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Association between Helicobacter pylori and end-stage renal disease: A meta-analysis

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World Journal of Gastroenterology 2017年第8期23卷 1497-1506页

作者： Karn Wijarnpreecha Charat Thongprayoon Pitchaphon Nissaisorakarn Natasorn Lekuthai Veeravich Jaruvongvanich Kiran Nakkala Ridhmi Rajapakse Wisit Cheungpasitporn department of internal medicine Bassett Medical Center department of internal medicine Jacobi Medical CenterAlbert Einstein College of Medicine department of medicine Faculty of Medicine Siriraj HospitalMahidol University department of medicine University of Hawaii Cape Fear Center for Digestive Diseases6.Division of Nephrology Department of Internal Medicine

To investigate the prevalence and association of Helicobacter pylori (H. pylori) with end-stage renal disease (ESRD).METHODSSA comprehensive literature search was completed from inception until October 2016. Studies that reported prevalence, relative risks, odd ratios, hazard ratios or standardized incidence ratio of H. pylori among ESRD patients were included. Participants without H. pylori were used as comparators to assess the association between H. pylori infection and ESRD. Pooled risk ratios and 95%CI was calculated using a random-effect model. Adjusted point estimates from each study were combined by the generic inverse variance method of DerSimonian and *** 4546 relevant studies, thirty-seven observational studies met all inclusion criteria. Thirty-five cross-sectional studies were included in the analyses to assess the prevalence and association of H. pylori with ESRD. The estimated prevalence of H. pylori among ESRD patients was 44% (95%CI: 40%-49%). The pooled RR of H. pylori in patients with ESRD was 0.77 (95%CI: 0.59-1.00) when compared with the patients without ESRD. Subgroup analysis showed significantly reduced risk of H. pylori in adult ESRD patients with pooled RR of 0.71 (95%CI: 0.55-0.94). The data on the risk of ESRD in patients with H. pylori were limited. Two cohort studies were included to assess the risk of ESRD in patients with H. pylori. The pooled risk RR of ESRD in patients with H. pylori was 0.61 (95%CI: 0.03-12.20).CONCLUSIONThe estimated prevalence of H. pylori in ESRD patients is 44%. Our meta-analysis demonstrates a decreased risk of H. pylori in adult ESRD patients.

关键词： Helicobacter pylori Kidney failure Renal disease Renal insufficiency End stage kidney disease Meta-analysis

Diagnosis of pancreatic tumors by endoscopic ultrasonography

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World Journal of Radiology 2010年第4期2卷 122-134页

作者： Hiroki Sakamoto Masayuki Kitano Ken Kamata Muhammad El-Masry Masatoshi Kudo Division of Gastroenterology and Hepatology Department of Internal Medicine Kinki University School of Medicine hepatogastroenterology and Endoscopy Unit Department of Internal Medicine Assiut University Hospitals

Pancreatic tumors are highly diverse, as they can be solid or cystic, and benign or malignant. Since their imaging features overlap considerably, it is often difficult to characterize these tumors. In addition, small pancreatic tumors, especially those less than 2 cm in diameter, are difficult to detect and diagnose. For characterizing pancreatic tumors and detecting small pancreatic tumors, endoscopic ultrasonography (EUS) is the most sensitive of the imaging procedures currently available. This technique also provides good results in terms of the preoperative staging of pancreatic tumors. EUS-guided fine needle aspiration (EUS-FNA) has also proved to be a safe and useful method for tissue sampling of pancreatic tumors. Despite these advantages, however, it is still difficult to differentiate between be-nign and malignant, solid or cystic pancreatic tumors, malignant neoplasms, and chronic pancreatitis using EUS, even when EUS-FNA is performed. Recently, contrast-enhanced EUS with Doppler mode (CE-EUS) employing ultrasound contrast agents, which indicate vascularization in pancreatic lesions, has been found to be useful in the differential diagnosis of pancreatic tumors, especially small pancreatic tumors. However, Doppler ultrasonography with contrast-enhancement has several limitations, including blooming artifacts, poor spatial resolution, and low sensitivity to slow flow. Consequently, an echoendoscope was developed recently that has a broad-band transducer and an imaging mode that was designed specifically for contrastenhanced harmonic EUS (CEH-EUS) with a secondgeneration ultrasound contrast agent. The CEH-EUS technique is expected to improve the differential diagnosis of pancreatic disease in the future. This review describes the EUS appearances of common solid and cystic pancreatic masses, the diagnostic accuracy of EUS-FNA, and the relative efficacies and advantages of CE-EUS and CEH-EUS along with their relative advantages and their complementary roles in

