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| 1 | Diagnosis and management of insulinoma显示文摘Insulinomas,the most common cause of hypoglycemia related to endogenous hyperinsulinism,occur in 1-4 people per million of the general population.Common autonomic symptoms of insulinoma include diaphroresis,tremor,and palpitations,whereas neuroglycopenenic symptoms include confusion,behavioural changes,personality changes,visual disturbances,seizure,and coma.Diagnosis of suspected cases is based on standard endocrine tests,especially the prolonged fasting test.Non-invasive imaging procedures,such as computed tomography and magnetic resonance imaging,are used when a diagnosis of insulinoma has been made to localize the source of pathological insulin secretion.Invasive modalities,such as endoscopic ultrasonography and arterial stimulation venous sampling,are highly accurate in the preoperative localization of insulinomas and have frequently been shown to be superior to noninvasive localization techniques.The range of techniques available for the localization of insulinomas means thatblind resection can be avoided.Intraoperative manual palpation of the pancreas by an experienced surgeon and intraoperative ultrasonography are both sensitive methods with which to finalize the location of insulinomas.A high proportion of patients with insulinomas can be cured with surgery.In patients with malignant insulinomas,an aggressive medical approach,including extended pancreatic resection,liver resection,liver transplantation,chemoembolization,or radiofrequency ablation,is recommended to improve both survival and quality of life.In patients with unresectable or uncontrollable insulinomas,such as malignant insulinoma of the pancreas,several techniques should be considered,including administration of ocreotide and/or continuous glucose monitoring,to prevent hypoglycemic episodes and to improve quality of life. | Takehiro Okabayashi Yasuo Shima Tatsuaki Sumiyoshi Akihito Kozuki Satoshi Ito Yasuhiro Ogawa Michiya Kobayashi Kazuhiro Hanazaki | 2013 | World Journal of Gastroenterology2013，19，6： | 78 |
| 2 | Endoscopic diagnosis of sessile serrated adenoma/polyp with and without dysplasia/carcinoma显示文摘Sessile serrated adenoma/polyps(SSA/Ps) are early precursor lesions in the serrated neoplasia pathway, which results in colorectal carcinomas with BRAF mutations, methylation for DNA repair genes, a Cp G island methylator phenotype, and high levels of microsatellite instability. Some of these lesions can rapidly become dysplastic or invasive carcinomas that exhibit high lymphatic invasion and lymph node metastasis potentials. Detecting serrated lesions, including SSA/Ps with and without dysplasia/carcinoma, is critical, but SSA/Ps can be difficult to detect, are inconsistently identified by endoscopists and pathologists, and are often incompletely resected. Therefore, SSA/Ps are considered to be major contributors to 'interval cancers'. If colonoscopists can identify the specific endoscopic characteristics of SSA/Ps, their detection and the effectiveness of colonoscopy may improve. Here, the endoscopic features of SSA/Ps with and without dysplasia/carcinoma, including the characteristics determined using magnifying endoscopy, are reviewed in the context of previous reports. Endoscopically, these subtle polyps are like hyperplastic polyps, because they are slightly elevated and pale. Unlike hyperplastic polyps, SSA/Ps are usually larger than 5 mm, frequently covered by a thin layer called the ‘‘mucus cap'', and are more commonly located in the proximal colon. Magnifying narrow-band imaging findings, which include dark spots inside the crypts and varicose microvascular vessels, in addition to the type II-open pit patterns detected using magnifying chromoendoscopy, effectively differentiate SSA/Ps from hyperplastic polyps. The lesions' endoscopic characteristics, which include their(semi)pedunculated morphologies, double elevations, central depressions, and reddishness, and the use of magnifying endoscopy, might help to detect dysplasia/carcinoma within SSA/Ps. Greater awareness may promote further research into improving the detection, identification, and complete resection rates of SSA/Ps with and without dysplasia/carcinoma and reduce the interval cancer rates. | Takashi Murakami Naoto Sakamoto Akihito Nagahara | 2018 | World Journal of Gastroenterology2018，24，29： | 25 |
