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Proposal of criteria to select candidates with colorectal liver metastases for hepatic resection:Comparison of our scoring system to the positive number of risk factors

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World Journal of Gastroenterology 2006年第39期12卷 6305-6309页

作者： Ikuo Nagashima Tadahiro Takada miki adachi Hirokazu Nagawa Tetsuichiro Muto Kota Okinaga Department of Surgery Teikyo University School of Medicine Tokyo Japan Department of Surgical Oncology University of Tokyo Graduate School of Medicine Tokyo Japan

AIM： To select accurately good candidates of hepatic resection for colorectal liver metastasis.METHODS： Thirteen clinicopathological features, which were recognized only before or during surgery, were selected retrospectively in 81 consecutive patients in one hospital （Group Ⅰ ）. These features were entered into a multivariate analysis to determine independent and significant variables affecting long-term prognosis after hepatectomy. Using selected variables, we created a scoring formula to classify patients with colorectal liver metastases to select good candidates for hepatic resection. The usefulness of the new scoring system was examined in a series of 92 patients from another hospital （Group Ⅱ ）, comparing the number of selected variables.RESULTS： Among 81 patients of Group Ⅰ, multivariate analysis, i.e. Cox regression analysis, showed that multiple tumors, the largest tumor greater than 5 cm in diameter, and resectable extrahepatic metastases were significant and independent prognostic factors for poor survival after hepatectomy （P 〈 0.05）. In addition, these three factors： serosa invasion, local lymph node metastases of primary cancers, and postoperative disease free interval less than 1 year including synchronous hepatic metastasis, were not significant, however, they were selected by a stepwise method of Cox regression analysis （0.05 〈 P 〈 0.20）. Using these six variables, we created a new scoring formula to classify patients with colorectal liver metastases. Finally, our new scoring system not only classified patients in Group I very well, but also that in Group Ⅱ, according to long-term outcomes after hepatic resection. The positive number of these six variables also classified them well.CONCLUSION： Both, our new scoring system and the positive number of significant prognostic factors are useful to classify patients with colorectal liver metastases in the preoperative selection of good candidates for hepatic resection.

关键词： Colorectal cancer Liver metastasis Hepatic resection Prognostic factor

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Effects of anti-hypertensive drugs on esophageal body contraction

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World Journal of Gastroenterology 2010年第8期16卷 987-991页

作者： Koichi Yoshida Kenji Furuta Kyoichi adachi Shunji Ohara Terumi Morita Takashi Tanimura Shuji Nakata Masaharu miki Kenji Koshino Yoshikazu Kinoshita Second Department of Internal Medicine Shimane University Faculty of Medicine Department of Clinical Nursing Shimane University Faculty of Medicine

AIM:To clarify the effects of anti-hypertensive drugs on esophageal contraction and determine their possi-ble relationship with gastro-esophageal reflux ***: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 ***: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.

关键词： Anti-hypertensive drug High-resolution manometry Lower esophageal sphincter Esophageal body contraction Calcium-channel blocker β1 blocker

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Esophageal epithelial surface in patients with gastroesophageal reflux disease:An electron microscopic study

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World Journal of Gastroenterology 2008年第37期14卷 5712-5716页

作者： Takane Azumi Kyoichi adachi Kenji Furuta Shuji Nakata Shunji Ohara Kenji Koshino Masaharu miki Terumi Morita Takashi Tanimura Nobuo Ashizawa Yoshikazu Kinoshita Second Department of Internal Medicine Shimane University School of MedicineShimane 693-8501 Japan

A/M： To investigate the intercellular spaces between the most superficially located esophageal epithelial cells in patients with gastroesophageal reflux disease （GERD）. METHODS： Eighteen patients with erosive esophagitis, 10 patients with non-erosive reflux disease （NERD）, and 18 normal asymptomatic volunteers were enrolled. Biopsy specimens were obtained from the lower esophageal mucosa without ulcer or erosion. Scanning electron microscopy was employed to investigate the tightness of the superficial cellular attachment. RESULTS： The intercellular space between the most superficially located epithelial cells in patients with erosive esophagitis or NERD was not different from that in asymptomatic healthy individuals. CONCLUSION： Widened luminal intercellular spaces of esophageal superficial epithelium are not responsible for the induction of reflux symptoms in patients with GERD.

关键词： Reflux esophagitis Non-erosive gastroesophageal reflux diseases Electron microscopy Questionnaire

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Determining factors for carotid mean/max intima-media thickness and brachial flow-mediated dilation in healthy young women

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World Journal of Cardiovascular Diseases 2012年第2期2卷 43-49页

作者： Shiro Hoshida Takashi miki Takafumi Nakagawa Yukinori Shinoda Takayoshi adachi Division of Cardiovascular Medicine Yao Municipal Hospital Yao Japan

Background: Many factors can contribute to atherosclerotic-type vascular changes in older individuals or men. Thus, confining the investigation to young women with no clinical evidence of the condition could enhance understanding of the early stages of cardiovascular disease. The aim of this study was to determine whether carotid mean/max intima-media thickness (IMT) and brachial flow-mediated dilation (FMD) values, which are well-known event-related indices, are associated with laboratory data and the other vascular indices of atherosclerosis in healthy young women. Methods: Carotid mean/max IMT and brachial FMD were measured in young women with no clinical evidence of atherosclerosis (n = 110;mean age, 39 years) who were instructed not to eat, drink or smoke after 9 PM the evening before testing. All participants also underwent laboratory assessment, including simultaneous measurements of arterial stiffness such as augmentation index (AI), cardioankle vascular index (CAVI) and brachial-ankle pulse wave velocity (baPWV). Results: Mean IMT was signifi-cantly and positively associated with age (p = 0.002), CAVI (p = 0.044), low-density lipoprotein-cholesterol (LDL-C, p = 0.047) and high-sensitive C-reactive protein (hs-CRP, p = 0.002) values but was not related to FMD, AI, baPWV or triglycerides (TG) in the multivariate regression analysis. Similarly, max IMT was positively associated with age (p p = 0.003) and hs-CRP (p = 0.005) values but was not related to FMD, AI, CAVI, baPWV, TG or blood pressure level in the multivariate regression analysis. The association between LDL-C and max IMT was much stronger than that between LDL-C and mean IMT. Brachial FMD was positively associated only with heart rate in the multivariate regression analysis. Conclusions: These results suggest that mean IMT more closely represents the sclerotic aspect of vascular change, whereas max IMT represents the atherotic aspect in healthy young women. Although the relationship between the auto

