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| 1 | Efficacy and safety of over-the-scope clip: Including complications after endoscopic submucosal dissection显示文摘AIM: To retrospectively review the results of over-thescope clip (OTSC) use in our hospital and to examine the feasibility of using the OTSC to treat perforations after endoscopic submucosal dissection (ESD). METHODS: We enrolled 23 patients who presented with gastrointestinal (GI) bleeding, fistulae and perforations and were treated with OTSCs (Ovesco Endoscopy GmbH, Tuebingen, Germany) between November 2011 and September 2012. Maximum lesion size was defined as lesion diameter. The number of OTSCs to be used per patient was not decided until the lesion was completely closed. We used a twin grasper (Ovesco Endoscopy GmbH, Tuebingen, Germany) as a grasping device for all the patients. A 9 mm OTSC was chosen for use in the esophagus and colon, and a 10 mm device was used for the stomach, duodenum and rectum. The overall success rate and complications were evaluated, with a particular emphasis on patients who had undergone ESD due to adenocarcinoma. In technical successful cases we included not only complete closing by using OTSCs, but also partial closing where complete closure with OTSCs is almost difficult. In overall clinical successful cases we included only complete closing by using only OTSCs perfectly. All the OTSCs were placed by 2 experienced endoscopists. The sites closed after ESD included not only the perforation site but also all defective ulcers sites.RESULTS: A total of 23 patients [mean age 77 years (range 64-98 years)] underwent OTSC placement during the study period. The indications for OTSC placement were GI bleeding (n = 9), perforation (n = 10), fistula (n = 4) and the prevention of post-ESD duodenal artificial ulcer perforation (n = 1). One patient had a perforation caused by a glycerin enema, after which a fistula formed. Lesion closure using the OTSC alone was successful in 19 out of 23 patients, and overall success rate was 82.6%. A large lesion size (greater than 20 mm) and a delayed diagnosis (more than 1 wk) were the major contributing factors for the overall unsuccessful clinical cases. The location of the unsuccessful lesion was in the stomach. The median operation time in the successful cases was 18 min, and the average observation time was 67 d. During the observation period, none of the patients experienced any complications associated with OTSC placement. In addition, we successfully used the OTSC to close the perforation site after ESD in 6 patients. This was a single-center, retrospective study with a small sample size. CONCLUSION: The OTSC is effective for treating GI bleeding, fistulae as well as perforations, and the OTSC technique proofed effective treatment for perforation after ESD. | Noriko Nishiyama Hirohito Mori Hideki Kobara Kazi Rafiq Shintarou Fujihara Mitsuyoshi Kobayashi Makoto Oryu Tsutomu Masaki | 2013 | World Journal of Gastroenterology2013，19，18： | 42 |
| 2 | Comparison between combination therapy of percutaneous ethanol injection and radiofrequency ablation and radiofrequency ablation alone for patients with hepatocellular carcinoma显示文摘AIM: In the present study, the characteristics of PEI-RFA treatment were further elucidated by analyzing the relationship between the volume of coagulated necrosis and the energy requirement for ablation or the amount of ethanol injected into HCC.METHODS: The volume of coagulated necrosis, total energy requirement and energy requirement for coagulation of per unit volume were examined in the groups of PEI-RFA and RFA alone using the Cool-tip RF system.RESULTS: The results showed that the volume of coagulated necrosis induced was significantly larger in PEI-RFA group than in routine RFA group, when the total energy administered was comparable in both groups.In PEI-RFA, enlargement of