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| 1 | Management of hepatitis B virus infection during treatment for hepatitis B virus-related hepatocellular carcinoma显示文摘Although liver resection is considered the most effective treatment for hepatocellular carcinoma(HCC), treatment outcomes are unsatisfactory because of the high rate of HCC recurrence. Since we reported hepatitis B e-antigen positivity and high serum hepatitis B virus(HBV) DNA concentrations are strong risk factors for HCC recurrence after curative resection of HBV-related HCC in the early 2000 s, many investigators have demonstrated the effects of viral status on HCC recurrence and post-treatment outcomes. These findings suggest controlling viral status is important to prevent HCC recurrence and improve survival after curative treatment for HBV-related HCC. Antiviral therapy after curative treatment aims to improve prognosis by preventing HCC recurrence and maintaining liver function. Therapy with interferon and nucleos(t)ide analogs may be useful for preventing HCC recurrence and improving overall survival in patients who have undergone curative resection for HBV-related HCC. In addition, reactivation of viral replication can occur after liver resection for HBV-related HCC. Antiviral therapy can be recommended for patients to prevent HBV reactivation. Nevertheless, further studies are required to establish treatment guidelines for patients with HBVrelated HCC. | Shoji Kubo Shigekazu Takemura Shogo Tanaka Hiroji Shinkawa Takayoshi Nishioka Akinori Nozawa Masahiko Kinoshita Genya Hamano Tokuji Ito Yorihisa Urata | 2015 | World Journal of Gastroenterology2015，21，27： | 19 |
| 2 | Long-term survival after resection of pancreatic cancer:A single-center retrospective analysis显示文摘AIM: To retrospectively analyze factors affecting the long-term survival of patients with pancreatic cancer who underwent pancreatic resection.METHODS: From January 2000 to December 2011,195 patients underwent pancreatic resection in our hospital.The prognostic factors after pancreatic resection were analyzed in all 195 patients.After excluding the censored cases within an observational period,the clinicopathological characteristics of 20 patients who survived ≥ 5(n = 20) and < 5(n = 76) years were compared.For this comparison,we analyzed the patients who underwent surgery before June 2008 and were observed for more than 5 years.For statistical analyses,the log-rank test was used to compare the cumulative survival rates,and the χ2 and Mann-Whitney tests were used to compare the two groups.The CoxHazard model was used for a multivariate analysis,and P values less than 0.05 were considered significant.A multivariate analysis was conducted on the factors that were significant in the univariate analysis.RESULTS: The median survival for all patients was 27.1 months,and the 5-year actuarial survival rate was 34.5%.The median observational period was 595 d.With the univariate analysis,the UICC stage was significantly associated with survival time,and the CA19-9 ≤ 200 U/m L,DUPAN-2 ≤ 180 U/m L,t u m o r s i ze ≤ 2 0 m m,R 0 re s e c t i o n,a b s e n c e o f lymph node metastasis,absence of extrapancreatic neural invasion,and absence of portal invasion were favorable prognostic factors.The multivariate analysis showed that tumor size ≤ 20 mm(HR = 0.40; 95%CI: 0.17-0.83,P = 0.012) and negative surgical margins(R0 resection)(HR = 0.48; 95%CI: 0.30-0.77,P = 0.003) were independent favorable prognostic factors.Among the 96 patients,20 patients survived for 5 years or more,and 76 patients died within 5 years after operation.Comparison of the 20 5-year survivors with the 76 non-survivors showed that lower concentrations of DUPAN-2(79.5 vs 312.5 U/mL,P = 0.032),tumor size ≤ 20 mm(35% vs 8%,P = 0.008),R0 resection(95% vs 61%,P = 0.004),and absence of lymph nodemetastases(60% vs 18%,P = 0.036) were significantly associated with the 5-year survival.CONCLUSION: Negative surgical margins and a tumor size ≤ 20 mm were independent favorable prognostic factors.Histologically curative resection and early tumor detection are important factors in achieving long-term survival. | Takehito Yamamoto Shintaro Yagi Hiromitsu Kinoshita Yusuke Sakamoto Kazuyuki Okada Kenji Uryuhara Takeshi Morimoto Satoshi Kaihara Ryo Hosotani | 2015 | World Journal of Gastroenterology2015，21，1： | 18 |
