Sakai Yatsugi Noda 2015World Journal of Gastroenterology2015,21,26:16
5Contrast 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 2010World Journal of Radiology2010,2,2:15
6流血和与内视镜的 submucosal 解剖联系的人工的胃的溃疡的管理显示文摘 Endoscopic submucosal dissection (ESD), an endoscopic procedure for the treatment of gastric epithelial neoplasia without lymph node metastases, spread rapidly, primarily in Japan, starting in the late 1990s. ESD enables en bloc resection of lesions that are difficult to resect using conventional endoscopic mucosal resection (EMR). However, in comparison to EMR, ESD requires a high level of endoscopic competence and a longer resection time. Thus, ESD is associated with a higher risk of adverse events, including intraoperative and postoperative bleeding and gastrointestinal perforation. In particular, because of a higher incidence of intraoperative bleeding with mucosal incision and submucosal dissection, which are distinctive endoscopic procedures in ESD, a strategy for endoscopic hemostasis, mainly by thermo-coagulation hemostasis using hemostatic forceps, is important. In addition, because of iatrogenic artificial ulcers that always form after ESD, endoscopic hemostasis and appropriate pharma-cotherapy during the healing process are essential.Yosuke Muraki Shotaro Enomoto Mikitaka Iguchi Mitsuhiro Fujishiro Naohisa Yahagi Masao Ichinose 2012World Journal of Gastrointestinal Endoscopy2012,4,1:14
7PTEN inhibition and axon regeneration and neural repair显示文摘The intrinsic growth ability of all the neurons declines during development although some may grow better than others. Numerous intracellular signaling proteins and transcription factors have been shown to regulate the intrinsic growth capacity in mature neurons. Among them, PI3 kinase/Akt pathway is important for controlling axon elongation. As a negative regulator of this pathway, the tumor suppressor phosphatase and tensin homolog(PTEN) appears critical to control the regenerative ability of young and adult neurons. This review will focus on recent research progress in axon regeneration and neural repair by PTEN inhibition and therapeutic potential of blocking this phosphatase for neurological disorders. Inhibition of PTEN by deletion in conditional knockout mice, knockdown by short-hairpin RNA, or blockade by pharmacological approaches, including administration of selective PTEN antagonist peptides, stimulates various degrees of axon regrowth in juvenile or adult rodents with central nervous system injuries. Importantly, post-injury PTEN suppression could enhance axonal growth and functional recovery in adult central nervous system after injury.Yosuke Ohtake Umar Hayat Shuxin Li 2015Neural Regeneration Research2015,10,9:14
8Endoscopic submucosal dissection for colorectal neoplasms:A review显示文摘The introduction of colorectal endoscopic submucosal dissection(ESD)has expanded the application of endoscopic treatment,which can be used for lesions with a low metastatic potential regardless of their size.ESD has the advantage of achieving en bloc resection with a lower local recurrence rate compared with that of piecemeal endoscopic mucosal resection.Moreover,in the past,surgery was indicated in patients with large lesions spreading to almost the entire circumference of the rectum,regardless of the depth of invasion,as endoscopic resection of these lesions was technically difficult.Therefore,a prime benefit of ESD is significant improvement in the quality of life for patients who have large rectal lesions.On the other hand,ESD is not as widely applied in the treatment of colorectal neoplasms as it is in gastric cancers owing to the associated technical difficulty,longer procedural duration,and increased risk of perforation.To diversify the available endoscopic treatment strategies for superficial colorectal neoplasms,endoscopists performing ESD need torecognize its indications,the technical issues involved in its application,and the associated complications.This review outlines the methods and type of devices used for colorectal ESD,and the training required by endoscopists to perform this procedure.Taku Sakamoto Genki Mori Masayoshi Yamada Yuzuru Kinjo Eriko So Seiichiro Abe Yosuke Otake Takeshi Nakajima Takahisa Matsuda Yutaka Saito 2014World Journal of Gastroenterology2014,20,43:13
