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Comparison of decompression tubes with metallic stents for the management of right-sided malignant colonic obstruction

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World Journal of Gastroenterology 2019年第16期25卷 1975-1985页

作者： yoshiyuki Suzuki Konosuke Moritani Yuki Seo Takayuki takahashi Department of Surgery Ashikaga Red Cross HospitalTochigi 326-0843Japan

BACKGROUND Emergency surgical resection is a standard treatment for right-sided malignant colonic obstruction; however, the procedure is associated with high rates of mortality and morbidity. Although a bridge to surgery can be created to obviate the need for emergency surgery, its effects on long-term outcomes and the most practical management strategies for right-sided malignant colonic obstruction remain unclear.AIM To determine the appropriate management approach for right-sided malignant colonic obstruction.METHODS Forty patients with right-sided malignant colonic obstruction who underwent curative resection from January 2007 to April 2017 were included in the study.We compared the perioperative and long-term outcomes of patients who received bridges to surgery established using decompression tubes and those created using self-expandable metallic stents(SEMS). The primary outcome was the overall survival duration(OS) and the secondary endpoints were the diseasefree survival(DFS) duration and the preoperative and postoperative morbidity rates. Analysis was performed on an intention-to-treat basis.RESULTS There were 21 patients in the decompression tube group and 19 in the SEMS group. There were no significant differences in the perioperative morbidity rates of the two groups. The OS rate was significantly higher in the decompression tube group than in the SEMS group(5-year OS rate; decompression tube 79.5%,SEMS 32%, P = 0.043). Multivariate analysis revealed that the bridge to surgery using a decompression tube was significantly associated with the OS(hazard ratio, 17.41; P = 0.004). The 3-year DFS rate was significantly higher in thedecompression tube group than in the SEMS group(68.9% vs 45.9%; log-rank test,P = 0.032). A propensity score–adjusted analysis also demonstrated that the prognosis was significantly better in the decompression tube group than in the SEMS group.CONCLUSION The bridge to surgery using trans-nasal and trans-anal decompression tubes for right-sided malignant colonic obstruction is saf

关键词： Right-sided colon cancer Large bowel obstruction Self-expandable metallic stent Trans-anal tube Trans-nasal tube

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Importance of an appropriate number of examined lymph nodes in patients with pancreatic cancer-the more the better?

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Hepatobiliary Surgery and Nutrition 2022年第4期11卷 605-607页

作者： Toshiro Ogura Hiroyuki Ishida Amane takahashi yoshiyuki Kawashima Department of Gastroenterological Surgery Saitama Cancer CenterSaitamaJapan

Pancreatic cancer is a highly aggressive malignant cancer with a 5-year survival rate of approximately 10%.The outcome of patients diagnosed with resectable pancreatic cancer as per the National Comprehensive Cancer Network(NCCN)classification and those who underwent resection was not satisfactory.Similar to other abdominal malignant tumors,the stages of pancreatic cancer are defined by local extension,lymph node metastasis,and distant metastasis.The presence or absence of lymph node metastasis is diagnosed by pathological examination of the retrieved lymph,the quality of the diagnosis based on lymph node(N)staging depends on the surgical and pathological aspects(1).

关键词： lymph metastasis patients

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Serum anti-Helicobacter pylori antibody titer and its association with gastric nodularity,atrophy,and age:A cross-sectional study

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World Journal of Gastroenterology 2018年第35期24卷 4061-4068页

作者： Osamu Toyoshima Toshihiro Nishizawa Kosuke Sakitani Tadahiro Yamakawa Yoshiyuki Takahashi Nobutake Yamamichi Keisuke Hata Yasuyuki Seto Kazuhiko Koike Hidenobu Watanabe Hidekazu Suzuki Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Surgical Oncology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Gastrointestinal Surgery Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Pathology and Cytology Laboratory Japan Tokyo 166-0003Japan Medical Education Center Keio University School of MedicineTokyo 160-8582Japan

