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| 1 | Magnifying colonoscopy as a non-biopsy technique for differential diagnosis of non-neoplastic and neoplastic lesions显示文摘瞄准:为了澄清与放大结肠镜检查观察的粘膜地窟模式是否对可行,把非肿瘤的息肉与肿瘤的息肉区分开来。方法:从通过 2000 年 3 月的 1999 年 6 月,有 210 损害的 180 个连续病人与放大结肠镜诊断了(CF-200Z,天堂光有限公司,东京,日本) 被注册。有 0.2% 靛青洋红染料的放大和多彩石印版内视镜检查法为粘膜地窟观察被用于每损害。损害出现打字我和 II 地窟模式被活体检视组织学地认为非肿瘤、检验,而损害证明到 V 地窟模式的类型 III 被移开内视镜的联盟者或通过手术。内视镜的诊断和 histologic 诊断的关联然后被调查。结果:在内视镜检查法, 24 损害证明我或 II 坑模式,和 186 损害显示出的一种类型打 III 到 V 坑模式。与 histologic 检查, 26 损害作为非肿瘤的息肉被诊断,并且 184 损害作为肿瘤的息肉被诊断。全面诊断精确性是 99.1%(208/210 ) 。敏感和特性是 92.3%(24/26 ) 并且 99.8%(184/186 ) 分别地。结论:放大结肠镜检查能作为一种非活体检视技术被使用区分肿瘤、非肿瘤的息肉。 | Shigeharu Kato Kuang I Fu Yasushi Sano Takahiro Fujii Yutaka Saito Takahisa Matsuda Ikuro Koba Shigeaki Yoshida Takahiro Fujimori | 2006 | World Journal of Gastroenterology2006，12，9： | 31 |
| 2 | Current status, problems, and perspectives of non-alcoholic fatty liver disease research显示文摘Non-alcoholic fatty liver disease(NAFLD) is a major chronic liver disease that can lead to liver cirrhosis, liver cancer, and ultimately death. NAFLD is pathologically classified as non-alcoholic fatty liver(NAFL) or non-alcoholic steatohepatitis(NASH) based on the existence of ballooned hepatocytes,although the states have been known to transform into each other. Moreover,since the detection of ballooned hepatocytes may be difficult with limited biopsied specimens, its clinical significance needs reconsideration. Repeated liver biopsy to assess histological NAFLD activity for therapeutic response is also impractical, creating the need for body fluid biomarkers and less invasive imaging modalities. Recent longitudinal observational studies have emphasized the importance of advanced fibrosis as a determinant of NAFLD outcome. Thus,identifying predictors of fibrosis progression and developing better screening methods will enable clinicians to isolate high-risk NAFLD patients requiring early intensive intervention. Despite the considerable heterogeneity of NAFLD with regard to underlying disease, patient age, and fibrosis stage, several clinical trials are underway to develop a first-in-class drug. In this review, we summarize the present status and future direction of NAFLD/NASH research towards solving unmet medical needs. | Naoki Tanaka Takefumi Kimura Naoyuki Fujimori Tadanobu Nagaya Michiharu Komatsu Eiji Tanaka | 2019 | World Journal of Gastroenterology2019，25，2： | 29 |
| 3 | Systematic review of anastomotic complications of esophagojejunostomy after laparoscopic total gastrectomy显示文摘AIM: To investigate the anastomotic complications ofesophagojejunostomy(EJS) after laparoscopic total gastrectomy(LTG), we reviewed retrospective studies.METHODS: A literature search was conducted in Pub Med for studies published from January 1, 1994 through January 31, 2015. The search terms included 'laparoscopic,' 'total gastrectomy,' and 'gastric cancer.' First, we selected 16 non-randomized controlled trials(RCTs) comparing LTG with open total gastrectomy(OTG) and conducted an updated meta-analysis of anastomotic complications after total gastrectomy. The Newcastle-Ottawa scoring system(NOS) was used to assess the quality of the non-RCTs included in this study. Next, we reviewed anastomotic complications in 46 case studies of LTG to compare the various procedures for EJS. RESULTS: The overall incidence of anastomotic leakage associated with EJS was 3.0%(30 of 984 patients) among LTG procedures and 2.1%(31 of 1500 patients) among OTG procedures in the 16 non-RCTs. The incidence of anastomotic leakage did not differ significantly between LTG and OTG(odds OR = 1.42, 95%CI: 0.86-2.33, P = 0.17, I2 = 0%). Anastomotic stenosis related to EJS was reported in 72(2.9%) of 2484 patients, and the incidence was 3.2% among LTG procedures and 2.7% among OTG procedures. The incidence of anastomotic stenosis related to EJS was slightly, but not significantly, higher in LTG than in OTG(OR = 1.55, 95%CI: 0.94-2.54, P = 0.08, I2 = 0%). The various procedures for LTG were classified into six categories in the review of case studies of LTG. The incidence of EJS leakage was similar(1.1% to 3.2%), although the incidence of EJS stenosis was relatively high when the Or VilTM device was used(8.8%) compared with other procedures(1.0% to 3.6%).CONCLUSION:The incidence of anastomotic complications associated with EJS was not different between LTG and OTG. Anastomotic stenosis was relatively common when the Or VilTM device was used. | Mikito Inokuchi Sho Otsuki Yoshitaka Fujimori Yuya Sato Masatoshi Nakagawa Kazuyuki Kojima | 2015 | World Journal of Gastroenterology2015，21，32： | 23 |
