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| 1 | Diagnostic value of antigenemia assay for cytomegalovirus gastrointestinal disease in immunocompromised patients显示文摘AIM:To investigate the utility of the cytomegalovirus(CMV)antigenemia assay for the diagnosis of CMV gastrointestinal disease(GID). METHODS:One hundred and thirty immunocompromised patients were enrolled in this study.Patients with a history of anti-CMV treatment and who had not undergone examination using the antigenemia assay were excluded.CMV-GID was defined as the detection of large cells with intranuclear inclusions alone or associated with granular cytoplasmic inclusions by biopsy.Biopsy sections were stained with hematoxylin and eosin and immunohistochemically stained with anti-CMV.We evaluated the association between CMV-GID and patient characteristics(symptoms,underlying disease,medication,leukocyte counts,and antigenemia assay).All patients were checked with an human immunodeficiency virus(HIV)antibody test before endoscopic examination.White blood cell(WBC)counts were obtained from medical records within 1 wk of endoscopy.Leukopenia was defined as a total WBC count<5000 cells/mm 3 . For HIV patients,we also checked CD4+counts from medical records. RESULTS:A total of 99 patients were retrospectively selected for analysis.Of the immunocompromised patients,19 had malignant disease,18 had autoimmune disease,19 had disorders of biochemical homeostasis, three had undergone transplantation,and 45 had HIV infection.A total of 50 patients had received immunosuppressive therapy.No patients had inflammatory bowel disease.Fifty-five patients were diagnosed as having CMV-GID.Univariate analysis indicated an association between HIV infection,leukopenia,and positive antigenemia and CMV-GID(P<0.05).Multivariate analysis using logistic regression revealed that HIV infection and positive antigenemia were the only independent factors related to CMV-GID(P<0.01).The sensitivity,specificity,positive predictive value,and negative predictive value of antigenemia for CMV-GID were 65.4%,93.6%, 91.9%,and 71.0%,respectively.In a subgroup analy-sis,patients with leukopenia displayed low sensitivity and high specificity.Minimal differences in accuracy were seen among patients with or without leukopenia. HIV-infected patients displayed low sensitivity and high specificity.Accuracy barely differed between HIV-positive and-negative patients.In HIV-infected patients, CD4 count<50 cells/μL resulted in low sensitivity and high specificity.Differences in accuracy among patients were minor,regardless of CD4 count.In patients who had undergone both quantitative real-time polymerase chain reaction(PCR)and antigenemia assay,real-time PCR was slightly more accurate in terms of sensitivity than the antigenemia assay;however,this difference was not statistically significant(P=0.312). CONCLUSION:If the antigenemia test is positive,endoscopic lesions are acceptable for the diagnosis of CMVGID without biopsy.The accuracy is not affected by HIV infection and leukopenia.Either PCR or the antigenemia assay are valid. | Naoyoshi Nagata Masao Kobayakawa Takuro Shimbo Kazufusa Hoshimoto Tomoyuki Yada Takuji Gotoda Junichi Akiyama Shinichi Oka Naomi Uemura | 2011 | World Journal of Gastroenterology2011，17，9： | 3 |
| 2 | Endoscopic appearance of AIDS-related gastrointestinal lymphoma with c-MYC rearrangements: Case report and literature review显示文摘Acquired immune deficiency syndrome (AIDS)-related lymphoma (ARL) remains the main cause of AIDS-related deaths in the highly active anti-retroviral therapy (HAART) era. Recently, rearrangement of MYC is associated with poor prognosis in patients with diffuse large B-cell lymphoma. Here, we report a rare case of gastrointestinal (GI)-ARL with MYC rearrangements and coinfected with Epstein-Barr virus (EBV) infection presenting with various endoscopic findings. A 38-yearold homosexual man who presented with anemia and was diagnosed with an human