| 3 | Clinicopathological features of alpha-fetoprotein producing early gastric cancer with enteroblastic differentiation显示文摘AIM To investigate clinicopathological features of early stage gastric cancer with enteroblastic differentiation(GCED).METHODS We retrospectively investigated data on 6 cases of early stage GCED and 186 cases of early stage conventional gastric cancer(CGC: well or moderately differentiated adenocarcinoma) who underwent endoscopic submucosal dissection or endoscopic mucosal resection from September 2011 to February 2015 in our hospital.GCED was defined as a tumor having a primitive intestine-like structure composed of cuboidal or columnar cells with clear cytoplasm and immunohistochemical positivity for either alpha-fetoprotein, Glypican 3 or SALL4. The following were compared between GCED and CGC: age, gender, location and size of tumor, macroscopic type, ulceration, depth of invasion, lymphatic and venous invasion, positive horizontal and vertical margin, curative resection rate.RESULTS Six cases(5 males, 1 female; mean age 75.7 years; 6 lesions) of early gastric cancer with a GCED component and 186 cases(139 males, 47 females; mean age 72.7 years; 209 lesions) of early stage CGC were investigated. Mean tumor diameters were similar but rates of submucosal invasion, lymphatic invasion, venous invasion, and non-curative resection were higher in GCED than CGC(66.6% vs 11.4%, 33.3% vs 2.3%, 66.6% vs 0.4%, 83.3% vs 11% respectively, P < 0.01). Deep submucosal invasion was not revealed endoscopically or by preoperative biopsy. Histologically, in GCED the superficial mucosal layer was covered with a CGC component. The GCED component tended to exist in the deeper part of the mucosa to the submucosa by lymphatic and/or venous invasion, without severe stromal reaction. In addition, Glypican 3 was the most sensitive marker for GCED(positivity, 83.3%), immunohistochemically.CONCLUSION Even in the early stage GCED has high malignant potential, and preoperative diagnosis is considered difficult. Endoscopists and pathologists should know the clinicopathological features of this highly malignant type of cancer. | Kohei Matsumoto Hiroya Ueyama Kenshi Matsumoto Yoichi Akazawa Hiroyuki Komori Tsutomu Takeda Takashi Murakami Daisuke Asaoka Mariko Hojo Natsumi Tomita Akihito Nagahara Yoshiaki Kajiyama Takashi Yao Sumio Watanabe | 2016 | World Journal of Gastroenterology2016，22，36： | 20 |
| 4 | Peginterferon and ribavirin treatment for hepatitis C virus infection显示文摘Pegylated interferon α (IFNα) in combination with ribavirin is currently recommended as a standard-of-care treatment for chronic hepatitis C virus (HCV) infection. This combination therapy has drastically improved the rate of sustained virological response, specifically in difficult-to-treat patients. Recently, individualized treatment, such as response-guided therapy, is being developed based on host-, HCV- and treatment-related factors. Furthermore, modified regimens with currently available medications, novel modified IFNα and ribavirin or combinations with specifically targeted antiviral therapy for HCV agents, are currently being investigated. The purpose of this review is to address some issues and epoch-making topics in the treatment of chronic HCV infection, and to discuss more optimal and highly individualized therapeutic strategies for HCV-infected patients. | Akihito Tsubota Kiyotaka Fujise Yoshihisa Namiki Norio Tada | 2011 | World Journal of Gastroenterology2011，17，4： | 16 |
| 5 | Factors associated with incomplete colonoscopy at a Japanese academic hospital显示文摘AIM:To evaluate significant risk factors for incomplete colonoscopy at a Japanese academic hospital.METHODS:A total of 11812 consecutive Japanese people were identified who underwent a colonoscopy at an academic hospital.A multiple logistic regression model was used to evaluate retrospectively the significant risk factors for incomplete colonoscopy.RESULTS:The cecal intubation rate was 95.0%.By univariate analysis,age,female sex,poor bowel cleansing,and a history of abdominal or pelvic surgery were significant risk factors for incomplete colonoscopy(P<0.001).Moreover,age-and sex-adjusted analysis showed that significant risk factors for incomplete colonoscopy were female sex(OR=1.38,95%CI:1.17-1.64,P=0.0002),age≥60 years old(OR=1.44,95%CI:1.22-1.71,P<0.0001),a history of prior abdominal or pelvic surgery(OR=1.55,95%CI:1.28-1.86,P<0.0001),poor bowel cleansing(OR=4.64,95%CI:3.69-5.84,P<0.0001),and inflammatory bowel disease(IBD)(OR=1.48,95%CI:1.13-1.95,P=0.0048).In Japanese men,by age-adjusted analysis,IBD(OR=1.69,95%CI:1.18-2.43,P=0.005)was an independent risk factor for incomplete colonoscopy.CONCLUSION:Several characteristics in the Japanese population were identified that could predict technical difficulty with colonoscopy. | Shigeo Koido Toshifumi Ohkusa Kosaburo Nakae Tetsuji Yokoyama Tomoyoshi Shibuya Naoto Sakamoto Kan Uchiyama Hiroshi Arakawa Taro Osada Akihito Nagahara Sumio Watanabe Hisao Tajiri | 2014 | World Journal of Gastroenterology2014，20，22： | 6 |