9Micro RNA-320 family is downregulated in colorectal adenoma and affects tumor proliferation by targeting CDK6显示文摘AIM: To investigate the microR NA(miR NA) expression during histological progression from colorectal normal mucosa through adenoma to carcinoma within a lesion. METHODS: Using microarray, the sequential changes in miR NA expression profiles were compared in colonic lesions from matched samples; histologically, nonneoplastic mucosa, adenoma, and submucosal invasive carcinoma were microdissected from a tissue sample. Cell proliferation assay was performed to observe the effect of miR NA, and its target genes were predicted using bioinformatics approaches and the expression profile of SW480 transfected with the miR NA mimics. mR NA and protein levels of the target gene in colon cancer cell lines with a mimic control or miR NA mimics were measured using qR TPCR and Western blotting. The expression levels of miR NA and target gene in colorectal tissue samples were also measured.RESULTS: Microarray analysis identified that the miR-320 family, including miR-320 a, miR-320 b, miR-320 c, miR-320 d and miR-320 e, were differentially expressed in adenomaand submucosal invasive carcinoma. The mi R-320 family, which inhibits cell proliferation, is frequently downregulated in colorectal adenoma and submucosal invasive carcinoma tissues. Seven genes including CDK6 were identified to be common in the results of gene expression array and bioinformatics analyses performed to find the target gene of the miR-320 family. We confirmed that mR NA and protein levels of CDK6 were significantly suppressed in colon cancer cell lines with miR-320 family mimics. CDK6 expression was found to increase from non-neoplastic mucosa through adenoma to submucosal invasive carcinoma tissues and showed an inverse correlation with miR-320 family expression.CONCLUSION: MiR-320 family affects colorectal tumor proliferation by targeting CDK6, plays important role in its growth, and is considered to be a biomarker for its early detection.Toshihiro Tadano Yoichi Kakuta Shin Hamada Yosuke Shimodaira Masatake Kuroha Yoko Kawakami Tomoya Kimura Hisashi Shiga Katsuya Endo Atsushi Masamune Seiichi Takahashi Yoshitaka Kinouchi Tooru Shimosegawa 2016World Journal of Gastrointestinal Oncology2016,8,7:9
10Helicobacter pylori infection in subjects negative for high titer serum antibody显示文摘AIM To investigate the clinicopathological features of the patients testing negative for high titer serum antiHelicobacter pylori(H. pylori) antibody.METHODS The antibody titers were measured using antigens derived from Japanese individuals. ^(13)C-urea breath test-positive individuals were defined as having H. pylori infection. We investigated the demographic characteristics, laboratory data, endoscopic findings including Kyoto classification of gastritis, and histology in negative-high titer patients without H. pylori eradication therapy. Kyoto classification consisted of scores for gastric atrophy, intestinal metaplasia, enlarged folds, nodularity, and redness.RESULTS Of the 136 subjects enrolled, 23(17%) had H. pylori infection. Kyoto classification had an excellent area under the receiver operating characteristics curve(0.886, 95% confidence interval: 0.803-0.968, P = 3.7 × 10^(-20)) for predicting H. pylori infection with a cutoff value of 2. Further, Kyoto classification, H. pylori density, and neutrophil activity had high accuracies(89.7%, 96.3%, and 94.1%, respectively). Kyoto classification was independent of the demographic and laboratory parameters in multivariate analysis.CONCLUSION Endoscopic Kyoto classification of gastritis is a useful predictor of H. pylori infection in negative-high titer antibody patients.Osamu Toyoshima Toshihiro Nishizawa Masahide Arita Yosuke Kataoka Kosuke Sakitani Shuntaro Yoshida Hiroharu Yamashita Keisuke Hata Hidenobu Watanabe Hidekazu Suzuki 2018World Journal of Gastroenterology2018,24,13:9