AIM To clarify the role of serum anti-Helicobacter pylori(H. pylori) antibody titers in gastric cancer.METHODS In this cross-sectional study, the effect of patients' baseline characteristics and endoscopic findings on their serum antibody titers were assessed. We evaluated consecutive patients who underwent esophagogastroduodenoscopy and their first evaluation for H. pylori infection using a serum antibody test. We excluded patients with a history of eradication therapy. The participants were divided into four groups according to their E-plate serum antibody titer. Patients with serum antibody titers < 3, 3-9.9, 10-49.9, and ≥ 50 U/m L were classified into groups A, B, C, and D, respectively. RESULTS In total, 874 participants were analyzed with 70%, 16%, 8.7%, and 5.1% of them in the groups A, B, C, and D, respectively. Patients in group C were older than patients in groups A and B. Gastric open-type atrophy, intestinal metaplasia, enlarged folds, diffuse redness, and duodenal ulcers were associated with a high titer. Regular arrangements of collecting venules, fundic gland polyps, superficial gastritis, and gastroesophageal reflux disease were related to a low titer. Multivariate analysis revealed that nodularity(P = 0.0094), atrophy(P = 0.0076), and age 40-59 years(vs age ≥ 60 years, P = 0.0090) were correlated with a high serum antibody titer in H. pylori-infected patients. Intestinal metaplasia and atrophy were related to age ≥ 60 years in group C and D.CONCLUSION Serum antibody titer changes with age, reflects gastric mucosal inflammation, and is useful in predicting the risk of gastric cancer.

关键词： Antibody Helicobacter pylori Gastritis Gastric cancer Endoscopy

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Serial changes in expression of functionally clustered genes in progression of liver fibrosis in hepatitis C patients

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World Journal of Gastroenterology 2008年第13期14卷 2010-2022页

作者： yoshiyuki Takahara Mitsuo takahashi Qing-Wei Zhang Hirotaka Wagatsuma Maiko Mori Akihiro Tamori Susumu Shiomi Shuhei Nishiguchi Exploratory & Applied Pharmaceutical Research Department Pharmaceutical Company Ajinomoto Co. Inc. 1-1 Suzuki-cho Kawasaki-ku Kawasaki 210-8681 Japan Department of Nuclear Medicine Graduate School of Medicine Osaka City University Osaka Japan Division of Hepatobiliary and Pancreatic Diseases Department of Internal Medicine Hyogo College of Medicine Nishinomiya Japan

AIM: To investigate the relationship of changes in expression of marker genes in functional categories or molecular networks comprising one functional category or multiple categories in progression of hepatic fibrosis in hepatitis C (HCV) patients. METHODS: Marker genes were initially identified using DNA microarray data from a rat liver fibrosis model. The expression level of each fibrosis associated marker gene was analyzed using reverse transcription-polymerase chain reaction (RT-PCR) in clinical biopsy specimens from HCV-positive patients (n = 61). Analysis of changes in expression patterns and interactions of marker genes in functional categories was used to assess the biological mechanism of fibrosis. RESULTS: The profile data showed several biological changes associated with progression of hepatic fibrosis. Clustered genes in functional categories showed sequential changes in expression. Several sets of clustered genes, including those related to the extracellular matrix (ECM), inflammation, lipid metabolism, steroid metabolism, and some transcription factors important for hepatic biology showed expression changes in the immediate early phase (F1/F2) of fibrosis. Genes associated with aromatic amino acid (AA) metabolism, sulfur-containing AA metabolism and insulin/ Wnt signaling showed expression changes in the middle phase (F2/F3), and some genes related to glucose metabolism showed altered expression in the late phase of fibrosis (F3/F4). Therefore, molecular networks showing serial changes in gene expression are present in liver fibrosis progression in hepatitis C patients. CONCLUSION: Analysis of gene expression profiles from a perspective of functional categories or molecular networks provides an understanding of disease and suggests new diagnostic methods. Selected marker genes have potential utility for biological identification of advanced fibrosis.

关键词：肝纤维化丙肝标记基因基因表达新陈代谢转录因子

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Factors affecting the quality of life of patients after gastrectomy as assessed using the newly developed PGSAS-45 scale: A nationwide multi-institutional study

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World Journal of Gastroenterology 2016年第40期22卷 8978-8990页

