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| 1 | Blockade of high mobility group box-1 protein attenuates experimental severe acute pancreatitis显示文摘AIM: To examine the effects of anti-high mobility group box 1 (HMGB1) neutralizing antibody in experimental se-vere acute pancreatitis (SAP).METHODS: SAP was induced by creating closed duode-nal loop in C3H/HeN mice. SAP was induced immediately after intraperitoneal injection of anti-HMGB1 neutralizing antibody (200 μg). Severity of pancreatitis, organ injury (liver, kidney and lung), and bacterial translocation to pancreas was examined 12 h after induction of SAP.RESULTS: Anti-HMGB1 neutralizing antibody significant-ly improved the elevation of the serum amylase level and the histological alterations of pancreas and lung in SAP. Anti-HMGB1 antibody also significantly ameliorated the elevations of serum alanine aminotransferase and cre-atinine in SAP. However, anti-HMGB1 antibody worsened the bacterial translocation to pancreas.CONCLUSION: Blockade of HMGB1 attenuated the development of SAP and associated organ dysfunction, suggesting that HMGB1 may act as a key mediator for inflammatory response and organ injury in SAP. | Hidehiro Sawa Takashi Ueda Yoshifumi Takeyama Takeo Yasuda Makoto Shinzeki Takahiro Nakajima Yoshikazu Kuroda | 2006 | World Journal of Gastroenterology2006，12，47： | 45 |
| 2 | A case of invasive hemolymphangioma of the pancreas显示文摘Hemolymphangioma of the pancreas is a very rare benign tumor. There were only five reports of this disease until March 2008. Herein, we report a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to duodenal invasion. A 53-year-old man had been admitted a referral hospital because of severe anemia due to gastrointestinal bleeding in December 2005. He was then transferred to our institute with a diagnosis of a tumor of the head of the pancreas with duodenal invasion in January 2006. No abnormalities were revealed except for anemia in laboratory data including CEA and CA19-9. Gastrointestinal endoscopy revealed bleeding at the duodenum. Computed tomography also demonstrated a heterogenous mass at the pancreatic head and suspected invasion to the duodenal wall. Ultrasonography showed a huge mass at the pancreatic head with a mixture of high and low echoic areas. Pylorous-preserving pancreatoduodenectomy was performed. The pancreatic tumor was soft and had invaded to the duodenum. The pathological diagnosis was a hemolymphangioma of the pancreas invaded to the duodenum. His postoperative course was uneventful and he was discharged on the 26th d after surgery. Hemolymphangioma of the pancreas is a very rare benign tumor. In a literature review until March 2008, we found five case reports. Major symptoms are abdominal pain and distension due to the enlarged tumor. However, we experienced a case of hemolymphangioma of the pancreas with gastrointestinal bleeding due to invasion to the duodenum. This disease is a very rare entity, but should be considered when patients have gastrointestinal bleeding. | Yoshikazu Toyoki Kenichi Hakamada Shunji Narumi Masaki Nara Daisuke Kudoh Keinosuke Ishido Mutsuo Sasaki | 2008 | World Journal of Gastroenterology2008，14，18： | 26 |
| 3 | 非球面表面形状的线测量技术显示文摘描述了一种在超精密磨削机床上基于误差分离法的非球面表面形状精密测量系统 .首先 ,论述了一般用于平面形状测量的两点法不能直接用于非球面形状测量的原因在于测头的设置误差会引起很大的形状测量误差 .提出了先通过两点法测量平面形状得出机床的运动误差 ,然后对测量非球面形状的另外一个测头的输出进行补偿以得出正确的非球面形状 .用此系统测量了一个直径为 3 0mm的非球面镜头的表面形状 . | ARAI Yoshikazu 高伟 SHIMIZU Hiroki KIYONO Satoshi KURIYAGAWA Tsunemoto | 2004 | 纳米技术与精密工程2004，2，3： | 20 |
