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| 1 | Cancer-associated fibroblasts in hepatocellular carcinoma显示文摘The hepatic stellate cells in the liver are stimulated sustainably by chronic injury of the hepatocytes, activating myofibroblasts, which produce abundant collagen. Myofibroblasts are the major source of extracellular proteins during fibrogenesis, and may directly, or secreted products, contribute to carcinogenesis and tumor progression. Cancer-associated fibroblasts(CAFs) are one of the components of the tumor microenvironment that promote the proliferation and invasion of cancer cells by secreting various growth factors and cytokines. CAFs crosstalk with cancer cells stimulates tumor progression by creating a favorable microenvironment for progression, invasion, and metastasis through the epithelial-mesenchymal transition. Basic studies on CAFs have advanced, and the role of CAFs in tumors has been elucidated. In particular, for hepatocellular carcinoma, carcinogenesis from cirrhosis is a known fact, and participation of CAFs in carcinogenesis is supported. In this review, we discuss the current literature on the role of CAFs and CAF-related signaling in carcinogenesis, crosstalk with cancer cells, immunosuppressive effects, angiogenesis, therapeutic targets, and resistance to chemotherapy. The role of CAFs is important in cancer initiation and progression. CAF-targeted therapy may be effective for suppression not only of fibrosis but also cancer progression. | Norio Kubo Kenichiro Araki Hiroyuki Kuwano Ken Shirabe | 2016 | World Journal of Gastroenterology2016，22，30： | 25 |
| 2 | Clinical investigation of 41 patients with ischemic colitis accompanied by ulcer显示文摘AIM: To investigate the relationship among the presence of ulcer lesions, underlying disease, and clinical course in patients with ischemic colitis. METHODS: The subjects were 41 patients (10 male and 31 female; mean age 70 years) with ischemic colitis who were admitted to and received treatment in our hospital from 2000 to 2006. We compared their characteristics and analyzed the mean lengths of admission and fast- ing for 9 patients with ulcer lesions (ulcer group) and 32 without (non-ulcer group). RESULTS: The groups with presence and absence of ulcer differed significantly only in white blood cell (WBC) count. Lengths of fasting and admission were 7.9 d and 17.9 d for the ulcer group and 4.4 d and 10.7 d for the non-ulcer group, respectively, and significantly longer in the ulcer group (P = 0.0057 and 0.0001). There was no correlation between presence of ulcer and presence of underlying diseases. CONCLUSION: Lengths of fasting and admission were significantly longer in patients with ischemic colitis with ulcer than for those without ulcer. | Satohiro Matsumoto Kenichiro Tsuji Satoshi Shirahama | 2007 | World Journal of Gastroenterology2007，13，8： | 18 |
| 3 | Xanthogranulomatous cholecystitis:Difficulty in differentiating from gallbladder cancer显示文摘AIM: To compare cases of xanthogranulomatous cholecystitis(XGC) and advanced gallbladder cancer and discuss the differential diagnoses and surgical options.METHODS: From April 2000 to December 2013, 6 XGC patients received extended surgical resections. During the same period, 16 patients were proven to have gallbladder(GB) cancer, according to extended surgical resection. Subjects chosen for analysis in this study were restricted to cases of XGC with indistinct borders with the liver as it is often difficult to distinguish these patients from those with advanced GB cancer. We compared the clinical features and computed tomography findings between XGC and advanced GB cancer. The following clinical features were retrospectively assessed: age, gender, symptoms, and tumor markers. As albumin and the neutrophil/lymphocyte ratio(NLR) are prognostic in several cancers, we compared serum albumin levels and the NLR between the two groups. The computerized tomography findings were used to compare the two diseases, determine the coexistence of gallstones, the pattern of GB thickening(focal or diffuse), the presence of a hypoattenuated intramural nodule, and continuity of the mucosal line.RESULTS: Based on the preoperative