11Endoscopic ultrasound-guided fine needle aspiration in the differentiation of type 1 and type 2 autoimmune pancreatitis显示文摘AIM:To investigate the usefulness of endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) in the differentiation of autoimmune pancreatitis(AIP).METHODS:We retrospectively reviewed 47 of 56 AIP patients who underwent EUS-FNA and met the Asian diagnostic criteria.On 47 EUS-FNA specimens,we evaluated the presence of adequate material and characteristic features of lymphoplasmacytic sclerosing pancreatitis(LPSP) and idiopathic duct-centric pancreatitis(IDCP) mentioned in the International Consensus Diagnostic Criteria and examined if these findings make a contribution to the differential diagnosis of type 1 and type 2 AIP.A disposable 22-gauge needle was used for EUS-FNA.RESULTS:Adequate specimens including pancreatic tissue for differentiating AIP from cancer were obtained from 43 of 47 patients who underwent EUSFNA.EUS-FNA was performed from the pancreatic head in 21 cases,which is known to be technically difficult when performed by core biopsy;there was no significant difference in the results compared with pancreatic body-tail.Nine of 47 patients met level 1 findings of LPSP and 5 patients met level 2 findings of LPSP.No one met level 1 findings of IDCP,but 3 patients met level 2 findings of IDCP.Of 10 seronegative cases,2 cases were diagnosed with 'definitive type 1 AIP',and 3 cases were diagnosed with 'probable type 2 AIP' when considering both the level 2 histological findings and response to steroids.CONCLUSION:EUS-FNA is useful in the differentiation of type 1 and type 2 AIP,particularly in seronegative cases.Takuya Ishikawa Akihiro Itoh Hiroki Kawashima Eizaburo Ohno Hirosh Matsubara Yuya Itoh Yosuke Nakamura Takeshi Hiramatsu Masanao Nakamura Ryoji Miyahara Naoki Ohmiya Hidemi Goto Yoshiki Hirooka 2012World Journal of Gastroenterology2012,18,29:8
12Prospective controlled study on the effects of polyethylene glycol in capsule endoscopy显示文摘AIM:To prospectively confirm whether a small amount of polyethylene glycol(PEG)ingested after swallowing endoscopy capsule improves image quality and completion rate.METHODS:Forty-four consecutive patients referred to us for capsule endoscopy(CE)were randomized to two groups.All patients were restricted to clear fluids for 12 h before the examination.Patients in group A(22 cases)received no additional preparation,while those in group B(20 cases)ingested 500 mL of PEG within a 2 h period starting 30 min after swallowing the capsule.Clear fluids and meals were allowed 2 h and 4 h after capsule ingestion,respectively.Image quality was assessed as the percentage of visualized bowel surface area as follows:1:<25%;2:25%-49%;3:50%-74%;4:75%-89%;5:>90%.The small bowel record was divided into five segments by time,and the score for each segment was evaluated.All CE examinations were performed with the Pillcam SB capsule endoscopy sys-tem(Given Imaging Co.Ltd.,Yoqnem).RESULTS:This study ended in December 2009,because sample size was considered large enough.A total of 44 patients were enrolled.Two patients in group B were excluded from the analysis because small bowel images could not be obtained from these patients;one had a full stomach,while the other presented with a massive gastric bleed.Thus,22 patients from group A and 20 patients from group B completed the study.There was no significant difference in age(P=0.22),sex(P=0.31),and indication for CE.No significant adverse events occurred in any of the study patients.In group A,image