| 3 | Intraductal neoplasm of the intrahepatic bile duct: Clinicopathological study of 24 cases显示文摘AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliary papillomatosis or intraductal growth of intrahepatic biliary neoplasm, were reviewed. Mucin immunohistochemistry was performed for mucin (MUC)1, MUC2, MUC5AC and MUC6. Ki-67, P53 and β-catenin immunoreactivity were also examined. We categorized each tumor as adenoma (low grade), borderline (intermediate grade), and malignant (carcinoma in situ , high grade including tumors with microinvasion). RESULTS: Among 24 cases of INihB, we identified 24 tumors. Twenty of 24 tumors (83%) were composed of a papillary structure; the same feature observed in intraductal papillary neoplasm of the bile duct (IPNB). In contrast, the remaining four tumors (17%) showed both tubular and papillary structures. In three of the four tumors (75%), macroscopic mucin secretion was limited but microscopic intracellular mucin was evident. Histologically, 16 tumors (67%) were malignant, three (12%) were borderline, and five (21%) were adenoma. Microinvasion was found in four cases (17%). Immunohistochemical analysis revealed that MUC1 was not expressed in the borderline/adenoma group but was expressed only in malignant lesions (P = 0.0095). Ki-67 labeling index (LI) was significantly higher in the malignant group than in the borderline/adenoma group (22.2 ± 15.5 vs 7.5 ± 6.3, P < 0.01). In the 16 malignant cases, expression of MUC5AC showed borderline significant association with high Ki-67 LI (P = 0.0622). Nuclear expression of β-catenin was observed in two (8%) of the 24 tumors, and these two tumors also showed MUC1 expression. P53 was negative in all tumors. CONCLUSION: Some cases of INihB have a tubular structure, and are subcategorized as IPNB with tubular structure. MUC1 expression in INihB correlates positively with degree of malignancy. | Yoshiki Naito Hironori Kusano Osamu Nakashima Eiji Sadashima Satoshi Hattori Tomoki Taira Akihiko Kawahara Yoshinobu Okabe Kazuhide Shimamatsu Jun Taguchi Seiya Momosaki Koji Irie Rin Yamaguchi Hiroshi Yokomizo Michiko Nagamine Seiji Fukuda Shinichi Sugiyama Naoyo Nishida Koichi Higaki Munehiro Yoshitomi Masafumi Yasunaga Koji Okuda Hisafumi Kinoshita Masayoshi Kage Masamichi Nakayama Makiko Yasumoto Jun Akiba Hirohisa Yano | 2012 | World Journal of Gastroenterology2012，18，28： | 16 |
| 4 | Analysis of the risk factors for severity in post endoscopic retrograde cholangiopancreatography pancreatitis: The indication of prophylactic treatments显示文摘AIM To determine the risk factors of severe post endoscopic retrograde cholangiopancreatography pancreatitis(s PEP) and clarify the indication of prophylactic treatments.METHODS At our hospital, endoscopic retrograde cholangiopancreatography(ERCP) was performed on 1507 patients from May 2012 to December 2015. Of these patients, we enrolled all 121 patients that were diagnosed with post endoscopic retrograde PEP. Fourteen of 121 patients diagnosed as s PEP were analyzed.RESULTS Forty-one patients had contrast media remaining in the pancreatic duct after completion of ERCP. Seventy-one patients had abdominal pain within three hours after ERCP. These were significant differences for s PEP(P < 0.05). The median of Body mass index, the median time for ERCP, the median serum amylase level of the next day, past histories including drinking and smoking, past history of pancreatitis, sphincter of Oddi dysfunction, whether emergency or not, expertise of ERCP procedure, diverticulum nearby Vater papilla, whether there was sphincterotomy or papillary balloon dilation, pancreatic duct cannulation, use of intraductal ultrasonography enforcement, and transpapillary biopsies had no significant differences with s PEP.CONCLUSION Contrast media remaining in the pancreatic duct and the appearance of abdominal pain within three hours after ERCP were risk factors of s PEP. | Hiroshi Matsubara Fumihiro Urano Yuki Kinoshita Shozo Okamura Hiroki Kawashima Hidemi Goto Yoshiki Hirooka | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，4： | 12 |
