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| 1 | Immunohistochemical molecular markers as predictors of curability of endoscopically resected submucosal colorectal cancer显示文摘AIM: To clarify the usefulness of immunohistochemical molecular markers in predicting lymph node metastasis of submucosal colorectal cancer. METHODS: We examined microvessel density, lymphatic vessel density, the Ki-67 labeling index, expression of MUC1 and Matrix metalloproteinase-7 (MMP-7) in tumor cells, and expression of cathepsin D in stromal cells at the invasive front by immunostaining of samples resected from 214 patients with submucosal colorectal cancer. Pathologic features were assessed on hematoxylin-eosin- stained samples. We evaluated the relations between clinicopathologic/immunohistochemical features and lymph node metastasis. RESULTS: Lesions of the superficial type, with an unfavorable histologic grade, budding, lymphatic involvement, high microvessel density (≥ 40), high lymphatic vessel density (≥ 9), high Ki-67 labeling index (≥ 42), and positivity of MUC1, cathepsin D, and MMP-7 showed a significantly high incidence of lymph node metastasis. Multivariate analysis revealed that high microvessel density, unfavorable histologic grade, cathepsin D positivity, high lymphatic vessel density, superficial type, budding, and MUC1 positivity were independent risk factors for lymph node metastasis.A combined examination with four independent immunohistochemical markers (microvessel density, cathepsin D, lymphatic vessel density, and MUC1) revealed that all lesions that were negative for all markers or positive for only one marker were negative for lymph node metastasis. CONCLUSION: Analysis of a combination of immuno- histochemical molecular markers in endoscopically resected specimens of submucosal colorectal cancer allows prediction of curability regardless of the pathologic features visible of hematoxylin-eosin-stained sections. | Iwao Kaneko Shinji Tanaka Shiro Oka Shigeto Yoshida Toru Hiyama Koji Arihiro Fumio Shimamoto Kazuaki Chayama | 2007 | World Journal of Gastroenterology2007，13，28： | 12 |
| 2 | 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 |
| 3 | Strategy for treatment of nonerosive reflux disease in Asia显示文摘The paper is to review the clinical and pathophysiologic differences between of nonerosive reflux disease (NERD) and reflux esophagitis (RE), and to propose a treatment strategy for NERD, especially for patients in Asia. A Medline search was performed regarding the clinical and pathophysiologic differences between NERD and RE, and treatment of NERD and RE. The characteristics of NERD patients in Asia are as follows: (1) high proportion of female patients, (2) low frequency of hiatal hernia, (3) high frequency of H pylori infection, (4) severe glandular atrophy of the gastric mucosa, and (5) frequent resistance to proton pump inhibitor (PPI) therapy. In Asian NERD patients, exposure of the esophagus to acid is not increased, and esophageal motility is normal. These characteristics are similar to those of patients in Western countries. Our recommended first-choice treatment is administration of PPI in combination with a prokinetic agent. However, at present, because there is limited evidence regarding effective treatments for NERD, it is best to try several different treatment strategies to find the best treatment for each patient. | Toru Hiyama Masaharu Yoshihara Shinji Tanaka Ken Haruma Kazuaki Chayama | 2008 | World Journal of Gastroenterology2008，14，20： | 10 |
| 4 | Defensive medicine practices among gastroenterologists in Japan显示文摘AIM: To clarify the prevalence of defensive medicine and the specific defensive medicine practices among gastro-enterologists in Japan.METHODS: A survey of gastroenterologists in Hiroshi-ma, Japan, was conducted by mail in March 2006. The number of gastroenterologists reporting defensive medi-cine behaviors or changes in their scope of practice and the reported defensive medicine practices, i.e., assurance and avoidance behaviors, were examined.RESULTS: A total of 131 (77%) out of 171 gastroenter-ologists completed the survey. Three (2%) respondents were sued, and most respondents (96%) had liability insurance. Nearly all respondents (98%) reported prac-ticing defensive medicine. Avoidance behaviors, such as avoiding certain procedures or interventions and avoiding caring for high-risk patients, were