image findings, we suspected GB carcinoma in all cases includingXGC in this series. In addition, by pathological examination, we found that the group of patients with XGC developed inflammatory disease after surgery. Patients with XGC tended to have abdominal pain(4/6, 67%). However, there was no significant difference in clinical symptoms, including fever, between the two groups. Serum albumin and NLR were also similar in the two groups. Serum tumor markers, such as carcinoembryonic antigen(CEA) and carbohydrate antigen 19-9(CA19-9), tended to increase in patients with GB cancer. However, no significant differences in tumor markers were identified. On the other hand, gallstones were more frequently observed in patients with XGC(5/6, 83%) than in patients with GB cancer(4/16, 33%)(P = 0.0116). A hypoattenuated intramural nodule was found in 3 patients with XGC(3/6, 50%), but in only 1 patient with GB cancer(1/16, 6%)(P = 0.0024). The GB thickness, continuous mucosal line, and bile duct dilatation showed no significant differences between XGC and GB cancer.CONCLUSION: Although XGC is often difficult to differentiate from GB carcinoma, it is possible to obtain an accurate diagnosis by careful intraoperative gross observation, and several intraoperative frozen sections. | Hideki Suzuki Satoshi Wada Kenichiro Araki Norio Kubo Akira Watanabe Mariko Tsukagoshi Hiroyuki Kuwano | 2015 | World Journal of Gastroenterology2015，21，35： | 18 |
| 4 | Diagnosis of autoimmune pancreatitis显示文摘Autoimmune pancreatitis(AIP) is a distinct form of chronic pancreatitis that is increasingly being reported. The presentation and clinical image findings of AIP sometimes resemble those of several pancreatic malignancies, but the therapeutic strategy differs appreciably. Therefore, accurate diagnosis is necessary for cases of AIP. To date, AIP is classified into two distinct subtypes from the viewpoints of etiology, serum markers, histology, other organ involvements, and frequency of relapse: type 1 is related to Ig G4(lymphoplasmacytic sclerosing pancreatitis) and type 2 is related to a granulocytic epithelial lesion(idiopathic duct-centric chronic pancreatitis). Both types of AIP are characterized by focal or diffuse pancreatic enlargement accompanied with a narrowing of the main pancreatic duct, and both show dramatic responses to corticosteroid. Unlike type 2, type 1 is characteristically associated with increasing levels of serum Ig G4 and positive serum autoantibodies, abundant infiltration of Ig G4-positive plasmacytes, frequent extrapancreatic lesions, and relapse. These findings have led several countries to propose diagnostic criteria for AIP, which consist of essentially similar diagnostic items; however, several differences exist for each country, mainly due to differences in the definition of AIP and the modalities used to diagnose this disease. An attempt to unite the diagnostic criteria worldwide was made with the publication in 2011 of the international consensus diagnostic criteria for AIP, established at the 2010 Congress of the International Association of Pancreatology(IAP). | Hiroyuki Matsubayashi Naomi Kakushima Kohei Takizawa Masaki Tanaka Kenichiro Imai Kinichi Hotta Hiroyuki Ono | 2014 | World Journal of Gastroenterology2014，20，44： | 17 |
| 5 | Helicobacter pylori infection and liver diseases: Epidemiology and insights into pathogenesis显示文摘Both Helicobacter pylori(H. pylori) infection and liver diseases, including nonalcoholic fatty liver disease(NAFLD), viral hepatitis, and hepatocellular carcinoma(HCC), have high prevalences worldwide, and the relationship between H. pylori infection and liver disease has been discussed for many years. Although positive correlations between H. pylori and NAFLD have been identified in some clinical and experimental studies, nega-tive correlations have also been obtained in high-quality clinical studies. Associations between H. pylori and the pathogenesis of chronic viral hepatitis, mainly disease progression with fibrosis, have also been suggested in some clinical studies. Concerning HCC, a possible role for H. pylori in hepatocarcinogenesis has been identified since H. pylori genes have frequently been detected