| 5 | Staging systems for hepatocellular carcinoma: Current status and future perspectives显示文摘Hepatocellular carcinoma(HCC) is a major health concern worldwide and the third cause of cancer-related death. Despite advances in treatment as well as careful surveillance programs, the mortality rates in most countries are very high. In contrast to other cancers, the prognosis and treatment of HCC depend on the tumor burden in addition to patient's underlying liver disease and liver functional reserve. Moreover, thereis considerable geographic and institutional variation in both risk factors attributable to the underlying liver diseases and the management of HCC. Therefore, although many staging and/or scoring systems have been proposed, there is currently no globally accepted system for HCC due to the extreme heterogeneity of the disease. The aim of this review is to focus on currently available staging systems as well as those newly reported in the literatures since 2012. Moreover, we describe problems with currently available staging systems and attempts to modify and/or add variables to existing staging systems. | Akiyoshi Kinoshita Hiroshi Onoda Nao Fushiya Kazuhiko Koike Hirokazu Nishino Hisao Tajiri | 2015 | World Journal of Hepatology2015，7，3： | 10 |
| 6 | Changes of gastric ulcer bleeding in the metropolitan area of Japan显示文摘BACKGROUND The two main causes of gastric ulcer bleeding are Helicobacter pylori(H.pylori)infection and ulcerogenic medicines,although the number of cases caused by each may vary with age.In Japan,the rate of H.pylori infection has fallen over the last decade and the number of prescriptions for non-steroidal anti-inflammatory drugs(NSAIDs)and antithrombotic drugs is increasing as the population ages.Methods of treatment for gastric ulcer bleeding have advanced with the advent of hemostatic forceps and potassium-competitive acid blocker(P-CAB).Thus,causes and treatments for gastric ulcer bleeding have changed over the last decade.AIM To examine the trends of gastric ulcer bleeding over 10 years in the metropolitan area of Japan.METHODS This is a single-center retrospective study.A total of 564 patients were enrolled from inpatients admitted to our hospital with gastric ulcer bleeding between 2006 and 2016.Age,medication history,H.pylori infection,method of treatment,rate of rebleeding,and the length of hospitalization were analyzed.Factors associated with gastric ulcer bleeding were evaluated using Fisher’s exact test,Pearson’s Chi-squared test or Student’s t-test as appropriate.The Jonckheere-Terpstra test was used to evaluate trends.A per-protocol analysis was used to examine the rate of H.pylori infection.RESULTS There was a significant increase in the mean age over time(P<0.01).The rate of H.pylori infection tended to decrease over the study period(P=0.10),whereas the proportion of patients taking antithrombotic agents or NSAIDs tended to increase(P=0.07).Over time,the use of NSAIDs and antithrombotic drugs increased with age.By contrast,the rate of H.pylori infection during the study period fell with age.H.pylori-induced ulcers accounted for the majority of cases in younger patients(<70 years old);however,the rate decreased with age(P<0.01).The method of treatment trend has changed significantly over time.The main method of endoscopic hemostasis has changed from clipping and injection to forceps coagulation(P<0.01),and frequently prescribed medicines have changed from proton pump inhibitor to P-CAB(P<0.01).The rate of rebleeding during the latter half of the study was significantly lower than that in the first half.CONCLUSION These trends,gastric ulcers caused by ulcerogenic drugs were increasing with age and H.pylori-induced ulcers were more common in younger patients,were observed. | Yoko Kubosawa Hideki Mori Satoshi Kinoshita Yoshihiro Nakazato Ai Fujimoto Masahiro Kikuchi Toshihiro Nishizawa Masayuki Suzuki Hidekazu Suzuki | 2019 | World Journal of Gastroenterology2019，25，42： | 10 |
