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1Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis显示文摘AIM:To investigate whether a noninvasive measurement of tissue strain has a potential usefulness for management of nonalcoholic steatohepatitis(NASH).METHODS:In total 26 patients,23 NASHs and 3 normal controls were enrolled in this study.NASH was staged based on Brunt criterion.At a region of interest(ROI),a shear wave was evoked by implementing an acoustic radiation force impulse(ARFI),and the propagation velocity was quantif ied.RESULTS:Shear wave velocity(SWV) could be reproducibly quantified at all ROIs in all subjects except for 4 NASH cases,in which a reliable SWV value was not calculated at several ROIs.An average SWV of 1.34 ± 0.26 m/s in fibrous stage 0-1 was significantly slower than 2.20 ± 0.74 m/s and 2.90 ± 1.01 m/s in stages 3 and 4,respectively,but was not significantly different from 1.79 ± 0.78 m/s in stage 2.When a cutoff value was set at 1.47 m/s,receiver operating characteristic analysis showed significance to dissociate stages 3 and 4 from stage 0-1(P=0.0092) with sensitivity,specificity and area under curve of 100%,75% and 94.2%,respectively.In addition,the correlation between SWV and hyaluronic acid was significant(P<0.0001),while a tendency toward negative correlation was observed with serum albumin(P=0.053).CONCLUSION:The clinical implementation of ARFI provides noninvasive repeated evaluations of liver stiffness at an arbitrary position,which has the potential to shed new light on NASH management.Akihiko Osaki Tomoyuki Kubota Takeshi Suda Masato Igarashi Keisuke Nagasaki Atsunori Tsuchiya Masahiko Yano Yasushi Tamura Masaaki Takamura Hirokazu Kawai Satoshi Yamagiwa Toru Kikuchi Minoru Nomoto Yutaka Aoyagi 2010World Journal of Gastroenterology2010,16,23:30
2Prognosis of metastatic splenic hilum lymph node in patients with gastric cancer after total gastrectomy and splenectomy显示文摘AIM:To clarify the significance of combined resection of the spleen to dissect the No.10 lymph node(LN). METHODS:We studied 191 patients who had undergone total gastrectomy with splenectomy,excluding non-curative cases,resection of multiple gastric cancer, and those with remnant stomach cancer.Various clinico-pathological factors were evaluated for any independent contributions to No.10 LN metastasis,usingχ 2 test. Significant factors were extracted for further analysis, carried out using a logistic regression method.Furthermore,lymph node metastasis was evaluated for any independent contribution to No.10 LN metastasis,using the same methods.The cumulative survival rate was calculated using the Kaplan-Meier method.The significance of any difference between the survival curves was determined using the Cox-Mantel test,and any difference was considered significant at the 5%level. RESULTS:From the variables considered to be potentially associated with No.10 LN metastasis,age, depth,invasion of lymph vessel,N factor,the numberof lymph node metastasis,Stage,the number of sites, and location were found to differ significantly between those with metastasis(the Positive Group)and those without(the Negative Group).A logistic regression analysis showed that the localization and Stage were significant parameters for No.10 LN metastasis.There was no case located on the lesser curvature in the Posi-tive Group.The numbers of No.2,No.3,No.4sa,No. 4sb,No.4d,No.7,and No.11 LN metastasis were each found to differ significantly between the Positive Group and the Negative Group.A logistic regression analysis showed that No.4sa,No.4sb,and No.11 LN metastasis were each a significant parameter for No.10 LN metastasis.There was no significant difference in survival curves between the Positive Group and the Negative Group. CONCLUSION:Splenectomy should be performed to dissect No.10 LN for cases which have No.4sa,No. 4sb or No.11 LN metastasis.However,in cases where the tumor is located on the lesser curvature,splenectomy can be omitted.Keishiro Aoyagi Kikuo Kouhuji Motoshi Miyagi Takuya Imaizumi Junya Kizaki Kazuo Shirouzu 2010World Journal of Hepatology2010,2,2:26
