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| 1 | Practical guidelines for diagnosis and early management of drug-induced liver injury显示文摘The spectrum of drug-induced liver injury (DILI) is both diverse and complex. The fi rst step in diagnosis is a suspicion of DILI based on careful consideration of recent comprehensive reports on the disease. There are some situations in which the suspicion of DILI is particularly strong. Exclusion of other possible etiologies according to the pattern of liver injury is essential for the diagnosis. In patients with suspected DILI,diagnostic scales,such as the Councils for International Organizations of Medical Sciences/ Roussel Uclaf Causality Assessment Method (CIOMS/ RUCAM) scale,may be helpful for the fi nal diagnosis. Early management of DILI involves prompt withdrawal of the drug suspected of being responsible,according to serum levels of alanine aminotransferase (ALT),alkaline phosphatase (ALP),and total bilirubin (T-Bil). However,as DILI patients may show resolution of liver injury without discontinuation of the drug,it should be carefully evaluated whether the suspected drug should be discontinued immediately with adequate consideration of the importance of the medication. | Kazuto Tajiri Yukihiro Shimizu | 2008 | World Journal of Gastroenterology2008，14，44： | 57 |
| 2 | New methods for the management of gastric varices显示文摘Bleeding from gastric varices has been successfully treated by endoscopic modalities. Once the bleeding from the gastric varices is stabilized, endoscopic treatment and/or interventional radiology should be performed to eradicate varices completely. Partial splenic artery embolization is a supplemental treatment to prolong the obliteration of the veins feeding and/or draining the varices. The overall incidence of bleeding from gastric varices is lower than that from esophageal varices. No studies to date have defi nitively characterized the causal factors behind bleeding from gastric varices. The initial episodes of bleeding from esophageal varices or gastric varices without prior treatment may be at least partly triggered by a violation of the mucosal barrier overlying varices. This is especially likely in the case of varices of the fundus. In view of the high rate of hemostasis achieved among bleeding gastric varices, treatment should be administered in selective cases. Among untreated cases, steps to prevent gastric mucosal injury confer very important protection against gastric variceal bleeding. | Hiroshi Yoshida Yasuhiro Mamada Nobuhiko Taniai Takashi Tajiri | 2006 | World Journal of Gastroenterology2006，12，37： | 31 |
| 3 | New methods for the management of esophageal varices显示文摘Bleeding from esophageal varices (EVs) is a catastrophic complication of chronic liver disease. Many years ago, surgical procedures such as esophageal transection or distal splenorenal shunting were the only treatments for EVs. In the 1970s, interventional radiology procedures such as transportal obliteration, left gastric artery embolization, and partial splenic artery embolization were introduced, improving the survival of patients with bleeding EVs. In the 1980s, endoscopic treatment, endoscopic injection sclerotherapy (EIS), and endoscopic variceal ligation (EVL), further contributed to improved survival. We combined IVR with endoscopic treatment or EIS with EVL. Most patients with EVs treated endoscopically required follow- up treatment for recurrent varices. Proper management of recurrent EVs can significantly improve patients’ quality of life. Recently, we have performed EVL at 2-mo (bimonthly) intervals for the management of EVs. Longer intervals between treatment sessions resulted in a higher rate of total eradication and lower rates of recurrence and additional treatment. | Hiroshi Yoshida Yasuhiro Mamada Nobuhiko Taniai Takashi Tajiri | 2007 | World Journal of Gastroenterology2007，13，11： | 30 |