作者： Koji Nakada Masazumi takahashi Masami Ikeda Shinichi Kinami Masashi Yoshida Yoshikazu Uenosono yoshiyuki Kawashima Sayumi Nakao Atsushi Oshio Yoshimi Suzukamo Masanori Terashima Yasuhiro Kodera Department of Laboratory Medicine Daisan Hospital Jikei University School of MedicineTokyo 201-8601Japan Division of Gastroenterological Surgery Yokohama Municipal Citizen’s HospitalYokohama 240-8555Japan Department of Surgery Asama General HospitalSaku 085-0022Japan Department of Surgical Oncology Kanazawa Medical SchoolKanazawa 920-0293Japan Department of Surgery International University of Health and Welfare HospitalTochigi 329-2763Japan Department of Digestive Surgery Breast and Thyroid SurgeryKagoshima University Graduate School of MedicineKagoshima 890-8620Japan Division of Gastroenterological Surgery Saitama Cancer CenterSaitanna 362-0806Japan Department of Surgery 2 Tokyo Women’s Medical UniversityTokyo 162-8666Japan Faculty of Letters Arts and SciencesWaseda UniversityTokyo 169-8050Japan Department of Physical Medicine and Rehabilitation Tohoku University Graduate School of MedicineSendai 980-8575Japan Division of Gastric Surgery Shizuoka Cancer CenterShizuoka 411-8777Japan Department of Gastroenterological Surgery Nagoya University Graduate School of MedicineNagaya 466-8550Japan

AIM To identify certain clinical factors other than the type of gastrectomy which affect the postoperative quality of life(QOL) of patients after gastrectomy.METHODS The postgastrectomy syndrome assessment scale(PGSAS)-45 was designed to assess the severity of symptoms, the living status and the QOL of gastrectomized patients. It consists of 45 items, of which 22 are original items while 23 were retrieved from the SF-8 and Gastrointestinal Symptoms Rating Scale questionnaires with permission. A nationwide surveillance study to validate PGSAS was conducted and 2368 gastric cancer patients who underwent various types of gastrectomy at 52 medical institutions were enrolled. Of these, 1777 patients who underwent total gastrectomy(TG) reconstructed with Roux-Y(n = 393), distal gastrectomy(DG) reconstructed with Billroth-I(n = 909), or DG reconstructed with Roux-Y(n = 475) were evaluated in the current study. The influence of the type of gastrectomy and other clinical factors such as age, sex, duration after surgery, the symptom severity, the degree of weight loss, dietary intake, and the ability for working on the postoperative QOL(i.e., dissatisfaction for daily life subscale, physical component summary and mental component summary of the SF-8) were examined by multiple regression analysis(MRA). In addition, importance of various symptoms such as esophageal reflux, abdominal pain, meal-related distress, indigestion, diarrhea, constipation and dumping on the postoperative living status and QOL were also appraised by MRA.RESULTS The postoperative QOL were significantly deteriorated in patients who underwent TG compared to those after DG. However, the extent of gastrectomy was not an influential factor on patients' QOL when adjusted by the MRA. Among various clinical factors, the symptom severity, ability for working, and necessity for additional meals were the most influential factorsto the postoperative QOL. As for the individual symptoms, meal-related distress, dumping, abdominal pain, and esophageal reflux significa

关键词： Postgastrectomy 症候群生活的质量病人 -- 报导结果效果尺寸 Gastrectomy

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2011年东日本大地震:位移延伸至海沟轴

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国际地震动态 2012年第1期33卷 1-2,19页

作者： Toshiya Fujiwara Shuichi Kodaira Tetsuo No Yuka Kaiho Narumi takahashi yoshiyuki Kaneda 左玉玲 Institute for Research on Earth Evolution Japan Agency for Marine-Earth Science and TechnologyNatsushima-cho 2-15Yokosuka 237-0061Japan IFREE JAMSTECShowa-machi 3173-25Kanazawa-kuYokohama 236-0001Japan Earthquake and Tsunami Research Project for Disaster Prevention JAMSTECShowa-machi 3173-25Kanazawa-kuYokohama 236-0001Japan 中国地震局地球物理研究所

2011年3月11日日本地震（Mw9．0）后发生的大海啸被认为是由延伸至日本海沟处一条俯冲带浅部的断层破裂所致。这是不同的地震和大地测量反演程序所揭示的结果^[1-2]；然而，精确的同震位移逆倾斜向上极限值仍然没有被明确界定。在此，... 详细信息

2011年3月11日日本地震（Mw9．0）后发生的大海啸被认为是由延伸至日本海沟处一条俯冲带浅部的断层破裂所致。这是不同的地震和大地测量反演程序所揭示的结果^[1-2]；然而，精确的同震位移逆倾斜向上极限值仍然没有被明确界定。在此，我们介绍了地震前和地震后穿越破裂带内的海沟重复进行的多波束水深测量结果，以估算其逆倾斜向上极限值，并量化海底位移。