| 4 | Retroperitoneal fibrosis associated with immunoglobulin G4-related disease显示文摘Retroperitoneal fibrosis is a rare disease characterized by the development of inflammation and fibrosis in the soft tissues of the retroperitoneum and other abdominal organs.Retroperitoneal fibrosis can be of 2 types:idiopathic and secondary.The recently advocated concept and diagnostic criteria of immunoglobulin G4(IgG4)-related disease,derived from research on autoimmune pancreatitis(AIP),has led to widespread recognition of retroperitoneal fibrosis as a condition caused by IgG4-related disease.We now know that previously diagnosed idiopathic retroperitoneal fibrosis includes IgG4-related disease;however,the actual prevalence is unclear.Conversely,some reports on AIP suggest that retroperitoneal fibrosis is concurrently found in about 10% of IgG4-related disease.Because retroperitoneal fibrosis has no specific symptoms,diagnosis is primarily based on diagnostic imaging(computed tomography and magnetic resonance imaging),which is also useful in evaluating the effect of therapy.Idiopathic retroperitoneal fibrosis can occur at different times with other lesions of IgG4-related disease including AIP.Thus,the IgG4 assay is recommended to diagnose idiopathic retroperitoneal fibrosis.High serum IgG4 levels should be treated and monitored as a symptom of IgG4-related disease.The first line of treatment for retroperitoneal fibrosis is steroid therapy regardless of its cause.For patients with concurrent AIP,i.e.,IgG4-related retroperitoneal fibrosis,the starting dose of steroid is usually 30-40 mg/d.The response to steroid therapy is generally favorable.In most cases,the pancreatic lesion and retroperitoneal fibrosis improve after the initial treatment.However,the epidemiology,treatment for recurring retroperitoneal fibrosis,and long-term prognosis are still largely unknown.Further analysis of such cases and research are necessary. | Nao Fujimori Tetsuhide Ito Hisato Igarashi Takamasa Oono Taichi Nakamura Yusuke Niina Masayuki Hijioka Lingaku Lee Masahiko Uchida Ryoichi Takayanagi | 2013 | World Journal of Gastroenterology2013，19，1： | 14 |
| 5 | Surgical treatment of HCC in a patient with lamivudine-resistant hepatitis B cirrhosis with adefovir dipivoxil显示文摘We describe a 77-year-old woman with chronic hepatitis B who became resistant to lamivudine.She was started on adefovir(10 mg daily)while still continuing lamivudine therapy.Four mo later her liver function improved and serum Hepatitis B virus(HBV)-DNA level became undetectable.Three years after the start of additional adefovir treatment,hepatocellular carcinoma (HCC)was detected and the patient underwent a successful hepa-tectomy.Our findings suggest tha-t the addition of adefovir to ongoing lamivudine therapy cannot completely suppress hepatocarcinogenesis,but is useful for improving liver function in patients with lamivudine-resistant HBV-related cirrhosis,allowing HCC surgery. | Takashi Akima Masaya Tamano Hidetsugu Yamagishi Keiichi Kubota Takahiro Fujimori Hideyuki Hiraishi | 2010 | World Journal of Hepatology2010，2，8： | 11 |