| 7 | Unsedated transnasal small-caliber esophagogastroduoden oscopy in elderly and bedridden patients显示文摘AIM:To evaluate the safety of unsedated transnasal small-caliber esophagogastroduodenoscopy(EGD)for elderly and critically ill bedridden patients. METHODS:One prospective randomized comparative study and one crossover comparative study between transnasal small-caliber EGD and transoral conventional EGD was done(Study 1).For the comparative study, we enrolled 240 elderly patients aged>65 years old. For the crossover analysis,we enrolled 30 bedridden patients with percutaneous endoscopic gastrostomy (PEG)(Study 2).We evaluated cardiopulmonary effects by measuring arterial oxygen saturation(SpO2)and calculating the rate-pressure product(RPP)(pulse rate×systolic blood pressure/100)at baseline,2 and 5 min after endoscopic intubation in Study 1.To assess the risk for endoscopy-related aspiration pneumoniaduring EGD,we also measured blood leukocyte counts and serum C-reactive protein(CRP)levels before and 3 d after EGD in Study 2. RESULTS:In Study 1,we observed significant decreases in SpO2 during conventional transoral EGD, but not during transnasal small-caliber EGD(0.24%vs -0.24%after 2 min,and 0.18%vs-0.29%after 5 min, P=0.034,P=0.044).Significant differences of the RPP were not found between conventional transoral and transnasal small-caliber EGD.In Study 2,crossover analysis showed statistically significant increases of the RPP at 2 min after intubation and the end of endoscopy (26.8 and 34.6 vs 3.1 and 15.2,P=0.044,P=0.046), and decreases of SpO2(-0.8%vs-0.1%,P=0.042) during EGD with transoral conventional in comparison with transnasal small-caliber endoscopy.Thus,for bedridden patients with PEG feeding,who were examined in the supine position,transoral conventional EGD more severely suppressed cardiopulmonary function than transnasal small-caliber EGD.There were also significant increases in the markers of inflammation, blood leukocyte counts and serum CRP values,in bedridden patients after transoral conventional EGD,but not after transnasal small-caliber EGD performed with the patient in the supine position.Leukocyte count increased from 6053±1975/L to 6900±3392/L(P=0.0008)and CRP values increased from 0.93±0.24 to 2.49±0.91 mg/dL(P=0.0005)at 3 d after transoral conventional EGD.Aspiration pneumonia,possibly caused by the endoscopic examination,was found subsequently in two of 30 patients after transoral conventional EGD. CONCLUSION:Transnasal small-caliber EGD is a safer method than transoral conventional EGD in critically ill, bedridden patients who are undergoing PEG feeding. | Mika Yuki Yuji Amano Yoshinori Komazawa Hiroyuki Fukuhara Toshihiro Shizuku Shun Yamamoto Yoshikazu Kinoshita | 2009 | World Journal of Gastroenterology2009，15，44： | 8 |
| 8 | Role of targeted therapy in metastatic colorectal cancer显示文摘Colorectal cancer(CRC) is a significant cause of cancer-related morbidity and mortality all over the world.Improvements of cytotoxic and biologic agents have prolonged the survival in metastatic CRC(mC RC),with a median overall survival of approximately 2 years and more in the past two decades.The biologic agents that have proven clinical benefits in m CRC mainly target vascular endothelial growth factor(VEGF) and epidermal growth factor receptor(EGFR).In particular,bevacizumab targeting VEGF and cetuximab and panitumumab targeting EGFR have demonstrated sig-nificant survival benefits in combination with cytotoxic chemotherapy in the first-line,second-line,or salvage setting.Aflibercept,ramucirumab,and regorafenib are also used in second-line or salvage therapy.Recent retrospective analyses have shown that KRAS or NRAS mutations were negative predictive markers for anti-EGFR therapy.Based on the evidence from large rand-omized clinical trials,personalized therapy is necessary for patients with m CRC according to their tumor biology and characteristics.The aim of this paper was to summarize the results of the major randomized clinical trials and highlight the benefits of the molecular targeted agents in patients with mC RC. | Yoshihito Ohhara Naoki Fukuda Satoshi Takeuchi Rio Honma Yasushi Shimizu Ichiro Kinoshita Hirotoshi Dosaka-Akita | 2016 | World Journal of Gastrointestinal Oncology2016，8，9： | 8 |