3Cancer cachexia,mechanism and treatment显示文摘It is estimated that half of all patients with cancer eventually develop a syndrome of cachexia, with anorexia and a progressive loss of adipose tissue and skeletal muscle mass. Cancer cachexia is characterized by systemic inflammation, negative protein and energy balance, and an involuntary loss of lean body mass. It is an insidious syndrome that not only has a dramatic impact on patient quality of life, but also is associated with poor responsesto chemotherapy and decreased survival. Cachexia is still largely an underestimated and untreated condition, despite the fact that multiple mechanisms are reported to be involved in its development, with a number of cytokines postulated to play a role in the etiology of the persistent catabolic state. Existing therapies for cachexia, including orexigenic appetite stimulants, focus on palliation of symptoms and reduction of the distress of patients and families rather than prolongation of life. Recent therapies for the cachectic syndrome involve a multidisciplinary approach. Combination therapy with diet modification and/or exercise has been added to novel pharmaceutical agents, such as Megestrol acetate, medroxyprogesterone, ghrelin, omega-3-fatty acid among others. These agents are reported to have improved survival rates as well as quality of life. In this review, we will discuss the emerging understanding of the mechanisms of cancer cachexia, the current treatment options including multidisciplinary combination therapies, as well an update on new and ongoing clinical trials.Tomoyoshi Aoyagi Krista P Terracina Ali Raza Hisahiro Matsubara Kazuaki Takabe 2015World Journal of Gastrointestinal Oncology2015,7,4:20
4Autoantibodies in primary biliary cirrhosis:Recent progress in research on the pathogenetic and clinical significance显示文摘Primary biliary cirrhosis(PBC)is a chronic progressive cholestatic liver disease characterized by immunemediated destruction of the small-and medium-sized intrahepatic bile ducts and the presence of antimitochondrial antibodies(AMA)in the serum.AMA are detected in over 90%of patients with PBC,whereas their prevalence in the general population is extremely low,varying from 0.16%to 1%.Previous studies have shown that the unique characteristics of biliary epithelial cells undergoing apoptosis may result in a highly direct and very specific immune response to mitochondrial autoantigens.Moreover,recent studies have demonstrated that serum from AMA-positive PBC patients is reactive with a number of xenobiotic modified E2 subunits of the pyruvate dehydrogenase complex,which is not observed in the serum of normal individuals.These findings indicate that chemicals originating from the environment may be associated with a breakdown in the tolerance to mitochondrial autoantigens.While it is currently generally accepted that AMA are the most specific serological markers of PBC,more than 60 au-toantibodies have been investigated in patients with PBC,and some have previously been considered specific to other autoimmune diseases.This review covers the recent progress in research on the pathogenetic and clinical significance of important autoantibodies in PBC.Determining the pathogenic role of those autoantibodies in PBC remains a priority of basic and clinical research.Satoshi Yamagiwa Hiroteru Kamimura Masaaki Takamura Yutaka Aoyagi 2014World Journal of Gastroenterology2014,20,10:19
5Characteristics and prognosis of synchronous multiple early gastric cancer显示文摘AIM:To assess the clinicopathologic characteristics,risk factors,and prognosis for synchronous multiple early gastric cancer(SMGC).METHODS:A total of 146 patients with SMGC and1194 patients with single gastric cancer who had undergone gastrectomy between 1989 and 2008 were retrospectively analyzed to determine their clinicopathologic characteristics and postoperative survival.Tumors were classified into groups on the basis of location and histology.Smoking habits were evaluated using the Brinkman index.Clinical and pathological factors were compared using either Fisher’s