| 6 | Progress in elucidating the relationship between Helicobacter pylori infection and intestinal diseases显示文摘Helicobacter pylori(H.pylori)infection causes changes to the intestinal flora,such as small intestinal bacterial overgrowth,and increases gastric acid secretionstimulating gastrointestinal hormones,mainly gastrin,due to a decrease in gastric acid caused by atrophic gastritis.In addition,the cellular components of H.pylori travel through the intestinal tract,so the bacterial infection affects the immune system.Therefore,the effects of H.pylori infection are observed not only in the stomach and the proximal duodenum but also in the small and large intestines.In particular,meta-analyses reported that H.pylori-infected individuals had an increased risk of colorectal adenoma and colorectal cancer.Moreover,a recent study reported that the risk of developing colorectal cancer was increased in subjects carrying H.pylori vacuolating cytotoxin A antibody.In addition,it has been reported that H.pylori infection exacerbates the symptoms of Fabry’s disease and familial Mediterranean fever attack and is involved in irritable bowel syndrome and small intestinal ulcers.On the other hand,some studies have reported that the frequency of ulcerative colitis,Crohn’s disease,and celiac disease is low in H.pylori-infected individuals.Thus,H.pylori infection is considered to have various effects on the small and large intestines.However,few studies have reported on these issues,and the details of their effects have not been well elucidated.Therefore,additional studies are needed. | Shunji Fujimori | 2021 | World Journal of Gastroenterology2021，27，47： | 9 |
| 7 | Ectopic hepatocellular carcinoma arising from pancreas: A case report and review of the literature显示文摘A 56-year-old man was found to have a pancreatic tail tumor. His blood chemistry showed no infection with hepatitis B or C virus and no elevations of tumor markers or pancreatic hormones. Abdominal ultrasound showed an encapsulated, rather heterogeneous, hypoechoic tumor, 6.5 cm in maximum diameter, with a beak sign. Helical dynamic CT revealed an irregularly enhanced tumor with pooling of contrast medium in the delayed phase. Abdominal angiography showed a hypervascular tumor. With a tentative diagnosis of non-functional islet-cell tumor, the patient underwent resection of the pancreatic body and tail with splenectomy. The contour of the liver and its surface were normal. In microscopic examination, tumor cells arranged in a trabecular pattern with focal bile pigment resembling hepatocellular carcinoma (HCC). Immunohistochemically, these tumor cells were positivefor HEPPAR-1, CAM5.2, cytokeratin 18 and COX-2, but negative for MUC-1, and cytokeratins 7, 20 and 8. These results supported a diagnosis of HCC without any adenocarcinoma component. The patient is currently doing well without any signs of recurrence in either the remaining pancreas or liver three years after surgery. We report the rare case with ectopic HCC in the pancreas with a review of the literature. | Keiichi Kubota Junji Kita Kyu Rokkaku Yoshimi Iwasaki Tokihiko Sawada Johji Imura Takahiro Fujimori | 2007 | World Journal of Gastroenterology2007，13，31： | 7 |
| 8 | What are the effects of proton pump inhibitors on the small intestine?显示文摘Generally, proton-pump inhibitors(PPIs) have great benefit for patients with acid related disease with less frequently occurring side effects. According to a recent report, PPIs provoke dysbiosis of the small intestinal bacterial flora, exacerbating nonsteroidal anti-inflammatory drug-induced small intestinal injury.Several meta-analyses and systematic reviews have reported that patients treated with PPIs, as well as post-gastrectomy patients, have a higher frequency of small intestinal bacterial overgrowth(SIBO) compared to patients who lack the aforementioned conditions.Furthermore, there is insufficient evidence that these conditions induce Clostridium difficile infection. At this time, PPI-induced dysbiosis is considered a type of SIBO. It now seems likely that intestinal bacterial flora influence many diseases, such as inflammatory bowel disease, diabetes mellitus, obesity, nonalcoholic fatty liver disease, and autoimmune diseases.When attempting to control intestinal bacterial flora with probiotics, prebiotics, and fecal microbiota transplantation, etc., the influence of acid suppression therapy, especially PPIs, should not be overlooked. | Shunji Fujimori | 2015 | World Journal of Gastroenterology2015，21，22： | 7 |