关键词： Contrast-enhanced endoscopic ultrasonography Endoscopic ultrasonography EUS-guided fine needle aspiration Pancreas Sonazoid

An exclusive fine-needle biopsy approach to sampling solid lesions under EUS guidance:a prospective cohort study

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Gastroenterology Report 2020年第5期8卷 349-354,I0001页

作者： Lindsey M.Temnykh Mahmoud A.Rahal Zahra Zia Mohammad A.Al-Haddad department of internal medicine Indiana University School of MedicineIndianapolisINUSA Division of Gastroenterology and Hepatology Department of Internal MedicineIndiana University School of MedicineIndianapolisINUSA

Background Endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB)is increasingly utilized to enhance the cytological yield of sampling solid lesions,but its superiority over existing fine-needle aspiration(FNA)platforms has not been clearly *** aim of our study was to compare the diagnostic accuracy and procedural outcomes of FNB using a new Franseen-tip needle to that of a traditional FNA in sampling solid lesions under EUS *** Consecutive patients with solid lesions referred for EUS-FNB sampling were ***-related outcomes were collected prospectively including patient demographics,number of passes performed,diagnostic sample adequacy,adverse events,and recovery *** Acquire needle was used to sample all lesions in the study *** EUSFNA procedures performed to sample solid lesions using the Expect needle were utilized as *** There were 180 patients undergoing EUS-FNB compared to 183 patients undergoing EUS-FNA procedures for solidlesion *** procedure time was significantly shorter in patients who underwent FNB compared to FNA(mean:37.4 vs 44.9 minutes,P<0.001).Significantly fewer passes were performed in the FNB cohort compared to the FNA group(mean:2.9 vs 3.8,P<0.001).The cytologic diagnostic yield was significantly higher in the FNB group compared to the FNA group(98.3%vs 90.2%,P=0.003).No significant difference in the incidence of adverse events was observed between the FNB and FNA groups(1.1%vs 0.5%,P=0.564).Conclusions An FNB-exclusive approach to sampling solid lesions under EUS guidance is safe and feasible,and may result in fewer overall passes,shorter procedure time,and improved diagnostic *** may replace FNA as the primary sampling modality of choice in all solid lesions.

关键词： endoscopic ultrasound fine-needle biopsy fine-needle aspiration pancreatic tumors

It is necessary to exam bottom and top slide smears of EUS-FNA for pancreatic cancer

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Hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 553-558页

作者： Jong-chanb Lee Haeryoung Kim Hyoung Woo Kim Jongchan Lee Kyu-hyun Paik Jingu Kang Jin-Hyeok Hwang Jaihwan Kim department of internal medicine Seoul National University College of Medicine Seoul National University Bundang Hospital department of Pathology Seoul National University College of Medicine Seoul National University Hospital department of internal medicine Chungbuk National University College of Medicine Chungbuk National University Hospital department of internal medicine The Catholic University of Korea Daejeon St. Mary’s Hospital department of internal medicine Kangdong Sacred Heart Hospital of Hallym University Medical Center

Background: Despite many reports on the diagnostic yield of cytology from endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA), inter-slide differences are unknown. This prospective study aimed to compare diagnostic yield and cellular characteristics of bottom slides(BS) and top slides(TS) from EUSFNA cytology performed without an on-site cytopathologist. Methods: In patients with suspected pancreatic cancer on previous imaging explorations, a single endoscopist performed EUS-FNA and obtained 2 sets of cytology slide(8 BS and 8 TS), 1 cellblock slide, and 1 biopsy slide. Both slide sets were randomly assigned. A cytopathologist with more than 10 years of expertise in pancreatic cytopathology blindly inspected and compared two slide sets. Results: In total, 73 specimens [42 head(57.5%), 16 body(21.9%), and 15 tail(20.5%)] were acquired for final analysis. Seventy-one cases were finally diagnosed with pancreatic cancer. The sensitivity and specificity of BS were 80.3% and 100.0%; and of TS 78.9% and 100.0%, respectively. In analyzing inter-slide difference, 66 cases(90.4%) showed consistent results between BS and TS. However, seven(9.6%) were positive only in one slide sets(4 BS and 3 TS). The proportions of specimens more than moderate and high cellularity were 75.3% and 60.3% in both slide sets( P > 0.99), and the proportion of artifact-free sets were 50.7%, and 52.1% for the BS and TS, respectively( P = 0.869). Conclusions: Although BS and TS exhibited highly consistent diagnostic yields in cytologic smears from EUS-FNA, the proportion of inter-slide discordance is clinically considerable. Both slide sets need to be examined if there is no on-site cytopathologist.

