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1Clinical 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 2012World Journal of Gastroenterology2012,18,19:24
2Short 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 2010World Journal of Gastrointestinal Endoscopy2010,2,2:19
3Multicenter study of endoscopic preoperative biliary drainage for malignant distal biliary obstruction显示文摘AIM: To determine the optimal method of endoscopic preoperative biliary drainage for malignant distal biliary obstruction.METHODS: Multicenter retrospective study was conducted in patients who underwent plastic stent(PS) or nasobiliary catheter(NBC) placement for resectable malignant distal biliary obstruction followed by surgery between January 2010 and March 2012. Procedurerelated adverse events, stent/catheter dysfunction(occlusion or migration of PS/NBC, developmentof cholangitis, or other conditions that required repeat endoscopic biliary intervention), and jaundice resolution(bilirubin level < 3.0 mg/d L) were evaluated. Cumulative incidence of jaundice resolution and dysfunction of PS/NBC were estimated using competing risk analysis. Patient characteristics and preoperative biliary drainage were also evaluated for association with the time to jaundice resolution and PS/NBC dysfunction using competing risk regression analysis.RESULTS: In total, 419 patients were included in the study(PS, 253 and NBC, 166). Primary cancers included pancreatic cancer in 194 patients(46%), bile duct cancer in 172(41%), gallbladder cancer in three(1%), and ampullary cancer in 50(12%). The median serum total bilirubin was 7.8 mg/d L and 324 patients(77%) had ≥ 3.0 mg/d L. During the median time to surgery of 29 d [interquartile range(IQR), 30-39 d]. PS/NBC dysfunction rate was 35% for PS and 18% for NBC [Subdistribution hazard ratio(SHR) = 4.76; 95%CI: 2.44-10.0, P < 0.001]; the pig-tailed tip was a risk factor for PS dysfunction. Jaundice resolution was achieved in 85% of patients and did not depend on the drainage method(PS or NBC).CONCLUSION: PS has insufficient patency for preoperative biliary drainage. Given the drawbacks of external drainage via NBC, an alternative method of internal drainage should be explored.Naoki Sasahira Tsuyoshi Hamada Osamu Togawa Ryuichi Yamamoto Tomohisa Iwai Kiichi Tamada Yoshiaki Kawaguchi Kenji Shimura Takero Koike Yu Yoshida Kazuya Sugimori Shomei Ryozawa Toshiharu Kakimoto Ko Nishikawa Katsuya Kitamura Tsunao Imamura Masafumi Mizuide Nobuo Toda Iruru Maetani Yuji Sakai Takao Itoi Masatsugu Nagahama Yousuke Nakai Hiroyuki Isayama 2016World Journal of Gastroenterology2016,22,14:18
4Improvement of prognosis for unresectable biliary tract cancer显示文摘AIM:To evaluate the chemotherapeutic outcomes and confirm the recent improvement of prognosis for unresectable biliary tract cancer.METHODS:A total of 186 consecutive patients with unresectable biliary tract cancer,who had been treated with chemotherapy between 2000 and 2009 at five institutions in Japan,were retrospectively analyzed.These patients were divided into three groups based on the year beginning chemotherapy:Group A(2000-2003),Group B(2004-2006),and Group C(2007-2009).The data were fixed at the end of December 2011.Overall survival and time-to-progression were analyzed and compared chronologically.RESULTS:No patient characteristics were significantly different among the three groups.The gallbladder was involved in about half of the patients in each group,and metastatic biliary tract cancer was present in three quarters of the enrollees.In Group A,5-fluorouracilbased chemotherapies were primarily selected as firstline chemotherapy,and only 24% were treated with second-line chemotherapy.In Group B,gemcitabine or S-1 monotherapy was mainly introduced as