coagulated necrosis was admitted in 3 dimensions and the amount of energy requirement per unit volume of coagulated necrosis was negatively correlated with the amount of ethanol injected into HCC.CONCLUSION: These results suggest that, compared to RFA alone, PEI-RFA enables to induce comparable coagulated necrosis with smaller energy requirement, and that PEI-RFA is likely to be less invasive than RFA alone irrespective of inducing enhanced coagulated necrosis.Thus, simple prior injection of ethanol may make RFA treatment more effective and less invasive for the treatment of patients with HCC. | Kazutaka Kurokohchi Seishiro Watanabe Tsutomu Masaki Naoki Hosomi Yoshiaki Miyauchi Takashi Himoto Yasuhiko Kimura Seiji Nakai Akihiro Deguchi Hirohito Yoneyama Shuhei Yoshida Shigeki Kuriyama | 2005 | World Journal of Gastroenterology2005，11，10： | 29 |
| 3 | A rare case of hyaline-type Castleman disease in the liver显示文摘Castleman disease often develops in the neck, mediastinum and pulmonary hilum. Its onset in the peritoneal cavity is very rare. The patient, a woman in her 70s, was referred to our department for a detailed examination of an abdominal mass. On abdominal ultrasonography, computed tomography scan, magnetic resonance imaging and positron emission tomography, a mass approximately 15 mm in diameter was noted in the hepatic S6. We attempted radical treatment and conducted a laparoscope-assisted right lobectomy. On the basis of histopathological findings, the patient was diagnosed as having hyaline type Castleman disease in the liver, a very rare condition. | Hisaaki Miyoshi Shima Mimura Takako Nomura Joji Tani Asahiro Morishita Hideki Kobara Hirohito Mori Hirohito Yoneyama Akihiro Deguchi Takashi Himoto Naoki Yamamoto Keiichi Okano Yasuyuki Suzuki Tsutomu Masaki | 2013 | World Journal of Hepatology2013，5，7： | 14 |
| 4 | A combination therapy of ethanol injection and radiofrequency ablation under general anesthesia for the treatment of hepatocellular carcinoma显示文摘AIM: To summarize the effects of laparoscopic ethanol injection and radiofrequency ablation (L-EI-RFA), thora- coscopic (T-EI-RFA) and open-surgery assisted EI-RFA (O-EI-RFA) under general anesthesia for the treatment of hepatocellular carcinoma (HCC). METHODS: Time-lag performance of RFA after ethanol injection (Time-lag PEI-RFA) was performed in all cases. The volume of coagulated necrosis and the applied en- ergy for total and per unit volume coagulated necrosis were examined in the groups treated under general (group G) or local anesthesia (group L). RESULTS: The results showed that the total applied energy and the applied energy per unit volume of whole and marginal, coagulated necrosis were significantly larger in group G than those in the group L, resulting in a larger volume of coagulated necrosis in the group G. The rate of local tumor recurrence within one year was extremely low in group G. CONCLUSION: These results suggest that EI-RFA, un- der general anesthesia, may be effective for the treat- ment of HCC because a larger quantity of ethanol and energy could be applied during treatment under pain- free condition for the patients. | Kazutaka Kurokohchi Seishiro Watanabe Hirohito Yoneyama Akihiro Deguchi Tsutomu Masaki Takashi Himoto Hisaaki Miyoshi Hamdy Saad Mohammad Akira Kitanaka Tomohiko Taminato Shigeki Kuriyama | 2008 | World Journal of Gastroenterology2008，14，13： | 10 |