| 9 | Protective effects of ursodeoxycholic acid on chenodeoxycholic acid-induced liver injury in hamsters显示文摘AIM: To investigate the effects of ursodeoxycholic acid (UDCA) on chenodeoxycholic acid (CDCA)-induced liver injury in hamsters, and to elucidate a correlation between liver injury and bile acid profiles in the liver. METHODS: Liver injury was induced in hamsters by administration of 0.5% (w/w) CDCA in their feed for 7 d. UDCA (50 mg/kg and 150 mg/kg) was administered for the last 3 d of the experiment. RESULTS: At the end of the experiment, serum alanine aminotransferase (ALT) increased more than 10 times and the presence of liver injury was confirmed histologically. Marked increase in bile acids was observed in the liver. The amount of total bile acids increased approximately three-fold and was accompanied by the increase in hydrophobic bile acids, CDCA and lithocholic acid (LCA). UDCA (50 mg/kg and 150 mg/kg) improved liver histology, with a significant decrease (679.3 ± 77.5 U/L vs 333.6 ± 50.4 U/L and 254.3 ± 35.5 U/ L, respectively, P < 0.01) in serum ALT level. UDCA decreased the concentrations of the hydrophobic bile acids, and as a result, a decrease in the total bile acid level in the liver was achieved. CONCLUSION: The results show that UDCA improves oral CDCA-induced liver damage in hamsters. The protective effects of UDCA appear to result from a decrease in the concentration of hydrophobic bile acids, CDCA and LCA, which accumulate and show the cytotoxicity in the liver. | Tomomichi Iwaki Kaoru Ishizaki Shuji Kinoshita Hideki Tanaka Atsushi Fukunari Makoto Tsurufuji Teruaki Imada | 2007 | World Journal of Gastroenterology2007，13，37： | 7 |
| 10 | Lymphomatoidgastropathy mimicking extranodal NK/T cell lymphoma,nasal type:A case report显示文摘Extranodal natural killer(NK)/T-cell lymphoma,nasal type,exhibits aggressive tumor behavior and carries a poor prognosis.Recently,lymphomatoid gastropathy with NK/T cell infiltration into gastric mucosa has been recognized as a pseudo-malignant disease which regresses without treatment.Because the conventional immunohistochemical criteria of lymphomatoid gastropathy is similar to that of extranodal NK/T-cell lymphoma nasal type,it is difficult to distinguish between the two conditions by histopathological evaluation only.Here,we report a rare case of lymphomatoid gastropathy in a 57-year-old female.Gastroendoscopy on routine check-up revealed elevated reddish lesions < 1 cm in diameter in the gastric fornix and body.Although repeat endoscopies at 1 and 6 mo later revealed no gastric lesions at any locations without any treatments,at 12 mo later gastric lymphomatoid lesions recurred at gastric fornix and body.Histological examination of endoscopic biopsy specimens at 12 mo showed atypical NK cell infiltration with CD3+,CD4-,CD5-,CD7+,CD8-,CD20-,CD30-,CD56+,CD79a-and T-cell-restricted intracellular antigen-1+ into gastric mucosa.After treatment for Helicobacter pylori(H.pylori) eradication,the lesions disappeared in all locations of the gastric fornix and body over the subsequent 12 mo.Here,we report a case of H.pylori-positive lymphomatoid gastropathy with massive NK-cell proliferation,and also review the literature concerning newly identified lymphomatoid gastropathy based on comparison of extra nodal NK/T-cell lymphoma nasal type.In any case,these lesions are evaluated with biopsy specimens,the possibility of this benign entity should be considered,and excessive treatment should be carefully avoided.Close follow-up for this case of lymphomatoid gastropathy is necessary to exclude any underlying malignancy. | Tomohiro Terai Mitsushige Sugimoto Hiroki Uozaki Tetsushi Kitagawa Mana Kinoshita Satoshi Baba Takanori Yamada Satoshi Osawa Ken Sugimoto | 2012 | World Journal of Gastroenterology2012，18，17： | 5 |