| 6 | Efficacy of endoluminal gastroplication in Japanese patients with proton pump inhibitor-resistant,non-erosive esophagitis显示文摘AIM:To evaluate the efficacy,safety,and long-term outcomes of endoluminal gastroplication(ELGP) in patients with proton pump inhibitor(PPI)-resistant,nonerosive reflux disease(NERD).METHODS:The subjects were NERD patients,diagnosed by upper endoscopy before PPI use,who had symptoms such as heartburn or reflux sensations two or more times a week even after 8 wk of full-dose PPI treatment.Prior to ELGP,while continuing full-dose PPI medication,patients' symptoms and quality of life(QOL) were assessed using the questionnaire for the diagnosis of reflux disease,the frequency scale for symptoms of gastro-esophageal reflux disease(FSSG),gastrointestinal symptoms rating scale,a 36-item short-form.In addition,24-h esophageal pH monitoring or 24-h intraesophageal pH/impedance(MII-pH) monitoring was performed.The Bard EndoCinch TM was used for ELGP,and 2 or 3 plications were made.After ELGP,all acid reducers were temporarily discontinued,and medication was resumed depending on the development and severity of symptoms.Three mo after ELGP,symptoms,QOL,pH or MII-pH monitoring,number of plications,and PPI medication were evaluated.Further,symptoms,number of plications,and PPI medication were evaluated 12 mo after ELGP to investigate long-term effects.RESULTS:The mean FSSG score decreased significantly from before ELGP to 3 and 12 mo after ELGP(19.1 ± 10.5 to 10.3 ± 7.4 and 9.3 ± 9.9,P < 0.05,respectively).The total number of plications decreased gradually at 3 and 12 mo after ELGP(2.4 ± 0.8 to 1.2 ± 0.8 and 0.8 ± 1.0,P < 0.05,respectively).The FSSG scores in cases with no remaining plications and in cases with one or more remaining plications were 4.4 and 2.7,respectively,after 3 mo,and 2.0 and 2.8,respectively,after 12 mo,showing no correlation to plication loss.On pH monitoring,there was no difference in the percent time pH < 4 from before ELGP to 3 mo after.Impedance monitoring revealed no changes in the number of reflux episodes or the symptom index for reflux events from before ELGP to 3 mo after,but the symptom sensitivity index decreased significantly 3 mo after ELGP(16.1 ± 12.9 to 3.9 ± 8.3,P < 0.01).At 3 mo after ELGP,6 patients(31.6%) had reduced their PPI medication by 50% or more,and 11 patients(57.9%) were able to discontinue PPI medication altogether.After 12 mo,3 patients(16.7%) were able to reduce the amount of PPI medication by 50% or more,and 12 patients(66.7%) were able to discontinue PPI medication altogether.A high percentage of cases with remaining plications had discontinued PPIs medication after 3 mo,but there was no difference after 12 mo.No serious complications were observed in this study.CONCLUSION:ELGP was safe,resulted in significant improvement in subjective symptoms,and allowed less medication to be used over the long term in patients with PPI-refractory NERD. | Kentaro Tokudome Yasushi Funaki Makoto Sasaki Shinya Izawa Yasuhiro Tamura Akihito Iida Naotaka Ogasawara Toshihiro Konagaya Yoshifumi Tokura Kunio Kasugai | 2012 | World Journal of Gastroenterology2012，18，41： | 5 |
| 7 | Comparison of pancreatic acinar cell carcinoma and adenocarcinoma using multidetector-row computed tomography显示文摘AIM:To distinguish acinar cell carcinoma(ACC)from pancreatic adenocarcinoma(AC)by comparing their computed tomography findings.METHODS:Patients with ACC and AC were identified on the basis of results obtained using surgically resected pancreatectomy specimens.The preoperative computer tomographic images of 6 acinar cell carcinoma patients and 67 pancreatic adenocarcinoma patients in 4 phases(non-contrast,arterial,portal venous,and delayed phase)were compared.The scan delay times were 40,70,and 120 s for each contrast-enhanced phase.The visual pattern,tomographic attenuation value,and time attenuation curve were assessed and compared between AC and ACC cases using the 2test,Wilcoxon signed-rank test,and Mann Whitney U test.RESULTS:The adenocarcinomas tended to be hypodense in all 4 phases.The acinar cell carcinomas also tended to be hypodense in the 3 contrast-enhancedphases,although their computed tomographic attenuation values were higher.Further,5 of the 6 acinar cell carcinomas(83%)were isodense in the non-contrast phase.The time attenuation curve of the adenocarcinomas showed a gradual increase through the 4 phases,and all adenocarcinomas showed peak enhancement during the delayed phase.The time attenuation curve of the acinar cell carcinomas showed peak enhancement during the portal venous phase in 4 cases and during the arterial phase in 2 cases.None of the 6 acinar cell carcinomas showed peak enhancement during the delayed phase.CONCLUSION:The tumor density in the non-contrast phase and time attenuation curve pattern clearly differ between acinar cell carcinomas and adenocarcinomas,and multidetector-row computed tomography can thus distinguish these tumors. | Tatsuaki Sumiyoshi Yasuo Shima Takehiro Okabayashi Akihito Kozuki Toshio Nakamura | 2013 | World Journal of Gastroenterology2013，19，34： | 5 |