| 9 | Serum autotaxin levels are correlated with hepatic fibrosis and ballooning in patients with non-alcoholic fatty liver disease显示文摘AIM To examine the relationship between serum autotaxin(ATX) concentrations and clinicopathological findings in non-alcoholic fatty liver disease(NAFLD) patients.METHODS One hundred eighty-six NAFLD patients who had undergone liver biopsy between 2008 and 2017 were retrospectively enrolled.Serum samples were collected at the time of biopsy and ATX was measured by enzyme immunoassays.Sera obtained from 160 healthy,nonobese individuals were used as controls.Histological findings were graded according to an NAFLD scoring system and correlations with serum ATX were calculated by Spearman's test.Diagnostic accuracy was evaluated using the area under the receiver operating characteristic curve(AUC).Cut-off values were identified by the Youden index,and the nearest clinically applicable value to the cutoff was considered the optimal threshold for clinical convenience.RESULTS Serum ATX levels were significantly higher in NAFLD patients than in controls(0.86 mg/L vs 0.76 mg/L,P < 0.001) and correlated significantly with ballooning score and fibrosis stage(r = 0.36,P < 0.001 and r = 0.45,P < 0.001,respectively).Such tendencies were stronger in female patients.There were no remarkable relationships between ATX and serum alanine aminotransferase,lipid profiles,or steatosis scores.The AUC values of ATX for predicting the presence of fibrosis(≥ F1),significant fibrosis(≥ F2),severe fibrosis(≥ F3),and cirrhosis(F4),were all more than 0.70 in respective analyses.CONCLUSION Serum ATX levels may at least partially reflect histological severity in NAFLD. | Naoyuki Fujimori Takeji Umemura Takefumi Kimura Naoki Tanaka Ayumi Sugiura Tomoo Yamazaki Satoru Joshita Michiharu Komatsu Yoko Usami Kenji Sano Koji Igarashi Akihiro Matsumoto Eiji Tanaka | 2018 | World Journal of Gastroenterology2018，24，11： | 6 |
| 10 | Endoscopic approach through the minor papilla for the management of pancreatic diseases显示文摘AIM:To clarify the efficacy and safety of an endoscopic approach through the minor papilla for the management of pancreatic diseases.METHODS:This study included 44 endoscopic retrograde cholangiopancreatography(ERCP) procedures performed in 34 patients using a minor papilla approach between April 2007 and March 2012.We retrospectively evaluated the clinical profiles of the patients,the endoscopic interventions,short-term outcomes,and complications.RESULTS:Of 44 ERCPs,26 were diagnostic ERCP,and 18 were therapeutic ERCP.The most common cause of difficult access to the main pancreatic duct through the major papilla was pancreas divisum followed by distortion of Wirsung's duct.The overall success rate of minor papilla cannulation was 80%(35/44),which was significantly improved by wire-guided cannulation(P = 0.04).Endoscopic minor papillotomy(EMP) was performed in 17 of 34 patients(50%) using a needle-knife(13/17) or a pull-type papillotome(4/17).EMP with pancreatic stent placement,which was the main therapeutic option for patients with chronic pancreatitis,recurrent acute pancreatitis,and pancreatic pseudocyst,resulted in short-term clinical improvement in 83% of patients.Mild post-ERCP pancreatitis occurred as an early complication in 2 cases(4.5%).CONCLUSION:The endoscopic minor papilla approach is technically feasible,safe,and effective when the procedure is performed in a high-volume referral center by experienced endoscopists. | Nao Fujimori Hisato Igarashi Akira Asou Ken Kawabe Lingaku Lee Takamasa Oono Taichi Nakamura Yusuke Niina Masayuki Hijioka Masahiko Uchida Kazuhiro Kotoh Kazuhiko Nakamura Tetsuhide Ito Ryoichi Takayanagi | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，3： | 6 |