| 4 | 为胃的癌症的内视镜的 submucosal 解剖的支持的技术和设备显示文摘 The indications for endoscopic treatment have expanded in recent years,and relatively intestinal-type mucosal stomach carcinomas with a low potential for metastasis are now often resected en bloc by endoscopic submucosal dissection(ESD),even if they measure over 20 mm in size.However,ESD requires complex maneuvers,which entails a long operation time,and is often accompanied by complications such as bleeding and perforation.Many technical developments have been implemented to overcome these complications.The scope,cutting device,hemostasis device,and other supportive devices have been improved.However,even with these innovations,ESD remains a potentially complex procedure.One of the major difficulties is poor visualization of the submucosal layer resulting from the poor countertraction afforded during submucosal dissection.Recently,countertraction devices have been developed.In this paper,we introduce countertraction techniques and devices mainly for gastric cancer. | Nobuyuki Sakurazawa Shunji Kato Itsuo Fujita Yoshikazu Kanazawa Hiroyuki Onodera Eiji Uchida | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，6： | 18 |
| 5 | Sentinel Node Mapping for Gastric Cancer: A Prospective Multicenter Trial in Japan显示文摘 | Yuko Kitagawa Hiroya Takeuchi Yu Takagi Shoji Natsugoe Masanori Terashima Nozomu Murakami Takashi Fujimura Hironori Tsujimoto Hideki Hayashi Nobunari Yoshimizu Akinori Takagane Yasuhiko Mohri Kazuhito Nabeshima Yoshikazu Uenosono Shinichi Kinami Junichi S | 2013 | Journal of Clinical Oncology2013，，29： | 11 |
| 6 | An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture显示文摘AIM: To clarify the usefulness of a new method for performing a pancreaticojejunostomy by using a fast-absorbable suture material irradiated polyglactin 910, and a temporary stent tube for a narrow pancreatic duct with a soft pancreatic texture.METHODS: Among 63 consecutive patients with soft pancreas undergoing a pancreaticoduodenectomy from 2003 to 2006, 35 patients were treated with a new reconstructive method. Briefly, after the pancreatic transaction, a stent tube was inserted into the lumen of the pancreatic duct and ligated with it by a fast-absorbable suture. Another tip of the stent tube was introduced into the intestinal lumen at the jejunal limb, where a purse-string suture was made by another fast-absorbable suture to roughly fix the tube. The pancreaticojejunostomy was completed by ligating two fast-absorbable sutures to approximate the ductal end and the jejunal mucosa, and by adding a rough anastomosis between the pancreatic parenchyma and the seromuscular layer of the jejunum. The initial surgical results with this method were retrospectively compared with those of the 28 patients treated with conventional duct-to-mucosa anastomosis.RESULTS: The incidences of postoperative morbidity including pancreatic fistula were comparable between the two groups (new; 3%-17% vs conventional; 7%-14% according to the definitions). There was no mortality and re-admission. Late complications were also rarely seen.CONCLUSION: A pancreaticojejunostomy using an irradiated polyglactin 910 suture material and a temporary stent is easy to perform and is feasible even in cases with a narrow pancreatic duct and a normal soft pancreas. | Kenichi Hakamada Shunji Narumi Yoshikazu Toyoki Masaki Nara Kenosuke Ishido Takuya Miura Norihito Kubo Mutsuo Sasaki | 2008 | World Journal of Gastroenterology2008，14，7： | 9 |
| 7 | Unsedated transnasal small-caliber esophagogastroduoden oscopy in elderly and bedridden patients显示文摘AIM:To evaluate the safety of unsedated transnasal small-caliber esophagogastroduodenoscopy(EGD)for elderly and critically ill bedridden patients. METHODS:One prospective randomized comparative study and one crossover comparative study between transnasal small-caliber EGD and transoral conventional EGD was done(Study 1).For the comparative study, we enrolled 240 elderly patients aged>65 years old. For the crossover analysis,we enrolled 30 bedridden patients with percutaneous endoscopic gastrostomy (PEG)(Study 2).We evaluated cardiopulmonary effects by measuring arterial oxygen