| 4 | One-step palliative treatment method for obstructive jaundice caused by unresectable malignancies by percutaneous transhepatic insertion of an expandable metallic stent显示文摘瞄准:为了描述包含可扩充的金属的经皮的 transhepatic 插入的一个简单一步舞方法,在妨碍的黄疸的治疗使用的斯滕特氏印模膏(他们) 由 unresectable 恶意引起了。方法:由于 unresectable 恶意与妨碍的黄疸诊断的十四个病人在学习被包括。在这些病人的恶意是很先进的癌或老年的结果。经皮的 transhepatic 胆管造影术在 ultrasonographic 指导下面被执行。在有一个内部金属性的指南的一根导管是先进的进十二指肠以后,一他们被放在胆总管,在一个点之间在到肝的核的 Vater 和入口的乳头状的小突起以外的 1 厘米。在用就一个单身者跨越距离是困难的情况中他们,另外的斯滕特氏印模膏被放。一根排水导管在地方被离开充当一把止血钳子。在胆汁郁积和斯滕特氏印模膏明显的分辨率被证实以后,导管被移开 2 或 3 d 过程以后。结果:EMS 的一步舞插入与 24.4 min 的一过程平均数时间在所有病人被完成。从要求了 2 他们的病人, 4 需要一过程时间超过 30 min。导管的移动的吝啬的时间过程以后是 2.3 d。所有病人与 7.8 瞬间的一吝啬的后续时间死于恶意。没有 stent 相关的复杂并发症或斯滕特氏印模膏阻塞被遇到。结论:他们的一步舞经皮的 transhepatic 插入是为决定胆汁的阻塞和罐头有效地改进病人生命的质量的一个简单过程。 | Hiroshi Yoshida Yasuhiro Mamada Nobuhiko Taniai Yoshiaki Mizuguchi Tetsuya Shimizu Shigeki Yokomuro Takayuki Aimoto Yoshiharu Nakamura Eiji Uchida Yasuo Arima Manabu Watanabe Eiichi Uchida Takashi Tajiri | 2006 | World Journal of Gastroenterology2006，12，15： | 28 |
| 5 | Useful detection of CD147 (EMMPRIN) for pathological diagnosis of early hepatocellular carcinoma in needle biopsy samples显示文摘AIM:To make clear whether CD147 (EMMPRIN) expression in pathological tumor samples with a fine-needle aspiration biopsy is useful for pathological diagnosis of early hepatocellular carcinoma (HCC). METHODS:Twenty-two patients (15 men and 7 women; median age 68 years,range 56-81 years) underwent a liver tissue biopsy in order to make a diagnosis of HCC. Paraffin-embedded liver biopsy tissue samples from 22 patients were stained with anti-CD147 antibody,murine monoclonal antibody 12C3 (MAb12C3) for immunohistochemical analysis. An immunohistochemical analysis of CD147 was performed and the degree of staining compared between tumor and non-tumor tissue. In addition,the degree of staining within tumor tissue was compared according to a number of clinicopathological variables. RESULTS:The degree of staining of CD147 was significantly higher in tumor tissues than non-tumor tissues,even in tumors less than 15 mm in diameter.The expression of this protein was significantly elevated in HCC tissue specimens from patients with a low value of serum AST and γ-GTP. | Satoshi Mamori Keisuke Nagatsuma Tomokazu Matsuura Kiyoshi Ohkawa Hiroshi Hano Masaharu Fukunaga Masato Matsushima Yoshifumi Masui Nao Fushiya Hiroshi Onoda Yasuyuki Searashi Ichiro Takagi Hisao Tajiri | 2007 | World Journal of Gastroenterology2007，13，21： | 20 |
| 6 | Branched-chain amino acids in liver diseases显示文摘Branched chain amino acids(BCAAs)have been shown to affect gene expression,protein metabolism,apoptosis and regeneration of hepatocytes,and insulin resistance.They have also been shown to inhibit the proliferation of liver cancer cells in vitro,and are essential for lymphocyte proliferation and dendritic cell maturation.In patients with advanced chronic liver disease,BCAA concentrations are low,whereas the concentrations of aromatic amino acids such as phenylalanine and tyrosine are high,conditions that may be closely associated with hepatic encephalopathy and the prognosis of these patients.Based on these basic observations,patients with advanced chronic liver disease have been treated clinically with BCAA-rich medicines,with positive effects. | Kazuto Tajiri Yukihiro Shimizu | 2013 | World Journal of Gastroenterology2013，19，43： | 16 |
| 7 | Clinical significance of serum procalcitonin in patients with ulcerative colitis显示文摘AIM:To investigate the association of procalcitonin(PCT)with ulcerative colitis(UC)activity.METHODS:Serum PCT levels,C-reactive protein(CRP)levels,the erythrocyte sedimentation rate,and the white blood cell count were analyzed in 18 patients with UC and 11 healthy volunteers.Serum PCT levels were analyzed by an electrochemiluminescence immunoassay.Severity assessments were based on Truelove and Witts’severity index.Correlation of serum PCT and CRP levels with UC activity was examined.Moreover,we assessed serum PCT and CRP levels in patients with a Mayo endoscopic subscore.RESULTS:Serum PCT levels in severe UC patients(n=7)(0.096±0.034 ng/mL)were significantly higher than in mild-to-moderate UC patients(n=11)(0.033±0.012 