very common (96%). Seventy-five percent of respondents reported often avoiding certain procedures or interventions. However, seasoned gastroenterologists (those in practice for more than 20 years) adopted avoidance behaviors significantly less often than those in practice for less than 10 years. Assurance behaviors, i.e., supplying additional services of marginal or no medical value, were also widespread (91%). Sixty-eight percent of respondents reported that they sometimes or often referred patients to other spe-cialists unnecessarily.CONCLUSION: Defensive medicine may be highly prev-alent among gastroenterologists throughout Japan, withpotentially serious implications regarding costs, access, and both technical and interpersonal quality of care. | Toru Hiyama Masaharu Yoshihara Shinji Tanaka Yuji Urabe Yoshihiko Ikegami Tatsuma Fukuhara Kazuaki Chayama | 2006 | World Journal of Gastroenterology2006，12，47： | 7 |
| 5 | Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer显示文摘 | Shiro Oka Shinji Tanaka Iwao Kaneko Ritsuo Mouri Mayuko Hirata Toru Kawamura Masaharu Yoshihara Kazuaki Chayama | 2006 | Gastrointestinal Endoscopy2006，，6： | 6 |
| 6 | Endoscopic appearance of AIDS-related gastrointestinal lymphoma with c-MYC rearrangements: Case report and literature review显示文摘Acquired immune deficiency syndrome (AIDS)-related lymphoma (ARL) remains the main cause of AIDS-related deaths in the highly active anti-retroviral therapy (HAART) era. Recently, rearrangement of MYC is associated with poor prognosis in patients with diffuse large B-cell lymphoma. Here, we report a rare case of gastrointestinal (GI)-ARL with MYC rearrangements and coinfected with Epstein-Barr virus (EBV) infection presenting with various endoscopic findings. A 38-yearold homosexual man who presented with anemia and was diagnosed with an human immunodeficiency virus infection for the first time. GI endoscopy revealed multiple dish-like lesions, ulcerations, bloody spots, nodular masses with active bleeding in the stomach, erythematous flat lesions in the duodenum, and multiple nodular masses in the colon and rectum. Magnified endoscopy with narrow band imaging showed a honeycomb-like pattern without irregular microvessels in the dish-like lesions of the stomach. Biopsy specimens from the stomach, duodenum, colon, and rectum revealed diffuse large B-cell lymphoma concomitant with EBV infection that was detected by high tissue EBV-polymerase chain reaction levels and Epstein-Barr virus small RNAs in situ hybridization. Fluorescence in situ hybridization analysis revealed a fusion between the immunoglobulin heavy chain (IgH) and c-MYC genes, but not between the IgH and BCL2 loci. After 1-mo of treatment with HAART and R-CHOP, endoscopic appearance improved remarkably, and the histological features of the biopsy specimens revealed no evidence of lymphoma. However, he died from multiple organ failure on the 139 th day after diagnosis. The cause of his poor outcome may be related to MYC rearrangement. The GI tract involvement in ARL is rarely reported, and its endoscopic findings are various and may be different from those in non-AIDS GI lymphoma; thus, we also conducted a literature review of GI-ARL cases. | Shohei Tanaka Naoyoshi Nagata Sohtaro Mine Toru Igari Taiichiro Kobayashi Jun Sugihara Haruhito Honda Katsuji Teruya Yoshimi Kikuchi Shinichi Oka Naomi Uemura | 2013 | World Journal of Gastroenterology2013，19，29： | 3 |
| 7 | Quest for the best endoscopic imaging modality for computer-assisted colonic polyp staging显示文摘BACKGROUND It was shown in previous studies that high definition endoscopy, high magnification endoscopy and image enhancement technologies, such as chromoendoscopy and digital chromoendoscopy [narrow-band imaging(NBI), iScan] facilitate the detection and classification of colonic polyps during endoscopic sessions. However, there are no comprehensive studies so far that analyze which endoscopic imaging modalities facilitate the automated classification of colonic polyps. In this work, we investigate the impact of endoscopic imaging modalities on the results of computer-assisted diagnosis systems for colonic polyp staging.AIM To assess which endoscopic imaging modalities are best suited for the computerassisted staging of colonic polyps.METHODS In our experiments, we apply twelve state-of-the-art feature extraction methods for the classification of colonic