exact test or Pearson’sχ2test.Logistic regression analysis was performed to identify independent risk factors.Survival rate was calculated using the Kaplan-Meier method.RESULTS:SMGCs accounted for 10.9%of gastric cancer cases and occurred predominantly in elderly male patients with a family history of gastric cancer who were both smokers and drinkers.These tumors were typically macroscopically elevated and histologically differentiated.There were no significant differences between SMGC and single gastric cancer patients with respect to tumor location,tumor size,lymph node metastasis,the number of metastatic lymph nodes,venous invasion,or tumor stage(P=0.052,P=0.347,P=0.595,P=0.805,P=0.559,and P=0.408,respectively).Further,there was no significant difference in postoperative survival between the patient groups(P=0.200).Of the 146SMGC patients,a single patient had remnant cancer.CONCLUSION:A careful preoperative endoscopy is necessary for patients who are at high risk of SMGC,and minimally invasive treatment may be indicated in some cases.Taro Isobe Kousuke Hashimoto Junya Kizaki Naotaka Murakami Keishiro Aoyagi Kikuo Koufuji Yoshito Akagi Kazuo Shirouzu 2013World Journal of Gastroenterology2013,19,41:17
6Advances in understanding and treating liver diseases during pregnancy:A review显示文摘Liver disease in pregnancy is rare but pregnancyrelated liver diseases may cause threat to fetal and maternal survival.It includes pre-eclampsia;eclampsia;haemolysis,elevated liver enzymes,and low platelets syndrome;acute fatty liver of pregnancy;hyperemesis gravidarum;and intrahepatic cholestasis of pregnancy.Recent basic researches have shown the various etiologies involved in this disease entity.With these advances,rapid diagnosis is essential for severe cases since the decision of immediate delivery is important for maternal and fetal survival.The other therapeutic options have also been shown in recent reports based on the clinical trials and cooperation and information sharing between hepatologist and gynecologist is important for timely therapeutic intervention.Therefore,correct understandings of diseases and differential diagnosis from the pre-existing and co-incidental liver diseases during the pregnancy will help to achieve better prognosis.Therefore,here we review and summarized recent advances in understanding the etiologies,clinical courses and management of liver disease in pregnancy.This information will contribute to physicians for diagnosis of disease and optimum management of patients.Kenya Kamimura Hiroyuki Abe Hirokazu Kawai Hiroteru Kamimura Yuji Kobayashi Minoru Nomoto Yutaka Aoyagi Shuji Terai 2015World Journal of Gastroenterology2015,21,17:15
7Current treatment options for colon cancer peritoneal carcinomatosis显示文摘Peritoneal carcinomatosis(PC),the dissemination of cancer cells throughout the lining of the abdominal cavity,is the second most common presentation of colon cancer distant metastasis.Despite remarkable advances in cytotoxic chemotherapy and targeted therapy for colon cancer over the last 15 years,it has been repeatedly shown that these therapies remain ineffective for colon cancer PC.Recently,there has been a rapid accumulation of reports that cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy(CRS-HIPEC) prolongs the life of colon cancer PC patients.Here,we will review the clinical presentation,the mechanisms of disease progression,and current treatment options for colon cancer PC,with a focus on the benefits and limitations of CRSHIPEC.Tomoyoshi Aoyagi Krista P Terracina Ali Raza Kazuaki Takabe 2014World Journal of Gastroenterology2014,20,35:15