| 11 | Mild drinking habit is a risk factor for hepatocarcinogenesis in non-alcoholic fatty liver disease with advanced fibrosis显示文摘AIM The impact of mild drinking habit(less than 20 g/d of ethanol) on the clinical course of non-alcoholic fatty liver disease(NAFLD) has not been determined. We examined the influence of a mild drinking habit on liver carcinogenesis from NAFLD. METHODS A total of 301 patients who had been diagnosed as having NAFLD by liver biopsy between 2003 and 2016 [median age: 56 years, 45% male, 56% with nonalcoholic steatohepatitis, 26% with advanced fibrosis(F3-4)] were divided into the mild drinking group withe thanol consumption of less than 20 g/d(mild drinking group, n = 93) and the non-drinking group(n = 208). Clinicopathological features at the time of liver biopsy and factors related to hepatocellular carcinoma(HCC) occurrence were compared between the groups.RESULTS We observed significant differences in male prevalence(P = 0.01), platelet count(P = 0.04), and gammaglutamyl transpeptidase(P = 0.02) between the test groups. Over 6 years of observation, the HCC appearance rate was significantly higher in the mild drinking group(6.5% vs 1.4%, P = 0.02). Multivariate survival analysis using Cox's regression model revealed that hepatic advanced fibrosis(F3-4)(P < 0.01, risk ratio: 11.60), diabetes mellitus(P < 0.01, risk ratio: 89.50), and serum triglyceride(P = 0.04, risk ratio: 0.98) were factors significantly related to HCC in all NAFLD patients, while the effect of a drinking habit was marginal(P = 0.07, risk ratio: 4.43). In patients with advanced fibrosis(F3-4), however, a drinking habit(P = 0.04, risk ratio: 4.83), alpha-fetoprotein(P = 0.01, risk ratio: 1.23), and diabetes mellitus(P = 0.03, risk ratio: 12.00) were identified as significant contributors to HCC occurrence. CONCLUSION A mild drinking habit appears to be a risk factor for hepatocarcinogenesis in NAFLD patients, especially those with advanced fibrosis. | Takefumi Kimura Naoki Tanaka Naoyuki Fujimori Ayumi Sugiura Tomoo Yamazaki Satoru Joshita Michiharu Komatsu Takeji Umemura Akihiro Matsumoto Eiji Tanaka | 2018 | World Journal of Gastroenterology2018，24，13： | 6 |
| 12 | Clinical significance of MET in gastric cancer显示文摘Chemotherapy has become the global standard treatment for patients with metastatic or unresectable gastric cancer(GC),although outcomes remain unfavorable.Many molecular-targeted therapies inhibiting signaling pathways of various tyrosine kinase receptors have been developed,and monoclonal antibodies targeting human epidermal growth factor receptor 2 or vascular endothelial growth factor receptor 2 have become standard therapy for GC.Hepatocyte growth factor and its receptor,c-MET(MET),play key roles in tumor growth through activated signaling pathways from receptor in GC cells.Genomic amplification of MET leads to the aberrant activation found in GC tumors and is related to survival in patients with GC.This review discusses the clinical significance of MET in GC and examines MET as a potential therapeutic target in patients with GC.Preclinical studies in animal models have shown that MET antibodies or smallmolecule MET inhibitors suppress tumor-cell proliferation and tumor progression in MET-amplified GC cells.These drugs are now being evaluated in clinical trials as treatments for metastatic or unresectable GC. | Mikito Inokuchi Sho Otsuki Yoshitaka Fujimori Yuya Sato Masatoshi Nakagawa Kazuyuki Kojima | 2015 | World Journal of Gastrointestinal Oncology2015，7，11： | 5 |
| 13 | Association between endotoxemia and histological features of nonalcoholic fatty liver disease显示文摘AIM To assess whether surrogate biomarkers of endotoxemia were correlated with the histological features ofnonalcoholic fatty liver disease(NAFLD).METHODS One hundred twenty-six NAFLD patients who had undergone percutaneous liver biopsy were enrolled. Serum lipopolysaccharide(LPS)-binding protein(LBP) and anti-endotoxin core immunoglobulin G(Endo Cab Ig G) antibody concentrations at the time of liver biopsy were measured using the enzyme-linked immunosorbent assays to examine for relationships between biomarker levels and histological scores. RESULTS Serum LBP concentration was significantly increased in nonalcoholic steatohepatitis(NASH) patients as compared with nonalcoholic fatty liver(NAFL) subjects and was correlated with steatosis(r = 0.38, P < 0.0001) and ballooning scores(r = 0.23, P = 0.01), but not with the severity of lobular