ng/mL)and healthy volunteers(n=11)(0.035±0.005 ng/mL)(P=0.0005 and P<0.0001,respectively).In addition,there was no difference in serum PCT levels between mild-to-moderate UC patients and healthy volunteers.Interestingly,patients with a Mayo endoscopic subscore of 3 points displayed significantly increased levels of serum PCT(0.075±0.043 ng/mL)compared with patients with a subscore of 2 points(0.03±0.011 ng/mL)(P=0.0302).Moreover,CRP levels in patients with severe UC or a Mayo endoscopic subscore of 3 points were not significantly higher than in patients with mild-to-moderate UC or a Mayo endoscopic subscore of 3 points.CONCLUSION:Serum PCT levels were significantly correlated with UC activity. | Shigeo Koido Toshifumi Ohkusa Kazuki Takakura Shunichi Odahara Shintaro Tsukinaga Toyokazu Yukawa Jimi Mitobe Mikio Kajihara Kan Uchiyama Hiroshi Arakawa Hisao Tajiri | 2013 | World Journal of Gastroenterology2013，19，45： | 15 |
| 8 | Liver physiology and liver diseases in the elderly显示文摘The liver experiences various changes with aging that could affect clinical characteristics and outcomes in patients with liver diseases.Both liver volume and blood flow decrease significantly with age.These changes and decreased cytochrome P450 activity can affect drug metabolism,increasing susceptibility to drug-induced liver injury.Immune responses against pathogens or neoplastic cells are lower in the elderly,although these individuals may be predisposed to autoimmunity through impairment of dendritic cell maturation and reduction of regulatory T cells.These changes in immune functions could alter the pathogenesis of viral hepatitis and autoimmune liver diseases,as well as the development of hepatocellular carcinoma.Moreover,elderly patients have significantly decreased reserve functions of various organs,reducing their tolerability to treatments for liver diseases.Collectively,aged patients show various changes of the liver and other organs that could affect the clinical characteristics and management of liver diseases in these patients. | Kazuto Tajiri Yukihiro Shimizu | 2013 | World Journal of Gastroenterology2013，19，46： | 15 |
| 9 | Development of osteomalacia in a post-liver transplant patient receiving adefovir dipivoxil显示文摘We report the case of a patient treated with living donor-related liver transplantation who suffered from osteomalacia during adefovir dipivoxil (ADV)-containing antiviral therapy for lamivudine-resistant hepatitis B virus infection. The patient had generalized bone pain,with severe hypophosphatemia after 20 mo of ADV therapy. Radiographic studies demonstrated the presence of osteomalacia. The peak plasma ADV level was 38 ng/mL after administration of ADV at 10mg/day. It was also found that ADV affected the metabolism of tacrolimus,a calcineurin-inhibitor,and caused an increase in the plasma levels of tacrolimus. The disability was reversed with the withdrawal of ADV and with mineral supplementation. ADV can cause an elevation of plasma tacrolimus levels,which may be associated with renal dysfunction. High levels of ADV and tacrolimus can cause nephrotoxicity and osteomalacia. This case highlights the importance of considering a diagnosis of osteomalacia in liver transplantation recipients treated with both ADV and tacrolimus. | Masami Minemura Yoshiharu Tokimitsu Kazuto Tajiri Yasuhiro Nakayama Kengo Kawai Hiroshi Kudo Katsuharu Hirano Yoshinari Atarashi Yutaka Yata Satoshi Yasumura Terumi Takahara Toshiro Sugiyama | 2010 | World Journal of Hepatology2010，2，12： | 13 |