| 11 | Pro-and anti-epileptic roles of microglia显示文摘Microglia are brain-resident immune cells that contribute to the maintenance of brain homeostasis.In the epileptic brain, microglia show various activation phenotypes depending on the stage of epileptogenesis.Therefore, it remains unclear whether microglial activation acts in a pro-epileptic or anti-epileptic manner.In mesial temporal lobe epilepsy, one of the most common form of epilepsies, microglia exhibit at least two distinct morphologies, amoeboid shape and ramified shape.Amoeboid microglia are often found in sclerotic area, whereas ramified microglia are mainly found in non-sclerotic area;however, it remains unclear whether these structurally distinct microglia share separate roles in the epileptic brain.Here, we review the roles of the two distinct microglial phenotypes, focusing on their pro-and anti-epileptic roles in terms of inflammatory response, regulation of neurogenesis and microglia-neuron interaction. | Shinichi Kinoshita Ryuta Koyama | 2021 | Neural Regeneration Research2021，16，7： | 5 |
| 12 | HER2 heterogeneity is a poor prognosticator for HER2-positive gastric cancer显示文摘BACKGROUND The clinical significance of intratumoral human epidermal growth factor receptor 2(HER2)heterogeneity is unclear for HER2-positive gastric cancer,although it has been reported to be a significant prognosticator for HER2-positive breast cancer,which has received trastuzumab-based chemotherapy.AIM To clarify the clinical significance of intratumoral HER2 heterogeneity for HER2-positive gastric cancer,which has received trastuzumab-based chemotherapy.METHODS Patients with HER2-positive unresectable or metastatic gastric cancer who received trastuzumab-based chemotherapy as a first line treatment were included.The patients were classified into two groups according to their intratumoral HER2 heterogeneity status examined by immunohistochemistry(IHC)on endoscopic biopsy specimens before treatment,and their clinical response to chemotherapy and survival were compared.RESULTS A total of 88 patients were included in this study,and HER2 heterogeneity was observed in 23(26%)patients(Hetero group).The overall response rate was significantly better in patients without HER2 heterogeneity(Homo group)(Homo vs Hetero:79.5%vs 35.7%,P=0.002).Progression-free survival of trastuzumab-based chemotherapy was significantly better in the Homo group(median,7.9 vs 2.5 mo,HR:1.905,95%CI:1.109-3.268).Overall survival was also significantly better in the Homo group(median survival time,25.7 vs 12.5 mo,HR:2.430,95%CI:1.389-4.273).Multivariate analysis revealed IHC HER2 heterogeneity as one of the independent poor prognostic factors(HR:3.115,95%CI:1.610-6.024).CONCLUSION IHC of HER2 heterogeneity is the pivotal predictor for trastuzumab-based chemotherapy.Thus,HER2 heterogeneity should be considered during the assessment of HER2 expression. | Akio Kaito Takeshi Kuwata Masanori Tokunaga Kohei Shitara Reo Sato Tetsuo Akimoto Takahiro Kinoshita | 2019 | World Journal of Clinical Cases2019，7，15： | 5 |
| 13 | 水下圆形重力式网箱缆绳张力对波、流的响应特性显示文摘通过模型试验研究了周长40 m、网高10 m的HDPE圆形升降式网箱沉降在水下时的缆绳张力。试验采用狄克逊准则,模型大比例尺λ=10和小比例尺λa=λd=2;网箱采用网格形式锚泊系统。试验时前主缆绳水平方向与波流夹角为0°,试验流速为0、5、10和15 cm/s,波浪周期范围1.3~2.2 s,波高范围10~30 cm。在各试验条件下对主缆绳和系框绳以及浮框绳张力进行了测试,以受力最大的缆绳为研究对象,分析了缆绳最大张力与波流因子之间的关系。结果显示:①在纯流作用下,前主缆绳受力最大;在纯波作用下,后侧主缆绳受力最大,最大张力随波高增大呈线性增长趋势,随周期变化的影响较小。②在波流作用下,高流速、低波高、高波周期条件时前主缆绳受力最大;在低流速、高波高、低波周期时后侧主缆绳受力最大;前主缆绳受水流作用影响较大,后侧主缆绳受波浪作用影响较大。③在波流作用下,各缆绳最大张力随波高、流速增大而增大,随周期增大而减小;后侧主缆绳最大张力无量纲量随波陡增大且基本呈线性增长趋势。 | 刘圣聪 黄六一 倪益 程晖 赵芬芳 王欣欣 梁振林 KINOSHITA Takeshi | 2019 | 水产学报2019，43，6： | 5 |
| 14 | Liver injury after aluminum potassium sulfate and tannic acid treatment of hemorrhoids显示文摘We are reporting a rare case of acute liver injury that developed after an internal hemorrhoid treatment with the aluminum potassium sulfate and tannic acid(ALTA) regimen. A 41-year-old man developed a fever and liver injury after undergoing internal hemorrhoid treatment with a submucosal injection of ALTA with lidocaine. The acute liver injury was classified clinically as hepatocellular and pathologically as cholestastic. We could not classify the mechanism of injury. High eosinophil and immunoglobulin E levels characterized the injury,and a drug lymphocyte