saturation(SpO2)and calculating the rate-pressure product(RPP)(pulse rate×systolic blood pressure/100)at baseline,2 and 5 min after endoscopic intubation in Study 1.To assess the risk for endoscopy-related aspiration pneumoniaduring EGD,we also measured blood leukocyte counts and serum C-reactive protein(CRP)levels before and 3 d after EGD in Study 2. RESULTS:In Study 1,we observed significant decreases in SpO2 during conventional transoral EGD, but not during transnasal small-caliber EGD(0.24%vs -0.24%after 2 min,and 0.18%vs-0.29%after 5 min, P=0.034,P=0.044).Significant differences of the RPP were not found between conventional transoral and transnasal small-caliber EGD.In Study 2,crossover analysis showed statistically significant increases of the RPP at 2 min after intubation and the end of endoscopy (26.8 and 34.6 vs 3.1 and 15.2,P=0.044,P=0.046), and decreases of SpO2(-0.8%vs-0.1%,P=0.042) during EGD with transoral conventional in comparison with transnasal small-caliber endoscopy.Thus,for bedridden patients with PEG feeding,who were examined in the supine position,transoral conventional EGD more severely suppressed cardiopulmonary function than transnasal small-caliber EGD.There were also significant increases in the markers of inflammation, blood leukocyte counts and serum CRP values,in bedridden patients after transoral conventional EGD,but not after transnasal small-caliber EGD performed with the patient in the supine position.Leukocyte count increased from 6053±1975/L to 6900±3392/L(P=0.0008)and CRP values increased from 0.93±0.24 to 2.49±0.91 mg/dL(P=0.0005)at 3 d after transoral conventional EGD.Aspiration pneumonia,possibly caused by the endoscopic examination,was found subsequently in two of 30 patients after transoral conventional EGD. CONCLUSION:Transnasal small-caliber EGD is a safer method than transoral conventional EGD in critically ill, bedridden patients who are undergoing PEG feeding. | Mika Yuki Yuji Amano Yoshinori Komazawa Hiroyuki Fukuhara Toshihiro Shizuku Shun Yamamoto Yoshikazu Kinoshita | 2009 | World Journal of Gastroenterology2009，15，44： | 8 |
| 8 | Usefulness of vonoprazan,a potassium ion-competitive acid blocker,for primary eradication of Helicobacter pylori显示文摘AIM To investigate usefulness of triple therapy with vonoprazan,a potassium ion-competitive acid blocker and antibiotics,for Helicobacter pylori(H.pylori) eradication.METHODS The H.pylori eradication rate was examined in 2507 patients(2055 undergoing primary eradication and 452 undergoing secondary eradication,excluding patients with subtotal gastrectomy) at the Japanese Red Cross Kyoto Daiichi Hospital from March 2013 to September 2015.For patients treated from March 2013 to February 2015,a proton pump inhibitor(PPI) was used to reduce acid secretion,while vonoprazan was used after March 2015.The success rates of the 2 regimens(PPI + amoxicillin + clarithromycin/metronidazole,or vonoprazan + amoxicillin + clarithromycin/metronidazole) were compared.RESULTS The success rate of primary H.pylori eradication was significantly higher in the vonoprazan group.When stratified by the underlying disease,a significant increase of the H.pylori eradication rate was observed in patients with chronic gastritis.A significantly lower H.pylori eradication rate was observed in younger patients compared to older patients in the PPI group,but there was no difference according to age in the vonoprazan group.On the otherhand,the success rate of secondary eradication was similar at approximately 90% in both groups.CONCLUSION Vonoprazan is very useful for primary eradication of H.pylori,and may become a first-line acid secretion inhibitor instead of PPIs. | Shinya Yamada Takumi Kawakami Yoshikazu Nakatsugawa Takahiro Suzuki Hideki Fujii Naoya Tomatsuri Hideki Nakamura Hideki Sato Yusuke Okuyama Hiroyuki Kimura Norimasa Yoshida | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，4： | 8 |