in resected HCC specimens. However, no study hasrevealed the direct involvement of H. pylori in promoting the development of HCC. Although findings regarding the correlations between H. pylori and liver disease pathogenesis have been accumulating, the existing data do not completely lead to an unequivocal conclusion. Further high-quality clinical and experimental analyses are necessary to evaluate the efficacy of H. pylori eradication in ameliorating the histopathological changes observed in each liver disease. | Kazuya Okushin Takeya Tsutsumi Kazuhiko Ikeuchi Akira Kado Kenichiro Enooku Hidetaka Fujinaga Kyoji Moriya Hiroshi Yotsuyanagi Kazuhiko Koike | 2018 | World Journal of Gastroenterology2018，24，32： | 15 |
| 6 | Results of mass endoscopic examination for gastric cancer in Kamigoto Hospital,Nagasaki Prefecture显示文摘AIM:To examine how the introduction of endoscopy to gastric cancer screening affected survival prognosis in a regional population. METHODS: The subjects comprised 4261 residents of Kamigoto,Nagasaki Prefecture,who underwent gastric X-ray examination for gastric cancer screening from 1991 to 1995,and all 7178 residents who underwent endoscopic examination for the same purpose from 1996 to 2003. The analysis evaluated trends in age-adjusted gastric cancer mortality rates and standard mortality ratios (SMRs) among the Kamigoto residents. RESULTS: According to demographic statistics,the 1995 and 2000 age-adjusted gastric cancer mortality rates in Nagasaki Prefecture (per 100 000 population) were 42.6 and 37.3 for males and 18.6 and 16.0 for females,while the corresponding rates in Kamigoto before and after the introduction of endoscopic screening were respectively 51.9 and 28.0,and 26.6 and 6.9. The data obtained in this study were divided into those for two periods,1990-1996 and 1997-2006,and SMRs were calculated separately for males and females. For the first period,the SMR was 1.04 (95% CI 0.50-1.58) for males and 1.54 (95% CI 0.71-2.38) for females,while for the second period the SMR was 0.71 (95% CI 0.33-1.10) for males and 0.62 (95% CI 0.19-1.05) for females. CONCLUSION: Following the introduction of endoscopic examination,gastric cancer death rates decreased in Kamigoto. | Satohiro Matsumoto Kazumi Yamasaki Kenichiro Tsuji Satoshi Shirahama | 2007 | World Journal of Gastroenterology2007，13，32： | 13 |
| 7 | Endoscopic ultrasonography guided-fine needle aspirationfor the diagnosis of solid pancreaticobiliary lesions:Clinicalaspects to improve the diagnosis显示文摘Endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA) has been applied to pancreaticobiliary lesions since the 1990 s and is in widespread use throughout the world today. We used this method to confirm the pathological evidence of the pancreaticobiliary lesions and to perform suitable therapies. Complications of EUS-FNA are quite rare, but some of them are severe. Operators should master conventional EUS observation and experience a minimum of 20-30 cases of supervised EUS-FNA on non-pancreatic and pancreatic lesions before attempting solo EUSFNA. Studies conducted on pancreaticobiliary EUSFNA have focused on selection of suitable instruments(e.g., needle selection) and sampling techniques(e.g., fanning method, suction level, with or without a stylet, optimum number of passes). Today, the diagnostic ability of EUS-FNA is still improving; the detection of pancreatic cancer(PC) currently has a sensitivity of 90%-95% and specificity of 95%-100%. In addition to PC, a variety of rare pancreatic tumors can be discriminated by conducting immunohistochemistry on the FNA materials. A flexible, large caliber needle has been used to obtain a large piece of tissue, which can provide sufficient histological information to be helpful in classifying benign pancreatic lesions. EUSFNA can supply high diagnostic yields even for biliary lesions or peri-pancreaticobiliary lymph nodes. This review focuses on the clinical aspects of EUS-FNA in the pancreaticobiliary field, with the aim of providing information that can enable more accurate and efficient diagnosis. | Hiroyuki Matsubayashi Toru Matsui Yohei Yabuuchi Kenichiro Imai Masaki Tanaka Naomi Kakushima Keiko Sasaki Hiroyuki Ono | 2016 | World Journal of Gastroenterology2016，22，2： | 12 |