| 10 | Immunotherapy for colorectal cancer显示文摘The incidence of colorectal cancer(CRC)is on the rise,and the prognosis for patients with recurrent or metastatic disease is extremely poor.Although chemotherapy and radiation therapy can improve survival rates,it is imperative to integrate alternative strategies such as immunotherapy to improve outcomes for patients with advanced CRC.In this review,we will discuss the effect of immunotherapy for inducing cytotoxic T lymphocytes and the major immunotherapeutic approaches for CRC that are currently in clinical trials,including peptide vaccines,dendritic cell-based cancer vaccines,whole tumor cell vaccines,viral vector-based cancer vaccines,adoptive cell transfer therapy,antibody-based cancer immunotherapy,and cytokine therapy.The possibility of combination therapies will also be discussed along with the challenges presented by tumor escape mechanisms. | Shigeo Koido Toshifumi Ohkusa Sadamu Homma Yoshihisa Namiki Kazuki Takakura Keisuke Saito Zensho Ito Hiroko Kobayashi Mikio Kajihara Kan Uchiyama Seiji Arihiro Hiroshi Arakawa Masato Okamoto Jianlin Gong Hisao Tajiri | 2013 | World Journal of Gastroenterology2013，19，46： | 11 |
| 11 | Pathologic complete response confirmed by surgical resection for liver metastases of gastrointestinal stromal tumor after treatment with imatinib mesylate显示文摘A 39-year-old male underwent distal gastrectomy for a high grade gastrointestinal stromal tumor(GIST) . Computed tomography(CT) and magnetic resonance imaging(MRI) 107 mo after the operation,revealed a cystic mass(14 cm in diameter) and a solid mass(9 cm in diameter) in the right and left lobes of the liver,respectively. A biopsy specimen of the solid mass showed a liver metastasis of GIST. The patient received imatinib mesylate(IM) treatment,400 mg/day orally. Following the IM treatment for a period of 35 mo,the patient underwent partial hepatectomy(S4 + S5) . The effect of IM on the metastatic lesions was interpreted as pathologic complete response(CR) . Pathologically verified cases showing therapeutic efficacy of IM have been rarely reported. | Seiji Suzuki Koji Sasajima Masayuki Miyamoto Hidehiro Watanabe Tadashi Yokoyama Hiroshi Maruyama Takeshi Matsutani Aimin Liu Masaru Hosone Shotaro Maeda Takashi Tajiri | 2008 | World Journal of Gastroenterology2008，14，23： | 11 |
| 12 | 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 |
| 13 | Simplified criteria for diagnosing superficial esophageal squamous neoplasms using Narrow Band Imaging magnifying endoscopy显示文摘AIM To simplify the diagnostic criteria for superficial esophageal squamous cell carcinoma(SESCC) on Narrow Band Imaging combined with magnifying endoscopy(NBI-ME).METHODS This study was based on the post-hoc analysis of a randomized controlled trial. We performed NBI-ME for 147 patients with present or a history of squamous cell carcinoma in the head and neck, or esophagus between January 2009 and June 2011. Two expert endoscopistsdetected 89 lesions that were suspicious for SESCC lesions, which had been prospectively evaluated for the following 6 NBI-ME findings in real time: 'intervascular background coloration'; 'proliferation of intrapapillary capillary loops(IPCL)'; and 'dilation', 'tortuosity', 'change in caliber', and 'various shapes(VS)' of IPCLs(i.e., Inoue's tetrad criteria). The histologic examination of specimens was defined as the gold standard for diagnosis. A stepwise logistic regression analysis was used to identify candidates for the simplified criteria from among the 6 NBI-ME findings for diagnosing SESCCs. We evaluated diagnostic performance of the simplified criteria compared with that of Inoue's criteria.RESULTS Fifty-four lesions(65%) were histologically diagnosed as SESCCs and the others as low-grade intraepithelial neoplasia or inflammation. In the univariate analysis, proliferation, tortuosity, change in caliber, and VS were significantly associated with SESCC(P < 0.01). The combination of VS and proliferation was statistically extracted from the 6 NBI-ME findings by using the stepwise logistic regression model. We defined the combination of VS and proliferation as simplified dyad criteria for SESCC. The areas under the curve of the simplified dyad criteria and Inoue's tetrad criteria were 0.70 and 0.73, respectively. No significant difference was shown between them. The sensitivity, specificity, and accuracy of diagnosis for SESCC were 77.8%, 57.1%, 69.7% and 51.9%, 80.0%, 62.9% for the simplified dyad criteria and Inoue's tetrad criteria, respectively.CONCLUSION The combination of proliferation and VS may serve as simplified criteria for the diagnosis of SESCC using NBIME. | Akira Dobashi Kenichi Goda Noboru Yoshimura Tomohiko R Ohya Masayuki Kato Kazuki Sumiyama Masato Matsushima Shinichi Hirooka Masahiro Ikegami Hisao Tajiri | 2016 | World Journal of Gastroenterology2016，22，41： | 10 |