关键词： Endoscopic ultrasound-guided fine-needle aspiration Pancreatic neoplasm Cytology

Recent advances in treatment of nodal and gastrointestinal follicular lymphoma

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World Journal of Gastroenterology 2023年第23期29卷 3574-3594页

作者： Takuya Watanabe department of internal medicine and Gastroenterology Watanabe Internal Medicine Aoyama ClinicNiigata-city 9502002Japan

Follicular lymphoma(FL)is the most common low-grade lymphoma,and although nodal FL is highly responsive to treatment,the majority of patients relapse repeatedly,and the disease has been incurable with a poor ***,primary FL of the gastrointestinal tract has been increasingly detected in Japan,especially due to recent advances in small bowel endoscopy and increased opportunities for endoscopic examinations and endoscopic ***,many cases are detected at an early stage,and the prognosis is good in many *** contrast,in Europe and the United States,gastrointestinal FL has long been considered to be present in 12%-24%of Stage-IV patients,and the number of advanced gastrointestinal cases is expected to *** editorial provides an overview of the recent therapeutic advances in nodal FL,including antibody-targeted therapy,bispecific antibody therapy,epigenetic modulation,and chimeric antigen receptor T-cell therapy,and reviews the latest therapeutic manuscripts published in the past *** on an understanding of the therapeutic advances in nodal FL,we also discuss future possibilities for gastroenterologists to treat gastrointestinal FL,especially in advanced cases.

关键词： Nodal and gastrointestinal follicular lymphoma Antibody-based therapy Bispecific antibody therapy Phosphatidylinositol-3 kinase inhibitor Epigenetic modulator Chimeric antigen receptor-T cell therapy

Balloon dilation itself may not be a major determinant of post-endoscopic retrograde cholangiopancreatography pancreatitis

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World Journal of Gastroenterology 2014年第45期20卷 16913-16924页

作者： Sung Ill Jang Gak Won Yun Dong Ki Lee department of internal medicine Kangnam Sacred Heart Hospital Hallym University College of Medicine department of internal medicine Gangnam Severance Hospital Yonsei University College of Medicine

Endoscopic retrograde cholangiopancreatography (ERCP) is the essential first modality for common bile duct (CBD) stone therapy. The conventional endoscopic treatment for CBD stones is stone removal after endoscopic sphincterotomy (EST). Stone removal after papillary stretching using balloon dilation instead of the conventional method has been widely adopted. There are many reports regarding endoscopic papillary balloon dilation (EPBD) utilizing a small balloon (< 10 mm) instead of EST for the removal of small CBD stones. In contrast, two cases of mortality due to post-ERCP pancreatitis (PEP) were reported after an EPBD clinical trial in the Western world, and the psychological barrier caused by these incidences hinders the use of this technique in Western countries. Endoscopic papillar large balloon dilation (EPLBD), which is used to treat large CBD stones, was not widely adopted when first introduced due to concerns about perforation and severe pancreatitis from the use of a large balloon (12-20 mm). However, as experience with this procedure accumulates, the occurrence of PEP with EPLBD is confirmed to be much lower than with EPBD. This report reviews whether EPBD and EPLBD, two procedures that use balloon dilation but differ in terms of indications and concept, contribute to the occurrence of PEP.

关键词： Post-endoscopic retrograde cholangiopancreatography pancreatitis Endoscopic papillary balloon dilation Endoscopic papillary large balloon dilation Common bile duct stone

Role of microRNAs in alcohol-induced liver disorders and non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2018年第36期24卷 4104-4118页

作者： Jorge-Luis Torres Ignacio Novo-Veleiro Laura Manzanedo Lucía Alvela-Suárez Ronald Macías Francisco-Javier Laso Miguel Marcos department of internal medicine University Hospital of SalamancaInstitute of Biomedical Research of Salamanca-IBSAL Spanish Working Group on Alcohol and Alcoholism Spanish Society of Internal Medicine department of internal medicine University Hospital of Santiago de Compostela department of internal medicine HM Rosaleda HospitalSantiago de Compostela department of medicine Faculty of MedicineUniversity of Salamanca

MicroRNAs(miRNAs) are small non-coding RNAs that regulate multiple physiological and pathological functions through the modulation of gene expression at the post-transcriptional level. Accumulating evidence has established a role for miRNAs in the development and pathogenesis of liver disease. Specifically, a large number of studies have assessed the role of miRNAsin alcoholic liver disease(ALD) and non-alcoholic fatty liver disease(NAFLD), two diseases that share common underlying mechanisms and pathological characteristics. The purpose of the current review is to summarize and update the body of literature investigating the role of miRNAs in liver disease. In addition, the potential use of miRNAs as biomarkers and/or therapeutic targets is discussed. Among all miRNAs analyzed, miR-34 a, miR-122 and miR-155 are most involved in the pathogenesis of NAFLD. Of note, these three miRNAs have also been implicated in ALD, reinforcing a common disease mechanism between these two entities and the pleiotropic effects of specific miRNAs. Currently, no single miRNA or panel of miRNAs has been identified for the detection of, or staging of ALD or NAFLD. While promising results have been shown in murine models, no therapeutic based-miRNA agents have been developed for use in humans with liver disease.