immunodeficiency virus infection for the first time. GI endoscopy revealed multiple dish-like lesions, ulcerations, bloody spots, nodular masses with active bleeding in the stomach, erythematous flat lesions in the duodenum, and multiple nodular masses in the colon and rectum. Magnified endoscopy with narrow band imaging showed a honeycomb-like pattern without irregular microvessels in the dish-like lesions of the stomach. Biopsy specimens from the stomach, duodenum, colon, and rectum revealed diffuse large B-cell lymphoma concomitant with EBV infection that was detected by high tissue EBV-polymerase chain reaction levels and Epstein-Barr virus small RNAs in situ hybridization. Fluorescence in situ hybridization analysis revealed a fusion between the immunoglobulin heavy chain (IgH) and c-MYC genes, but not between the IgH and BCL2 loci. After 1-mo of treatment with HAART and R-CHOP, endoscopic appearance improved remarkably, and the histological features of the biopsy specimens revealed no evidence of lymphoma. However, he died from multiple organ failure on the 139 th day after diagnosis. The cause of his poor outcome may be related to MYC rearrangement. The GI tract involvement in ARL is rarely reported, and its endoscopic findings are various and may be different from those in non-AIDS GI lymphoma; thus, we also conducted a literature review of GI-ARL cases. | Shohei Tanaka Naoyoshi Nagata Sohtaro Mine Toru Igari Taiichiro Kobayashi Jun Sugihara Haruhito Honda Katsuji Teruya Yoshimi Kikuchi Shinichi Oka Naomi Uemura | 2013 | World Journal of Gastroenterology2013，19，29： | 3 |
| 3 | Easy fixation effects the prevention of Peterson’s hernia and Roux stasis syndrome显示文摘BACKGROUND Laparoscopic distal gastrectomy(LDG)for gastric cancer has been progressed and popular in Japan,since it was first described in 1994.Several reconstruction methods can be adopted according to remnant stomach size,and balance of pros and cons.Roux-en-Y(R-Y)reconstruction is a one of standard options after LDG.Its complications include Petersen’s hernia and Roux stasis syndrome.Here we report our ingenious attempt,fixation of Roux limb and duodenal stump,for decreasing the development of Petersen’s hernia and Roux stasis syndrome.AIM To develop a method to decrease the development of Petersen’s hernia and Roux stasis syndrome.METHODS We performed ante-colic R-Y reconstruction after LDG.After R-Y reconstruction,we fixed Roux limb onto the duodenal stump in a smooth radian.Via this small improvement in Roux limb,Roux limb was placed to the right of the ligament of Treitz.This not only changed the anatomy of the Petersen’s defect,but it also kept a fluent direction of gastrointestinal anastomosis and avoided a cross-angle after jejunojejunostomy.31 patients with gastric cancer was performed this technique after R-Y reconstruction.Clinical parameters including clinicopathologic characteristics,perioperative outcomes,postoperative complication and follow-up data were evaluated.RESULTS The operative time was(308.0±84.6 min).This improvement method took about 10 min.Two(6.5%)patients experienced pneumonia and pancreatitis,respectively.No patient required reoperation or readmission.All patients were followed up for at least 3 year,and none of the patients developed postoperative complications related to internal hernia or Roux stasis syndrome.CONCLUSION This 10 min technique is a very effective method to decrease the development of Petersen’s hernia and Roux stasis syndrome in patients who undergo LDG. | Jian-Zhong Wu Hajime Orita Shun Zhang Hiroyuki Egawa Yukinori Yube Sanae Kaji Shinichi Oka Tetsu Fukunaga | 2020 | World Journal of Gastrointestinal Surgery2020，12，8： | 2 |
| 4 | Nicotinamide phospho- ribosyl- transferase regulates cell survival through nad+synthesis in cardiac myocytes显示文摘 | Chiao-Po Hsu Shinichi Oka Dan Shao et a/ | 2009 | Cite Res2009，105，5： | 1 |