| 8 | Dietary habits and behaviors associated with nonalcoholic fatty liver disease显示文摘Nonalcoholic fatty liver disease(NAFLD)is one of the most frequent causes of health problems in Western(industrialized)countries.Moreover,the incidence of infantile NAFLD is increasing,with some of these patients progressing to nonalcoholic steatohepatitis.These trends depend on dietary habits and life-style.In particular,overeating and its associated obesity affect the development of NAFLD.Nutritional problems in patients with NAFLD include excess intake of energy,carbohydrates,and lipids,and shortages of polyunsaturated fatty acids,vitamins,and minerals.Although nutritional therapeutic approaches are required for prophylaxis and treatment of NAFLD,continuous nutrition therapy is difficult for many patients because of their dietary habits and lifestyle,and because the motivation for treatment differs among patients.Thus,it is necessary to assess the nutritional background and to identify nutritional problems in each patient with NAFLD.When assessing dietary habits,it is important to individually evaluate those that are consumed excessively or insufficiently,as well as inappropriate eating behaviors.Successful nutrition therapy requires patient education,based on assessments of individual nutrients,and continuing the treatment.In this article,we update knowledge about NAFLD,review the important aspects of nutritional assessment targeting treatment success,and present some concrete nutritional care plans which can be applied generally. | Kenichiro Yasutake Motoyuki Kohjima Kazuhiro Kotoh Manabu Nakashima Makoto Nakamuta Munechika Enjoji | 2014 | World Journal of Gastroenterology2014，20，7： | 9 |
| 9 | Distribution of late gadolinium enhancement in various types of cardiomyopathies:Significance in differential diagnosis, clinical features and prognosis显示文摘The recent development of cardiac magnetic resonance(CMR)techniques has allowed detailed analyses of cardiac function and tissue characterization with high spatial resolution.We review characteristic CMR features in ischemic and non-ischemic cardiomyopathies(ICM and NICM),especially in terms of the location and distribution of late gadolinium enhancement(LGE).CMR in ICM shows segmental wall motion abnormalities or wall thinning in a particular coronary arterial territory,and the subendocardial or transmural LGE.LGE in NICM generally does not correspond to any particular coronary artery distribution and is located mostly in the mid-wall to subepicardial layer.The analysis of LGE distribution is valuable to differentiate NICM with diffusely impaired systolic function,including dilated cardiomyopathy,end-stage hypertrophic cardiomyopathy(HCM),cardiac sarcoidosis,and myocarditis,and those with diffuse left ventricular(LV)hypertrophy including HCM,cardiac amyloidosis and Anderson-Fabry disease.A transient low signal intensity LGE in regions of severe LV dysfunction is a particular feature of stress cardiomyopathy.In arrhythmogenic right ventricular cardiomyopathy/dysplasia,an enhancement of right ventricular(RV)wall with functional and morphological changes of RV becomes apparent.Finally,the analyses of LGE distribution have potentials to predict cardiac outcomes and response to treatments. | Hiroshi Satoh Makoto Sano Kenichiro Suwa Takeji Saitoh Mamoru Nobuhara Masao Saotome Tsuyoshi Urushida Hideki Katoh Hideharu Hayashi | 2014 | World Journal of Cardiology2014，6，7： | 8 |
| 10 | A body mass index ≥25 kg/m2 is associated with a poor prognosis in patients with acute pancreatitis: a study of Japanese patients显示文摘BACKGROUND:In Asian population, there is limited infor mation on the relevance between obesity and poor outcomes in acute pancreatitis(AP). The objective of this study was to examine the clinical impact of obesity based on body mass index(BMI) on prognosis of AP in Japanese patients.METHODS:A total of 116 patients with AP were enrolled in this study. Univariate and multivariate logistic regression analyses were performed to examine relations between BMI and patients' outcomes. Additionally, to investigate whether including obesity as a prognostic