| 8 | Pathophysiology of functional heartburn based on Rome Ⅲ criteria in Japanese patients显示文摘AIM:To investigate the pathophysiology of functional heartburn(FH) in Japanese patients.METHODS:A total of 111 patients with proton pump inhibitor(PPI)-refractory non-erosive gastroesophageal reflux disease underwent intraesophageal pressure testing and 24-h multichannel intraluminal impedancep H(24MII-p H) testing.The patients also completed several questionnaires while they were receiving the PPI treatment, including the questionnaire for the diagnosis of reflux disease(QUEST), the frequency scale for the symptoms of gastroesophageal reflux disease(FSSG), the gastrointestinal symptoms rating scale(GSRS), SF-36, and the Cornell Medical Index(CMI).The subjects were classified into FH and endoscopy-negative reflux disease(ENRD) groups based on the Rome Ⅲ criteria.RESULTS:Thirty-three patients with esophageal motility disorder were excluded from this study, while 22 patients with abnormal esophageal acid exposure time(p H-POS) and 34 with hypersensitive esophagus(HE) were included in the ENRD group.The FH group included 22 patients with no reflux involvement.Sex, age, and body mass index did not differ significantly between the groups.The mean SF-36 values were < 50(normal) for all scales in these groups, with no significant differences.The GSRS scores in these groups were not different and showed overlap with other gastrointestinal symptoms.The QUEST and the FSSG scores did not differ significantly between the groups.Neuroticism was diagnosed using the CMI questionnaire in 17 of the 78 included subjects within the p H-POS(n=4),HE(n=8),and FH(n=5)groups,with no significant differences.CONCLUSION:Clinical characteristics of the FH and PPI-refractory ENRD groups were similar.Therefore,esophageal function should be examined via manometry and 24MII-p H testing to differentiate between them. | Yasuhiro Tamura Yasushi Funaki Shinya Izawa Akihito Iida Yoshiharu Yamaguchi Kazunori Adachi Naotaka Ogasawara Makoto Sasaki Hiroshi Kaneko Kunio Kasugai | 2015 | World Journal of Gastroenterology2015，21，16： | 4 |
| 9 | A white opaque substance-positive gastric hyperplastic polyp with dysplasia显示文摘The endoscopic findings of gastric hyperplastic polyps (HPs) with dysplasia have not been well-defined, and the clinical significance of these lesions, including their malignant potential, is unclear. In this report, we describe a case of a white opaque substance (WOS)positive gastric HP with dysplasia. A 76-year-old woman was referred to our hospital for endoscopic resection of a gastric HP. Upper endoscopy revealed a 25-mm whitish and reddish polypoid lesion on the greater curvature in the lower third of the stomach. The whitish part was diagnosed as a WOS using conventional and magnifying endoscopy with narrow band imaging. An examination of the biopsy specimen indicated that the lesion was a typical gastric HP. However, because of its color and the presence of a WOS, we suspected that this lesion was an atypical gastric HP. Therefore, we performed a polypectomy. Histopathologically, diffuse lowto high-grade dysplasia was found on the surface of the polyp. We performed immunohistochemical staining using a monoclonal antibody specific for adipophilin as a marker of lipid droplets (LDs). LDs were detected in approximately all of the neoplastic cells, especially in the surface epithelium of the intervening apical parts and were located in the subnuclear cytoplasm of the neoplastic cells. According to endoscopic and histopathological findings, the WOS-positive epithelium indicated dysplasia of the gastrointestinal phenotype, which could absorb lipids. The presence of a WOS in a gastric HP may be considered an endoscopic finding that is predictive of the neoplastic transformation of a gastric HP. We suggest that a WOS-positive gastric HP should be resected endoscopically to investigate its neoplastic transformation. | Hiroya Ueyama Kenshi Matsumoto Akihito Nagahara Ryosuke Gushima Takuo Hayashi Takashi Yao Sumio Watanabe | 2013 | World Journal of Gastroenterology2013，19，26： | 4 |