firstline chemotherapy,and 51% of the patients who were refractory to first-line chemotherapy were treated with second-line chemotherapy mainly with monotherapy.In Group C,the combination therapy with gemcitabine and S-1 was mainly chosen as first-line chemotherapy,and 53% of the patients refractory to first-line chemotherapy were treated with second-line chemotherapy mainly with combination therapy.The median timeto-progressions were 4.4 mo,3.5 mo and 5.9 mo in Groups A,B and C,respectively(4.4 mo vs 3.5 mo vs 5.9 mo,P < 0.01).The median overall survivals were 7.1,7.3,and 11.7 mo in Groups A,B and C(7.1 mo vs 7.3 mo vs 11.7 mo,P = 0.03).Induction rates of all three drugs(gemcitabine,platinum analogs,and fluoropyrimidine) in Groups A,B and C were 4%,2% and 27%(4% vs 2% vs 27%,P < 0.01).CONCLUSION:The prognosis of unresectable biliary tract cancer has improved recently.Using three effective drugs(gemcitabine,platinum analogs,and fluoropyrimidine) may improve the prognosis of this cancer.Takashi Sasaki Hiroyuki Isayama Yousuke Nakai Naminatsu Takahara Naoki Sasahira Hirofumi Kogure Suguru Mizuno Hiroshi Yagioka Yukiko Ito Natsuyo Yamamoto Kenji Hirano Nobuo Toda Minoru Tada Masao Omata Kazuhiko Koike 2013World Journal of Gastroenterology2013,19,1:8
5Interpretation of Laser Weld Penetration and Welding Phenomena (Invited Paper)显示文摘Deeply penetrated welds can be produced with high-power-density lasers.Thus the factors affecting laser weld penetration,laser-induced plume behavior and the interaction between a laser beam and a plume,keyhole behavior,melt flows in the molten pool,and the generation and prevention of bubbles and porosity were investigated.Consequently,the effects of plasma and plume on the weld penetration were interpreted in CO2 and fiber lasers welding,respectively.The formation of spattering,underfilled beads,and humping was understood.It was confirmed that porosity was easily formed at high powers and low welding speeds due to the generation of many bubbles from the tip of a keyhole.Seiji Katayama Yousuke Kawahito 2009中国激光2009,36,12:8
6A pedunculated polyp-shaped small-bowel lymphangioma causing gastrointestinal bleeding and treated by double-balloon enteroscopy显示文摘We report a rare case of a small-bowel lymphangioma causing massive gastrointestinal (GI) bleeding that we successfully diagnosed and treated using double-balloon enteroscopy (DBE). An 81-year-old woman suffering from repeated GI bleeding of unknown origin underwent a capsule endoscopy at a previous hospital. She was suspected of having bleeding from the jejunum, and was referred to our department for diagnosis and treatment. An oral DBE revealed a 20 mm × 10 mm, regularly surfaced, white to yellowish, elongated, pedunculated jejunal polyp with small erosions at 10 cm distal to the ligament of Treiz. Since no other source of bleeding was identified by endoscopy in the deep jejunum, anendoscopic polypectomy (EP) was performed for this lesion. A subsequent histopathological examination of the resected polyp showed clusters of lymphatic vessels with marked cystic dilatation in the submucosa and the deep layer of the lamina propria mucosae. These characteristics are consistent with the typical features of small-bowel lymphangioma with erosions. Although clip-ping hemostasis was performed during EP, re-bleeding occurred. Finally, a complete hemostasis was achieved by performing an additional argon plasma coagulation.Akihiko Kida Koichiro Matsuda Satoshi Hirai Akiyoshi Shimatani Yousuke Horita Katsushi Hiramatsu Mitsuru Matsuda Hidero Ogino Shin Ishizawa Yatsugi Noda 2012World Journal of Gastroenterology2012,18,34:5