关键词：日本海沟同震位移大地震断层破裂反演程序大地测量水深测量极限值

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Kyoto classification in patients who developed multiple gastric carcinomas after Helicobacter pylori eradication

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World Journal of Gastrointestinal Endoscopy 2020年第9期12卷 276-284页

作者： Kosuke Sakitani Toshihiro Nishizawa Akira Toyoshima Shuntaro Yoshida Tatsuya Matsuno Tomoharu Yamada Masatoshi Irokawa Yoshiyuki Takahashi Yousuke Nakai Osamu Toyoshima Kazuhiko Koike Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology Sakitani Endoscopy ClinicChiba 275-0026Japan Department of Gastroenterology International University of Health and WelfareNarita HospitalChiba286-8520Japan Department of Colorectal Surgery Japanese Red Cross Medical CenterTokyo 150-8935Japan Department of Gastroenterology Graduate School of Medicinethe University of TokyoTokyo 113-8655Japan

BACKGROUND Endoscopic Kyoto classification predicts gastric cancer risk;however,the score in the patients with primary gastric cancer after Helicobacter pylori(H.pylori)eradication therapy is unknown.AIM To elucidate the Kyoto classification score in patients with both single gastric cancer and multiple gastric cancers developed after H.pylori eradication.METHODS The endoscopist recorded the Kyoto classification at the endoscope and the Kyoto classification score at the time of the first diagnosis of gastric cancer after H.pylori eradication.The score was compared between single gastric cancer group and multiple gastric cancers group.RESULTS The Kyoto score at the time of diagnosis of 45 cases of gastric cancer after H.pylori eradication was 4.0 points in average.The score was 3.8 points in the single gastric cancer group,and 5.1 points in the multiple gastric cancers group.The multiple group had a significantly higher score than the single group(P=0.016).In the multiple gastric cancers group,all the patients(7/7)had 5 or higher Kyoto score,while in single gastric cancer group,the proportion of patients with a score of 5 or higher was less than half,or 44.7%(17/38).CONCLUSION Patients diagnosed with gastric cancer after H.pylori eradication tended to have advanced gastritis.In particular,in cases of multiple gastric cancers developed after H.pylori eradication,the endoscopic Kyoto classification score tended to be 5 or higher in patients with an open type atrophic gastritis and the intestinal metaplasia extended to the corpus.

关键词： Kyoto classification Gastric cancer Helicobacter pylori Eradication therapy Metachronous Intestinal metaplasia

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Gene expression profiles of hepatic cell-type specific marker genes in progression of liver fibrosis

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World Journal of Gastroenterology 2006年第40期12卷 6473-6499页

作者： yoshiyuki Takahara Mitsuo takahashi Hiroki Wagatsuma Fumihiko Yokoya Qing-Wei Zhang Mutsuyo Yamaguchi Hiroyuki Aburatani Norifumi Kawada Exploratory and Applied Pharmaceutical Research Department Pharmaceutical Company Ajinomoto Co. Inc Kawasaki 210-8681 Japan Biochemical Information project BiolT Business Development Group Fujitsu Limited Tokyo Japan Center for Collaborative Research Research Center for Advanced Science and Technology the University of Tokyo Tokyo Japan Department of Hepatology Graduate School of Medicine Osaka City University Osaka Japan

AIM: To determine the gene expression profile data for the whole liver during development of dimethylni-trosamine (DMN)-induced hepatic fibrosis.METHODS: Marker genes were identified for different types of hepatic cells, including hepatic stellate cells (HSCs), Kupffer cells (including other inflammatory cells), and hepatocytes, using independent temporal DNA microarray data obtained from isolated hepatic cells. RESULTS: The cell-type analysis of gene expression gave several key results and led to formation of three hypotheses: (1) changes in the expression of HSC-specific marker genes during fibrosis were similar to gene expression data in in vitro cultured HSCs, suggesting a major role of the self-activating characteristics of HSCs in formation of fibrosis; (2) expression of mast cell-specific marker genes reached a peak during liver fibrosis, suggesting a possible role of mast cells in formation of fibrosis; and (3) abnormal expression of hepatocyte-specific marker genes was found across several metabolic pathways during fibrosis, including sulfur-containing amino acid metabolism, fatty acid metabolism, and drug metabolism, suggesting a mechanistic relationship between these abnormalities and symptoms of liver fibrosis. CONCLUSION: Analysis of marker genes for specific hepatic cell types can identify the key aspects of fibro-genesis. Sequential activation of inflammatory cells and the self-supporting properties of HSCs play an important role in development of fibrosis.

