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An effective and safe gastric endoscopic submucosal dissection in the right lateral position using an inverted overtube

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World Journal of Gastroenterology 2014年第6期20卷 1623-1625页

作者： Hirohito Mori Kazi Rafiq Hideki Kobara Noriko Nishiyama Shintaro Fujihara Tatsuo Yachida Maki Ayagi joji tani Hisaaki Miyoshi Tsutomu Masaki Department of Gastroenterology and Neurology Kagawa University

Previously, we reported the efficacy of a newly developed inverted overtube in shortening the hemostatic time and obtaining a clear endoscopic view in emergency endoscopic hemostasis. This device also helped us to perform gastric endoscopic submucosal dissection(ESD) more safely by changing the direction of gravity in the right lateral position. To perform a safe ESD, it is important to make an appropriate angle and distance between the electric knife and the gastric mucosa. In this position, the distance to gastric mucosa is reduced, and the angle of the electric knife changes from vertical to somewhat oblique, facilitating safer cutting.

关键词： Gastric endoscopic submucosal dissection Direction of gravity Right lateral position Appropriate angle and distance

Diabetes mellitus and metformin in hepatocellular carcinoma

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World Journal of Gastroenterology 2016年第27期22卷 6100-6113页

作者： Koji Fujita Hisakazu Iwama Hisaaki Miyoshi joji tani Kyoko Oura Tomoko Tadokoro Teppei Sakamoto Takako Nomura Asahiro Morishita Hirohito Yoneyama Tsutomu Masaki Department of Gastroenterology and Neurology Faculty of Medicine Kagawa University Kagawa 760-8521 Japan Life Science Research Center Kagawa University Kagawa 760-8521 Japan

Hepatocellular carcinoma(HCC) is the leading cause of cancer-related death worldwide. Diabetes mellitus, a risk factor for cancer, is also globally endemic. The clinical link between these two diseases has been the subject of investigation for a century, and diabetes mellitus has been established as a risk factor for HCC. Accordingly, metformin, a first-line oral anti-diabetic, was first proposed as a candidate anti-cancer agent in 2005 in a cohort study in Scotland. Several subsequent large cohort studies and randomized controlled trials have not demonstrated significant efficacy for metformin in suppressing HCC incidence and mortality in diabetic patients; however, two recent randomized controlled trials have reported positive data for the tumor-preventive potential of metformin in non-diabetic subjects. The search for biological links between cancer and diabetes has revealed intracellular pathways that are shared by cancer and diabetes. The signal transduction mechanisms by which metformin suppresses carcinogenesis in cell lines or xenograft tissues and improves chemoresistance in cancer stem cells have also been elucidated. This review addresses the clinical and biological links between HCC and diabetes mellitus and the anti-cancer activity of metformin in clinical studies and basic experiments.

关键词： Hepatocellular carcinoma Diabetes mellitus Metformin Risk

Reduction effect of bacterial counts by preoperative saline lavage of the stomach in performing laparoscopic and endoscopic cooperative surgery

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World Journal of Gastroenterology 2014年第42期20卷 15763-15770页

作者： Hirohito Mori Hideki Kobara Takaaki Tsushimi Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida joji tani Hisaaki Miyoshi Asahiro Morishita Tsutomu Masaki Departments of Gastroenterology and Neurology Facultyof Medicine Kagawa University Department of Gastroenterological Surgery Ehime Rosai Hospital

AIM: To investigate the effects of gastric lavage with 2000 mL of saline in laparoscopic and endoscopic cooperative surgery.

关键词： Laparoscopic and endoscopic cooperative surgery Systemic gastric lavage Disinfection Bacterial counts Duodenal balloon occlusion

Influence of percutaneous local therapy for hepatocellular carcinoma on gastric function

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World Journal of Gastroenterology 2013年第10期19卷 1618-1624页

作者： Mitsuyoshi Kobayashi Fumihiko Kinekawa Kazuya Matsuda Shintaro Fujihara Noriko Nishiyama Takako Nomura joji tani Hisaaki Miyoshi Hideki Kobara Akihiro Deguchi Hirohito Yoneyama Hirohito Mori Tsutomu Masaki Department of Gastroenterology and Neurology Faculty of MedicineKagawa UniversityMiki-choKita-gunKagawa 761-0793Japan Department of Internal Medicine Sanuki Municipal HospitalSanuki-cityKagawa 769-2393Japan Department of Internal Medicine Matsuda ClinicTakamatsu-cityKagawa 760-0071Japan

AIM:To investigate the influence of percutaneous local therapy on gastric myoelectrical activity in patients with hepatocellular ***:Forty-four patients with hepatocellular carcinoma(HCC) [27 males and 17 females,ranging in age from 49 to 81 years old(69.7 ± 8.01 years)] who were admitted for percutaneous local therapy were enrolled in this *** examined clinical abdominal symptoms using the Gastrointestinal Symptom Rating Scale(GSRS) before and 3 d after percutaneous local *** also measured cutaneous fasting and postprandial electrogastrography(EGG) recordings before and 3 d after percutaneous local ***:We found that the percentage of normogastria in the fasting period was lower in the Child B group than in the Child A group(66.8% ± 8.6% vs 84.0% ± 3.8%).After percutaneous local therapy for HCC,the percentages of normogastria in the fasting period were significantly decreased(81.6% ± 3.5% vs 75.2% ± 4.5%).None of the postprandial EGG parameters changed significantly after percutaneous local therapy for *** local therapy for HCC reduced the power ratio(PR).In particular,the PR of tachygastria was significantly decreased after therapy(P < 0.01).However,no significant differences were found in the postprandial EGG ***,no significant differences were found in the calculated GSRS scores obtained from the questionnaire before and after ***:Gastric slow-wave dysrhythmias were induced by percutaneous local therapy in HCC patients,even though the GSRS scores obtained from the questionnaire did not change significantly.

