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Rikkunshito increases appetite by enhancing gastrointestinal and incretin hormone levels in patients who underwent pyloruspreserving pancreaticoduodenectomy: A retrospective study

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 871-881页

作者： Hiroshi Kono naohiro hosomura Hidetake Amemiya Katsutoshi Shoda Shinji Furuya Hidenori Akaike Yoshihiko Kawaguchi Hiromichi Kawaida Daisuke Ichikawa First Department of Surgery University of YamanashiChuoYamanashi 409-3898Japan

BACKGROUND Rikkunshito(TJ-43)relieves gastrointestinal disturbance by increases in the levels of acylated ghrelin.AIM To investigate the effects of TJ-43 in patients undergoing pancreatic surgery.METHODS Forty-one patients undergoing pylorus-preserving pancreaticoduodenectomy(PpPD)were divided into two groups;patients took daily doses of TJ-43 after surgery or after postoperative day(POD)21.The plasma levels of acylated and desacylated ghrelin,cholecystokinin(CCK),peptide YY(PYY),gastric inhibitory peptide(GIP),and active glucagon-like peptide(GLP)-1 were evaluated.Oral calorie intake was assessed at POD 21 in both groups.The primary endpoint of this study was the total food intake after PpPD.RESULTS The levels of acylated ghrelin were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 administration at POD 21,and oral intake was significantly increased in patients treated with TJ-43.The CCK and PYY levels were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 treatment.Furthermore,the GIP and active GLP-1 levels increased and values at POD 21 were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 administration.Insulin secretion tended to increase in patients treated with TJ-43.CONCLUSION TJ-43 may have advantages for oral food intake in patients in the early phase after pancreatic surgery.Further investigation is needed to clarify the effects of TJ-43 on incretin hormones.

关键词： Gastrointestinal hormone Japanese traditional herbal medicine Ghrelin Incretin Pancreatic surgery

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Surgical techniques and postoperative management to prevent postoperative pancreatic fistula after pancreatic surgery

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World Journal of Gastroenterology 2019年第28期25卷 3722-3737页

作者： Hiromichi Kawaida Hiroshi Kono naohiro hosomura Hidetake Amemiya Jun Itakura Hideki Fujii Daisuke Ichikawa First Department of Surgery Faculty of Medicine University of Yamanashi Yamanashi 409-3898 Japan Department of Surgery Kofu Manicipal Hospital Yamanashi 400-0832 Japan

Postoperative pancreatic fistula (POPF) is one of the most severe complications after pancreatic surgeries. POPF develops as a consequence of pancreatic juice leakage from a surgically exfoliated surface and/or anastomotic stump, which sometimes cause intraperitoneal abscesses and subsequent lethal hemorrhage. In recent years, various surgical and perioperative attempts have been examined to reduce the incidence of POPF. We reviewed several well-designed studies addressing POPF-related factors, such as reconstruction methods, anastomotic techniques, stent usage, prophylactic intra-abdominal drainage, and somatostatin analogs, after pancreaticoduodenectomy and distal pancreatectomy, and we assessed the current status of POPF. In addition, we also discussed the current status of POPF in minimally invasive surgeries, laparoscopic surgeries, and robotic surgeries.

关键词： Postoperative pancreatic fistula Pancreaticoduodenectomy Pancreatojejunostomy Pancreatogastrostomy Distal pancreatectomy Prophylactic drainage Somatostatin analogs

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Is surgery the best treatment for elderly gastric cancer patients?

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World Journal of Gastrointestinal Surgery 2021年第11期13卷 1351-1360页

作者： Yoshihiko Kawaguchi Hidenori Akaike Katsutoshi Shoda Shinji Furuya naohiro hosomura Hidetake Amemiya Hiromichi Kawaida Hiroshi Kono Daisuke Ichikawa First Department of Surgery Faculty of MedicineUniversity of YamanashiYamanashi 409-3898Japan

As the elderly population increases,the number of patients with gastric cancer has also been increasing.Elderly people have various preoperative problems such as malnutrition,high frequency of comorbidities,decreased performance status,and dementia.Furthermore,when surgery is performed,high postoperative complication rates and death from other diseases are also concerns.The goal of surgery in the elderly is that short-term outcomes are comparable to those in nonelderly,and long-term outcomes reach life expectancy.Perioperative problems in the elderly include:(1)Poor perioperative nutritional status;(2)Postoperative pneumonia;and(3)Psychological problems(dementia and postoperative delirium).Malnutrition in the elderly has been reported to be associated with increased postoperative complications and dementia,pointing out the importance of nutritional management.In addition,multidisciplinary team efforts,including perioperative respiratory rehabilitation,preoperative oral care,and early postoperative mobilization programs,are effective in preventing postoperative pneumonia.Furthermore,there are many reports on the usefulness of laparoscopic surgery for the elderly,and we considered that minimally invasive surgery would be the optimal treatment after assessing preoperative risk.