| 14 | Short-and long-term outcomes of endoscopically treated superficial non-ampullary duodenal epithelial tumors显示文摘BACKGROUND It is widely recognized that endoscopic resection(ER) of superficial nonampullary duodenal epithelial tumors(SNADETs) is technically challenging and may carry high risks of intraoperative and delayed bleeding and perforation.These adverse events could be more critical than those occurring in other levels of the gastrointestinal tract. Because of the low prevalence of the disease and the high risks of severe adverse events, the curability including short-and long-term outcomes have not been standardized yet.AIM To investigate the curability including short-and long-term outcomes of ER for SNADETs in a large case series.METHODS This retrospective study included cases that underwent ER for SNADETs at our university hospital between March 2004 and July 2017. Short-term outcomes of ER were measured based on en bloc and R0 resection rates as well as adverse events. Long-term outcomes included local recurrence detected on endoscopic surveillance and disease-specific mortality in patients followed up for ≥ 12 mo after ER.RESULTS In the study, 131 patients with 147 SNADETs were analyzed. The 147 ERs consisted of 136 endoscopic mucosal resections(EMRs)(93%) and 11 endoscopic submucosal dissections(ESDs)(7%). The median tumor diameter was 10 mm.The pathology diagnosis was adenocarcinoma(56/147, 38%), high-grade intraepithelial neoplasia(44/147, 30%), or low-grade intraepithelial neoplasia(47/147, 32%). The R0 resection rate was 68%(93/136) in the EMR group and73%(8/11) in the ESD group, respectively. Cap-assisted EMR(known as EMR-C)showed a higher rate of R0 resection compared to the conventional method of EMR using a snare(78% vs 62%, P = 0.06). No adverse event was observed in the EMR group, whereas delayed bleeding, intraoperative perforation, and delayed perforation in 3, 3, and 5 patients occurred in the ESD group, respectively. One patient with perforation required emergency surgery. In the 43 mo median follow-up period, local recurrence was found in four EMR cases and all cases were treated endoscopically. No patient died due to tumor recurrence.CONCLUSION Our findings suggest that ER provides good long-term outcomes in the patients with SNADETs. EMR is likely to become the safe and reliable treatment for small SNADETs. | Yuko Hara Kenichi Goda Akira Dobashi Tomohiko Richard Ohya Masayuki Kato Kazuki Sumiyama Takehiro Mitsuishi Shinichi Hirooka Masahiro Ikegami Hisao Tajiri | 2019 | World Journal of Gastroenterology2019，25，6： | 9 |
| 15 | Postoperative bile leakage managed successfully by intrahepatic biliary ablation with ethanol显示文摘我们报导手术后的倔强的胆汁漏的一个案例与乙醇由肝内的胆汁的脱离成功地设法。与肝细胞癌诊断的一个 75 岁的人包括有尾的脑叶和前面的片断的部分经历了扩大以后的 segmentectomy。纳入胆汁管的前面的分支的肝的肿瘤小心地被分开并且 resected。手术后地从肝表面排干的液体包含了全部的胆红素的高集中,在每天的 150 mL 的经常的体积。在 d 上 32 在外科以后,引流管的 fistulogram 表明了前面的胆汁管的改进。内视镜后退胆管造影术表明了近似前面的胆汁管和外部前面的胆汁管的没有改进的完全的阻塞。在 d 上 46 在外科以后,一后退 transhepatic 胆汁的排水(RTBD ) 试管在开的外科下面被插入到前面的胆汁管。然而,拿的 RTBD 的对比研究 7 瞬间外科以后表明尽管有延长保守管理,管仍然是专利,我们因此决定执行孤立的胆汁管的乙醇脱离。四 mL 纯乙醇被注入孤立的前面的胆汁管十分钟,过程一个星期正在被重复五次。追随者 23 尝试,胆汁果汁的体积每天到达了不到 10 mL。RTBD 二天以后被夹钳并且搬迁。在 RTBD 移动以后,病人没有抱怨或症状。没有肝脓肿形成,后续磁性的回声成像表明了注射乙醇的前面的片断的萎缩。 | Tetsuya Shimizu Hiroshi Yoshida Yasuhiro Mamada Nobuhiko Taniai Satoshi Matsumoto Yoshiaki Mizuguchi Shigeki Yokomuro Yasuo Arima Koho Akimaru Takashi Tajiri | 2006 | World Journal of Gastroenterology2006，12，21： | 9 |