inflammation or fibrosis. Multivariate linear regression analysis revealed that LBP was associated with steatosis score and circulating C-reactive protein, aspartate aminotransferase, and fibrinogen levels. Serum Endo Cab Ig G concentration was comparable between NASH and NAFL patients. No meaningful correlations were detected between Endo Cab Ig G and histological findings. CONCLUSION LBP/Endo Cab Ig G were not correlated with lobular inflammation or fibrosis. More accurate LPS biomarkers are required to stringently assess the contribution of endotoxemia to conventional NASH. | Hiroyuki Kitabatake Naoki Tanaka Naoyuki Fujimori Michiharu Komatsu Ayaka Okubo Kyogo Kakegawa Takefumi Kimura Ayumi Sugiura Tomoo Yamazaki Soichiro Shibata Yuki Ichikawa Satoru Joshita Takeji Umemura Akihiro Matsumoto Masayoshi Koinuma Kenji Sano Toshifumi Aoyama Eiji Tanaka | 2017 | World Journal of Gastroenterology2017，23，4： | 5 |
| 14 | Asymptomatic small intestinal ulcerative lesions:Obesity and Helicobacter pylori are likely to be risk factors显示文摘It is often difficult to explain why ulcerative lesions are found in the small intestine because there are no obvious aggressors such as gastric acid.In particular,the treatment of small intestinal ulcerative lesions in asymptomatic patients with no symptoms,normal physical examinations,and normal blood test findings is not well documented.According to a summary of capsule endoscopy studies in healthy subjects,approximately 10%of subjects have small intestinal mucosal breaks.The number of mucosal breaks in these instances is approximately 1-3.We examined small intestinal mucosal breaks in healthy subjects recruited from our past two studies.Mucosal breaks were observed in approximately 10%of subjects,and the average number was 0.24±1.21.The number of mucosal breaks in the small intestine was correlated with body mass index and was significantly higher in Helicobacter pylori-infected subjects and higher in males.These results indicate that 1-2 small ulcerative lesions,such as erosions in the small intestine,can be considered to be in the normal range,and close examination is not required.It is assumed that a follow-up medical examination is required for such asymptomatic persons.The presence of many small ulcerative lesions or an unequivocal ulcer indicates an abnormality for which close examination is desired.However,in many cases,it is sufficient to scrutinize after detecting anemia,but it is difficult to make a judgment due to insufficient reports,and future studies are required. | Shunji Fujimori | 2021 | World Journal of Gastroenterology2021，27，28： | 5 |
| 15 | Narrow-band imaging observation of colorectal lesions using NICE classification to avoid discarding significant lesions显示文摘AIM: To assess the risk of failing to detect diminutive and small colorectal cancers with the 'resect and discard' policy.METHODS: Patients who received colonoscopy and polypectomy were recruited in the retrospective study. Probable histology of the polyps was predicted by six colonoscopists by the use of NICE classification. The incidence of diminutive and small colorectal cancersand their endoscopic features were assessed. RESULTS: In total, we found 681 cases of diminutive(1-5 mm) lesions in 402 patients and 197 cases of small(6-9 mm) lesions in 151 patients. Based on pathology of the diminutive and small polyps, 105 and 18 were non-neoplastic polyps, 557 and 154 were low-grade adenomas, 18 and 24 were high-grade adenomas or intramucosal/submucosal(SM) scanty invasive carcinomas, 1 and 1 were SM deeply invasive carcinoma, respectively. The endoscopic features of invasive cancer were classified as NICE type 3 endoscopically.CONCLUSION: The risk of failing to detect diminutive and small colorectal invasive cancer with the 'resect and discard' strategy might be avoided through the use of narrow-band imaging observation with the NICE classification scheme and magnifying endoscopy. | Santa Hattori Mineo Iwatate Wataru Sano Noriaki Hasuike Hidekazu Kosaka Taro Ikumoto Masahito Kotaka Akihiro Ichiyanagi Chikara Ebisutani Yasuko Hisano Takahiro Fujimori Yasushi Sano | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，12： | 5 |