关键词： Elderly Gastric cancer Surgery Laparoscopy Gastrectomy Dementia

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Macrophage colony-stimulating factor expressed in non-cancer tissues provides predictive powers for recurrence in hepatocellular carcinoma

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World Journal of Gastroenterology 2016年第39期22卷 8779-8789页

作者： Hiroshi Kono Hideki Fujii Shinji Furuya Michio Hara Kazuyoshi Hirayama Yoshihiro Akazawa Yuuki Nakata Masato Tsuchiya naohiro hosomura Chao Sun First Department of Surgery Faculty of Medicine University of Yamanashi

AIM To investigate the role of macrophage colony-stimulating factor(M-CSF) in patients with hepatocellular carcinoma(HCC) after surgery. METHODS Expression of M-CSF, distribution of M2 macrophages(Mφs), and angiogenesis were assessed in the liver, including tumors and peritumoral liver tissues. The prognostic power of these factors was assessed. Mouse isolated hepatic Mφs or monocytes were cultured with media containing M-CSF. The concentration of vascular endothelial growth factor(VEGF) in media was assessed. Furthermore, the role of the M-CSF-matured hepatic Mφs on proliferation of the vascular endothelial cell(VEC) was investigated. RESULTS A strong correlation between the expressions of M-CSF and CD163 was observed in the peritumoral area. Also, groups with high density of M-CSF, CD163 or CD31 showed a significantly shorter time to recurrence(TTR) than low density groups. Multivariate analysis revealedthe expression of M-CSF or hepatic M2Mφs in the peritumoral area as the most crucial factor responsible for shorter TTR. Moreover, the expression of M-CSF and hepatic M2Mφs in the peritumoral area had better predictable power of overall survival. Values of VEGF in culture media were significantly greater in the hepatic Mφs compared with the monocytes. Proliferation of the VEC was greatest in the cells co-cultured with hepatic Mφs when M-CSF was present in media.CONCLUSION M-CSF increases hepatocarcinogenesis, most likely by enhancing an angiogenic factor derived from hepatic Mφ and could be a useful target for therapy against HCC.

关键词： M2 巨噬细胞脉管的 endothelial 生长因素脉管的 endothelial 房间单核白血球 Angiogenesis

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miR-122-5p as a novel biomarker for alpha-fetoproteinproducing gastric cancer

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World Journal of Gastrointestinal Oncology 2018年第10期10卷 344-350页

作者： Suguru Maruyama Shinji Furuya Kensuke Shiraishi Hiroki Shimizu Hidenori Akaike naohiro hosomura Yoshihiko Kawaguchi Hidetake Amemiya Hiromichi Kawaida Makoto Sudo Shingo Inoue Hiroshi Kono Daisuke Ichikawa First Department of Surgery Faculty of Medicine University of Yamanashi

AIM To investigate the clinical utility of alpha-fetoprotein(AFP)-producing gastric cancer(AFPGC)-specific microRNA(mi RNA)for monitoring and prognostic prediction of patients.METHODS We performed a comprehensive miRNA array-based approach to compare miRNA expression levels between AFP-positive and AFP-negative cells in three patients with primary AFPGC.We next examined the expression levels of the selected miRNAs in five AFPGC and ten non-AFPGC tissue samples by quantitative reverse transcription-polymerase chain reaction to validate their utility.We also investigated the expression levels of the selected miRNA not only in tissue but also in plasma samples.Moreover,we investigated the relationship between plasma AFP levels and plasma selected miRNA expression levels,and also investigated the correlation of the selected miRNA expression levels and malignant potential.RESULTS Among the five miRNAs selected from the miRNA array results,the expression levels of miR-122-5p were significantly higher in the AFPGC patients than in the non-AFPGC patients(P<0.05).In tissue samples,mi R-122-5p expression level tended to be lower in the non-AFPGC tissue than the normal gastric mucosa.Conversely,in the AFPGC tissue,miR-122-5p expression level was significantly higher in the AFPGC tissue than both the normal gastric mucosa and the nonAFPGC tissue samples(P<0.05).Plasma mi R-122-5p expression levels were also significantly higher in the AFPGC patients than the health volunteers and the nonAFPGC patients(P<0.05)and were strongly correlated with plasma AFP levels(r=0.7975,P<0.0001).Moreover,the correlation of miR-122-5p expression in tissue samples with malignant potential was stronger than that of plasma AFP level in the AFPGC patients.In contrast,no correlation was found between mi R-122-5p expression levels and liver metastasis in the non-AFPGC patients.CONCLUSION miR-122-5p might be a useful biomarker for early detection and disease monitoring in AFPGC.

关键词： Gastric cancer Alpha-fetoprotein Alphafetoprotein producing gastric cancer MicroRNA miR-122-5p

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