| 10 | Tunable and switchable polarization rotation with non-reciprocal plasmonic thin films at designated wavelengths显示文摘We experimentally demonstrate an ultra-thin plasmonic optical rotator in the visible regime that induces a polarization rotation that is continuously tunable and switchable by an external magnetic field.The rotator is a magneto-plasmonic hybrid structure consisting of a magneto-optical EuSe slab and a one-dimensional plasmonic gold grating.At low temperatures,EuSe possesses a large Verdet constant and exhibits Faraday rotation,which does not saturate over a regime of several Tesla.By combining these properties with plasmonic Faraday rotation enhancement,a large tuning range of the polarization rotation of up to 8.4° for a film thickness of 220 nm is achieved.Furthermore,through experiments and simulations,we demonstrate that the unique dispersion properties of the structure enable us to tailor the wavelengths of the tunable polarization rotation to arbitrary spectral positions within the transparency window of the magneto-optical slab.The demonstrated concept might lead to important,highly integrated,non-reciprocal,photonic devices for light modulation,optical isolation,and magnetic field optical sensing.The simple fabrication of EuSe nanostructures by physical vapor deposition opens the way for many potentially interesting magneto-plasmonic systems and three-dimensional magneto-optical metamaterials. | Dominik Floess Jessie Y Chin Akihito Kawatani Daniel Dregely Hanns-Ulrich Habermeier Thomas Weiss Harald Giessen | 2015 | Light(Science & Applications)2015，4，1： | 4 |
| 11 | Seasonal variations in the onset of ulcerative colitis in Japan显示文摘AIM:To investigate seasonal variations in the onset and relapse of ulcerative colitis(UC)in Japanese patients.METHODS:Between 1994 and 2006,198 Japanese patients diagnosed with UC according to conventional criteria in an academic hospital were enrolled for onset evaluation.Among 265 Japanese patients with UC who were observed for more than 12 mo,165 patients relapsed(239 times)and were enrolled for relapse evaluation.The patients’symptoms were recorded each month for 12 consecutive years.RESULTS:There was monthly seasonality in symptom onset during October and March for UC.The onset of symptoms in UC patients frequently occurred during the winter.Variation in UC onset was observed according to both month(P=0.015)and season(P=0.048).Relapse commonly occurred in October,and variations in relapse were not significant either in month(P=0.52)or season(P=0.12).Upper respiratory inflammation was the main factor responsible for relapse.CONCLUSION:Our results suggest that environmental factors associated with winter and spring seasonality may be responsible for triggering the clinical onset of UC in Japan. | Shigeo Koido Toshifumi Ohkusa Hiroaki Saito Tetsuji Yokoyama Tomoyoshi Shibuya Naoto Sakamoto Kan Uchiyama Hiroshi Arakawa Taro Osada Akihito Nagahara Sumio Watanabe Hisao Tajiri | 2013 | World Journal of Gastroenterology2013，19，47： | 3 |
| 12 | Effects of denosumab treatment in chronic liver disease patients with osteoporosis显示文摘BACKGROUND Effective treatment of osteoporosis is essential for improving morbidity and health-related quality of life in chronic liver disease(CLD)patients.Denosumab has been shown to increase bone mineral density(BMD)and decrease the risk of osteoporotic fracture in the general population.However,there are few reports evaluating the efficacy of denosumab in CLD patients.AIM To investigated the effects and safety of denosumab in CLD patients with osteoporosis.METHODS Sixty CLD patients with osteoporosis were subcutaneously administered denosumab once every 6 mo.The study period for evaluating efficacy and safety was 12 mo.Changes from baseline in BMD at the lumbar spine,femoral neck,and total hip were evaluated at 12 mo of denosumab treatment.Bone turnover and quality were assessed by measuring serum tartrate-resistant acid phosphatase-5b(bone resorption marker),serum total procollagen type I N-terminal propeptide(bone formation maker),and plasma pentosidine(bone quality marker).RESULTS Among the 405 CLD patients,138(34.1%)patients were diagnosed with osteoporosis;among these,78 patients met the exclusion criteria and thus 60 patients were finally included in the present study.The median percentage changes from baseline to 12 mo of denosumab treatment in BMD at the lumbar spine,femoral neck,and total hip were+4.44%,+3.71%,and+4.03%,respectively.Denosumab significantly improved BMD,regardless of sex,patient age,and presence of liver cirrhosis.Serum tartrate-resistant acid phosphatase-5b and procollagen type I N-terminal propeptide levels constantly and significantly declined after denosumab treatment(P<0.001).Plasma pentosidine levels were also significantly lower at 12 mo of treatment(P=0.010).No patients experienced fractures and moderate-to-severe adverse events,except for transient hypocalcemia.CONCLUSION Denosumab treatment was safe and increased BMD,suppressed bone turnover,and improved bone quality marker levels in CLD patients with osteoporosis,irrespective of differences in baseline characteristics. | Chisato Saeki Mitsuru Saito Tsunekazu Oikawa Masanori Nakano Yuichi Torisu Masayuki Saruta Akihito Tsubota | 2020 | World Journal of Gastroenterology2020，26，33： | 3 |