关键词： Gastric myoelectrical activity Electrogastrography Hepatocellular carcinoma Percutaneous ethanol injection Radiofrequency ablation

A rare case of hyaline-type Castleman disease in the liver

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World Journal of Hepatology 2013年第7期5卷 404-408页

作者： Hisaaki Miyoshi Shima Mimura Takako Nomura joji tani Asahiro Morishita Hideki Kobara Hirohito Mori Hirohito Yoneyama Akihiro Deguchi Takashi Himoto Naoki Yamamoto Keiichi Okano Yasuyuki Suzuki Tsutomu Masaki Department of Gastroenterology and Neurology Faculty of Medicine Kagawa University Department of Gastroenterological Surgery Faculty of Medicine Kagawa University

Castleman disease often develops in the neck, mediastinum and pulmonary hilum. Its onset in the peritoneal cavity is very rare. The patient, a woman in her 70s, was referred to our department for a detailed examination of an abdominal mass. On abdominal ultrasonography, computed tomography scan, magnetic resonance imaging and positron emission tomography, a mass approximately 15 mm in diameter was noted in the hepatic S6. We attempted radical treatment and conducted a laparoscope-assisted right lobectomy. On the basis of histopathological findings, the patient was diagnosed as having hyaline type Castleman disease in the liver, a very rare condition.

关键词： Castleman disease Hyaline type Liver tumor Hepatectomy Positron emission tomography

Therapeutic efficacy of ramucirumab after lenvatinib for post-progression treatment of unresectable hepatocellular carcinoma

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Gastroenterology Report 2021年第2期9卷 133-138,I0002页

作者： Atsushi Hiraoka Takashi Kumada Toshifumi Tada Chikara Ogawa joji tani Shinya Fukunishi Masanori Atsukawa Masashi Hirooka Kunihiko Tsuji Toru Ishikawa Koichi Takaguchi Kazuya Kariyama Ei Itobayashi Kazuto Tajiri Noritomo Shimada Hiroshi Shibata Hironori Ochi Kazuhito Kawata Hidenori Toyoda Hideko Ohama Kazuhiro Nouso Akemi Tsutsui Takuya Nagano Norio Itokawa Korenobu Hayama Taeang Arai Michitaka Imai Yohei Koizumi Shinichiro Nakamura Kojiro Michitaka Yoichi Hiasa Masatoshi Kudo Gastroenterology Center Ehime Prefectural Central HospitalEhimeJapan Department of Gastroenterology and Hepatology Ogaki Municipal HospitalGifuJapan Department of Internal Medicine Himeji Red Cross HospitalHyogoJapan Department of Gastroenterology and Hepatology Takamatsu Red Cross HospitalTakamatsuJapan Department of Gastroenterology and Hepatology Kagawa universityKagawaJapan Department of Gastroenterology Osaka Medical CollegeOsakaJapan Division of Gastroenterology and Hepatology Department of Internal MedicineNippon Medical SchoolTokyoJapan Department of Gastroenterology and Metabology Ehime University Graduate School of MedicineEhimeJapan Center of Gastroenterology Teine Keijinkai HospitalSapporoJapan Department of Gastroenterology Saiseikai Niigata HospitalNiigataJapan Department of Hepatology Kagawa Prefectural Central HospitalTakamatsuJapan Department of Gastroenterology Okayama City HospitalOkayamaJapan Department of Gastroenterology Asahi General HospitalAsahiJapan Department of Gastroenterology Toyama University HospitalToyamaJapan Division of Gastroenterology and Hepatology Otakanomori HospitalKashiwaJapan Department of Gastroenterology Tokushima Prefectural Central HospitalTokushimaJapan Hepato-biliary Center Matsuyama Red Cross HospitalMatsuyamaJapan Department of Hepatology Hamamatsu University School of MedicineHamamatsuJapan Department of Gastroenterology Kindai UniversityOsakaJapan

Background:Lenvatinib is used for unresectable hepatocellular carcinoma(u-HCC)as first-line,as well as second-and third-line therapy in *** evaluated the therapeutic efficacy of newly developed ramucirumab when given after lenvatinib for post-progression ***:Of 385 patients with u-HCC and treated with lenvatinib at 16 different institutions in Japan between May 2018 and January 2020,28 who received ramucirumab as the next treatment were enrolled and therapeutic responses were evaluated in a retrospective ***:The median age of the 28 patients given ramucirumab was 70 years and the median albumin-bilirubin score *** the 28 patients,23 were male,21 were classified as Child-Pugh A and 7 as Child-Pugh B,and 25 were Barcelona Clinic Liver Cancer Stage *** was given as second-line therapy in 14,third-line in 9,and fourth-line in *** response was obtained in only 26 patients;the objective response rate was 3.8%(1/26)and the disease-control rate was 42.3%(11/26),with a median period to progression of 2.0 *** reasons for discontinuation of ramucirumab were progression of disease in 16 and Grade 3 adverse events(gastrointestinal bleeding,ascites)in ***:The anticipated therapeutic efficacy of ramucirumab for post-progression treatment following lenvatinib was not seen in our early experience.

关键词： hepatocellular carcinoma ramucirumab lenvatinib sorafenib