关键词： Intima-Media Thickness Flow-Mediated Dilation Young Women

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IGF2 differentially methylated region hypomethylation in relation to pathological and molecular features of serrated lesions

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World Journal of Gastroenterology 2014年第29期20卷 10050-10061页

作者： Takafumi Naito Katsuhiko Nosho miki Ito Hisayoshi Igarashi Kei Mitsuhashi Shinji Yoshii Hironori Aoki Masafumi Nomura Yasutaka Sukawa Eiichiro Yamamoto Yasushi adachi Hiroaki Takahashi Masao Hosokawa Masahiro Fujita Toshinao Takenouchi Reo Maruyama Hiromu Suzuki Yoshifumi Baba Kohzoh Imai Hiroyuki Yamamoto Shuji Ogino Yasuhisa Shinomura Department of Gastroenterology Rheumatology and Clinical ImmunologySapporo Medical University School of Medicine Department of Gastroenterology Keiyukai Sapporo Hospital Center for Gastroenterology Teine-Keijinkai Hospital Department of Medical Oncolo-gy Dana-Farber Cancer InstituteBostonMA 02115United States Department of Surgery Keiyukai SapporoHospital Department of Pathology Keiyukai Sapporo Hospital Department of Molecular Biology Sapporo Medical University School of Medicine Department of Gastroenterological Surgery Graduate School of Medical ScienceKumamoto University Division of Cancer Research The Institute of Medical ScienceThe University of Tokyo Division of Gastroenterology and Hepatology Department of Internal MedicineSt.Marianna University School of Medicine

AIM: To investigate insulin-like growth factor 2 (IGF2) differentially methylated region (DMR)0 hypomethylation in relation to clinicopathological and molecular features in colorectal serrated lesions.

关键词： BRAF Colon polyp Colorectal neoplasia Colorectum Genome Insulin-like growth factor Long interspersed nucleotide element-1 Microsatellite instability Serrated pathway

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Association of Fusobacterium nucleatum with immunity andmolecular alterations in colorectal cancer

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World Journal of Gastroenterology 2016年第2期22卷 557-566页

作者： Katsuhiko Nosho Yasutaka Sukawa Yasushi adachi miki Ito Kei Mitsuhashi Hiroyoshi Kurihara Shinichi Kanno Itaru Yamamoto Keisuke Ishigami Hisayoshi Igarashi Reo Maruyama Kohzoh Imai Hiroyuki Yamamoto Yasuhisa Shinomura Department of Gastroenterology Rheumatology and Clinical ImmunologySapporo Medical University School of MedicineSapporo 060-8543Japan Department of Molecular Biology Sapporo Medical University School of MedicineSapporo 060-8543Japan Division of Cancer Research The Institute of Medical ScienceThe University of TokyoTokyo 108-8639Japan Division of Gastroenterology and Hepatology Department of Internal MedicineSt.Marianna University School of MedicineKawasaki 216-8511Japan

The human intestinal microbiome plays a major role in human health and diseases, including colorectal cancer. Colorectal carcinogenesis represents a heterogeneous process with a differing set of somatic molecular alterations, influenced by diet, environmental and microbial exposures, and host immunity. Fusobacterium species are part of the human oral and intestinal microbiota. Metagenomic analyses have shown an enrichment of Fusobacterium nucleatum(F. nucleatum) in colorectal carcinoma tissue. Using 511 colorectal carcinomas from Japanese patients, we assessed the presence of F. nucleatum. Our results showed that the frequency of F. nucleatum positivity in the Japanese colorectal cancer was 8.6%(44/511), which was lower than that in United States cohort studies(13%). Similar to the United States studies, F. nucleatum positivityin Japanese colorectal cancers was significantly associated with microsatellite instability(MSI)-high status. Regarding the immune response in colorectal cancer, high levels of infiltrating T-cell subsets(i.e., CD3+, CD8+, CD45RO+, and FOXP3+ cells) have been associated with better patient prognosis. There is also evidence to indicate that molecular features of colorectal cancer, especially MSI, influence T-cell-mediated adaptive immunity. Concerning the association between the gut microbiome and immunity, F. nucleatum has been shown to expand myeloid-derived immune cells, which inhibit T-cell proliferation and induce T-cell apoptosis in colorectal cancer. This finding indicates that F. nucleatum possesses immunosuppressive activities by inhibiting human T-cell responses. Certain micro RNAs are induced during the macrophage inflammatory response and have the ability to regulate host-cell responses to pathogens. Micro RNA-21 increases the levels of IL-10 and prostaglandin E2, which suppress antitumor T-cell-mediated adaptive immunity through the inhibition of the antigen-presenting capacities of dendritic cells and T-cell proliferation in color

关键词： BRAF CpG island methylator phenotype Colon neoplasia Fusobacterium species miR-21

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