| 13 | Role of diffusion-weighted imaging in evaluating therapeutic efficacyafter transcatheter arterial chemoembolization for hepatocellular carcinoma显示文摘 | Kei Kubota Tomoaki Yamanishi Satoshi Itoh Yoriko Murata Kana Miyatake Hiroaki Yasunami Kazuo Morio Norihiko Hamada Akihito Nishioka Yasuhiro Ogawa | 2010 | Oncology Reports2010，，3： | 3 |
| 14 | A mutation of the start codon in the X region of hepatitis B virus DNA in a patient with non-B,non-C chronic hepatitis显示文摘There are cases of hepatitis involving occult hepatitis B virus(HBV)infection in which,even though the HB surface antigen(HBsAg)is negative,HBV-DNA is detected by a polymerase chain reaction(PCR).We con-ducted a sequence analysis of the entire HBV region in a case of non-B non-C chronic hepatitis in a 46-yearold female.A diagnosis of non-B non-C chronic hepatitis was made.Although HBV markers,such as HBs antibody(anti-HBs),anti-HBc,HBeAg and anti-HBe,were negative,HBV-DNA was positive.Nested PCR was performed to amplify the precore region of HBV-DNA and all remaining regions by long nested PCR.Sequence analysis of the two obtained bands was conducted by direct sequencing.Compared with the control strains,the ATG(Methionine)start codon in the X region had mut ated to GTG(Valine).It is assumed that a mutation at the start codon in the X region may be the reason why HBV markers are negative in some cases of hepatitis that involve occult HBV infection. | Kiyotaka Fujise Keiko Tatsuzawa Midori Kono Sadayori Hoshina Akihito Tsubota Minoru Niiya Yoshihisa Namiki Norio Tada Hisao Tajiri | 2011 | World Journal of Hepatology2011，3，2： | 3 |
| 15 | CT/^(99m)Tc-GSA SPECT fusion images demonstrate functional differences between the liver lobes显示文摘AIM: To evaluate the functional differences between the 2 liver lobes in non-cirrhotic patients by using computed tomography/99mTc-galactosyl human serum albumin (CT/99mTc-GSA) single-photon emission computed tomography (SPECT) fusion images. METHODS: Between December 2008 and March 2012, 264 non-cirrhotic patients underwent preoperative liver function assessment using CT/99mTc-GSA SPECT fusion images. Of these, 30 patients, in whom the influence of a tumor on the liver parenchyma was estimated to be negligible, were selected. Specifically, the selected patients were required to meet either of the following criteria: (1) the presence of an extrahepatic tumor; or (2) presence of a single small intrahepatic tumor. These 30 patients were retrospectively analyzed to calculate the percentage volume (%Volume) and the percentage function (%Function) of each lobe. The ratio between the %Function and %Volume (function-to-volume ratio) of each lobe was also calculated, and the ratios were compared between the 2 lobes. Furthermore, the correlations between the function-to-volume ratio and each of 2 liver parameters [lobe volume and diameter ratio of the left portal vein to the right portal vein (LPV-to-RPV diameter ratio)] were investigated. RESULTS: The median values of %Volume and %Function were 62.6% and 67.1% in the right lobe, with %Function being significantly higher than %Volume (P < 0.01). The median values of %Volume and %Function were 31.0% and 28.7% in the left lobe, with %Function being significantly lower than %Volume (P < 0.01). The function-to-volume ratios of the right lobe (1.04-1.14) were significantly higher than those of the left lobe (0.74-0.99) (P < 0.01). The function-to-volume ratio showed no significant correlation between the lobe volume in either lobe. In contrast, the function-to-volume ratio showed significant correlations with the LPV-to-RPV diameter ratio in both lobes (right lobe: negative correlation, rs = -0.37, P = 0.048; left lobe: positive correlation, r s = 0.71, P < 0.001). The function-to-volume ratio in the left lobe tended to be higher, and that in the right lobe tended to be lower, in accordance with the increase in the LPV-to-RPV diameter ratio. CONCLUSION: CT/99mTc-GSA SPECT fusion images demonstrated that the function of the left lobe was significantly decreased compared with that of the right lobe in non-cirrhotic livers. | Tatsuaki Sumiyoshi Yasuo Shima Ryoutarou Tokorodani Takehiro Okabayashi Akihito Kozuki Yasuhiro Hata Yoshihiro Noda Yoriko Murata Toshio Nakamura Kiminori Uka | 2013 | World Journal of Gastroenterology2013，19，21： | 3 |