| 9 | Single-Walled Carbon Nanotube Growth with Non-Iron- Group “Catalysts” by Chemical Vapor Deposition显示文摘Various materials have been found to“catalyze”carbon nanotube growth in chemical vapor deposition(CVD)when they become nano-sized particles.These involve not only metals,such as Pd,Pt,Au,Ag,and Cu,but also semiconductors,such as Si,Ge,and SiC.Alumina and diamond nanoparticles also produce carbon nanotubes.These“catalysts”,which are better called“seeds”,can be categorized into two types:one type forms a eutectic liquid or highly-mobile alloy with carbon,and carbon atoms precipitate from the eutectic alloy;the other type remains as a solid phase and form a carbon surface layer during CVD growth.In this paper,we review recent studies of SWCNT growth with these non-iron-group materials and highlight the mechanisms involved. | Yoshikazu Homma Huaping Liu Daisuke Takagi Yoshihiro Kobayashi | 2009 | Nano Research2009，2，10： | 6 |
| 10 | Clinical outcomes of enteroscopy using the double-balloon method for strictures of the small intestine显示文摘AIM: To evaluate the clinical outcome of enteroscopy, using the double-balloon method, focusing on the involvement of neoplasms in strictures of the small intestine.METHODS: Enteroscopy, using the double-balloon method, was performed between December 1999 and December 2002 at Jichi Medical School Hospital, Japan and strictures of the small intestine were found in 17 out of 62 patients. These 17 consecutive patients were subjected to analysis.RESULTS: The double-balloon enteroscopy contributed to the diagnosis of small intestinal neoplasms found in 3out of 17 patients by direct observation of the strictures as well as biopsy sampling. Surgical procedures were chosen for these three patients, while balloon dilation was chosen for the strictures in four patients diagnosed with inflammation without involvement of neoplasm.CONCLUSION: Double-balloon enteroscopy is a useful method for the diagnosis and treatment of strictures in the small bowel. | Keijiro Sunada Hironori Yamamoto Hiroto Kita Tomonori Yano Hiroyuki Sato Yoshikazu Hayashi Tomohiko Miyata Yutaka Sekine Akiko Kuno Michiko Iwamoto Hirohide Ohnishi Kenichi Ido Kentaro Sugano | 2005 | World Journal of Gastroenterology2005，11，7： | 6 |
| 11 | Non-steroidal anti-inflammatory drug-induced small bowel injuries identified by double-balloon endoscopy显示文摘AIM: To clarify clinical features of the NSAID-induced small bowel lesions using a new method of endoscopy.METHODS: This is a retrospective study and we analyzed seven patients with small bowel lesions while taking NSAIDs among 61 patients who had undergone doubleballoon endoscopy because of gastro-intestinal bleeding or anemia between September 2000 and March 2004, at Jichi Medical School Hospital in Japan. Neither conventional EGD nor colonoscopy revealed any lesions of potential bleeding sources including ulcerations. Double-balloon endoscopy was carried out from oral approach in three patients, from anal approach in three patients, and from both approaches in one patient.RESULTS: Ulcers or erosions were observed in the ileum in six patients and in the jejunum in one patient, respectively.The ulcers were multiple in all the patients with different features from tiny punched out ulcers to deep ulcerations with oozing hemorrhage or scar. All the patients recovered uneventfully and had full resolution of symptoms after suspension of the drug.CONCLUSION: NSAIDs can induce injuries in the small bowel even in patients without any lesions in both the stomach and colon. | Yoshikazu Hayashi Hironori Yamamoto Hiroto Kita Keijiro Sunada Hiroyuki Sato Tomonori Yano Michiko Iwamoto Yutaka Sekine Tomohiko Miyata Akiko Kuno Takaaki Iwaki Yoshiyuki Kawamura Hironari Ajibe Kenichi Ido Kentaro Sugano | 2005 | World Journal of Gastroenterology2005，11，31： | 6 |