| 5 | Management of a large mucosal defect after duodenal endoscopic resection显示文摘Duodenal endoscopic resection is the most difficult type of endoscopic treatment in the gastrointestinal tract(GI) and is technically challenging because of anatomical specificities. In addition to these technical difficulties, this procedure is associated with a significantly higher rate of complication than endoscopic treatment in other parts of the GI tract. Postoperative delayed perforation and bleeding are hazardous complications, and emergency surgical intervention is sometimes required. Therefore, it is urgently necessary to establish a management protocol for preventing serious complications. For instance, the prophylactic closure of large mucosal defects after endoscopic resection may reduce the risk of hazardous complications. However, the size of mucosal defects after endoscopic submucosal dissection(ESD) is relatively large compared with the size after endoscopic mucosal resection, making it impossible to achieve complete closure using only conventional clips. The over-the-scope clip and polyglycolic acid sheets with fibrin gel make it possible to close large mucosal defects after duodenal ESD. In addition to the combination of laparoscopic surgery and endoscopic resection, endoscopic full-thickness resection holds therapeutic potential for difficult duodenal lesions and may overcome the disadvantages of endoscopic resection in the near future. This review aims to summarize the complications and closure techniques of large mucosal defects and to highlight some directions for management after duodenal endoscopic treatment. | Shintaro Fujihara Hirohito Mori Hideki Kobara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Tsutomu Masaki | 2016 | World Journal of Gastroenterology2016，22，29： | 10 |
| 6 | Total pancreatectomy and islet autotransplantation: A decade nationwide analysis显示文摘AIM: To investigate outcomes and predictors of inhospital morbidity and mortality after total pancreatectomy(TP) and islet autotransplantation. METHODS: The nationwide inpatient sample(NIS) database was used to identify patients who underwent TP and islet autotransplantation(IAT) between 2002-2012 in the United States. Variables of interest were inherent variables of NIS database which included demographic data(age, sex, and race), comorbidities(such as diabetes mellitus, hypertension, and deficiency anemia), and admission type(elective vs nonelective). The primary endpoints were mortality and postoperative complications according to the ICD-9 diagnosis codes which were reported as the second to 25 th diagnosis of patients in the database. Risk adjusted analysis was performed to investigate morbidity predictors. Multivariate regression analysis was used to identify predictors of in-hospital morbidity.RESULTS: We evaluated a total of 923 patients who underwent IAT after pancreatectomy during 2002-2012. Among them, there were 754 patients who had TP + IAT. The most common indication ofsurgery was chronic pancreatitis(86%) followed by acute pancreatitis(12%). The number of patients undergoing TP + IAT annually significantly increased during the 11 years of study from 53 cases in 2002 to 155 cases in 2012. Overall mortality and morbidity of patients were 0% and 57.8 %, respectively. Postsurgical hypoinsulinemia was reported in 42.3% of patients, indicating that 57.7% of patients were insulin independent during hospitalization. Predictors of inhospital morbidity were obesity [adjusted odds ratio(AOR): 3.02, P = 0.01], fluid and electrolyte disorders(AOR: 2.71, P < 0.01), alcohol abuse(AOR: 2.63, P < 0.01), and weight loss(AOR: 2.43, P < 0.01). CONCLUSION: TP + IAT is a safe procedure with no mortality, acceptable morbidity, and achieved high rate of early insulin independence. Obesity is the most significant predictor of in-hospital morbidity. | Reza Fazlalizadeh Zhobin Moghadamyeghaneh Aram N Demirjian David K Imagawa Clarence E Foster Jonathan R Lakey Michael J Stamos Hirohito Ichii | 2016 | World Journal of Transplantation2016，6，1： | 9 |