| 16 | Liver involvement in systemic infection显示文摘The liver is often involved in systemic infections,resulting in various types of abnormal liver function test results.In particular,hyperbilirubinemia in the range of 2-10 mg/dL is often seen in patients with sepsis,and several mechanisms for this phenomenon have been proposed.In this review,we summarize how the liver is involved in various systemic infections that are not considered to be primarily hepatotropic.In most patients with systemic infections,treatment for the invading microbes is enough to normalize the liver function tests.However,some patients may show severe liver injury or fulminant hepatic failure,requiring intensive treatment of the liver. | Masami Minemura Kazuto Tajiri Yukihiro Shimizu | 2014 | World Journal of Hepatology2014，6，9： | 9 |
| 17 | Survivin expression in early hepatocellular carcinoma and post-treatment with anti-cancer drug under hypoxic culture condition显示文摘瞄准:在肝细胞癌(HCC ) 的早阶段期间调查 survivin 的表示。方法:在肝肿瘤和从 17 个病人拿的非肿瘤织物标本的 survivin 的 Immunohistochemical 表示被比较。另外,在早阶段 HCC 响应反癌症药决定 survivin 表示, survivin 表示在 hypoxic 文化条件下面与反癌症药在 HCC 房间的治疗以后被决定。结果:Survivin 蛋白质在早 HCC 标本在 64.7% 房间被表示。在在 peritumoral hepatocytes 的 survivin 表示率和在 HCC 标本(低率的组对高率的组) 的表示的率之间的关联被观察。在 HCC 房间的 survivin 蛋白质集中被组织缺氧和反癌症药的联合增加。结论:这研究建议 survivin 能在早 HCC 被用作一个治疗学的目标。 | Satoshi Mamori Tadashi Asakura Kiyoshi Ohkawa Hisao Tajiri | 2007 | World Journal of Gastroenterology2007，13，40： | 8 |
| 18 | Serrated polyps of the colon and rectum: Endoscopic features including image enhanced endoscopy显示文摘In this review, I outline the characteristic endoscopic findings of serrated lesions of the colorectum based on image enhanced endoscopy(IEE). Histopathologically, lesions with serrated structures are typically classified into the following three types based: hyperplastic polyps(HPs), traditional serrated adenomas(TSAs), and sessile serrated adenoma/polyps(SSA/Ps). Both HP and SSA/P often present as dark-green colors on auto fluorescence imaging(AFI) colonoscopy that are similar to the normal surrounding mucosa. In contrast, TSAs often have elevated shapes and present as magenta colors that are similar to the tubular adenomas. The superficial type of TSA also includes many lesions that present as magenta colors. When SSA/Ps are associated with cytological dysplasia, many lesions present with magenta colors, whereas lesions that are not associated with cytological dysplasia present with dark-green colors. When observed via narrow band imaging(NBI), many SSA/P include lesions with strong mucous adhesions. Because these lesions are observed with reddish mucous adhesions, we refer to them as 'red cap sign' and place such signs among the typical findings of SSA/P. Because the dilatation of the pit in SSA/P is observed as a round/oval black dot on magnified observations, we refer to this finding as Ⅱ-dilatation pit(Ⅱ-D pit) and also positioned it as a characteristic finding of SSA/P. In contrast, dilatations of the capillary vessels surrounding the glands, such as those that occur in tubular adenoma, are not considered to be useful for differentiating HPs from SSA/Ps. However, in cases in which SSA/P is associated with cytological dysplasia, the dilatation of capillary vessels is observed in the same area. When submucosal layer invasion occurs in the same area, the blood flow presents with irregularities that are similar to those of common colorectal cancer at an early stage and disappears as the invasion proceeds deeply. The surface pattern of invasive cancer that is observed at the tumor surface is also likely to disappear. Based on the above results, we considered that the differentiations between HP and TSA, between TSA and SSA/P, and between HP and SSA/P might become easier due to the concomitant use of white light observation and IEE. We also concluded that AFI and NBI can be useful modalities for SSA/P lesions associated with cytological dysplasia. | Shoichi Saito Hisao Tajiri Masahiro Ikegami | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，9： | 8 |