polyps to five endoscopic image databases of colonic lesions. For this purpose, we employ a specifically designed experimental setup to avoid biases in the outcomes caused by differing numbers of images per image database. The image databases were obtained using different imaging modalities. Two databases were obtained by high-definition endoscopy in combination with i-Scan technology(one with chromoendoscopy and one without chromoendoscopy). Three databases were obtained by highmagnification endoscopy(two databases using narrow band imaging and one using chromoendoscopy). The lesions are categorized into non-neoplastic and neoplastic according to the histological diagnosis.RESULTS Generally, it is feature-dependent which imaging modalities achieve high results and which do not. For the high-definition image databases, we achieved overall classification rates of up to 79.2% with chromoendoscopy and 88.9% without chromoendoscopy. In the case of the database obtained by high-magnification chromoendoscopy, the classification rates were up to 81.4%. For the combination of high-magnification endoscopy with NBI, results of up to 97.4% for one database and up to 84% for the other were achieved. Non-neoplastic lesions were classified more accurately in general than non-neoplastic lesions. It was shown that the image recording conditions highly affect the performance of automated diagnosis systems and partly contribute to a stronger effect on the staging results than the used imaging modality.CONCLUSION Chromoendoscopy has a negative impact on the results of the methods. NBI is better suited than chromoendoscopy. High-definition and high-magnification endoscopy are equally suited. | Georg Wimmer Michael Gadermayr Gernot Wolkersdorfer Roland Kwitt Toru Tamaki Jens Tischendorf Michael Hafner Shigeto Yoshida Shinji Tanaka Dorit Merhof Andreas Uhl | 2019 | World Journal of Gastroenterology2019，25，10： | 2 |
| 8 | Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer显示文摘 | Shiro Oka Shinji Tanaka Iwao Kaneko Ritsuo Mouri Mayuko Hirata Toru Kawamura Masaharu Yoshihara Kazuaki Chayama | 2006 | Gastrointestinal Endoscopy2006，，6： | 2 |
| 9 | STAT3 deficiency prevents hepatocarcinogenesis and promotes biliary proliferation in thioacetamide-induced liver injury显示文摘AIM To elucidate the role of STAT3 in hepatocarcinogenesis and biliary ductular proliferation following chronic liver injury. METHODS We investigated thioacetamide(TAA)-induced liver injury, compensatory hepatocyte proliferation, and hepatocellular carcinoma(HCC) development in hepatic STAT3-deficient mice. In addition, we evaluated TAAinduced biliary ductular proliferation and analyzed the activation of sex determining region Y-box9(SOX9) and Yes-associated protein(YAP), which regulate the transdifferentiation of hepatocytes to cholangiocytes.RESULTS Both compensatory hepatocyte proliferation and HCC formation were significantly decreased in hepatic STAT3-deficient mice as compared with control mice. STAT3 deficiency resulted in augmentation of hepatic necrosis and fibrosis. On the other hand, biliary ductular proliferation increased in hepatic STAT3-deficient livers as compared with control livers. SOX9 and YAP were upregulated in hepatic STAT3-deficient hepatocytes.CONCLUSION STAT3 may regulate hepatocyte proliferation as well as transdifferentiation into cholangiocytes and serve as a therapeutic target for HCC inhibition and biliary regeneration. | Mitsuhiko Abe Takafumi Yoshida Jun Akiba Yu Ikezono Fumitaka Wada Atsutaka Masuda Takahiko Sakaue Toshimitsu Tanaka Hideki Iwamoto Toru Nakamura Michio Sata Hironori Koga Akihiko Yoshimura Takuji Torimura | 2017 | World Journal of Gastroenterology2017，23，37： | 2 |
| 10 | Long-term outcomes of extended radical resection combined with intraoperative radiation therapy for pancreatic cancer显示文摘 | Hiroshi Takamori Takehisa Hiraoka Keiichiro Kanemitsu Tatsuya Tsuji Hiroshi Tanaka Akira Chikamoto Kei Horino Toru Beppu Masahiko Hirota Hideo Baba | 2008 | Journal of Hepato - Biliary - Pancreatic Surgery2008，，6： | 2 |
| 11 | Vitamin D receptor expression is associated with colon cancer in ulcerativecolitis显示文摘 | Koji Wada Hiroaki Tanaka Kiyoshi Maeda Toru Inoue Eiji Noda Ryosuke Amano Naoshi Kubo Kazuya Muguruma Nobuya Yamada Masakazu Yashiro Tetsuji Sawada Bunzo Nakata Masaichi Ohira Kosei Hirakawa | 2009 | Oncology Reports2009，，5： | 2 |