关键词：基因表达肝疾病病理治疗临床

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characteristics of intestinal pseudo-obstruction in patients with mitochondrial diseases

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World Journal of Gastroenterology 2012年第33期18卷 4557-4562页

作者： Yusuke Sekino Masahiko Inamori Eiji Yamada Hidenori Ohkubo Eiji Sakai Takuma Higurashi Hiroshi Iida Kunihiro Hosono Hiroki Endo Takashi Nonaka Hirokazu takahashi Tomoko Koide Yasunobu Abe Eiji Gotoh Shigeru Koyano yoshiyuki Kuroiwa Shin Maeda Atsushi Nakajima Gastroenterology Division Yokohama City University School of Medicine Yokohama 236-0004 Japan Department of Medical Education Yokohama City University School of Medicine Yokohama 236-0004 Japan Department of Neurology Yokohama City University School of Medicine Yokohama 236-0004 Japan

AIM: To reveal the frequency, characteristics and prognosis of chronic intestinal pseudo-obstruction (CIP) in mitochondrial disease patients. METHODS: Between January 2000 and December 2010, 31 patients (13 males and 18 females) were di-agnosed with mitochondrial diseases at our hospital. We conducted a retrospective review of the patients' sex, subclass of mitochondrial disease, age at onset of mitochondrial disease, frequency of CIP and the age at its onset, and the duration of survival. The age at onset or at the first diagnosis of the disorder that led to the clinical suspicion of mitochondrial disease was also examined. RESULTS: Twenty patients were sub-classified with mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS), 8 with chronic progressive external ophthalmoplegia (CPEO), and 3 with myoclonus epilepsy associated with ragged-red fibers (MERRF). Nine patients were diagnosed with CIP, 8 of the 20 (40.0%) patients with MELAS, 0 of the 8 (0.0%) patients with CPEO, and 1 of the 3 (33.3%) patients with MERRF. The median age (range) at the diagnosis and the median age at onset of mitochondrial disease were 40 (17-69) and 25 (12-63) years in patients with CIP, and 49 (17-81) and 40 (11-71) years in patients without CIP. During the survey period, 5 patients (4 patients with MELAS and 1 with CPEO) died. The cause of death was cardiomyopathy in 2 patients with MELAS, cerebral infarction in 1 patient with MELAS, epilepsy and aspiration pneumonia in 1 patient with MELAS, and multiple metastases from gastric cancer and aspiration pneumonia in 1 patient with CPEO. CONCLUSION: Patients with CIP tend to have disorders that are suspected to be related to mitochondrial diseases at younger ages than are patients without CIP.

关键词：线粒体疾病肠梗阻患者假性死亡原因 CIP 心肌病生存时间

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Recent advances in prostate cancer: WNT signaling, chromatin regulation, and transcriptional coregulators

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Asian Journal of Andrology 2023年第2期25卷 158-165页

作者： Sayuri takahashi Ichiro Takada Department of Urology The Institute of Medical ScienceThe University of TokyoShirokanedaiMinato-kuTokyo 108-8639Japan Department of Urology The Faculty of MedicineThe University of TokyoHongoBunkyo-kuTokyo 113-8655Japan

Prostate cancer is one of the most common diseases in men worldwide.Surgery,radiation therapy,and hormonal therapy are effective treatments for early-stage prostate cancer.However,the development of castration-resistant prostate cancer has increased the mortality rate of prostate cancer.To develop novel drugs for castration-resistant prostate cancer,the molecular mechanisms of prostate cancer progression must be elucidated.Among the signaling pathways regulating prostate cancer development,recent studies have revealed the importance of noncanonical wingless-type MMTV integration site family(WNT)signaling pathways,mainly that involving WNT5A,in prostate cancer progression and metastasis;however,its role remains controversial.Moreover,chromatin remodelers such as the switch/sucrose nonfermentable(SWI/SNF)complex and chromodomain helicase DNA-binding proteins 1 also play important roles in prostate cancer progression through genome-wide gene expression changes.Here,we review the roles of noncanonical WNT signaling pathways,chromatin remodelers,and epigenetic enzymes in the development and progression of prostate cancer.

关键词： chromatin remodeling histone-modifying enzymes prostate cancer WNT5A

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