quality deteriorated as the capsule progressed distally.However,in group B,image quality was maintained to the distal small bowel.In each of the five segments,the visibility score was significantly higher in group B than in group A(segment 1:4.3± 0.7vs 4.7±0.5,P=0.03;segment 2:4.2±0.9vs 4.8 ±0.4,P=0.01;segment 3:4.0±1.0 vs 4.6±0.7,P =0.04;segment 4:3.6±1.1 vs 4.5±0.6,P=0.003;segment 5:2.7±1.0vs 4.4±0.8,P=0.00004).Thus,the use of PEG during CE examination significantly improved image quality in all time segments,and this effect was more pronounced in the distal ileum.The completion rate to the cecum was not significantly different between groups A and B(81.8%vs 85.0%,P =0.89).There was no difference in the gastric transit time between groups(36.2±35.0 min vs 54.0±56.6 min,P=0.23),but the small bowel transit time was significantly longer in group A than in group B(246.0± 107.0 minvs 171.0±104.0 min,P=0.04).CONCLUSION:The ingestion of a small amount of PEG after the swallowing of an endoscopy capsule significantly improved CE image quality,but did not enhance the completion rate to the cecum.Takafumi Ito Ken Ohata Akiko Ono Hideyuki Chiba Yosuke Tsuji Hajime Sato Nobuyuki Matsuhashi 2012World Journal of Gastroenterology2012,18,15:7
13New pyrometallurgical process of EAF dust treatment with CaO addition显示文摘The non-carbothermic zinc pyrometallurgical processing of electric arc furnace(EAF) dust was investigated on a laboratory scale. The main objective of this process was to convert highly stable zinc ferrite(Zn Fe2O4), which accounts for more than half of total zinc in the EAF dust, into Zn O and Ca2Fe2O5 by Ca O addition. The EAF dust was mixed with Ca O powder in various ratios, pressed into pellets, and heated in a muffle furnace in air at temperatures ranging from 700 to 1100°C for a predetermined holding time. All Zn Fe2O4 was transformed into Zn O and Ca2Fe2O5 at a minimum temperature of 900°C within 1 h when sufficient Ca O to achieve a Ca/Fe molar ratio of 1.1 was added. However, at higher temperatures, excess Ca O beyond the stoichiometric ratio was required because it was consumed by reactions leading to the formation of compounds other than Zn Fe2O4. The evaporation of halides and heavy metals in the EAF dust was also studied. These components could be preferentially volatilized into the gas phase at 1100°C when Ca O was added.Romchat Chairaksa-Fujimoto Yosuke Inoue Naoyoshi Umeda Satoshi Itoh Tetsuya Nagasaka 2015International Journal of Minerals,Metallurgy and Materials2015,22,8:7
14Neither Multiple Tumors Nor Portal Hypertension Are Surgical Contraindications for Hepatocellular Carcinoma显示文摘Takeaki Ishizawa Kiyoshi Hasegawa Taku Aoki Michiro Takahashi Yosuke Inoue Keiji Sano Hiroshi Imamura Yasuhiko Sugawara Norihiro Kokudo Masatoshi Makuuchi 2008Gastroenterology2008,,7:7
15Nature:单核细胞SatM导致组织纤维化显示文摘在一项新的研究中,来自日本大阪大学免疫学前沿研究中心(IFReC)的研究人员报道了一类新的他们称之为SatM的单核细胞。针对小鼠的研究表明SatNI可能是导致组织纤维化的原因,而且成为一种治疗很少有有效疗法的疾病的新药物靶标。Takashi Satoh, Katsuhiro Nakagawa, Fumihiro Yamane, Kiyoharu Fukushima, Isao Ebina Shizuo Akira Takashi Satoh, Katsuhiro Nakagawa, Fumihiro Yamane, Kiyoharu Fukushima, Isao Ebina Shizuo Akira Fuminori Sugihara Yoshichika Yoshioka Ryusuke Kuwahara Motooki Ashihara, Yosuke Minowa Isao Ebina Atsushi Kumanogoh Atsushi Kumanogoh 2017现代生物医学进展2017,17,3:7
16Laparoscopic hemicolectomy in a patient with situs inversustotalis显示文摘As among persons with normal anatomy, occasional patients with situs inversus develop malignant tumors. Recently, several laparoscopic operations have been reported in patients with situs inversus. We describe laparoscopic hemicolectomy with radical lymphadenectomy in such a patient. Careful consideration of the mirror-image anatomy permitted safe operation using techniques not otherwise differing from those in ordinary cases. Thus, curative laparoscopic surgery for colon cancer in the presence of situs inversus is feasible and safe.Yushi Fujiwara Yosuke Fukunaga Masayuki Higashino Shinya Tanimura Masashi Takemura Yoshinori Tanaka Harushi Osugi 2007World Journal of Gastroenterology2007,13,37:6