7Clinical analysis of high serum IgE in autoimmune pancreatitis显示文摘AIM: To clarify the clinical significance of high serum IgE in autoimmune pancreatitis (AIP). METHODS: Forty-two AIP patients, whose IgE was measured before steroid treatment, were analyzed. To evaluate the relationship between IgE levels and the disease activity of AIP, we examined (1) Frequency of high IgE (> 170 IU/mL) and concomitant allergic dis-eases requiring treatment; (2) Correlations between IgG, IgG4, and IgE; (3) Relationship between the presence of extrapancreatic lesions and IgE; (4) Re-lationship between clinical relapse and IgE in patients treated with steroids, and (5) Transition of IgE before and after steroid treatment. RESULTS: IgE was elevated in 36/42 (86%) patients.Concomitant allergic disease was observed in seven patients (allergic rhinitis in three, bronchial asthma in three, and urticaria in one). There were no signifi-cant correlations between IgG, IgG4, and IgE (r = -0.168 for IgG, and r = -0.188 for IgG4). There was no significant difference in IgE in the patients with and without extrapancreatic lesions (526 ± 531 IU/mL vs 819 ± 768 IU/mL, P = 0.163), with and without clini-cal relapse (457 ± 346 IU/mL vs 784 ± 786 IU/mL, P = 0.374). There was no significant difference in IgE between before and after steroid treatment (723 ± 744 IU/mL vs 673 ± 660 IU/mL, P = 0.633). CONCLUSION: Although IgE does not necessarily reflect the disease activity, IgE might be useful for the diagnosis of AIP in an inactive stage.Kenji Hirano Minoru Tada Hiroyuki Isayama Kazumichi Kawakubo Hiroshi Yagioka Takashi Sasaki Hirofumi Kogure Yousuke Nakai Naoki Sasahira Takeshi Tsujino Nobuo Toda Kazuhiko Koike 2010World Journal of Gastroenterology2010,16,41:4
8A dipeptidyl peptidase-4 inhibitor, sitagliptin, exerts anti-inflammatory effects in type 2 diabetic patients显示文摘Noriko Satoh-Asahara Yousuke Sasaki Hiromichi Wada Mayu Tochiya Azusa Iguchi Reiko Nakagawachi Shinji Odori Shigeo Kono Koji Hasegawa Akira Shimatsu 2012Metabolism2012,,:3
9Risk factors for pancreatitis following transpapillary self-expandable metal stent placement显示文摘Kazumichi Kawakubo Hiroyuki Isayama Yousuke Nakai Osamu Togawa Naoki Sasahira Hirofumi Kogure Takashi Sasaki Saburo Matsubara Natsuyo Yamamoto Kenji Hirano Takeshi Tsujino Nobuo Toda Minoru Tada Masao Omata Kazuhiko Koike 2012Surgical Endoscopy2012,,3:2
10Covered metallic stents in the management of malignant and benign pancreatobiliary strictures显示文摘Hiroyuki Isayama Yousuke Nakai Osamu Togawa Hirofumi Kogure Yukiko Ito Takashi Sasaki Naoki Sasahira Kenji Hirano Takeshi Tsujino Minoru Tada Takao Kawabe Masao Omata 2009Journal of Hepato - Biliary - Pancreatic Surgery2009,,5:2
11Endoscopy-based Kyoto classification score of gastritis related to pathological topography of neutrophil activity显示文摘BACKGROUND Endoscopy-based Kyoto classification for gastritis and pathological topographic distribution of neutrophil infiltration are correlated with gastric cancer risk.AIM To investigate the association between Kyoto classification and the topographic distribution of neutrophil activity.METHODS Kyoto classification score,ranging from 0 to 8,consisted of atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Neutrophil activity was scored according to the updated Sydney System using biopsy samples obtained from the greater curvature of the corpus and the antrum.The participants were divided into four categories,inactive stomach,antrumpredominant gastritis,pangastritis,and corpus-predominant gastritis,based on the topographic distribution of neutrophil activity.Effects of sex,age,body mass index,drinking habit,smoking habit,family history of gastric cancer,serum Helicobacter pylori(H.pylori)antibody,and Kyoto score on topography of neutrophil infiltration were analyzed.RESULTS A total of 327 patients(comprising 50.7%women,with an average age of 