关键词： Alcohol use disorder Alcoholic liver disease Non-alcoholic fatty liver disease Steatosis Obesity miRNA Biomarkers

A candidate targeting molecule of insulin-like growth factor-Ⅰ receptor for gastrointestinal cancers

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World Journal of Gastroenterology 2010年第46期16卷 5779-5789页

作者： Yasushi Adachi Hiroyuki Yamamoto Hirokazu Ohashi Takao Endo David P Carbone Kohzoh Imai Yasuhisa Shinomura First department of internal medicine Sapporo Medical University department of internal medicine Sapporo Shirakabadai Hospital Vanderbilt-Ingram Cancer Center and departments of medicine and Cell Biology Vanderbilt University

Advances in molecular research in cancer have brought new therapeutic strategies into clinical *** new group of targets is tyrosine kinase receptors,which can be treated by several strategies,including small molecule tyrosine kinase inhibitors(TKIs) and monoclonal antibodies(mAbs).Aberrant activation of growth factors/receptors and their signal pathways are required for malignant transformation and progression in gastrointestinal(GI) *** concept of targeting specif ic carcinogenic receptors has been validated by successful clinical application of many new *** I insulin-like growth factor(IGF) receptor(IGF-IR) signaling potently stimulates tumor progression and cellular differentiation,and is a promising new molecular target in human *** this review,we focus on this promising therapeutic target,*** IGF/IGF-IR axis is an important modifier of tumor cell proliferation,survival,growth,and treatment sensitivity in many malignant diseases,including human GI *** studies demonstrated that downregulation of IGF-IR signals reversed the neoplastic phenotype and sensitized cells to anticancer *** results were mainly obtained through our strategy of adenoviruses expressing dominant negative IGF-IR(IGF-IR/dn) against gastrointestinal cancers,including esophagus,stomach,colon,and *** also summarize a variety of strategies to interrupt the IGFs/IGF-IR axis and their preclinical *** mAbs and TKIs targeting IGF-IR have entered clinical trials,and early results have suggested that these agents have generally acceptable safety profiles as single *** summarize the advantages and disadvantages of each strategy and discuss the merits/demerits of dual targeting of IGF-IR and other growth factor receptors,including Her2 and the insulin receptor,as well as other alternatives and possible drug ***,IGF-IR might be a candidate for a molecular therapeutic target in human GI carcino

关键词： Dominant negative Gastrointestinal cancer Insulin like growth factor-I receptor Monoclonal anti-body Tyrosine kinase inhibitor

New approaches to gastric cancer staging:Beyond endoscopic ultrasound,computed tomography and positron emission tomography

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World Journal of Gastroenterology 2014年第38期20卷 13783-13790页

作者： Hyuk Yoon Dong Ho Lee department of internal medicine Seoul National University Bundang Hospital department of internal medicine and Liver Research Institute Seoul National University College of Medicine

Currently, there is no single gold standard modality for staging of gastric cancer and several methods have been used complementarily in the each clinical situation. To make up for the shortcomings of conventional modalities such as endoscopic ultrasound, computed tomography and 18F-fluoro-2-deoxyglucose positron emission tomography, numerous attempts with new approaches have been made for gastric cancer staging. For T staging, magnifying endoscopy with narrow-band was evaluated to differentiate mucosal cancer from submucosal cancer. Single/double contrast-enhanced ultrasound and diffusion-weighted magnetic resonance imaging were also tried to improve diagnostic accuracy of gastric cancer. For intraoperative staging with sentinel node mapping, indocyanine green infrared and fluorescence imaging was introduced. In addition, to detect micrometastasis, real-time reverse transcription-polymerase chain reaction system with multiple markers was studied. Staging laparoscopy using 5-aminolevulinic acid-mediated photodynamic diagnosis and percutaneous diagnostic peritoneal lavage were also evaluated. However, most studies reporting new staging methods is preliminary and further studies for validation in clinical practice are needed. In this mini-review, we discuss new progress in gastric cancer staging. Especially, we focus on new diagnostic approach to gastric cancer staging beyond the conventional modalities and briefly review the remarkable clinical results of the studies published over the past three years.

关键词： Gastric cancer Neoplasm staging Diagnostic accuracy New methods New approaches