stimulation test was negative on postoperative day 25. Fluid replacement for two weeks after hospitalization improved the liver injury. ALTA therapy involves injecting chemicals into the submucosa,from the rectum to the anus,and this is the first description of a case that developed a severe liver disorder after this treatment; hence,an analysis of future cases as they accumulate is desirable. | Kenichi Yoshikawa Reimi Kawashima Yuki Hirose Keiko Shibata Takafumi Akasu Noriko Hagiwara Takeharu Yokota Nami Imai Akira Iwaku Go Kobayashi Hirohiko Kobayashi Akiyoshi Kinoshita Nao Fushiya Hiroyuki Kijima Kazuhiko Koike Masayuki Saruta | 2017 | World Journal of Gastroenterology2017，23，27： | 5 |
| 15 | Neoadjuvant chemotherapy followed by surgery in gastric cancer patients with extensive lymph node metastasis显示文摘Gastric cancer with extensive lymph node metastasis(ELM) is usually considered unresectable and is associated with poor outcomes. Cases with clinical enlargement of the para-aortic lymph nodes and/or bulky lymph node enlargement around the celiac artery and its branches are generally dealt with as ELM. A standard treatment for gastric cancer with ELM has yet to be determined. Two phase Ⅱ studies of neoadjuvant chemotherapy followed by surgery showed that neoadjuvant chemotherapy with S-1 plus cisplatin followed by surgical resection with extended lymph node dissection could represent a treatment option for gastric cancer with ELM. However,many clinical questions remain unresolved,including the criteria for diagnosing ELM,optimal regime,number of courses and extent of lymph node dissection. | Seiji Ito Yuichi Ito Kazunari Misawa Yasuhiro Shimizu Taira Kinoshita | 2015 | World Journal of Clinical Oncology2015，6，6： | 4 |
| 16 | Effects of anti-hypertensive drugs on esophageal body contraction显示文摘AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux disease.METHODS:Thirteen healthy male volunteers were enrolled. Esophageal body peristaltic contractions and lower esophageal sphincter (LES) pressure were measured using high resolution manometry. All subjects were randomly examined on four separate occasions following administrations of nifedipine,losartan,and atenolol,as well as without any drug administration.RESULTS:Peristaltic contractions by the esophageal body were separated into three segments by two troughs. The peak peristaltic pressures in the mid and lower segments of the esophageal body under atenolol administration were signifi cantly higher than those without medication in a supine position. On the other hand,peristaltic pressures under nifedipine administration were lower than those observed without drug ad-ministration. Losartan did not change esophageal body peristalsis. Atenolol elevated LES pressure and slowed peristaltic wave transition,while the effects of nifedip-ine were the opposite. CONCLUSION:Among the anti-hypertensive drugs tested,atenolol enhanced esophageal motor activity,which was in contrast to nifedipine. | Koichi Yoshida Kenji Furuta Kyoichi Adachi Shunji Ohara Terumi Morita Takashi Tanimura Shuji Nakata Masaharu Miki Kenji Koshino Yoshikazu Kinoshita | 2010 | World Journal of Gastroenterology2010，16，8： | 4 |
| 17 | Distal pancreatectomy with resection of the celiac axis and reconstruction of the hepatic artery for carcinoma of the body and tail of the pancreas显示文摘 | Masaru Konishi Taira Kinoshita Toshio Nakagori Kazuto Inoue Tatsuya Oda Takahiro Kimata Hiroyuki Kikuchi Munemasa Ryu | 2000 | Journal of Hepato - Biliary - Pancreatic Surgery2000，，2： | 4 |