50.2 years)were enrolled in this study.H.pylori infection rate was 82.9%with a mean Kyoto score of 4.63.The Kyoto score was associated with the topographic distribution of neutrophil activity.Kyoto scores were significantly higher in the order of inactive stomach,antrum-predominant gastritis,pangastritis,and corpuspredominant gastritis(3.05,4.57,5.21,and 5.96,respectively).Each individual score of endoscopic findings(i.e.,atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness)was correlated with the topographic distribution of neutrophil activity.On multivariate analysis,the Kyoto score,age,and serum H.pylori antibody were independently associated with the topographic distribution of neutrophil activity.CONCLUSION The Kyoto classification score was associated with the topographic distribution of neutrophil activity.Osamu Toyoshima Toshihiro Nishizawa Shuntaro Yoshida Yoshiki Sakaguchi Yousuke Nakai Hidenobu Watanabe Hidekazu Suzuki Chizu Tanikawa Koichi Matsuda Kazuhiko Koike 2020World Journal of Gastroenterology2020,26,34:2
12Kyoto classification in patients who developed multiple gastric carcinomas after Helicobacter pylori eradication显示文摘BACKGROUND Endoscopic Kyoto classification predicts gastric cancer risk;however,the score in the patients with primary gastric cancer after Helicobacter pylori(H.pylori)eradication therapy is unknown.AIM To elucidate the Kyoto classification score in patients with both single gastric cancer and multiple gastric cancers developed after H.pylori eradication.METHODS The endoscopist recorded the Kyoto classification at the endoscope and the Kyoto classification score at the time of the first diagnosis of gastric cancer after H.pylori eradication.The score was compared between single gastric cancer group and multiple gastric cancers group.RESULTS The Kyoto score at the time of diagnosis of 45 cases of gastric cancer after H.pylori eradication was 4.0 points in average.The score was 3.8 points in the single gastric cancer group,and 5.1 points in the multiple gastric cancers group.The multiple group had a significantly higher score than the single group(P=0.016).In the multiple gastric cancers group,all the patients(7/7)had 5 or higher Kyoto score,while in single gastric cancer group,the proportion of patients with a score of 5 or higher was less than half,or 44.7%(17/38).CONCLUSION Patients diagnosed with gastric cancer after H.pylori eradication tended to have advanced gastritis.In particular,in cases of multiple gastric cancers developed after H.pylori eradication,the endoscopic Kyoto classification score tended to be 5 or higher in patients with an open type atrophic gastritis and the intestinal metaplasia extended to the corpus.Kosuke Sakitani Toshihiro Nishizawa Akira Toyoshima Shuntaro Yoshida Tatsuya Matsuno Tomoharu Yamada Masatoshi Irokawa Yoshiyuki Takahashi Yousuke Nakai Osamu Toyoshima Kazuhiko Koike 2020World Journal of Gastrointestinal Endoscopy2020,12,9:2
13Daikenchuto for postoperative adhesive small bowel obstruction:A systematic review and meta-analysis显示文摘AIM To assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction(ASBO).METHODS A systematic search of Pub Med(MEDLINE),CINAHL,the Cochrane Library and Ichushi Web was conducted,and the reference lists of review articles were handsearched.The outcomes of interest were the incidence rate of surgery,the length of hospital days and mortality.The quality of the included studies,publication bias and between-study heterogeneity were also assessed.RESULTS Three randomized controlled trials(RCTs)and three retrospective cohort studies were selected for analysis.In the three RCTs,Daikenchuto significantly reduced the incidence of surgery(p OR=0.13;95%CI:0.03-0.50).Similarly,Daikenchuto significantly reduced the incidence of surgery(p OR=0.53;95%CI:0.32-0.87)in the three cohort studies.The length of hospital stay and mortality were not measured or described consistently.CONCLUSION The present meta-analysis demonstrates that administering Daikenchuto is associated with a lower incidence of surgery for patients with postoperative ASBO in the Japanese population.In order to better generalize these results,additional studies will be needed.Tomohiko Ukai Satoru Shikata Ryuki Kassai Yousuke Takemura 2016World Journal of Meta-Analysis2016,4,4:2