| 12 | Validation study of postoperative liver failure and mortality risk scores after liver resection for perihilar cholangiocarcinoma显示文摘Background:Surgery for perihilar cholangiocarcinoma(PHCC)remains a challenging procedure with high morbidity and mortality.The Academic Medical Center(Amsterdam UMC)and Memorial Sloan Kettering Cancer Center proposed a postoperative mortality risk score(POMRS)and post-hepatectomy liver failure score(PHLFS)to predict patient outcomes.This study aimed to validate the POMRS and PHLFS for PHCC patients at Hokkaido University.Methods:Medical records of 260 consecutive PHCC patients who had undergone major hepatectomy with extrahepatic bile duct resection without pancreaticoduodenectomy at Hokkaido University between March 2001 and November 2018 were evaluated to validate the PHLFS and POMRS.Results:The observed risks for PHLF were 13.7%,24.5%,and 39.8%for the low-risk,intermediate-risk,and high-risk groups,respectively,in the study cohort.A receiver-operator characteristic(ROC)analysis revealed that the PHLFS had moderate predictive value,with an analysis under the curve(AUC)value of 0.62.Mortality rates based on the POMRS were 1.7%,5%,and 5.1%for the low-risk,intermediate-risk,and high-risk groups,respectively.The ROC analysis demonstrated an AUC value of 0.58.Conclusions:This external validation study showed that for PHLFS the threshold for discrimination in an Eastern cohort was reached(AUC>0.6),but it would require optimization of the model before use in clinical practice is acceptable.The POMRS were not applicable in the eastern cohort.Further external validation is recommended. | Takehiro Noji Satoko Uemura Jimme KWiggers Kimitaka Tanaka Yoshitsugu Nakanishi Toshimichi Asano Toru Nakamura Takahiro Tsuchikawa Keisuke Okamura Pim BOlthof William RJarnagin Thomas Mvan Gulik Satoshi Hirano | 2022 | Hepatobiliary Surgery and Nutrition2022，11，3： | 2 |
| 13 | Tribulusamide A and B, New Hepatoprotective Lignanamides from the Fruits of Tribulus terrestris: Indications of Cytoprotective Activity in Murine Hepatocyte Culture显示文摘 | Jian-Xin Li Qin Shi Quan-Bo Xiong Jeevan Prasain Yasuhiro Tezuka Toru Hareyama Zheng-Tao Wang Ken Tanaka Tsuneo Namba Shigetoshi Kadota | 1998 | Planta Med1998，，07： | 2 |
| 14 | Reduction in gastric cancer mortality by screening based on serum pepsinogen concentration: A case-control study显示文摘 | Masaharu Yoshihara Toru Hiyama Shigeto Yoshida Masanori Ito Shinji Tanaka Yoshiyuki Watanabe Ken Haruma | 2007 | Scandinavian Journal of Gastroenterology2007，，6： | 2 |
| 15 | Contrast-enhanced sonography of pancreatic carcinoma: correlations with pathological findings显示文摘 | Kazushi Numata Yutaka Ozawa Noritoshi Kobayashi Toru Kubota Hiroshi Shimada Akinori Nozawa Yukio Nakatani Kazuya Sugimori Kenichi Matsuo Toshio Imada Katsuaki Tanaka | 2005 | Journal of Gastroenterology2005，，6： | 2 |
| 16 | Effect of Sevelamer and Calcium-Based Phosphate Binders on Coronary Artery Calcification and Accumulation of Circulating Advanced Glycation End Products in Hemodialysis Patients显示文摘 | Takatoshi Kakuta Reika Tanaka Toru Hyodo Hajime Suzuki Genta Kanai Mikako Nagaoka Hiroo Takahashi Nobuhito Hirawa Yoichi Oogushi Toshio Miyata Hiroyuki Kobayashi Masafumi Fukagawa Akira Saito | 2011 | American Journal of Kidney Diseases2011，，3： | 2 |
| 17 | Production of intergeneric hybrid plants between Sandersonia aurantiaca and Gloriosa rothschildiana via ovule culture (Colchicaceae)显示文摘 | Toru Nakamura Sachiko Kuwayama Shigefumi Tanaka Tomo Oomiya Hiroyuki Saito Masaru Nakano | 2005 | Euphytica2005，，3： | 1 |
| 18 | Signaling axis in schwann cell proliferation and differentiation显示文摘 | Toru Ogata Shin-ichi Yamamoto Sakae Tanaka | 2006 | Molecular Neurobiology2006，，1： | 1 |
| 19 | Advantage of endoscopic submucosal dissection compared with EMR for early gastric cancer显示文摘 | Shiro Oka Shinji Tanaka Iwao Kaneko Ritsuo Mouri Mayuko Hirata Toru Kawamura Masaharu Yoshihara Kazuaki Chayama | 2006 | Gastrointestinal Endoscopy2006，，6： | 1 |
| 20 | IL-18 gene polymorphisms affect IL-18 production capability by monocytes显示文摘 | Junsuke Arimitsu Toru Hirano Shinji Higa Mari Kawai Tetsuji Naka Atsushi Ogata Yoshihito Shima Minoru Fujimoto Tomoki Yamadori Keisuke Hagiwara Tomoharu Ohgawara Yusuke Kuwabara Ichiro Kawase Toshio Tanaka | 2006 | Biochemical and Biophysical Research Communications2006，，4： | 1 |
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