| 12 | MK615 decreases RAGE expression and inhibits TAGE-induced proliferation in hepatocellular carcinoma cells显示文摘AIM:To investigate the proliferative effect of advanced glycation end-products(AGEs) and the role of their cellular receptor(RAGE) on hepatocellular carcinoma(HCC) cells,and the inhibitory effects of MK615,an extract from Japanese apricot,against AGEs were also evaluated.METHODS:Two HCC cell lines,HuH7 and HepG2,were used.Expression of RAGE was investigated by poly-merase chain reaction,Western blotting,and flow cytemetry(FACS).The effect of MK615 on RAGE expression was also evaluated by FACS.The proliferative effects of a control(unglycated bovine serum albumin),glucosederived AGEs(Glc-AGE),and glyceraldehyde-derived AGEs(Glycer-AGE),and the anti-proliferative effect of MK615 against AGEs,were evaluated using MTT assays.RESULTS:Expression of RAGE was confirmed at both the mRNA and protein levels in both HuH7 and HepG2.FACS revealed that the level of RAGE expression was higher in HuH7 than in HepG2.Treatment with 0.1 μg/mL MK615 decreased the expression level of RAGE from 24.3% to 3.7% in HuH7 and from 6.2% to 4.8% in HepG2.The growth indices for the control,Glc-AGE,and Glycer-AGE were 1.06 ± 0.08,0.99 ± 0.04,and 1.38 ± 0.05,respectively,in HuH7(P = 0.037),and were 1.03 ± 0.04,1.04 ± 0.03,and 1.07 ± 0.05,respectively,in HepG2(P > 0.05).When the cells were cultured simultaneously with Glycer-AGE and MK615,MK615 abrogated the proliferative effect of Glycer-AGE in HuH7.CONCLUSION:Only Glycer-AGE has a proliferative effect on HuH7,which expresses a higher level of RAGE.MK615 suppresses the proliferative effect of GlycerAGE on HuH7 by decreasing the expression of RAGE. | Yuhki Sakuraoka Tokihiko Sawada Toshie Okada Takayuki Shiraki Yoshikazu Miura Katsuya Hiraishi Tatsushi Ohsawa Masakazu Adachi Jun-ichi Takino Masayoshi Takeuchi Keiichi Kubota | 2010 | World Journal of Gastroenterology2010，16，42： | 6 |
| 13 | Intraoperative ultrasound as an educational guide for laparoscopic biliary surgery显示文摘AIM: To analyze the efficacy of routine intraoperative ultrasound (IOUS) as a guide for understanding biliary tract anatomy, to avoid bile duct injury (BDI) after laparoscopic cholecystectomy (LC), as well as any burden during the learning period. METHODS: A retrospective analysis was performed using 644 consecutive patients who underwent LC from 1991 to 2006. An educational program with the use of IOUS as an operative guide has been used in 276 cases since 1998. RESULTS: IOUS was highly feasible even in patients with high-grade cholecystitis. No BDI was observed after the introduction of the educational program, despite 72% of operations being performed by inexperienced surgeons. Incidences of other morbidity, mortality, and late complications were comparable before and after the introduction of routine IOUS. However, the operation time was significantly extended after the educational program began (P < 0.001), and the grade of laparoscopic cholecystitis (P = 0.002), use of IOUS (P = 0.01), and the experience of the surgeons (P = 0.05) were significant factors for extending the length of operation. CONCLUSION: IOUS during LC was found to be a highly feasible modality, which provided accurate, real- time information about the biliary structures. Theeducational program using IOUS is expected to minimize the incidence of BDI following LC, especially when performed by less-skilled surgeons. | Kenichi Hakamada Shunji Narumi Yoshikazu Toyoki Masaki Nara Motonari Oohashi Takuya Miura Hiroyuki Jin Syuichi Yoshihara Michihiro Sugai Mutsuo Sasaki | 2008 | World Journal of Gastroenterology2008，14，15： | 6 |