14Hepatic reactive lymphoid hyperplasia in a patient with primary biliary cirrhosis显示文摘Reactive lymphoid hyperplasia(RLH) of the liver is an extremely rare lesion characterized by the proliferation of non-neoplastic lymphocytes forming follicles.Hepatic RLH is known to be associated with gastrointestinal carc inoma and autoimmune diseases including primary biliary cirrhosis(PBC).We report a case of hepatic RLH in a patient with PBC and gastric cancer.A 68 year old Japanese woman with a 10 year history of liver enzyme abnormality was admitted.Laboratory testing revealed that her anti-mitochondrial antibody was markedly elev ated.Five mo after the diagnosis of PBC,she was foun d to have gastric cancer.Abdominal computed tom og raphy disclosed a liver nodule in S8,suggesting metas tatic gastric carcinoma.Histopathologically,the resected liver lesion comprised of a nodular proliferation of small lym phocytes with lymphoid follicles.This is the first reported case of hepatic RLH in a patient with both PBC and gastric cancer.Pre-operative diagnosis of hepatic RLH by clinical imaging is extremely difficult.Therefore,a need le biopsy could be useful to make a diagnosis of hepat ic RLH,especially to differentiate from metastatic gastroin t estinal carcinoma.Mitsuaki Ishida Tamio Nakahara Yousuke Mochizuki Tomoyuki Tsujikawa Akira Andoh Yasuharu Saito Hiroshi Yamamoto Fumiyoshi Kojima Machiko Hotta Tohru Tani Yoshihide Fujiyama Hidetoshi Okabe 2010World Journal of Hepatology2010,2,10:2
15Electrochemical modification of active carbon fiber electrode and its application to double-layer capacitor显示文摘Toshiyuki Momma Xingjiang Liu Tetsuya Osaka Yousuke Ushio Yoshimitsu Sawada 1995Journal of Power Sources1995,,2:2
16Outcomes after clearance of pancreatic stones with or without pancreatic stenting显示文摘Naoki Sasahira Minoru Tada Hiroyuki Isayama Kenji Hirano Yousuke Nakai Natsuyo Yamamoto Takeshi Tsujino Nobuo Toda Yutaka Komatsu Haruhiko Yoshida Takao Kawabe Masao Omata 2007Journal of Gastroenterology2007,,1:2
17Remediation of toxic metal contaminated soil by washing with biodegradable aminopolycarboxylate chelants显示文摘Zinnat A. Begum Ismail M.M. Rahman Yousuke Tate Hikaru Sawai Teruya Maki Hiroshi Hasegawa 2012Chemosphere2012,,10:2
18Measurement of radial and axial forces of biliary self-expandable metallic stents显示文摘Hiroyuki Isayama Yousuke Nakai Yoshihide Toyokawa Osamu Togawa Chimyon Gon Yukiko Ito Yoko Yashima Hiroshi Yagioka Hirofumi Kogure Takashi Sasaki Toshihiko Arizumi Saburo Matsubara Natsuyo Yamamoto Naoki Sasahira Kenji Hirano Takeshi Tsujino Nobuo Toda Mi 2009Gastrointestinal Endoscopy2009,,1:2
19The inhibitory effects of tra- madol on muscarinic receptor - induced responses in xenopus oocytes ex- pressing cloned M3 receptors显示文摘Yousuke S Kouichiro M Munehiro S 2002Anesth Analg2002,95,5:1
20Diagnostic utility of biopsy specimens for autoimmune pancreatitis显示文摘Kenji Hirano Noriyoshi Fukushima Minoru Tada Hiroyuki Isayama Suguru Mizuno Keisuke Yamamoto Yoko Yashima Hiroshi Yagioka Takashi Sasaki Hirofumi Kogure Yousuke Nakai Naoki Sasahira Takeshi Tsujino Takao Kawabe Masashi Fukayama Masao Omata 2009Journal of Gastroenterology2009,,7:1
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