| 5 | Silent Information Regulator 1 Protects the Heart From Ischemia/Reperfusion显示文摘 | Chiao-Po Hsu Peiyong Zhai Takanobu Yamamoto Yasuhiro Maejima Shouji Matsushima Nirmala Hariharan Dan Shao Hiromitsu Takagi Shinichi Oka Junichi Sadoshima | 2010 | Circulation2010，，21： | 1 |
| 6 | The expression of vascular endothelial growth factor and proliferative activity of cancer cells in gastric cancer显示文摘 | M. Ikeguchi Shinichi Oka Hiroaki Saito Akira Kondo Shunichi Tsujitani Michio Maeta Nobuaki Kaibara | 1999 | Langenbeck’s Archives of Surgery1999，，3： | 1 |
| 7 | Less invasive surgery for early gastric cancer based on the low probability of lymph node metastasis显示文摘 | Shunichi Tsujitani Shinichi Oka Hiroaki Saito Akira Kondo Masahide Ikeguchi Michio Maeta Nobuaki Kaibara | 1999 | Surgery1999，，2： | 1 |
| 8 | Visible-light active photocatalytic WO3 films loaded with Pt nanoparticles deposited by sputtering显示文摘 | Murata Akiyo Oka Nobuto Nakamura Shinichi | 2012 | J NanosciNanotechnol2012，12，6： | 1 |
| 9 | 隧道墙附近火源火灾热气流的计算流体动力学(英文)显示文摘运用CFD进行数字模拟,以了解纵向通风隧道内热烟气流的特性。通过模拟发现对火源进行模拟非常重要,热烟气流特性受火源位置的影响很大,并且对火源模拟方法很敏感。火源生成的火焰区是燃烧引起的化学反应区域。即使火源附近的木垛排列完好,也很难在考虑这些化学反应条件下模拟热生成区域。建议考虑纵向通风隧道内火焰形状并对它进行数字模拟。模拟结果与试验结果非常吻合。试验证明,在纵向通风隧道内,热烟气流从靠近墙体火源处顺风向隧道中心蔓延。数字模拟结果发现,火灾羽流造成的螺旋上升空气会在墙体和羽流之间形成一个涡流区。 | OSAMU IMAZEKI HITOSHI KURIOKA YASUSHI OKA SHINICHI TAKIGAWA REIKO AMANO | 2007 | 消防科学与技术2007，26，2： | 0 |
| 10 | Diagnostic value of endothelial markers and HHV-8 staining in gastrointestinal Kaposi sarcoma and its difference in endoscopic tumor staging显示文摘AIM: To clarify the diagnostic values of hematoxylin and eosin (HE), D2-40, CD31, CD34, and HHV-8 immunohistochemical (IHC) staining in gastrointestinal Kaposi's sarcoma (GI-KS) in relation to endoscopic tumor staging. METHODS: Biopsy samples (n = 133) from 41 human immunodeficiency virus-infected patients were reviewed. GI-KS was defined as histologically negative for other GI diseases and as a positive clinical response to KS therapy. The receiver operating characteristic area under the curve (ROC-AUC) was compared in relation to lesion size, GI location, and macroscopic appearances on endoscopy. RESULTS: GI-KS was confirmed in 84 lesions (81.6%). Other endoscopic findings were polyps (n = 9), inflammation (n = 4), malignant lymphoma (n = 4), and condyloma (n = 2), which mimicked GI-KS on endoscopy. ROC-AUC of HE, D2-40, blood vessel markers, and HHV-8 showed results of 0.83, 0.89, 0.80, and 0.82, respectively. For IHC staining, the ROC-AUC of D2-40 was significantly higher (P < 0.05) than that of HE staining only. In the analysis of endoscopic appearance, the ROC-AUC of HE and IHC showed a tendency toward an increase in tumor staging (e.g. , small to large, patches, and polypoid to SMT appearance). D2-40 was significantly (P < 0.05) advantageous in the upper GI tract and for polypoid appearance compared with HE staining. CONCLUSION: The diagnostic value of endothelial markers and HHV-8 staining was found to be high, and its accuracy tended to increase with endoscopic tumor staging. D2-40 will be useful for complementing HE staining in the diagnosis of GI-KS, especially in the upper GI tract and for polypoid appearance. | Naoyoshi Nagata Toru Igari Takuro Shimbo Katsunori Sekine Junichi Akiyama Yohei Hamada Hirohisa Yazaki Norio Ohmagari Katsuji Teruya Shinichi Oka Naomi Uemura | 2013 | World Journal of Gastroenterology2013，19，23： | 0 |
| 11 | Long-term outcomes of postgastrectomy syndrome after total laparoscopic distal gastrectomy using the augmented rectangle technique显示文摘BACKGROUND For total laparoscopic distal gastrectomies for gastric cancer,the reconstruction method is critical to the clinical outcome of the procedure.However,which reconstruction technique is optimal remains controversial.We originally reported the augmented rectangle technique(ART)as a reconstruction option for total laparoscopic Billroth I reconstructions.Still,little is known about its effect on long-term outcomes,specifically the incidence of postgastrectomy syndrome and its impact on quality of life.AIM To analyze