| 7 | Reduction effect of bacterial counts by preoperative saline lavage of the stomach in performing laparoscopic and endoscopic cooperative surgery显示文摘AIM:To investigate the effects of gastric lavage with2000 mL of saline in laparoscopic and endoscopic cooperative surgery.METHODS:Twenty two patients who were diagnosed with a gastric gastrointestinal stromal tumor were enrolled.In former term,irrigations of the stomach were conducted whenever it was necessary,not systematically(Non systemic lavage group).In latter term,the stomach was thoroughly cleaned with 2000 mL of saline using an endoscope with a water jet,and Duodenal balloon occlusion was conducted to prevent refluxedbile and pancreatic juice(Systemic lavage+balloon occlusion group).The gastric wall was sprayed with 20mL of distilled water,and 20 mL of gastric juice was collected in a sterile tube and submitted for culture.20mL of ascites was also collected from the laparoscopic ports and submitted for culture.We compared WBC,CRP,BT between two groups,and verify the reduction effect of bacterial counts in Systemic lavage+balloon occlusion group.RESULTS:WBC count before,1 d after,and 3 d after laparoscopic and endoscopic cooperative surgery(LECS)were 5060(95%CI:4250-9640),12140(6050-14110),and 6910(5320-12520)in Non systemic lavage group,4400(3660-7620),8910(6480-10980),and 5950(4840-7860)in Systemic lavage+balloon occlusion group.Significant differences between two groups at the day after LECS(P=0.029)and the 3 d after LECS(P=0.042).CRP levels in Non systemic lavage group and in Systemic lavage+balloon occlusion group were significantly different at the day after LECS(P=0.005)and the 3 d after LECS(P=0.028).BTs(℃)in Non systemic lavage group and in Systemic lavage+balloon occlusion group were also significantly different at the day after LECS(P=0.004)and the 3 d after LECS(P=0.006).In a logarithmic comparison,bacterial load before gastric lavage,after lavage,and ascites culture were 6.08(95%CI:4.04-6.97),0.48(0-0.85),and 0.21(0-0.56).The bacterial counts before and after gastric lavage were significantly suppressed(P=0.007),but no significant difference between gastric juice culture after lavage and ascites(P=0.154).CONCLUSION:Pre-LECS lavage with 2000 mL of saline exhibited a bacteria-reducing effect equivalent to disinfectants and obtained favorable results in terms of clinical symptoms and data. | Hirohito Mori Hideki Kobara Takaaki Tsushimi Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Joji Tani Hisaaki Miyoshi Asahiro Morishita Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，42： | 9 |
| 8 | Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial显示文摘 | Tetsuya Mitsudomi Satoshi Morita Yasushi Yatabe Shunichi Negoro Isamu Okamoto Junji Tsurutani Takashi Seto Miyako Satouchi Hirohito Tada Tomonori Hirashima Kazuhiro Asami Nobuyuki Katakami Minoru Takada Hiroshige Yoshioka Kazuhiko Shibata Shinzoh Kudoh Ei | 2010 | Lancet Oncology2010，，2： | 8 |
| 9 | Diabetes mellitus and metformin in hepatocellular carcinoma显示文摘Hepatocellular carcinoma(HCC) is the leading cause of cancer-related death worldwide. Diabetes mellitus, a risk factor for cancer, is also globally endemic. The clinical link between these two diseases has been the subject of investigation for a century, and diabetes mellitus has been established as a risk factor for HCC. Accordingly, metformin, a first-line oral anti-diabetic, was first proposed as a candidate anti-cancer agent in 2005 in a cohort study in Scotland. Several subsequent large cohort studies and randomized controlled trials have not demonstrated significant efficacy for metformin in suppressing HCC incidence and mortality in diabetic patients; however, two recent randomized controlled trials have reported positive data for the tumor-preventive potential of metformin in non-diabetic subjects. The search for biological links between cancer and diabetes has revealed intracellular pathways that are shared by cancer and diabetes. The signal transduction mechanisms by which metformin suppresses carcinogenesis in cell lines or xenograft tissues and improves chemoresistance in cancer stem cells have also been elucidated. This review addresses the clinical and biological links between HCC and diabetes mellitus and the anti-cancer activity of metformin in clinical studies and basic experiments. | Koji Fujita Hisakazu Iwama Hisaaki Miyoshi Joji Tani Kyoko Oura Tomoko Tadokoro Teppei Sakamoto Takako Nomura Asahiro Morishita Hirohito Yoneyama Tsutomu Masaki | 2016 | World Journal of Gastroenterology2016，22，27： | 7 |