| 16 | Prospective real-time evaluation of diagnostic performance using endocytoscopy in differentiating neoplasia from nonneoplasia for colorectal diminutive polyps(≤ 5 mm)显示文摘AIM To clarify the diagnostic performance of endocytoscopy for differentiation between neoplastic and nonneoplastic colorectal diminutive polyps.METHODS Patients who underwent endocytoscopy between October and December 2016 at Sano Hospital were prospectively recruited. When diminutive polyps(≤5 mm) were detected, the lesions were evaluated by endocytoscopy after being stained with 0.05% crystal violet and 1% methylene blue. The diminutivepolyps were classified into five categories(EC 1 a, 1 b, 2, 3 a, and 3 b). Endoscopists were asked to take a biopsy from any lesion diagnosed as EC1 b(indicator of hyperplastic polyp) or EC2(indicator of adenoma). We have assessed the diagnostic performance of endocytoscopy for EC2 and EC1 b lesions by comparison with the histopathology of the biopsy specimen. RESULTS A total of 39 patients with 63 diminutive polyps were analyzed. All polyps were evaluated by endocytoscopy. The mean polyp size was 3.3 ± 0.9 mm. Among the 63 diminutive polyps, 60 were flat and 3 were pedunculated. The mean time required for EC observation, including the time for staining with crystal violet and methylene blue, was 3.0 ± 1.9 min. Histopathologic evaluation showed that 13 polyps were hyperplastic and 50 were adenomas. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of EC2 for adenoma compared with EC1 b for hyperplastic polyp were 98.0%, 92.3%, 96.8%, 98.0% and 92.3%, respectively. There were only two cases of disagreement between the endoscopic diagnosis made by endocytoscopy and the corresponding histopathological diagnosis.CONCLUSION Endocytoscopy showed a high diagnostic performance for differentiating between neoplastic and non-neoplastic colorectal diminutive polyps, and therefore has the potential to be used for 'real-time histopathology'. | Takahiro Utsumi Yasushi Sano Mineo Iwatate Hironori Sunakawa Akira Teramoto Daizen Hirata Santa Hattori Wataru Sano Noriaki Hasuike Kazuhito Ichikawa Takahiro Fujimori | 2018 | World Journal of Gastrointestinal Oncology2018，10，4： | 4 |
| 17 | Size does not determine the grade of malignancy of early invasive colorectal cancer显示文摘AIM:To clarify the clinicopathological characteristics of small and large early invasive colorectal cancers(EI-CRCs),and to determine whether malignancy grade depends on size.METHODS:A total of 583 consecutive EI-CRCs treated by endoscopic mucosal resection or surgery at the National Cancer Center Hospital between 1980 and 2004 were enrolled in this study.Lesions were classified into two groups based on size:small(≤10mm) and large(>10mm).Clinicopathological features,incidence of lymph node metastasis(LNM) and risk factors for LNM,such as depth of invasion,lymphovascular invasion(LVI) and poorly differentiated adenocarcinoma(PDA) were analyzed in all resected specimens.RESULTS:There were 120(21%) small and 463(79%) large lesions.Histopathological analysis of the small lesion group revealed submucosal deep cancer(sm:≥1000 μm) in 90(75%) cases,LVI in 26(22%) cases,and PDA in 12(10%) cases.Similarly,the large lesion group exhibited submucosal deep cancer in 380(82%) cases,LVI in 125(27%) cases,and PDA in 79(17%) cases.The rate of LNM was 11.2% and 12.1% in the small and large lesion groups,respectively.CONCLUSION:Small EI-CRC demonstrated the same aggressiveness and malignant potential as large cancer. | Takahisa Matsuda Yutaka Saito Takahiro Fujii Toshio Uraoka Takeshi Nakajima Nozomu Kobayashi Fabian Emura Akiko Ono Tadakazu Shimoda Hiroaki Ikematsu Kuang-I Fu Yasushi Sano Takahiro Fujimori | 2009 | World Journal of Gastroenterology2009，15，22： | 4 |
| 18 | Crown and canopy structure in relation to productivity,proceedings of an international workshop held in Japan显示文摘 | Fujimori T Whitehead D | 1986 | Forestry and Forest Products Research Institute1986，，： | 4 |