17Significance of functional hepatic resection rate calculated using 3D CT/^(99m)Tc-galactosyl human serum albumin singlephoton emission computed tomography fusion imaging显示文摘AIM: To evaluate the usefulness of the functional hepatic resection rate(FHRR) calculated using 3D computed tomography(CT)/^(99m)Tc-galactosyl-human serum albumin(GSA) single-photon emission computed tomography(SPECT) fusion imaging for surgical decision making. METHODS: We enrolled 57 patients who underwent bi- or trisectionectomy at our institution between October 2013 and March 2015. Of these, 26 patients presented with hepatocellular carcinoma, 12 with hilar cholangiocarcinoma, six with intrahepatic cholangiocarcinoma, four with liver metastasis, and nine with other diseases. All patients preoperatively underwent three-phase dynamic multidetector CT and ^(99m)Tc-GSA scintigraphy. We compared the parenchymal hepatic resection rate(PHRR) with the FHRR, which was defined as the resection volume counts per total liver volume counts on 3D CT/^(99m)Tc-GSA SPECT fusion images.RESULTS: In total, 50 patients underwent bisectionectomy and seven underwent trisectionectomy.Biliary reconstruction was performed in 15 patients, including hepatopancreatoduodenectomy in two. FHRR and PHRR were 38.6 ± 19.9 and 44.5 ± 16.0, respectively; FHRR was strongly correlated with PHRR. The regression coefficient for FHRR on PHRR was 1.16(P < 0.0001). The ratio of FHRR to PHRR for patients with preoperative therapies(transcatheter arterial chemoembolization, radiation, radiofrequency ablation, etc.), large tumors with a volume of > 1000 m L, and/or macroscopic vascular invasion was significantly smaller than that for patients without these factors(0.73 ± 0.19 vs 0.82 ± 0.18, P < 0.05). Postoperative hyperbilirubinemia was observed in six patients. Major morbidities(Clavien-Dindo grade ≥ 3) occurred in 17 patients(29.8%). There was no case of surgeryrelated death.CONCLUSION: Our results suggest that FHRR is an important deciding factor for major hepatectomy, because FHRR and PHRR may be discrepant owing to insufficient hepatic inflow and congestion in patients with preoperative therapies, macroscopic vascular invasion, and/or a tumor volume of > 1000 m L.Yosuke Tsuruga Toshiya Kamiyama Hirofumi Kamachi Shingo Shimada Kenji Wakayama Tatsuya Orimo Tatsuhiko Kakisaka Hideki Yokoo Akinobu Taketomi 2016World Journal of Gastroenterology2016,22,17:6
18Serum angiotensin-converting enzyme level for evaluating significant fibrosis in chronic hepatitis B显示文摘AIM To evaluate the diagnostic performance of angiotensinconverting enzyme(ACE)on significant liver fibrosis in patients with chronic hepatitis B(CHB). METHODS In total,100 patients with CHB who underwent liver biopsy in our hospital were enrolled,and 70 patients except for 30 patients with hypertension,fatty liver or habitual alcoholic consumption were analyzed.We compared histological liver fibrosis and serum ACE levels and evaluated the predictive potential to diagnose significant liver fibrosis by comparison with several biochemical marker-based indexes such as the aspartate aminotransferase(AST)-to-platelet ratio index(APRI),the fibrosis index based on four factors(FIB-4),the Mac-2 binding protein glycosylation isomer(M2BPGi)level and the number of platelets(Plt). RESULTS Serum ACE levels showed moderately positive correlation with liver fibrotic stages(R2=0.181).Patients with significant,advanced fibrosis and cirrhosis(F2-4)had significantly higher serum ACE levels than those with early-stage fibrosis and cirrhosis(F0-1).For significant fibrosis(≥F2),the 12.8 U/L cut-off value of ACE showed 91.7%sensitivity and 75.0%specificity.The receiver-operating characteristic(ROC)curves analysis revealed that the area under the curve(AUC)value of ACE was 0.871,which was higher than that of APRI,FIB-4,M2BPGi and Plt. CONCLUSION The serum ACE level could be a novel noninvasive,easy,accurate,and inexpensive marker of significant fibrosis stage in patients with CHB.Ryuichi Noguchi Kosuke Kaji Tadashi Namisaki Kei Moriya Mitsuteru Kitade Kosuke Takeda Hideto Kawaratani Yasushi Okura Yosuke Aihara Masanori Furukawa Akira Mitoro Hitoshi Yoshiji 2017World Journal of Gastroenterology2017,23,36:6
