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Quality of life after total vs distal gastrectomy with Rouxen-Y reconstruction: Use of the Postgastrectomy Syndrome Assessment Scale-45

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World Journal of Gastroenterology 2017年第11期23卷 2068-2076页

作者： Masazumi Takahashi Masanori Terashima Hiroshi Kawahira eishi nagai Yoshikazu Uenosono Shinichi Kinami Yasuhiro Nagata Masashi Yoshida Keishiro Aoyagi Yasuhiro Kodera Koji Nakada Division of Gastroenterological Surgery Yokohama Municipal Citizen’s Hospital Division of Gastric Surgery Shizuoka Cancer Center Center for Frontier Medical Engineering Chiba University Department of Surgery and Science Graduate school of medicine Kyushu University Department of Digestive Surgery Kagoshima University Graduate School of Medicine Department of Surgical Oncology Kanazawa Medical School Center for Comprehensive Community Care Education Graduate School of Biomedical Sciences Nagasaki University Department of Surgery International University of Health and Welfare Hospital Department of Surgery Kurume University School of Medicine Department of Gastroenterological Surgery Nagoya University Graduate School of Medicine Department of Laboratory Medicine The Jikei University School of Medicine

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 *** 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.

关键词： Postgastrectomy syndrome Quality of life Gastric cancer Gastrectomy Patient-reported outcome

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Overexpression of c-met in the early stage of pancreatic carcinogenesis; altered expression is not sufficient for progression from chronic pancreatitis to pancreatic cancer

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World Journal of Gastroenterology 2006年第24期12卷 3878-3882页

作者： Kenoki Ohuchida Kazuhiro Mizumoto Nami Ishikawa Yasuhiro Ogura Daisuke Yamada Takuya Egami Hayato Fujita Seiji Ohashi eishi nagai Masao Tanaka Department of Surgery and Oncology Graduate School of Medical Sciences Kyushu UniversityFukuokaJapan

AIM： To investigate c-met expression during early pancreatic carcinogenesis. METHODS： We used 46 bulk tissues and 36 microdissected samples, including normal pancreas, chronic pancreatitis, and pancreatic cancer, for quantitative realtime reverse transcription-polymerase chain reaction. RESULTS： In bulk tissue analyses, pancreatic cancer tissues expressed significantly higher levels of c-met than did chronic pancreatitis and normal pancreas tissues. c-met levels did not differ between chronic pancreatitis and normal pancreas tissues. In microdissection-based analyses, c-met was expressed at higher levels in microclissected pancreatic cancer cells and pancreatitisaffected epithelial cells than in normal ductal epithelial cells （both, P 〈 0.01）. Interestingly, pancreatitis-affected epithelial cells expressed levels of c-met similar to those of pancreatic cancer cells. CONCLUSION： Overexpression of c-met occurs during the early stage of pancreatic carcinogenesis, and a single alteration of c-met expression is not sufficient for progression of chronic pancreatitis-affected epithelial cells to pancreatic cancer cells.

关键词： c-met', Pancreatic cancer Chronic pancreatitis Pancreatic carcinogenesis

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