postgastrectomy syndrome and quality of life after ART using the Postgastrectomy Syndrome Assessment Scale-37(PGSAS-37)questionnaire.METHODS At Juntendo University,a total of 94 patients who underwent ART for Billroth I reconstruction with total laparoscopic distal gastrectomies for gastric cancer between July 2016 and March 2020 completed the PGSAS-37 questionnaire.Multidimensional analysis was performed,comparing those 94 ART cases from our institution(ART group)to 909 distal gastrectomy cases with a Billroth I reconstruction from other Japanese institutions who also completed the PGSAS-37 as part of a larger national database(PGSAS group).RESULTS Patients in the ART group had significantly better total symptom scores in all the symptom subscales(i.e.,esophageal reflux,abdominal pain,meal-related distress,indigestion,diarrhea,constipation,and dumping).The loss of body weight was marginally greater for those in the ART group than in the PGSAS group(-9.3%vs-7.9%,P=0.054).The ART group scored significantly lower in their dissatisfaction of ongoing symptoms,during meals,and with daily life.CONCLUSION ART for Billroth I reconstruction provided beneficial long-term results for postgastrectomy syndrome and quality of life in patients undergoing total laparoscopic distal gastrectomies for gastric cancer. | Suguru Yamauchi Hajime Orita Jun Chen Hiroki Egawa Yutaro Yoshimoto Akira Kubota Ryota Matsui Yukinori Yube Sanae Kaji Shinichi Oka Malcolm V Brock Tetsu Fukunaga | 2022 | World Journal of Gastrointestinal Surgery2022，14，2： | 0 |
| 12 | Effectiveness and safety of a laparoscopic training system combined with modified reconstruction techniques for total laparoscopic distal gastrectomy显示文摘BACKGROUND Total laparoscopic distal gastrectomy(TLDG)is increasing due to some advantages over open surgery,which has generated interest in gastrointestinal surgeons.However,TLDG is technically demanding especially for lymphadenectomy and gastrointestinal reconstruction.During the course of training,trainee surgeons have less chances to perform open gastrectomy compared with that of senior surgeons.AIM To evaluate an appropriate,efficient and safe laparoscopic training procedures suitable for trainee surgeons.METHODS Ninety-two consecutive patients with gastric cancer who underwent TLDG plus Billroth I reconstruction using an augmented rectangle technique and involving trainees were reviewed.The trainees were taught a laparoscopic view of surgical anatomy,standard operative procedures and practiced essential laparoscopic skills.The TLDG procedure was divided into regional lymph node dissections and gastrointestinal reconstruction for analyzing trainee skills.Early surgical outcomes were compared between trainees and trainers to clarify the feasibility and safety of TLDG performed by trainees.Learning curves were used to assess the utility of our training system.RESULTS Five trainees performed a total of 52 TLDGs(56.5%),while 40 TLDGs were conducted by two trainers(43.5%).Except for depth of invasion and pathologic stage,there were no differences in clinicopathological characteristics.Trainers performed more D2 gastrectomies than trainees.The total operation time was significantly longer in the trainee group.The time spent during the lesser curvature lymph node dissection and the Billroth I reconstruction were similar between the two groups.No difference was found in postoperative complications between the two groups.The learning curve of the trainees plateaued after five TLDG cases.CONCLUSION Preparing trainees with a laparoscopic view of surgical anatomy,standard operative procedures and practice in essential laparoscopic skills enabled trainees to perform TLDG safely and feasibly. | Shun Zhang Hajime Orita Hiroyuki Egawa Ryota Matsui Suguru Yamauchi Yukinori Yube Sanae Kaji Toru Takahashi Shinichi Oka Noriyuki Inaki Tetsu Fukunaga | 2020 | World Journal of Gastroenterology2020，26，13： | 0 |
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