8Molecular targeting therapy using bevacizumab for peritoneal metastasis from gastric cancer显示文摘AIM: To clarify the significance of vascular endothelial growth factor(VEGF) in peritoneal metastasis from gastric cancer, using the gastric cancer cell line MKN-45 compared with the high potential peritoneal dissemination gastric cancer cell line MKN-45 P. METHODS: The supernatant of culture medium of MKN-45 cells or MKN-45 P cells was collected and the concentrations were measured of various cytokines, matrix metalloproteinases, growth factor and angiogenic factors, including VEGF. We performed an initial pilot study to explore whether bevacizumab, a humanized monoclonal antibody against VEGF, had any suppressive effect on the peritoneal dissemination from gastric cancer in an experimental nude mouse modelof peritoneal metastasis. RESULTS: The concentrations of interleukin-6(IL-6), IL-8, VEGF and matrix metalloproteinase-2 protein in the culture supernatant were each significantly higher than each of those for MKN-45. In the in vivo study, the volume of ascites and the mitotic index were significantly lower in the therapy group than in the nontherapy group. The survival curve of the therapy group was significantly higher than that of the non-therapy group. These results suggested that VEGF was correlated with peritoneal metastasis from gastric cancer. CONCLUSION: Findings suggested that bevacizumab for inhibiting VEGF could suppress peritoneal dissemination from gastric cancer.Keishiro Aoyagi Kikuo Kouhuji Motoshi Miyagi Junya Kizaki Taro Isobe Kousuke Hashimoto Kazuo Shirouzu 2013World Journal of Critical Care Medicine2013,2,4:12
94气门直喷式柴油机的涡流形成过程显示文摘降低排气污染是柴油机一项迫切而重要的任务。每缸4气门的布置方案是实现该目标而采取的一项先进技术。阐述了使用稳态气流装置。通过试验方法2气门和4气门缸盖的缸内空气运动的形成过程。试验时,分别使用示踪激光片技术(TLS)和激光多普勒测速仪(LDV)进行显像和测速。采用示踪激光片技术和激光多普勒测速仪进行显像并测量了2气门和4气门缸盖的缸内空气运动。2气门气缸盖主要依靠螺旋气道来的强旋涡产生涡流运动。当涡流向下流过气缸时,同时由气缸中心向气缸周边扩散。与此相反,4气门气缸盖则主要依靠切向和螺旋气道来的、沿气缸周边处的强气流产生涡流运动。随着气流的继续流动,外部气流不断影响内部气流。当诸如2气门与4气门缸盖间的气流图像变化很大时,最好采用脉动式涡流计而不是叶片式涡流计来测量总涡流强度。Aoyagi Y Yokota H Sugihara H 瞿俊鸣 1996国外内燃机1996,28,1:8
10Nitrifiers activity and community characteristics under stress conditions in partial nitrification systems treating ammonium-rich wastewater显示文摘Long-term exposure of nitrifiers to high concentrations of free ammonia(FA) and free nitrous acid(FNA) may affect nitrifiers activity and nitrous oxide(N_2O) emission.Two sequencing batch reactors(SBRs) were operated at influent ammonium nitrogen(NH_4-N) concentrations of 800 mg/L(SBRH) and 335 mg/L(SBRL),respectively.The NH_4-N removal rates in SBRHand SBRLwere around 2.4 and 1.0 g/L/day with the nitritation efficiencies of 99.3% and 95.7%,respectively.In the simulated SBR cycle,the N_2O emission factors were 1.61% in SBRH and 2.30% in SBRL.N_2O emission was affected slightly by FA with the emission factor of0.22%–0.65%,while N_2O emission increased with increasing FNA concentrations with the emission factor of 0.22%–0.96%.The dominant ammonia oxidizing bacteria(AOB) were Nitrosomonas spp.in both reactors,and their relative proportions were 38.89% in SBRHand13.36% in SBRL.Within the AOB genus,a species(i.e.,operational taxonomic unit [OTU] 76) that was phylogenetically identical to Nitrosomonas europaea accounted for 99.07% and 82.04% in SBRHand SBRL,respectively.Additionally,OTU 215,which was related to Nitrosomonas stercoris,accounted for 16.77% of the AOB in SBRL.Jia Miao Qidong Yin Tomoyuki Hori Tomo Aoyagi Hiroshi Habe Guangxue Wu 2018Journal of Environmental Sciences2018,30,11:8
11Characterization of CD133^+ parenchymal cells in the liver:Histology and culture显示文摘AIM:To reveal the characteristics of CD133+ cells in the liver.METHODS:This study examined the histological characteristics of CD133+ cells in non-neoplastic and neoplastic liver tissues by immunostaining,and also analyzed the biological characteristics of CD133+ cells derived from human hepatocellular carcinoma(HCC) or cholangiocarcinoma cell lines.RESULTS:Immunostaining revealed constant expression of CD133 in non-neoplastic and neoplastic biliary epithelium,and these cells had the immunophenotype CD133+/CK19+/HepPar-1-.A small number of CD133+/CK19-/HepPar-1+ cells were also identified in HCC and combined hepatocellular and cholangiocarcinoma.In addition,small ductal structures,resembling the canal of Hering,partly surrounded by hepatocytes were positive for CD133.CD133 expression was observed in three HCC(HuH7,PLC5 and HepG2) and two cholangiocarcinoma cell lines(HuCCT1 and CCKS1).Fluorescence-activated cell sorting(FACS) revealed that CD133+ and CD133-cells