| 16 | Early apoptosis and cell death induced by ATX-S10Na(Ⅱ)-mediated photodynamic therapy are Bax- and p53-dependent in human colon cancer cells显示文摘AIM: To investigate the roles of Bax and p53 proteins in photosensitivity of human colon cancer cells by using lysosome-localizing photosensitizer, ATX-S10Na (Ⅱ).METHODS: HCT116 human colon cancer cells and Bax-null or p53-null isogenic derivatives were irradiated with a diode laser. Early apoptosis and cell death in response to photodynamic therapy were determined by MTT assays, annexin V assays, transmission electron microscopy assays, caspase assays and western blotting.RESULTS: Induction of early apoptosis and cell death was Bax- and p53-dependent. Bax and p53 were required for caspase-dependent apoptosis. The levels of anti-apoptotic Bcl-2 family proteins, Bcl-2 and Bcl-xL, were decreased in Bax- and p53-independent manner.CONCLUSION: Our results indicate that early apoptosis and cell death of human colon cancer cells induced by photodynamic therapy with lysosome-localizing photosensitizer ATX-S10Na (Ⅱ) are mediated by p53-Bax network and low levels of Bcl-2 and Bcl-xL proteins. Our results might help in formulating new therapeutic approaches in photodynamic therapy. | Makoto Mitsunaga Akihito Tsubota Kohichi Nariai Yoshihisa Namiki Makoto Sumi Tetsuya Yoshikawa Kiyotaka Fujise | 2007 | World Journal of Gastroenterology2007，13，5： | 3 |
| 17 | Four-week pegylated interferon a-2a monotherapy for chronic hepatitis C with genotype 2 and low viral load:A pilot,randomized study显示文摘AIM:To assess the efficacy and advantages of 4-wk pegylated interferon a-2a(peg-IFN-a2a) monotherapy for chronic hepatitis C patients with strong predictors of sustained virologic response(SVR).METHODS:Patients(n = 33) with genotype 2 and low viral load(< 100 KIU/mL),who became HCV RNA negative after 1 wk of IFN treatment,were randomly allocated to receive a 4-or 12-wk treatment course at a ratio of 2:1,respectively,with a subsequent 24-wk follow-up period.Peg-IFN-a2a was administered subcutaneously at a dose of 180 μg or 90 μg once weekly.SVR was defined as absence of serum HCV RNA at the end of the follow-up period.RESULTS:All patients completed the treatment schedule,and more than half were symptom-free during the treatment.In the 4-wk treatment group,20 of 22(91%) patients achieved SVR.Two patients relapsed,but achieved SVR following re-treatment with peg-IFN-a2a alone.In the 12-wk treatment group,11 of 11(100%) patients attained SVR.CONCLUSION:Our results show that a 4-wk course of peg-IFN-a2a monotherapy can achieve a high SVR rate in 'IFN-sensitive' patients,without negatively affecting outcome. | Akihito Tsubota Ken-ichi Satoh Mashu Aizawa Seishi Takamatsu Yoshihisa Namiki Toshifumi Ohkusa Kiyotaka Fujise Hisao Tajiri | 2008 | World Journal of Gastroenterology2008，14，47： | 3 |
| 18 | Fractal analysis of retinal vasculature in normal subjects on ultra-wide field fluorescein angiography显示文摘AIM: To evaluate the fractal feature of the retinal vasculature of normal eyes on a stereographic projected and montaged ultra-wide field(UWF) fluorescein angiography(FA).METHODS: Prospective, observational, cross-sectional study. Totally 59 eyes of 31 normal subjects were imaged using the Optos 200 Tx. Images obtained at different gaze angles stereographically projected and montaged. The early-phase UWF FA frames were processed to segment the retinal vasculature and the results were exported as binary masks. The fractal dimension(FD) was calculated using the box-counting method.RESULTS: The global FD for the entire retina was 1.6±0.04, with no difference between males and females(1.59±0.04 vs 1.61±0.04, P=0.084) or between right and left eyes(1.6±0.04 vs 1.6±0.05, P=0.61). FD was nonuniformly distributed among four quadrants(P<0.001) and decreased as the distance from the fovea increased(P<0.001). A negative association was observed between FD and age(R=-0.37, P=0.006), and this relationship was observed in the posterior and mid-peripheral retina(P<0.05) but absent in far-periphery(P>0.05).CONCLUSION: Fractal geometry is non-uniformly distributed across the retina in normal eyes and decreases from the fovea to the far-periphery. Subjects with an older age tend to have a smaller FD, however, the FD in the farperiphery does not appear to be influenced by age. | Wen-Ying Fan Alan Fleming Gavin Robertson Akihito Uji Jano van Hemert Michael Singer Min Sagong Michael Ip SriniVas R.Sadda | 2020 | International Journal of Ophthalmology(English edition)2020，13，7： | 3 |