| 14 | CONSTRUCTION OF A GENOMIC DNA LIBRARY WITH ATA VECTOR AND ITS APPLICATION IN CLONING OF THE PHYTOENE SYNTHASE GENE FROM THE CYANOBACTERIUM SPIRULINA PLATENSIS M-135显示文摘An efficient and simple method for constructing a genomic DNA library using a TAcloning vector is presented. It is based on the sonicative cleavage of genomic DNA and modification offragment ends with Taq DNA polymerase, followed by ligation using a TA vector. This method was ap-plied for cloning of the phytoene synthase gene crtB from Spirulina platensis. This method is useful whengenomic DNA cannot be efficiently digested with restriction enzymes, a problem often encountered duringthe construction of a genomic DNA library of cyanobacteria. | Yoshikazu Kawata Shin-ichi Yano Hiroyuki Kojima(Osaka Mational Research Institute. Agency of Industrial Science and Technology, Ikeda, Osaka 563, Japan) | 1998 | Chinese Journal of Oceanology and Limnology1998，16，S1： | 5 |
| 15 | Hemosuccus pancreaticus: Problems and pitfalls in diagnosis and treatment显示文摘Hemosuccus pancreaticus is a rare cause of intermittent upper gastrointestinal bleeding. We report two cases of hemosuccus pancreaticus with multiple episodes of upper gastrointestinal bleeding. The causes of hemorrhage were rupture of pseudoaneurysm of the splenic artery and bleeding from the wall of pancreatic pseudocyst. Interventional radiology is the first modality for early diagnosis and possible treatment of hemosuccus pancreaticus. When angiography shows no abnormal findings or interventional radiological therapy can not be successful, surgery should be considered without delay. Our patients herein underwent surgery without recurrence or sequelae. Intraoperative ultrasonography and pancreatoscopy were helpful modalities for confirming the source of hemorrhage and determining the cutting line of the pancreas. When we encounter intermittent upper gastrointestinal bleeding with an obscure source, hemosuccus pancreaticus should be included in differential diagnoses especially in patients with chronic pancreatitis, which would lead to a prompt and proper treatment. | Yoshikazu Toyoki Kenichi Hakamada Shunji Narumi Masaki Nara Keinosuke Ishido Mutsuo Sasaki | 2008 | World Journal of Gastroenterology2008，14，17： | 5 |
| 16 | Effects of anti-hypertensive drugs on esophageal body contraction显示文摘AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux disease.METHODS:Thirteen healthy male volunteers were enrolled. Esophageal body peristaltic contractions and lower esophageal sphincter (LES) pressure were measured using high resolution manometry. All subjects were randomly examined on four separate occasions following administrations of nifedipine,losartan,and atenolol,as well as without any drug administration.RESULTS:Peristaltic contractions by the esophageal body were separated into three segments by two troughs. The peak peristaltic pressures in the mid and lower segments of the esophageal body under atenolol administration were signifi cantly higher than those without medication in a supine position. On the other hand,peristaltic pressures under nifedipine administration were lower than those observed without drug ad-ministration. Losartan did not change esophageal body peristalsis. Atenolol elevated LES pressure and slowed peristaltic wave transition,while the effects of nifedip-ine were the opposite. CONCLUSION:Among the anti-hypertensive drugs tested,atenolol enhanced esophageal motor activity,which was in contrast to nifedipine. | Koichi Yoshida Kenji Furuta Kyoichi Adachi Shunji Ohara Terumi Morita Takashi Tanimura Shuji Nakata Masaharu Miki Kenji Koshino Yoshikazu Kinoshita | 2010 | World Journal of Gastroenterology2010，16，8： | 4 |