factor improved the predic tive accuracy of a Japanese prognostic factor score(PF score)a receiver-operating characteristic(ROC) curve analysis of mortality was conducted.RESULTS:Multiple logistic regression analyses revealed that BMI ≥25 kg/m^2 was associated with a significant higher mor tality [odds ratio(OR)=15.8; 95% confidence interval(CI):1.1-227; P=0.043]. The area under the ROC curve(AUC) for the combination of PF score and BMI ≥25 kg/m^2(AUC=0.881;95% CI:0.809-0.952) was higher than that for the PF score alone(AUC=0.820; 95% CI:0.713-0.927)(P=0.034).CONCLUSIONS:The negative impact of a high BMI on the prognosis of AP was confirmed in a Japanese population Including BMI ≥25 kg/m2 as an additional parameter to PF score enhanced the predictive value of the PF score for AP-related mortality. | Tsukasa Ikeura Kota Kato Makoto Takaoka Masaaki Shimatani Masanobu Kishimoto Kenichiro Nishi Shuji Kariya Kazuichi Okazaki | 2017 | Hepatobiliary & Pancreatic Diseases International2017，16，6： | 8 |
| 11 | Coexistence of esophageal superficial carcinoma and multiple leiomyomas:A case report显示文摘平滑肌瘤是食管的最普通的良性瘤。他们通常作为单个损害或作为二或三个小瘤发生。仅仅包括超过 10 个小瘤的食道的多重平滑肌瘤的二个案例以前被报导了。而且,有食道的有鳞的房间癌覆闷死粘膜下层肿瘤的很少报告。我们描述作为有表面的食道的癌症与二或三个平滑肌瘤小瘤共存被诊断的一个 71 岁的人。在外科期间, 10 或一直不外科手术前地是明显的更多的小瘤在整个食管在粘膜下层和肌层是摸得出的。当食道的癌症的内部转移被怀疑,我们认为另外的淋巴是腺切除术,但是因为病人的严重血缺氧,不得不排除这种选择。显微镜检查表明所有小瘤是平滑肌瘤(20 损害,在直径的多达 3 厘米) ,并且癌房间的那侵略被限制到粘膜下层层 overlying 一个相对大的平滑肌瘤。这是与众多的独居的平滑肌瘤共存的表面的食道的癌症的第一份报告。多重极小的平滑肌瘤经常也在一个癌损害罐头的底作为内部转移,和一个平滑肌瘤被误诊作为肿瘤侵略被误诊。现在的案例证明那精确诊断与共存为病人的管理被要求表面的食道的癌症和多重平滑肌瘤。 | Takeshi Iwaya Chihaya Maesawa Noriyuki Uesugi Toshimoto Kimura Kenichiro Ikeda Yusuke Kimura Shingo Mitomo Kaoru Ishida Nobuhiro Sato Go Wakabayashi | 2006 | World Journal of Gastroenterology2006，12，28： | 7 |
| 12 | Two-week treatment with proton pump inhibitor is sufficient for healing post endoscopic submucosal dissection ulcers显示文摘AIM:To investigate the optimum period of treatment for post endoscopic submucosal dissection(ESD)ulcers.METHODS:Patients who underwent ESD for gastric cancer were randomized to two groups and treated with esomeprazole 20 mg per day for 4 wk(4W group)or 2 wk(2W group).At 4 wk after ESD,we measured the size of the artificial ulcers by endoscopy and determined the ulcer healing rate,compared with the size of the ESD specimens.This randomized controlled trial study was approved by our ethics committee and registered in the UMIN Clinical Trial Registry.RESULTS:A total of 60 consecutive patients were included in the study.All patients received rebamipide 300 mg per day for 4 wk.One patient in 2W group who showed bleeding within two weeks and received endoscopic treatment was excluded from further analysis.The numbers of patients with ulcers in the healing/scar stage in the 2W and 4W groups at 4 wk after ESD were 20/6 and 28/5,respectively,with no significant difference.The ulcer healing rate in the 2W and 4W groups were 96.1%[95%confidence interval(CI):94.6%-97.55]vs 94.8%(95%CI:92.6%-97.1%),respectively,with no statistical difference(UMIN000006951).CONCLUSION:Two-wk treatment with a proton pump inhibitor is as effective as four-week treatment for healing post ESD ulcers. | Makoto Arai Tomoaki Matsumura Kenichiro Okimoto Arata Oyamada Keiko Saito Shoko Minemura Daisuke Maruoka Takeshi Tanaka Tomoo Nakagawa Tatsuro Katsuno Osamu Yokosuka | 2014 | World Journal of Gastroenterology2014，20，43： | 6 |
| 13 | Endoscopic naso-pancreatic drainage for the treatment of pancreatic fistula occurring after LDLT显示文摘Pancreatic fistula is a quite rare complication in patients who undergo living donor liver transplantation(LDLT).However,in the cases that show pancreatic fistula,the limited volume of the graft and the resultant inadequate liver function may complicate the management of the fistula.As a result,the pancreatic fistula may result in the death of the patient.We present 2 cases in whichendoscopic treatment was effective against pancreatic fistulas that developed after LDLT.In case 1,a 61-yearold woman underwent LDLT for primary biliary cirrhosis.Because of a portal venous thrombus caused by a splenorenal shunt,the patient underwent portal vein reconstruction,and a splenorenal shunt was ligated on