| 19 | Inhibition of gastric perception of mild distention by omeprazole in volunteers显示文摘AIM:To evaluate the effects of omeprazole on gastric mechanosensitivity in humans. METHODS:A double lumen polyvinyl tube with a plastic bag was introduced into the stomach of healthy volunteers under fluorography and connected to a barostat device. Subjects were then positioned so they were sitting comfortably, and the minimal distending pressure (MDP) was determined after a 30-min adaptation period. Isobaric distensions were performed in stepwise increments of 2 mmHg (2 min each) starting from the MDP. Subjects were instructed to score feel-ings at the end of every step using a graphic rating scale:0, no perception; 1, weak/vague; 2, weak but significant; 3, moderate/vague; 4, moderate but signifi-cant; 5, severe discomfort; and 6, unbearable pain. After this first test, subjects received omeprazole (20 mg, after dinner) once daily for 1 wk. A second test was performed on the last day of treatment. RESULTS:No adverse effects were observed. Mean MDP before and after treatment was 6.3 ± 0.3 mmHg and 6.2 ± 0.5 mmHg, respectively. One subject before and 2 after treatment did not reach a score of 6 at the maximum bag volume of 750 mL. After omeprazole, there was a significant increase in the distension pres-sure required to reach scores of 1 (P = 0.019) and 2 (P = 0.017) as compared to baseline. There were no changes in pressure required to reach the other scores after treatment. Two subjects before and one after omeprazole rated their abdominal feeling < 1 at MDP, and mean (± SE) abdominal discomfort scores at MDP were 0.13 ± 0.09 and 0.04 ± 0.04, respectively. Mean scores induced by each MDP + 2, 4, 6, 8, 10, 12, 14, 16, 18 and 20 (mmHg) were 1.1 ± 0.3, 2.0 ± 0.4, 2.9 ± 0.5, 3.3 ± 0.4, 4.6 ± 0.3, 5.2 ± 0.3, 5.5 ± 0.2, 5.5 ± 0.3, 5.7 ± 0.3, and 5.4, respectively. After omepra-zole, abdominal feeling scores for the same incremental pressures over MDP were 0.3 ± 0.1, 0.8 ± 0.1, 2.0 ± 0.4, 2.8 ± 0.4, 3.8 ± 0.4, 4.6 ± 0.4, 4.9 ± 0.3, 5.4 ± 0.4, 5.2 ± 0.6, and 5.0 ± 1.0, respectively. A signif- icant decrease in feeling score was observed at intrabag pressures of MDP + 2 mmHg (P = 0.028) and + 4 mmHg (P = 0.013), respectively, after omeprazole. No significant score changes were observed at pres-sures ≥ MDP + 6 mmHg. CONCLUSION:Although the precise mechanisms are undetermined, the present study demonstrated that omeprazole decreases mechanosensitivity to mild gastric distension. | Akihito Iida Hiroshi Kaneko Toshihiro Konagaya Yasushi Funaki Kentaro Tokudome Shinya Izawa Yasuhiro Tamura Mari Mizuno Naotaka Ogasawara Makoto Sasaki Kunio Kasugai | 2012 | World Journal of Gastroenterology2012，18，39： | 3 |
| 20 | Characteristic pathological findings and effects of ecabet sodium in rat reflux esophagitis显示文摘AIM:To explore the pathological flndings in the entire esophagus in rats with reflux esophagitis, and the effects of ecabet sodium(ES).METHODS:A rat model of chronic acid reflux esophagitis was used.In the treatment group, ES was administered after surgery(n = 16).No drug was administered postoperatively to the esophagitis group(n = 9).Shamoperated rats were used as a control group(n = 5).Rats were sacriflced on day 7 after the operation.The epithelial thickness and leukocyte inflltration were examined in the upper, middle and lower areas of the esophagus.The survival rate, incidence of esophageal ulcer, and mean surface area and number of esophageal ulcers were determined in the esophagitis and ES groups.Esophageal histology was assessed in all three groups.RESULTS:Leukocyte infiltration in the esophagitis group was 26.3 ± 22.0 in the middle esophagus and 8.2 ± 4.9 in the upper esophagus, which was signiflcantly greater than that in the controls(1.3 ± 1.1 and 1.4 ± 1.0, respectively)(P < 0.05).The thickness of the epithelium in the esophagitis group was 210.8 ± 47.7 μm in the lower esophagus and 204.2 ± 60.1 μm in the middle esophagus, which was significantlygreater than that in the controls(26.0 ± 5.5 and 21.0 ± 6.5 μm, respectively)(P < 0.05).The mean number of ulcers per animal in the ES group in the entire esophagus was 5.4 ± 2.5, which was signiflcantly less than that in the esophagitis group(9.0 ± 3.5)(P < 0.05).The epithelial thickness in the ES group was 97.5 ± 32.2 μm in the lower esophagus, which was decreased compared with that in the esophagitis group(210.8 ± 47.7 μm)(P < 0.05).CONCLUSION:Mucosal inflammation extended to the upper esophagus close to the hypopharynx.Our study suggested that ES may have a useful defensive role in reflux esophagitis. | Daisuke Asaoka Akihito Nagahara Masako Oguro Yuko Izumi Akihiko Kurosawa Taro Osada Masato Kawabe Mariko Hojo Michiro Otaka Sumio Watanabe | 2009 | World Journal of Gastroenterology2009，15，28： | 2 |
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