| 17 | Overexpression of S-adenosylmethionine decarboxylase(SAMDC)in Xeno-pus embryos activates maternal program of apoptosis as a 'fail-safe'mechanism of early embryogenesis显示文摘In Xenopus, injection of S-adenosylmethionine decarboxylase (SAMDC) mRNA into fertilized eggs or 2-cell stage embryos induces massive cell dissociation and embryo-lysis at the early gastrula stage due toactivation of the maternal program of apoptosis. We injected SAMDC mRNA into only one of the animalside blastomeres of embryos at different stages of cleavage, and examined the timing of the onset of theapoptotic reaction. In the injection at 4-and 8-cell stages, a considerable number of embryos developed intotadpoles and in the injection at 16-and 32-cell stages, all the embryos became tadpoles, although tadpolesobtained were sometimes abnormal. However, using GFP as a lineage tracer, we found that descendant cellsof the blastomere injected with SAMDC mRNA at 8-to 32-cell stages are confined within the blastocoel atthe early gastrula stage and undergo apoptotic cell death within the blastocoel, in spite of the continued development of the injected embryos. These results indicate that cells overexpressed with SAMDC undergo apoptotic cell death consistently at the early gastrula stage, irrespective of the timing of the mRNA injection.We assume that apoptosis is executed in Xenopus early gastrulae as a 'fall-safe' mechanism to eliminate physiologically-severely damaged cells to save the rest of the embryo. | MASATAKEKAI CHIKARAKAITO HIROSHIFUKAMACHI TAKAYASUHIGO EIJI TAKAYAMA HIROSHI HARA YOSHIKAZU OHYA KAZUEI IGARASHI KOICHIRO SHIOKAWA | 2003 | Cell Research2003，13，3： | 4 |
| 18 | Des-gamma-carboxy prothrombin as an important prognostic indicator in patients with small hepatocellular carcinoma显示文摘AIM:To clarify the effect of a high des-gamma-carboxy prothrombin (DCP) level on the invasiveness and prognosis of small hepatocellular carcinoma. METHODS: Among 142 consecutive patients with known DCP levels, who underwent hepatectomy because of hepatocellular carcinoma, 85 patients met the criteria for small hepatocellular carcinoma, i.e. one ≤ 5 cm sized single tumor or no more than three ≤ 3 cm sized tumors. RESULTS: The overall survival rate of the 142 patients was 92.1% for 1 year, 69.6% for 3 years, and 56.9% for 5 years. Multivariate analysis showed that microscopic vascular invasion (P = 0.03) and serum DCP ≥ 400 mAU/mL (P = 0.02) were independent prognostic factors. In the group of patients who met the criteria for small hepatocellular carcinoma, DCP ≥ 400 mAU/mL was found to be an independent prognostic factor for recurrence-free (P = 0.02) and overall survival (P = 0.0005). In patients who did not meet the criteria, the presence of vascular invasion was an independent factor for recurrence-free (P = 0.02) and overall survivals (P = 0.01). In 75% of patients with small hepatocellular carcinoma and high DCP levels, recurrence occurred extrahepatically. CONCLUSION: For small hepatocellular carcinoma, a high preoperative DCP level appears indicative fortumor recurrence. Because many patients with a high preoperative DCP level develop extrahepatic recurrence, it is necessary to screen the whole body. | Kenichi Hakamada Norihisa Kimura Takuya Miura Hajime Morohashi Keinosuke Ishido Masaki Nara Yoshikazu Toyoki Shunji Narumi Mutsuo Sasaki | 2008 | World Journal of Gastroenterology2008，14，9： | 4 |
| 19 | Laterally spreading tumors:Limitations of computed tomography colonography显示文摘AIM:To prospectively investigate the detection rate of laterally spreading tumors(LSTs)of the colorectum by computed tomography(CT)colonography(CTC).METHODS:Patients with LSTs measuring≥20 mm detected during colonoscopy were prospectively enrolled in the study.All patients underwent colonoscopy and subsequent CTC on the same day.CTC was performed using multi-detector CT without contrast in the prone and supine positions.Two radiologists blinded to the existence of LSTs read the virtual endoscopic images as well as 2-D images.LSTs were classified into granular and non-granular types based on colonoscopic