derived from HuH7 and HuCCT1 cells similarly produced CD133+ and CD133-cells during subculture.To examine the relationship between CD133+ cells and the side population(SP) phenotype,FACS was performed using Hoechst 33342 and a monoclonal antibody against CD133.The ratios of CD133+/CD133-cells were almost identical in the SP and non-SP in HuH7.In addition,four different cellular populations(SP/CD133+,SP/CD133-,non-SP/CD133+,and non-SP/CD133-) could similarly produce CD133+ and CD133-cells during subculture.CONCLUSION:This study revealed that CD133 could be a biliary and progenitor cell marker in vivo.However,CD133 alone is not sufficient to detect tumor-initiating cells in cell lines.Seiichi Yoshikawa Yoh Zen Takahiko Fujii Yasunori Sato Tetsuo Ohta Yutaka Aoyagi Yasuni Nakanuma 2009World Journal of Gastroenterology2009,15,39:6
12The increase in surface CXCR4 expression on lung extravascular neutrophils and its effects on neutrophils during endotoxin-induced lung injury显示文摘Inflammatory stimuli,such as a microbes or lipopolysaccharides,induce a rapid release of neutrophils from the bone marrow and promote neutrophil migration into inflamed sites to promote host defense.However,an excess accumulation and retention of neutrophils in inflamed tissue can cause severe tissue injuries in the later stages of inflammation.Recent studies have reported that both CXCL12 levels in injured lungs and its receptor,CXCR4,on accumulated neutrophils in injured lungs,increased;furthermore,these studies showed that the CXCL12/CXCR4 signaling pathway participated in neutrophil accumulation in the later stages of lipopolysaccharide(LPS)-induced lung injury.However,the mechanisms underlying this increase in surface CXCR4 expression in neutrophils remain unclear.In this study,we found that surface CXCR4 expression increased in extravascular,but not intravascular,neutrophils in the lungs of LPS-induced lung injury model mice.Furthermore,ex vivo studies revealed that CXCL12 acted not only as a chemoattractant,but also as a suppressor of cell death for the lung neutrophils expressing CXCR4.Sulfatide,one of the native ligands for L-selectin,induced the increase of surface CXCR4 expression on isolated circulating neutrophils,suggesting that the activation of L-selectin may be involved in the increase in surface CXCR4.Our findings show that surface CXCR4 levels on neutrophils increase after extravasation into injured lungs,possibly through the activation of L-selectin.The CXCL12/CXCR4 signaling pathway plays an important role in the modulation of neutrophil activity during acute lung injury,not only by promoting chemotaxis but also by suppressing cell death.Mitsuhiro Yamada Hiroshi Kubo Seiichi Kobayashi Kota Ishizawa Mei He Takaya Suzuki Naoya Fujino Hiroyuki Kunishima Masamitsu Hatta Katsushi Nishimaki Tetsuji Aoyagi Kouichi Tokuda Miho Kitagawa Hisakazu Yano Hirokazu Tamamura Nobutaka Fujii Mitsuo Kaku 2011Cellular & Molecular Immunology2011,8,4:6
13Features of hepatocellular carcinoma in cases with autoimmune hepatitis and primary biliary cirrhosis显示文摘AIM: To characterize the clinical features of hepatocellular carcinoma (HCC) associated with autoimmune liver disease, we critically evaluated the literature on HCC associated with autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC). METHODS: A systematic review of the literature was conducted using the Japana Centra Revuo Medicina database which produced 38 cases of HCC with AIH (AIH-series) and 50 cases of HCC with PBC (PBC-series). We compared the clinical features of these two sets of patients with the general Japanese HCC population. RESULTS: On average, HCC was more common in men than in women with AIH or PBC. While many patients underwent chemolipiodolization (CL) or transcatheter arterial embolization (TAE) (AIH-series: P = 0.048 (vs operation), P = 0.018 (vs RFA, PEIT); PBC-series: P = 0.027 (vs RFA, PEIT), others refused therapeutic interventions [AIH-series: P = 0.038 (vs RFA, PEIT); PBC-series: P = 0.003 (vs RFA, PEIT)].Liver failure was the primary cause of death among patients in this study, followed by tumor rupture. The survival interval between diagnosis and death was fairly short, averaging 14 ± 12 mo in AIH patients and 8.4 ± 14 mo in PBC patients. CONCLUSION: We demonstrated common clinical features among Japanese cases of HCC arising from AIH and PBC.Takuya Watanabe Kenji Soga Haruka Hirono Katsuhiko Hasegawa Koichi Shibasaki Hirokazu Kawai Yutaka Aoyagi 2009World Journal of Gastroenterology2009,15,2:5