| 18 | Evaluation of endoscopic biliary stenting for obstructive jaundice caused by hepatocellular carcinoma显示文摘AIM:To review the usefulness of endoscopic biliary stenting for obstructive jaundice caused by hepatocellular carcinoma and identify problems that may need to be addressed.METHODS:The study population consisted of 36 patients with obstructive jaundice caused by hepatocellular carcinoma(HCC)who underwent endoscopic biliary stenting(EBS)as the initial drainage procedure at our hospital.The EBS technical success rate and drainage success rate were assessed.Drainage was considered effective when the serum total bilirubin level decreased by 50%or more following the procedure compared to the pre-drainage value.Survival time after the procedure and patient background characteristics were assessed comparatively between the successful drainage group(group A)and the non-successful drainage group(group B).The EBS stent patency duration in the successful drainage group(group A)was also assessed.RESULTS:The technical success rate was 100%for both the initial endoscopic nasobiliary drainage and EBS in all patients.Single stenting was placed in 21 patients and multiple stenting in the remaining 15 patients.The drainage successful rate was 75%and the median interval to successful drainage was 40 d(2-295 d).The median survival time was 150 d in group A and 22 d in group B,with the difference between the two groups being statistically significant(P<0.0001).There were no statistically significant differences between the two groups with respect to patient background characteristics,background liver condition,or tumor factors;on the other hand,the two groups showed statistically significant differences in patients without a history of hepatectomy(P=0.009)and those that received multiple stenting(P=0.036).The median duration of stent patency was 43 d in group A(2-757 d).No early complications related to the EBS technique were encountered.Late complications occurred in 13 patients(36.1%),including stent occlusion in 7,infection in 3,and distal migration in 3.CONCLUSION:EBS is recommended as the initial drainage procedure for obstructive jaundice caused by HCC,as it appears to contribute to prolongation of survival time. | Gen Sugiyama Yoshinobu Okabe Yusuke Ishida Fumihiko Saitou Ryuichi Kawahara Hiroto Ishikawa Hiroyuki Horiuchi Hisafumi Kinoshita Osamu Tsuruta Michio Sata | 2014 | World Journal of Gastroenterology2014，20，22： | 4 |
| 19 | Epigenetic Programming: The Challenge to Species Hybridization显示文摘在许多有机体,单个种类的染色体被在授精前后行动的繁殖障碍的一个范围孤立。在一个房间(杂交) 以内的面对不同染色体的在种类结果之间的成功的交配,它能由于不利基因相互作用在细胞的事件导致不兼容。除了如此的基因相互作用,最近的研究证明了染色体, transposons 的 silencing,非添加剂基因表示的控制和 genomic 印力量的 epigenetic 控制也在植物和动物种类贡献繁殖障碍。这些基因并且 epigenetic 机制在在种类之间的基因流动的预防起一个重要作用。在这评论,我们在种类杂交期间集中于与混合不兼容有关的 epigenetic 控制的方面,并且也在在不同染色体之间的相互作用考虑关键机制。 | Ryo Ishikawa Tetsu Kinoshita | 2009 | Molecular Plant2009，2，4： | 4 |
| 20 | Phosphorylation of alphaB-crystallin in epiretinal membrane of human proliferative diabetic retinopathy显示文摘AIM: To examine phosphorylation of alpha B-crystallin(p-αBC), a vascular endothelial growth factor(VEGF)chaperone, and immunohistochemically investigate relationship between p-αBC, VEGF and phosphorylated p38-mitogen-activated protein kinase(p-p38 MAPK) in the epiretinal membrane of human proliferative diabetic retinopathy(PDR).METHODS: Eleven epiretinal membranes of PDR surgically excised were included in this study. Two normal retinas were also collected from enucleation tissues due to choroidal melanoma. Paraformaldehyde-fixed, paraffin-embedded tissue sections were processed for immunohistochemistry with anti-p-αBC, VEGF, CD31,and p-p38 MAPK antibodies.RESULTS: Immunoreactivity for p-αBC was observed in all of the epiretinal membranes examined, where phosphorylation on serine(Ser) 59 showed strongest immunoreactivity in over 70% of the membranes. The immunolocalization of p-αBC was detected in the CD31-positive endothelial cells, and co-localized with VEGF and p-p38 MAPK in PDR membranes. Immunoreactivity for p-αBC, however, was undetectable in endothelial cells of the normal retinas, where p-p38 MAPK immunoreactivity was less marked than PDR membranes.CONCLUSION: Phosphorylation of αBC, in particular,phosphorylation on Ser59 by p-p38 MAPK may play a potential role as a molecular chaperon for VEGF in the pathogenesis of epiretinal membranes in PDR. | Yoko Dong Zhenyu Dong Satoru Kase Ryo Ando Junichi Fukuhara Satoshi Kinoshita Saori Inafuku Yoshiaki Tagawa Erdal Tan Ishizuka Wataru Saito Miyuki Murata Atsuhiro Kanda Kousuke Noda Susumu Ishida | 2016 | International Journal of Ophthalmology(English edition)2016，9，8： | 4 |
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