appearance.RESULTS:Forty-seven pathologically proven LSTs were evaluated prospectively.Histology included adenomas in 19,mucosal cancers in 19 and T1 cancers in 9.The mean diameter of the LSTs was 35.1 mm.Twenty-eight(60%)LSTs were correctly identified by CTC,and the configuration was similar to the colonoscopic appearance in most cases.Detection rate for the granular type was significantly higher than that for the nongranular type(71%vs 31%,P=0.013).Detection rate of adenomas was significantly lower than mucosal cancers(32%vs 79%,P=0.008)and T1 cancers(32%vs 78%,P=0.042).CONCLUSION:The detection rate of LSTs by CTC,particularly the non-granular type was not acceptable.Practitioners should be aware of the relatively low detection rate when using CTC. | Kazutomo Togashi Kenichi Utano Shigeyoshi Kijima Yosuke Sato Hisanaga Horie Keijirou Sunada Alan T Lefor Hideharu Sugimoto Yoshikazu Yasuda | 2014 | World Journal of Gastroenterology2014，20，46： | 4 |
| 20 | Factors affecting the quality of life of patients after gastrectomy as assessed using the newly developed PGSAS-45 scale: A nationwide multi-institutional study显示文摘AIM To identify certain clinical factors other than the type of gastrectomy which affect the postoperative quality of life(QOL) of patients after gastrectomy.METHODS The postgastrectomy syndrome assessment scale(PGSAS)-45 was designed to assess the severity of symptoms, the living status and the QOL of gastrectomized patients. It consists of 45 items, of which 22 are original items while 23 were retrieved from the SF-8 and Gastrointestinal Symptoms Rating Scale questionnaires with permission. A nationwide surveillance study to validate PGSAS was conducted and 2368 gastric cancer patients who underwent various types of gastrectomy at 52 medical institutions were enrolled. Of these, 1777 patients who underwent total gastrectomy(TG) reconstructed with Roux-Y(n = 393), distal gastrectomy(DG) reconstructed with Billroth-I(n = 909), or DG reconstructed with Roux-Y(n = 475) were evaluated in the current study. The influence of the type of gastrectomy and other clinical factors such as age, sex, duration after surgery, the symptom severity, the degree of weight loss, dietary intake, and the ability for working on the postoperative QOL(i.e., dissatisfaction for daily life subscale, physical component summary and mental component summary of the SF-8) were examined by multiple regression analysis(MRA). In addition, importance of various symptoms such as esophageal reflux, abdominal pain, meal-related distress, indigestion, diarrhea, constipation and dumping on the postoperative living status and QOL were also appraised by MRA.RESULTS The postoperative QOL were significantly deteriorated in patients who underwent TG compared to those after DG. However, the extent of gastrectomy was not an influential factor on patients' QOL when adjusted by the MRA. Among various clinical factors, the symptom severity, ability for working, and necessity for additional meals were the most influential factorsto the postoperative QOL. As for the individual symptoms, meal-related distress, dumping, abdominal pain, and esophageal reflux significantly affected the postoperative QOL in that order, while the influence of indigestion, diarrhea and constipation was insignificant. CONCLUSION Several clinical factors such as the symptom severity(especially in meal-related distress and dumping), ability for working and necessity for additional meals were the main factors which affected the patients' wellbeing after gastrectomy. | Koji Nakada Masazumi Takahashi Masami Ikeda Shinichi Kinami Masashi Yoshida Yoshikazu Uenosono Yoshiyuki Kawashima Sayumi Nakao Atsushi Oshio Yoshimi Suzukamo Masanori Terashima Yasuhiro Kodera | 2016 | World Journal of Gastroenterology2016，22，40： | 4 |
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