14Molecular targeting to treat gastric cancer显示文摘Trastuzumab that targets human epidermal growth factor receptor 2(HER2) protein is the only approved molecular targeting agent for treating gastric cancer in Japan and the outcomes have been favorable. However,trastuzumab is effective for only 10% to 20% of the population with gastric cancer that expresses HER2 protein. Molecular targeting therapy with bevacizumab against vascular endothelial growth factors(VEGF) and with cetuximab and panitumumab against the epidermal growth factors pathway that have been approved for treating colorectal cancer are not considered effective for treating gastric cancer according to several clinical trials. However,ramucirumab that targets VEGF receptor-2 prolonged overall survival in a large phase Ⅲ clinical trial and it might be an effective molecular targeting therapy for gastric cancer. The significance of molecular targeting therapy for gastric cancer remains controversial. A large-scale randomized clinical trial of novel molecular targeting agents with which to treat gastric cancer is needed.Keishiro Aoyagi Kikuo Kouhuji Junya Kizaki Taro Isobe Kousuke Hashimoto Kazuo Shirouzu 2014World Journal of Gastroenterology2014,20,38:5
15Effects of estradiol and progesterone on the proinflammatory cytokine production by mononuclear cells from patients with chronic hepatitis C显示文摘AIM:To investigate the effects of estradiol (E2) and progesterone on the unstimulated and oxidative stressstimulated production of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-8, and macrophage chemotactic protein (MCP)-1 by peripheral blood mononuclear cells (PBMCs) from patients with chronic hepatitis C and healthy controls. METHODS:The PBMCs were separated from agematched 72 males and 71 females with and without chronic hepatitis C, who were divided into two groups based on a mean menopausal age of 50 years. Oxidative stress was induced by hydrogen peroxide in the cells incubated in serum-free media. Cytokines in the culture supernatant were measured by an enzyme-linked immunosorbent assay. RESULTS:The highest levels of the spontaneous production of TNF-α, IL-1β, IL-8, and MCP-1 by the unstimulated PBMCs were in the older male patients with chronic hepatitis C and the lowest levels were in the premenopausal female healthy controls. E2 inhibited the cytokine production by the unstimulated PBMCs from the older male and post-menopausal female patients, which was further stimulated by progesterone. The exposure to hydrogen peroxide in the PBMCs from the younger male and pre-menopausal female healthy subjects induced the production of cytokines. The change rates of the hydrogen peroxide-stimulated cytokine production were suppressed by E2 and enhanced by progesterone. CONCLUSION:These findings suggest that E2 may play a favorable role in the course of persistent liver injury by preventing the accumulation of monocytes-macrophages and by inhibiting proinflammatory cytokine production, whereas progesterone may counteract the favorable E2 effects.Ying Yuan Ichiro Shimizu Mi Shen Eriko Aoyagi Hidetaka Takenaka Tatuzo Itagaki Mari Urata Katsutaka Sannomiya Nao Kohno Katsuyoshi Tamaki Masayuki Shono Tetsuji Takayama 2008World Journal of Gastroenterology2008,14,14:5