postoperative day(POD)7.The main pancreatic duct was injured during the manipulation to achieve hemostasis,thereby necessitating open drainage.However,discharge of pancreatic fluid continued even after POD 300.Endoscopic naso-pancreatic drainage(ENPD)was performed,and this procedure resulted in a remarkable decrease in drain output.The refractory pancreatic fistula healed on day 40 after ENPD.In case 2,a 58-year-old man underwent LDLT for cirrhosis caused by the hepatitis C virus.When the portal vein was exposed during thrombectomy,the pancreatic head was injured,which led to the formation of a pancreatic fistula.Conservative therapy was ineffective;therefore,ENPD was performed.The pancreatic fistula healed on day 38 after ENPD.The findings in these 2 cases show that endoscopic drainage of the main pancreatic duct is a less invasive and effective treatment for pancreatic fistulas that develop after LDLT. | Akihisa Nagatsu Toshiya Kamiyama Satoru Todo Masahiko Taniguchi Tomomi Suzuki Hiroyuki Furukawa Tsuyoshi Shimamura Kenichiro Yamashita Hiroshi Kawakami Daisuke Abo | 2011 | World Journal of Gastroenterology2011，17，30： | 5 |
| 14 | Rebamipide enema therapy for left-sided ischemic colitis patients accompanied by ulcers:Open label study显示文摘AIM: To attempt rectal administration of rebamipide in the treatment of ischemic colitis patients with ulcers, and evaluate its effects. METHODS: We compared 9 ischemic colitis patients (2 men, 7 women) with ulcers treated by bowel rest only from 2000 to 2005 (conventional therapy group), with 6 patients (2 men, 4 women) treated by rebamipide enema therapy in 2006 (rebamipide enema therapy group) and analyzed the mean duration of fasting and hospitalization, degree of ulcer healing, and decrease in WBC count for the two groups. RESULTS: The mean duration of fasting and hos- pitalization were 2.7 ± 1.8 d and 9.2 ± 1.5 d in the rebamipide group and 7.9 ± 4.1 d and 17.9 ± 6.8 d in the control group, respectively, and signifi cantly re- duced in the rebamipide group (t = -2.915; P = 0.0121 and t = -3.054; P = 0.0092). As for the degree of ul- cer healing at 7 d after admission, the ulcer score was reduced by 3.5 ± 0.5 (points) in the rebamipide group and 2.8 ± 0.5 (points) in the control group (t = 1.975; P = 0.0797), while the decrease in WBC count was 120.0 ± 55.8 (× 102/μL) in the rebamipide group and 85.9 ± 56.8 (× 102/μL) in the control group (t = 1.006; P = 0.3360). CONCLUSION: In left-sided ischemic colitis patients with ulcers, rebamipide enema therapy significantly reduced the duration of fasting and hospitalization, recommending its use as a new and effective thera- peutic alternative. | Satohiro Matsumoto Kenichiro Tsuji Satoshi Shirahama | 2008 | World Journal of Gastroenterology2008，14，25： | 5 |
| 15 | Assessment of disease progression in patients with transfusion-associated chronic hepatitis C using transient elastography显示文摘AIM:To evaluate the relationship between liver stiffness and duration of infection in blood transfusion-associated hepatitis C virus (HCV) patients with or without hepatocellular carcinoma (HCC).METHODS:Between December 2006 and June 2008,a total of 524 transfusion-associated HCV-RNA positive patients with or without HCC were enrolled.Liver stiffness was obtained noninvasively by using Fibroscan (Echosens,Paris,France).The date of blood transfusion was obtained by interview.Duration of infection was derived from the interval between the date of bloodtransfusion and the date of liver stiffness measurement (LSM).Patients were stratified into four groups based on the duration of infection (17-29 years;30-39 years;40-49 years;and 50-70 years).The difference in liver stiffness between patients with and without HCC was assessed in each group.Multiple linear regression analysis was used to determine the factors associated with liver stiffness.RESULTS:A total of 524 patients underwent LSM.Eight patients were excluded because of unsuccessful measurements.Thus 516 patients were included in the current analysis (225 with HCC and 291 without).The patients were 244 men and 272 women,with a mean age of 67.8 ± 9.5 years.The median liver stiffness was 14.3 kPa (25.8 in HCC group and 7.6 in