| 10 | Bleeding duodenal hemangioma: Morphological changes and endoscopic mucosal resection显示文摘Recently, the development of endoscopic procedures has increased the availability of minimally invasive treatments; however, there have been few case reports of duodenal hemangioma treated by endoscopic mucosal resection. The present report describes a case of duodenal hemangioma that showed various endoscopic changes over time and was treated by endoscopic mucosal resection. An 80-year-old woman presented with tarry stools and a loss of appetite. An examination of her blood revealed severe anemia, and her hemoglobin level was 4.2 g/dL. An emergency upper gastrointestinal endoscopy was performed. A red, protrusive, semipedunculated tumor (approximately 20 mm in diameter) with spontaneous bleeding on its surface was found in the superior duodenal angle. Given the semipedunculated appearance of the tumor, it was suspected to be an epithelial tumor with a differential diagnosis of hyperplastic polyp. The biopsy results suggested a telangiectatic hemangioma. Because this lesion was considered to be responsible for her anemia, endoscopic mucosal resection was performed for diagnostic and treatment purposes after informed consent was obtained. A histopathological examination of the resected specimen revealed dilated and proliferated capillary lumens of various sizes, which confirmed the final diagnosis of duodenal hemangioma. Neither anemia nor tumor recurrence has been observed since the endoscopic mucosal resection (approximately 1 year). Duodenal hemangiomas can be treated endoscopically provided that sufficient consideration is given to all of the possible treatment strategies. Interestingly, duodenal hemangiomas show morphological changes that are influenced by various factors, such as mechanical stimuli. | Noriko Nishiyama Hirohito Mori Hideki Kobara Shintarou Fujihara Takako Nomura Mitsuyoshi Kobayashi Tsutomu Masaki | 2012 | World Journal of Gastroenterology2012，18，22： | 7 |
| 11 | Serum manganese superoxide dismutase and thioredoxin are potential prognostic markers for hepatitis C virus-related hepatocellular carcinoma显示文摘AIM:To evaluate the clinical significance of oxidative stress markers in patients with hepatitis C virus(HCV)related hepatocellular carcinoma(HCC).METHODS:Sixty-four consecutive patients who were admitted to Kagoshima University Medical and Dental Hospital were enrolled in this retrospective study.All patients had chronic liver disease(CLD) due to infection with HCV.Thirty patients with HCV-related HCC,34 with HCV-related CLD without HCC(non-HCC),and 20 healthy volunteers(HVs) were enrolled.Possible associations between serum manganese superoxide dismutase(MnSOD) and thioredoxin(TRX) levels and clinical parameters or patient prognosis were analyzed over a mean follow-up period of 31.7 mo.RESULTS:The serum MnSOD levels were significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.03) or HVs(P < 0.001).Similarly,serum TRX levels were also significantly higher in patients with HCV-related HCC than in patients without HCC(P = 0.04) or HVs(P < 0.01).However,serum levels of MnSOD and TRX were not correlated in patients with HCC.Among patients with HCC,the overall survival rate(OSR) was lower in patients with MnSOD levels ≥ 110 ng/mL than in patients with levels < 110 ng/mL(P = 0.01),and the OSR tended to be lower in patients with TRX levels < 80 ng/mL(P = 0.05).In addition,patient prognosis with HCC was poorest with serum MnSOD levels ≥ 110 ng/mL and serum TRX levels < 80 ng/mL.Furthermore,a multivariate analysis using a Cox proportional hazard model and serum levels of five factors(MnSOD,prothrombin time,serum albumin,serum α-fetoprotein(AFP),and serum des-γ-carboxy prothrombin) revealed that MnSOD levels ≥ 110 ng/mL(risk ratio:4.12,95% confidential interval:1.22-13.88,P = 0.02) and AFP levels ≥ 40 ng/mL(risk ratio:6.75;95% confidential interval:1.70-26.85,P < 0.01) were independent risk factors associated with a poor patient prognosis.CONCLUSION:Serum MnSOD and TRX levels are potential clinical biomarkers that predict patient prognosis in HCV-related HCC. | Tsutomu Tamai Hirofumi Uto Yoichiro Takami Kouhei Oda Akiko Saishoji Masashi Hashiguchi Kotaro Kumagai Takeshi Kure Seiichi Mawatari Akihiro Moriuchi Makoto Oketani Akio Ido Hirohito Tsubouchi | 2011 | World Journal of Gastroenterology2011，17，44： | 7 |
| 12 | Two rare gastric hamartomatous inverted polyp cases suggest the pathogenesis of growth显示文摘Gastric hamartomatous inverted polyps(GHIP)are difficult to diagnose accurately because of inversion into the submucosal layer.GHIP are diagnosed using the pathological characteristics of the tumor,including the fibroblast cells,smooth muscle,nerve components,glandular hyperplasia,and cystic gland dilatation.Although Peutz-Jeghers syndrome,juvenile polyposis,and Cowden disease are hereditary,it is rare to encounter 2 cases of monostotic and asymptomatic gastric hamartomas.The pathogeneses of hamartomatous inverted polyps and inverted hyperplastic polyps remain controversial because of the paucity of reported cases.There are 3 hypotheses regarding the pathogenesis of complete gastric inverted polyps.Based on our experience with 2 successive,rare GHIP cases,we affirm the hypothesis that after a hamartomatous change occurs in the submucosal layer,some of these components are exposed to the gastric mucosa and,consequently,form a hypertrophic lesion.In Case 1,our hypothesis explains why a tiny hypertrophic change was first detected on the top of the submucosal tumor using a detailed narrow band imaging-magnified endoscopy.There was no confirmation that the milky white mucous and calcification structures were exuding directly from the biopsy site like Case 1,and in Case 2 the presence of this mucous was indirectly confirmed during an endoscopic submucosal dissection(ESD).Regarding the pathogenesis of GHIP,a submucosal hamartomatous change may occur prior to the growth of hypertrophic portions.An en bloc resection using ESD is recommended for treatment. | Hirohito Mori Hideki Kobara Takaaki Tsushimi Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，19： | 7 |
| 13 | Rectal perforations and fistulae secondary to a glycerin enema:Closure by over-the-scope-clip显示文摘Rectal perforations due to glycerin enemas(GE) typically occur when the patient is in a seated or lordotic standing position.Once the perforation occurs and peritonitis results,death is usually inevitable.We describe two cases of rectal perforation and fistula caused by a GE.An 88-year-old woman presented with a large rectal perforation and a fistula just after receiving a GE.Her case was further complicated by an abscess in the right rectal wall.The second patient was a 78-year-old woman who suffered from a rectovesical fistula after a GE.In both cases,we performed direct endoscopic abscess lavage with a saline solution and closed the fistula using an over-the-scope-clip(OTSC) procedure.These procedures resulted in dramatic improvement in both patients.Direct endoscopic lavage and OTSC closure are very useful for pararectal abscess lavage and fistula closure,respectively,in elderly patients who are in poor general condition.Our two cases are the first reports of the successful endoscopic closure of fistulae using double OTSCs after endoscopic lavage of the debris and an abscess of the rectum secondary to a GE. | Hirohito Mori Hideki Kobara Shintaro Fujihara Noriko Nishiyama Mitsuyoshi Kobayashi Tsutomu Masaki Kunihiko Izuishi Yasuyuki Suzuki | 2012 | World Journal of Gastroenterology2012，18，24： | 6 |