16Computed tomography perfusion imaging as a potential imaging biomarker of colorectal cancer显示文摘Neovascularization was reported to arise early in the adenoma-carcinoma sequence in colorectal cancer(CRC),and the importance of angiogenesis in cancer progression has been established.Computed tomography(CT)perfusion(CTP)based on high temporal resolution CT images enables evaluation of hemodynamics of tissue in vivo by modeling tracer kinetics.CTP has been reported to characterize tumor angiogenesis,and to be a sensitive marker for predicting recurrence or survival in CRC.In this review,we will discuss the biomarker value of CTP in the management of CRC patients.Koichi Hayano Takeshi Fujishiro Dushyant V Sahani Asami Satoh Tomoyoshi Aoyagi Gaku Ohira Toru Tochigi Hisahiro Matsubara Kiyohiko Shuto 2014World Journal of Gastroenterology2014,20,46:5
17Active treatments are a rational approach for hepatocellular carcinoma in elderly patients显示文摘AIM: To determine whether an active intervention is beneficial for the survival of elderly patients with hepa-tocellular carcinoma (HCC). METHODS: The survival of 740 patients who received various treatments for HCC between 1983 and 2011 was compared among different age groups using Cox regression analysis. Therapeutic options were principal-ly selected according to the clinical practice guidelines for HCC from the Japanese Society of Hepatology. The treatment most likely to achieve regional control capa-bility was chosen, as far as possible, in the following order: resection, radiofrequency ablation, percutaneous ethanol injection, transcatheter arterial chemoembo-lization, transarterial oily chemoembolization, hepatic arterial infusion chemotherapy, systemic chemotherapy including molecular targeting, or best supportive care.Each treatment was used alone, or in combination, with a clinical goal of striking the best balance be-tween functional hepatic reserve and the volume of the targeted area, irrespective of their age. The percent survival to life expectancy was calculated based on a Japanese national population survey. RESULTS: The median ages of the subjects during each 5-year period from 1986 were 61, 64, 67, 68 and 71 years and increased significantly with time (P<0.0001). The Child-Pugh score was comparable among younger (59 years of age or younger), middle-aged (60-79 years of age), and older (80 years of age or older) groups (P=0.34), whereas the tumor-node-metastasis stage tended to be more advanced in the younger group (P=0.060). Advanced disease was significantly more frequent in the younger group compared with the middle-aged group (P=0.010), whereas there was no difference between the middle-aged and elderly groups (P=0.75). The median sur-vival times were 2593, 2011, 1643, 1278 and 1195 d for 49 years of age or younger, 50-59 years of age, 60-69 years of age, 70-79 years of age, or 80 years of age or older age groups, respectively, whereas the me-dian percent survival to life expectancy were 13.9%, 21.9%, 24.7%, 25.7% and 37.6% for each group, respectively. The impact of age on actual survival time was significant (P=0.020) with a hazard ratio of 1.021, suggesting that a 10-year-older patient has a 1.23-fold higher risk for death, and the overall survival was the worst in the oldest group. On the other hand, when the survival benefit was evaluated on the basis of per-cent survival to life expectancy, age was again found to be a significant explanatory factor (P=0.022); how-ever, the oldest group showed the best survival among the five different age groups. The youngest group revealed the worst outcomes in this analysis, and the hazard ratio of the oldest against the youngest was 0.35 for death. The survival trends did not differ substan-tially between the survival time and percent survival tolife expectancy, when survival was compared overall or among various therapeutic interventions. CONCLUSION: These results suggest that a thera-peutic approach for HCC should not be restricted due to patient age.Takeshi Suda Aiko Nagashima Shyunsaku Takahash Tsutomu Kanefuji Kenya Kamimura Yasushi Tamura Ma-saaki Takamura Masato Igarashi Hirokazu Kawai Satoshi Yamagiwa Minoru Nomoto Yutaka Aoyagi 2013World Journal of Gastroenterology2013,19,24:4