| 19 | BRIEF ARTICLE New reduced volume preparation regimen in colon capsule endoscopy显示文摘AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.METHODS:A pilot,multicenter,randomized controlled trial compared our proposed 'reduced volume method'(group A) with the 'conventional volume method'(group B) preparation regimens.Group A did not drink polyethylene glycol electrolyte lavage solution(PEGELS) the day before the capsule procedure,while group B drank 2 L.During the procedure day,groups A and B drank 2 L and 1 L of PEG-ELS,respectively,and swallowed the colon capsule(PillCam COLON capsule).Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups,and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that time.Capsule videos were reviewed for grading of cleansing level,RESULTS:Sixty-four subjects were enrolled,with results from 60 analyzed.Groups A and B included 31 and 29 subjects,respectively.Twenty-nine(94%) subjects in group A and 25(86%) subjects in group B had adequate bowel preparation(ns).Twenty-two(71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16(55%) of the 29 subjects in group B(ns).Of the remaining 22 subjects whose capsules were not excreted within the battery life,all of the capsules reached the left side colon before they stopped functioning.A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS,due to ingesting the PEG-ELS faster than recommended.CONCLUSION:Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method. | Yasuo Kakugawa Yutaka Saito Shoichi Saito Kenji Watanabe Naoki Ohmiya Mitsuyuki Murano Shiro Oka Tetsuo Arakawa Hidemi Goto Kazuhide Higuchi Shinji Tanaka Hideki Ishikawa Hisao Tajiri | 2012 | World Journal of Gastroenterology2012，18，17： | 8 |
| 20 | Indicators of sorafenib efficacy in patients with advanced hepatocellular carcinoma显示文摘AIM:To determine significant indicators for the efficacy of sorafenib in patients with advanced hepatocellular carcinoma(HCC).METHODS:A total of 46 patients with Barcelona Clinic Liver Cancer stage C who received sorafenib for more than 30 d at the Iizuka Hospital from June 2009 to December 2012 were enrolled in this study.Multivariate and univariate analyses were performed to evaluate the associations of hepatic function according to Child-Pugh grade,location and size of the largest tumor and adverse events of sorafenib treatment,such as hand-foot syndrome(HFS),hypertension,diarrhea,and alopecia,with the efficacy of treatment,as measured by overall survival(OS)and time to progression(TTP).RESULTS:Patients included 39 men and 7 women whose ages ranged from 48 to 85 years(70.6±9.6years).HCC was classified according to etiology as follows:hepatitis C virus(n=26),hepatitis B virus(n=9),and other(n=11).Liver function in patients was categorized as Child-Pugh grade A(n=30)or B(n=16).Tumors were categorized by size[<5 cm(n=33)or>5 cm(n=13)]and the location of the largest tumor was used to categorize patients with intrahepatic(n=28)or extrahepatic(n=18)HCC.HFS,hypertension,diarrhea,and alopecia were present in22(47.8%),19(41.3%),15(32.6%)and 7 patients(15.2%),respectively.The median OS of all patients was 373 d and the median TTP was 112 d.The etiology of HCC did not correlate with the median OS and TPP.The median OS of patients with tumors<5 cm was significantly longer than those with larger tumors(496 vs 245 d;HR=0.19,95%CI:0.07-0.48;P<0.01).According to the results of a multivariate analysis,the size of the largest tumor affected OS(HR=0.22,95%CI:0.08-0.59;P<0.01).The median TTP was significantly longer in patients with extrahepatic compared to intrahepatic major HCC(224 vs 98 d;HR=0.32;95%CI:0.14-0.67;P<0.01).The median TTP of patients with HFS was significantly longer than those without it(195 d vs 83 d;HR=0.41,95%CI:0.20-0.82;P<0.05),and the median TTP was significantly longer in patients with hypertension(195 d vs84 d;HR=0.43,95%CI:0.21-0.84;P<0.05).According to the results of the multivariate analysis,extrahepatic major HCC(HR=0.36,P<0.01)and HFS(HR=0.44,P<0.05)prolonged TTP.CONCLUSION:Extrahepatic major HCC and HFS are associated with prolonged TTP and are useful indicators for judging the efficacy of sorafenib treatment. | Masayoshi Yada Akihide Masumoto Kenta Motomura Hirotaka Tajiri Yusuke Morita Hideo Suzuki Takeshi Senju Toshimasa Koyanagi | 2014 | World Journal of Gastroenterology2014，20，35： | 7 |
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