| 14 | Hepatitis B virus reactivation with a rituximab-containing regimen显示文摘Rituximab is currently used not only in the treatment of B-cell lymphoma but also for various other diseases, including autoimmune diseases, post-transplant graft vs host disease, and rejection following kidney transplants. Due to rituximab's widespread use, great progress has been made regarding research into complications that arise from its use, one of the most serious being the reactivation of hepatitis B virus(HBV), and efforts continue to establish guidelines for preventive treatment against this occurrence. This report discusses preventive measures against rituximab-induced HBV reactivation and future objectives. | Yutaka Tsutsumi Yoshiya Yamamoto Shinichi Ito Hiroyuki Ohigashi Souichi Shiratori Hirohito Naruse Takanori Teshima | 2015 | World Journal of Hepatology2015，7，21： | 5 |
| 15 | Phase III study of sorafenib after transarterial chemoembolisation in Japanese and Korean patients with unresectable hepatocellular carcinoma显示文摘 | Masatoshi Kudo Kazuho Imanaka Nobuyuki Chida Kohei Nakachi Won-Young Tak Tadatoshi Takayama Jung-Hwan Yoon Takeshi Hori Hiromitsu Kumada Norio Hayashi Shuichi Kaneko Hirohito Tsubouchi Dong Jin Suh Junji Furuse Takuji Okusaka Katsuaki Tanaka Osamu Matsui | 2011 | European Journal of Cancer2011，，14： | 5 |
| 16 | Prevalence of linked angina and gastroesophageal reflux disease in general practice显示文摘AIM: To evaluate the association between gastroesophageal re? ux diseases (GERD) and coronary heart diseases. METHODS: One thousand nine hundred and seventy consecutive patients who attended our hospital were enrolled. All of the patients who first attend our hospital were asked to respond to the F-scale questionnaire regardless of their chief complaints. All patients had a careful history taken, and resting echocardiography (ECG) was performed by physicians if the diagnostic necessity arose. Patients with ECG signs of coronary artery ischemia were defined as STsegment depression based on the Minnesota code. RESULTS: Among 712 patients (36%) with GERD, ECG was performed in 171 (24%), and ischemic changes were detected in eight (5%). Four (50%) of these patients with abnormal findings upon ECG had no chest symptoms such as chest pain, chest oppression, or palpitations. These patients (0.6%; 4/712) were thought to have non-GERD heartburn, which may be related to ischemic heart disease. Of 281 patients who underwent ECG and did not have GERD symptoms, 20 (7%) had abnormal findings upon ECG. In patients with GERD symptoms and ECG signs of coronary artery ischemia, the prevalence of linked angina was considered to be 0.4% (8/1970 patients).CONCLUSION: The present study suggested that ischemic heart disease might be found although a patient was referred to the hospital with a complaint of GERD symptoms. Physicians have to be concerned about missing clinically important coronary artery disease while evaluating patients for GERD symptoms. | Hirohito Kato Takamasa Ishii Tatsuo Akimoto Yoshihisa Urita Motonobu Sugimoto | 2009 | World Journal of Gastroenterology2009，15，14： | 5 |
| 17 | Survival of geriatric patients after percutaneous endoscopic gastrostomy in Japan显示文摘AIM: To examine the long term survival of geriatric patients treated with percutaneous endoscopic gastrostomy (PEG) in Japan. METHODS: We retrospectively included 46 Japanese community and tertiary hospitals to investigate 931 consecutive geriatric patients (≥ 65 years old) with swallowing difficulty and newly performed PEG between Jan 1st 2005 and Dec 31st 2008. We set death as an outcome and explored the associations among patient’s characteristics at PEG using log-rank tests and Cox proportional hazard models. RESULTS: Nine hundred and thirty one patients were followed up for a median of 468 d. A total of 502 deaths were observed (mortality 53%). However, 99%, 95%, 88%, 75% and 66% of 931 patients survived more than 7, 30, 60 d, a half year and one year, respectively. In addition, 50% and 25% of the patients survived 753 and 1647 d, respectively. Eight deaths were considered as PEG-related, and were associated with lower serum albumin levels (P = 0.002). On the other hand, among 28 surviving patients (6.5%), PEG was removed. In a multivariate hazard model, older age [hazard ratio (HR), 1.02; 95% confidence interval (CI), 1.00-1.03; P = 0.009], higher C-reactive protein (HR, 1.04; 95% CI: 1.01-1.07; P = 0.005), and higher blood urea nitrogen (HR, 1.01; 95% CI: 1.00-1.02; P = 0.003) were significant poor prognostic factors, whereas higher albumin (HR, 0.67; 95% CI: 0.52-0.85; P = 0.001), female gender (HR, 0.60; 95% CI: 0.48-0.75; P < 0.001) and no previous history of ischemic heart disease (HR, 0.69; 95% CI: 0.54-0.88, P = 0.003) were markedly better prognostic factors. CONCLUSION: These results suggest that more than half of geriatric patients with PEG may survive longer than 2 years. The analysis elucidated prognostic factors. | Yutaka Suzuki Seryna Tamez Akihiko Murakami Akihiko Taira Akihiro Mizuhara Akira Horiuchi Chie Mihara Eiji Ako Hirohito Muramatsu Hitoshi Okano Hitoshi Suenaga Kazuaki Jomoto Junya Kobayashi Katsunari Takifuji Kazuhiro Akiyama Koh Tahara Koji Onishi Makoto Shimazaki Masami Matsumoto Masashi Ijima Masato Murakami Masato Nakahori Michiaki Kudo Michio Maruyama Mikako Takahashi Naohiro Washizawa Shigeru Onozawa Satoshi Goshi Satoyoshi Yamashita Shigeki Ono Shin Imazato Shinji Nishiwaki Shuichirou Kitahara Takao Endo Takao Iiri Takeshi Nagahama Takuto Hikichi Tatsuya Mikami Tetsuo Yamamoto Tetsushi Ogawa Tomoko Ogawa Tomoyuki Ohta Toshifumi Matsumoto Toshiroh Kura Tsutomu Kikuchi Tsuyoshi Iwase Tsuyotoshi Tsuji Yukio Nishiguchi Mitsuyoshi Urashima | 2010 | World Journal of Gastroenterology2010，16，40： | 4 |
| 18 | Case of pediatric traditional serrated adenoma resected via endoscopic submucosal dissection显示文摘Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/polyps,and TSAs.TSA is the least common of the three types and accounts for about 5% of serrated polyps.Here we report a pediatric case of TSA that was successfully resected by endoscopic submucosal dissection(ESD).This rare case report describes a pediatric patient with no family history of colonic polyp who was admitted to our hospital with hematochezia.On colonoscopy,we found a polypoid lesion measuring 10 mm in diameter in the lower rectum.We selected ESD as a surgical option for en bloc resection,and histopathological examination revealed TSA.The findings in this case suggest that TSA with precancerous potential can occur in children,and that ESD is useful for treating this lesion. | Sonoko Kondo Hirohito Mori Noriko Nishiyama Takeo Kondo Ryuichi Shimono Hitoshi Okada Takashi Kusaka | 2017 | World Journal of Gastroenterology2017，23，24： | 4 |
| 19 | Effect of the anti-diabetic drug metformin in hepatocellular carcinomain vitro and in vivo显示文摘 | Hisaaki Miyoshi Kiyohito Kato Hisakazu Iwama Emiko Maeda Teppei Sakamoto Koji Fujita Yuka Toyota Joji Tani Takako Nomura Shima Mimura Mitsuyoshi Kobayashi Asahiro Morishita Hideki Kobara Hirohito Mori Hirohito Yoneyama Akihiro Deguchi Takashi Himoto Kazut | 2014 | International Journal of Oncology2014，，1： | 3 |
| 20 | Swallowed Fluticasone Improves Histologic but Not Symptomatic Response of Adults With Eosinophilic Esophagitis显示文摘 | Jeffrey A. Alexander Kee Wook Jung Amindra S. Arora Felicity Enders David A. Katzka Gail M. Kephardt Hirohito Kita Lori A. Kryzer Yvonne Romero Thomas C. Smyrk Nicholas J. Talley | 2012 | Clinical Gastroenterology and Hepatology2012，，7： | 3 |
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