18Regulation of CTNNB1 signaling in gastric cancer and stem cells显示文摘Recent research has shown that the alteration of combinations in gene expression contributes to cellular phenotypic changes. Previously, it has been demonstrated that the combination of cadherin 1 and cadherin 2 expression can identify the diffuse-type and intestinaltype gastric cancers. Although the diffuse-type gastric cancer has been resistant to treatment, the precise mechanism and phenotypic involvement has not been revealed. It may be possible that stem cells transform into gastric cancer cells, possibly through the involvement of a molecule alteration and signaling mechanism. In this review article, we focus on the role of catenin beta 1(CTNNB1 or β-catenin) and describe the regulation of CTNNB1 signaling in gastric cancer and stem cells.Shihori Tanabe Kazuhiko Aoyagi Hiroshi Yokozaki Hiroki Sasaki 2016World Journal of Gastrointestinal Oncology2016,8,8:4
19Collagenous gastritis: Review显示文摘Collagenous gastritis is a rare disease characterized by the subepithelial deposition of collagen bands thicker than 10 μm and the infiltration of inflammatory mononuclear cells in the lamina propria. Collagenous colitis and collagenous sprue have similar histological characteristics to collagenous gastritis and are thought to be part of the same disease entity. However, while collagenous colitis has become more common in the field of gastroenterology, presenting with clinical symptoms of chronic diarrhea in older patients,collagenous gastritis is rare. Since the disease was first reported in 1989, only 60 cases have been documented in the English literature. No safe and effective treatments have been identified from randomized, controlled trials. Therefore, better understanding of the disease and the reporting of more cases will help to establish diagnostic criteria and to develop therapeutic strategies. Therefore, here we review the clinical characteristics, endoscopic and histological findings, treatment, and clinical outcomes from case reports and case series published to date, and provide a summary of the latest information on the disease. This information will contribute to improved knowledge of collagenous gastritis so physicians can recognize and correctly diagnose the disease, and will help to develop a standard therapeutic strategy for future clinical trials.Kenya Kamimura Masaaki Kobayashi Yuichi Sato Yutaka Aoyagi Shuji Terai 2015World Journal of Gastrointestinal Endoscopy2015,7,3:3
20Quality of life after total vs distal gastrectomy with Rouxen-Y reconstruction: Use of the Postgastrectomy Syndrome Assessment Scale-45显示文摘AIM To investigate the detrimental impact of loss of reservoir capacity by comparing total gastrectomy(TGRY) and distal gastrectomy with the same Rouxen-Y(DGRY) reconstruction. The study was conducted using an integrated questionnaire, the Postgastrectomy Syndrome Assessment Scale(PGSAS)-45, recently developed by the Japan Postgastrectomy Syndrome Working Party.METHODS The PGSAS-45 comprises 8 items from the Short Form-8, 15 from the Gastrointestinal Symptom Rating Scale, and 22 newly selected items. Uni-and multivariate analysis was performed on 868 questionnaires completed by patients who underwent either TGRY(n = 393) or DGRY(n = 475) for stage I gastric cancer(52 institutions). Multivariate analysis weighed of six explanatory variables, including the type of gastrectomy(TGRY/DGRY), interval after surgery, age, gender, surgical approach(laparoscopic/open), and whether the celiac branch of the vagus nerve was preserved/divided on the quality of life(QOL).RESULTS The patients who underwent TGRY experienced the poorer QOL compared to DGRY in the 15 of 19 main outcome measures of PGSAS-45. Moreover, multiple regression analysis indicated that the type of gastrectomy, TGRY, most strongly and broadly impaired the postoperative QOL among six explanatory variables. CONCLUSION The results of the present study suggested that TGRY had a certain detrimental impact on the postoperative QOL, and the loss of reservoir capacity could be a major cause.Masazumi Takahashi Masanori Terashima Hiroshi Kawahira Eishi Nagai Yoshikazu Uenosono Shinichi Kinami Yasuhiro Nagata Masashi Yoshida Keishiro Aoyagi Yasuhiro Kodera Koji Nakada 2017World Journal of Gastroenterology2017,23,11:3
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