nonHCC group).The patients who developed HCC in short duration of infection were male dominant,having lower platelet count,with a history of heavier alcohol consumption,showing higher liver stiffness,and receiving blood transfusion at an old age.Liver stiffness was positively correlated with duration of infection in patients without HCC (r=0.132,P=0.024) but not in patients with HCC (r=-0.103,P=0.123).Liver stiffness was significantly higher in patients with HCC than in those without in each duration group (P < 0.0001).The factors significantly associated with high liver stiffness in multiple regression were age at blood transfusion (P < 0.0001),duration of infection (P=0.0015),and heavy alcohol consumption (P=0.043) CONCLUSION:Although liver stiffness gradually increases over time,HCC develops in patients with high stiffness value regardless of the duration of infection. | Ryota Masuzaki Ryosuke Tateishi Haruhiko Yoshida Toru Arano Koji Uchino Kenichiro Enooku Eriko Goto Hayato Nakagawa Yoshinari Asaoka Yuji Kondo Tadashi Goto Hitoshi Ikeda Shuichiro Shiina Masao Omata Kazuhiko Koike | 2012 | World Journal of Gastroenterology2012，18，12： | 4 |
| 16 | Ectopic gastrointestinal variceal bleeding with portal hypertension显示文摘Massive gastrointestinal bleeding from gastrointestinal varices is one of the most serious complications in patients with portal hypertension. However, if no bleeding point can be detected by endoscopy in the predilection sites of gastrointestinal varices, such as the esophagus and stomach, ectopic gastrointestinal variceal bleeding should be considered as a differential diagnosis. Herein, we report a case of ectopic ileal variceal bleeding in a 57-year-old woman, which was successfully diagnosed by multi-detector row CT(MDCT) and angiography and treated by segmental ileum resection. To date, there have been no consensus for the treatment of ectopic ileal variceal bleeding. This review was designed to clarify the clinical characteristics of patients with ectopic ileal variceal and discuss possible treatment strategies. From the PubMed database and our own database, we reviewed 21 consecutive cases of ileal variceal bleeding diagnosed from 1982 to 2017. MDCT and angiography is useful for the rapid examination and surgical resection of an affected lesion and is a safe and effective treatment strategy to avoid further bleeding. | Keita Minowa Shuhei Komatsu Kenichiro Takashina Sachie Tanaka Tatsuya Kumano Kenichiro Imura Katsumi Shimomura Jun Ikeda Fumihiro Taniguchi Yasuo Ueshima Tecchuu Lee Eito Ikeda Eigo Otsuji Yasuhiro Shioaki | 2017 | World Journal of Gastrointestinal Surgery2017，9，12： | 4 |
| 17 | Resected case of eosinophilic cholangiopathy presenting with secondary sclerosing cholangitis显示文摘Eosinophilic cholangiopathy is a rare condition characterized by eosinophilic infiltration of the biliary tract and causes sclerosing cholangitis.We report a patient with secondary sclerosing cholangitis with eosinophilic cholecystitis.A 46-year-old Japanese man was admitted to our hospital with jaundice. Computed tomography revealed dilatation of both the intrahepatic and extrahepatic bile ducts,diffuse thickening of the wall of the extrahepatic bile duct,and thickening of the gallbladder wall.Under the diagnosis of lower bile duct carcinoma,he underwent pyloruspreserving pancreatoduodenectomy and liver biopsy. On histopathological examination,conspicuous fibrosis was seen in the lower bile duct wall.In the gallbladder wall,marked eosinophilic infiltration was seen.Liver biopsy revealed mild portal fibrosis.He was diagnosed as definite eosinophilic cholecystitis with sclerosing cholangitis with unknown etiology.The possible etiology of sclerosing cholangitis was consequent fibrosis from previous eosinophilic infiltration in the bile duct.The clinicopathological findings of our case and a literature review indicated that eosinophilic cholangiopathy could cause a condition mimicking primary sclerosing cholangitis(PSC).Bile duct wall thickening in patientswith eosinophilic cholangitis might be due to fibrosis of the bile duct wall.Eosinophilic cholangiopathy might be confused as PSC with eosinophilia. | Fumihiko Miura Takehide Asano Hodaka Amano Masahiro Yoshida Naoyuki Toyota Keita Wada Kenichiro Kato Tadahiro Takada Junichi Fukushima Fukuo Kondo Hajime Takikawa | 2009 | World Journal of Gastroenterology2009，15，11： | 4 |