| 19 | Hepcidin/ferroportin expression levels involve efficacy of pegylated-interferon plus ribavirin in hepatitis C virusinfected liver显示文摘AIM:To investigate the relationship between the ironmetabolism-related gene expression profiles and efficacy of antiviral therapy in chronic hepatitis C patients.METHODS:The hepatic expression profile of ironmetabolism-related genes was analyzed and its association with virological response to pegylated-interferon plus ribavirin combination therapy was evaluated.A hundred patients with chronic hepatitis C(genotype1b,n = 50; genotype 2,n = 50) were enrolled and retrospectively analyzed.Liver biopsy samples were subjected to quantitative polymerase chain reaction for iron-metabolismrelated genes and protein expression(Western blotting analysis) for ferroportin.As a control,normal liver tissue was obtained from 18 living donors of liver transplantation.Serum hepcidin level was measured by sensitive liquid chromatography/electrospray ionization tandem mass spectrometry.RESULTS:Iron overload is associated with liver damage by increasing oxidative stress and hepatitis C virus(HCV)is reported to induce iron accumulation in hepatocytes in vivo.Conversely,iron administration suppresses HCV replication in vitro.Therefore,the association between HCV infection and iron metabolism remains unclear.Compared with controls,patients had significantly higher gene expression for transferrin,iron-regulatoryproteins 1 and 2,divalent metal transporter 1,and ferroportin,but similar for transferrin receptors 1 and2,and hepcidin.When the expression profiles were compared between sustained virological response(SVR)and non-SVR patients,the former showed significantly lower transcription and protein expression of hepcidin and ferroportin.Expression of hepcidin-regulating genes,BMPR1,BMPR2,and hemojuvelin,was significantly increased,whereas BMP2 was decreased in HCV-infected liver.BMPR2 and hemojuvelin expression was significantly lower in the SVR than non-SVR group.HCV infection affects the expression of iron-metabolism-related genes,leading to iron accumulation in hepatocytes.CONCLUSION:Decreased expression of hepcidin and ferroportin in SVR patients indicates the importance of hepatocytic iron retention for viral response during pegylated-interferon plus ribavirin treatment. | Motoyuki Kohjima Tsuyoshi Yoshimoto Munechika Enjoji Nobuyoshi Fukushima Kunitaka Fukuizumi Tsukasa Nakamura Miho Kurokawa Nao Fujimori Yusuke Sasaki Yasushi Shimonaka Yusuke Murata Susumu Koyama Ken Kawabe Kazuhiro Haraguchi Yorinobu Sumida Naohiko Harada Masaki Kato Kazuhiro Kotoh Makoto Nakamuta | 2015 | World Journal of Gastroenterology2015，21，11： | 4 |
| 20 | Bronchial bleeding caused by recurrent pneumonia after radical esophagectomy for esophageal cancer显示文摘We herein report a case of bronchial bleeding afterradical esophagectomy that was treated with lobectomy.A 65-year-old male who underwent subtotal esophagectomy with three-field lymph node dissection for esophageal carcinoma was referred to our hospital because of sudden hemoptysis.After the esophagectomy,bilateral vocal cord paralysis was observed,and the patient suffered from repeated episodes of aspiration pneumonia.Bronchoscopy revealed hemosputum in the right middle lobe bronchus,and contrast-enhanced computed tomography showed tortuous arteries arising from the right inferior phrenic artery and left subclavian artery toward the right middle lobe bronchus.Although bronchial arterial embolization was performed twice to control the recurrent hemoptysis,the procedures were unsuccessful.Right middle lobectomy was therefore performed via video-assisted thoracic surgery.Engorged bronchial arterys with medial hypertrophy and overgrowth of the small branches were noted near the bronchus in the resected specimen.The patient recovered uneventfully and was discharged on postoperative day 14. | Toshihiro Kitajima Kota Momose Seigi Lee Shusuke Haruta Masaki Ueno Hisashi Shinohara Sakashi Fujimori Takeshi Fujii Ryoji Takei Tadasu Kohno Harushi Udagawa | 2015 | World Journal of Gastroenterology2015，21，11： | 3 |
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