19How Convolutional Neural Networks Diagnose Plant Disease显示文摘Deep learning with convolutional neural networks(CNNs)has achieved great success in the classification of various plant diseases.However,a limited number of studies have elucidated the process of inference,leaving it as an untouchable black box.Revealing the CNN to extract the learned feature as an interpretable form not only ensures its reliability but also enables the validation of the model authenticity and the training dataset by human intervention.In this study,a variety of neuron-wise and layer-wise visualization methods were applied using a CNN,trained with a publicly available plant disease image dataset.We showed that neural networks can capture the colors and textures of lesions specific to respective diseases upon diagnosis,which resembles human decision-making.While several visualizationmethods were used as they are,others had to be optimized to target a specific layer that fully captures the features to generate consequential outputs.Moreover,by interpreting the generated attention maps,we identified several layers that were not contributing to inference and removed such layers inside the network,decreasing the number of parameters by 75%without affecting the classification accuracy.The results provide an impetus for the CNN black box users in the field of plant science to better understand the diagnosis process and lead to further efficient use of deep learning for plant disease diagnosis.Yosuke Toda Fumio Okura 2019Plant Phenomics2019,1,1:6
20Trisomy 3 may predict a poor response of gastric MALT lymphoma to Helicobacter pylori eradication therapy显示文摘AIM: To investigate the relation of the response to Helicobacter pylori eradication therapy to the depth of tumor invasion and chromosome abnormalities in patients with mucosaassociated lymphoid tissue (MALT) lymphoma and to determine the clinical value of aneuploidy.METHODS: We studied 13 patients with localized gastric MALT lymphoma of stage E1. Before eradication therapy,the depth of tumor invasion was assessed by endoscopic ultrasonography in 8 patients and by endoscopic examination and gastrointestinal series in the remaining patients. To detect chromosomal abnormalities, paraffin-embedded tissue sections of diagnostic biopsy specimens underwent tissuefluorescence in situ hybridization (FISH), using chromosomespecific α-satellite DNA probes for chromosomes 3,7,12,and 18 and YAC clones for t(11;18)(q21;q21).RESULTS: Seven of the 13 patients had complete regression(CR) in response to H pylori eradication therapy. No patient with CR had submucosal tumor invasion. Trisomy 18 was seen in 1 patient with CR, and both trisomies 12 and 18 were present in another patient with CR. All patients with no response or progressive disease had deep submucosal tumor invasion and showed t(11;18)(q21;q21) or trisomy 3. Trisomy 7 was not detected in this series of patients.CONCLUSION: The depth of tumor invasion is an accurate predictor of the response of stage E1 MALT lymphoma to H pylori eradication therapy and is closely associated with the presence of chromosomal abnormalities. Trisomy 3 may predict the aggressive development of MALT lymphoma.Sawako Taji Kenichi Nomura Yosuke Matsumoto Hideaki Sakabe Naohisa Yoshida Shoji Mitsufuji Kazuhiro Nishida Shigeo Horiike Shigeo Nakamura Masuji Morita Masafumi Taniwaki 2005World Journal of Gastroenterology2005,11,1:6
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