| 18 | 一种新型桥梁结构——镂空蝴蝶形腹板桥梁的设计和施工显示文摘该文介绍了日本的一座新型桥梁结构,镂空混凝土腹板桥梁,又叫蝴蝶形腹板梁桥。这种桥梁结构形式采用工厂化预制的蝴蝶形腹板。与传统混凝土箱形梁桥相比,这种新型结构梁桥的恒载自重减轻了大约10%,与此同时,预应力钢筋数量和下部结构尺寸也随之减小,大大节约了工程造价。该桥型具有自重轻、可工厂化预制、施工工期短、养护费用低和环保等诸多优点,适用于中小跨径桥梁的设计和施工。 | 黄睿奕 Yuki KAMINAGA Kenichiro ASHIZUKA Akira TAKAHASHI | 2017 | 中外公路2017，37，3： | 4 |
| 19 | Hand-assisted laparoscopic restorative proctocolectomy for ulcerative colitis显示文摘AIM To evaluate the utility of hand-assisted laparoscopic restorative proctocolectomy(HALS-RP) compared with the conventional open procedure(OPEN-RP).METHODS Fifty-one patients who underwent restorative total proctocolectomy with rectal mucosectomy and ileal pouch anal anastomosis between January 2008 and July 2015 were retrospectively analyzed.Twentythree patients in the HALS-RP group and twentyfour patients in the OPEN-RP group were compared.Four patients who had purely laparoscopic surgery were excluded.Restorative total proctocolectomy was performed with mucosectomy and a hand-sewn ilealpouch-anal anastomosis.Preoperative comorbidities,intraoperative factors such as blood loss and operative time,postoperative complications,and postoperative course were compared between two groups.RESULTS Patients in both groups were matched with regards to patient age,gender,and American Society of Anesthesiologists score.There were no significant differences in extent of colitis,indications for surgery,preoperative comorbidities,and preoperative medications in the two groups.The median operative time for the HALS-RP group was 369(320-420) min,slightly longer than the OPEN-RP group at 355(318-421) min; this was not statistically significant.Blood loss was significantly less in HALS-RP [300(230-402) m L] compared to OPEN-RP [512(401-1162) m L,P = 0.003].Anastomotic leakage was noted in 3 patients in the HALS-RP group and 2 patients in the OPEN-RP group(13% vs 8.3%,NS).The rates of other postoperative complications and the length of hospital stay were not different between the two groups.CONCLUSION HALS-RP can be performed with less blood loss and smaller skin incisions.This procedure is a feasible technique for total proctocolectomy for ulcerative colitis. | Norimitsu Shimada Hiroki Ohge Raita Yano Naoki Murao Norifumi Shigemoto Shinnosuke Uegami Yusuke Watadani Kenichiro Uemura Yoshiaki Murakami Taijiro Sueda | 2016 | World Journal of Gastrointestinal Surgery2016，8，8： | 4 |
| 20 | Characteristics of symptomatic reflux episodes in Japanese proton pump inhibitor-refractory non-erosive reflux disease patients显示文摘AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease(NERD) patients.METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg twice daily for at least 8 wk, were included in this study. All patients underwent 24 h combined impedance- p H on rabeprazole. The symptom index(SI) was considered to be positive if ≥ 50%, and proximal reflux episodes were determined when reflux reached 15 cm above the proximal margin of the lower esophageal sphincter.RESULTS: In 14(40%) SI-positive patients, with liquid weakly acid reflux, the occurrence rate of reflux symptoms was significantly more frequent in proximal reflux episodes(46.7%) than in distal ones(5.7%)(P < 0.001). With liquid acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(38.5%) and distal ones(20.5%)(NS). With mixed liquid-gas weakly acid reflux, the occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent(31.0%) than in distal reflux ones(3.3%)(P < 0.001). With mixed liquid-gas acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(29.4%) and distal ones(14.3%)(NS).CONCLUSION: The proximal extent of weakly acidic liquid and mixed liquid-gas reflux is a major factor associated with reflux perception in SI-positive patients on proton pump inhibitor therapy. | Kenichiro Nakagawa Tomoyuki Koike Katsunori Iijima Masahiro Saito Hiroki Kikuchi Waku Hatta Nobuyuki Ara Kaname Uno Naoki Asano Tooru Shimosegawa | 2015 | World Journal of Gastroenterology2015，21，47： | 4 |
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