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Evaluation of three lymph node staging systems for prognostic prediction in gastric cancer:A systematic review and meta-analysis

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World Journal of Gastrointestinal Oncology 2025年第3期17卷 334-348页

作者： Ming Cheng Yang Yu Takehiro Watanabe Yutaro Yoshimoto Sanae Kaji Yukinori Yube Munehisa Kaneda Hajime Orita Shinji Mine You-Yong Wu Tetsu Fukunaga Department of Upper Gastroenterological Surgery Juntendo University School of MedicineTokyo 113-8431Japan Department of Gastrointestinal Surgery The Second Affiliated Hospital of Soochow UniversitySuzhou 215004Jiangsu ProvinceChina Department of Gastrointestinal Surgery Peking University Cancer HospitalBeijing 100142China

BACKGROUND Lymph node status is a critical prognostic factor in gastric cancer(GC),but stage migration may occur in pathological lymph nodes(pN)*** address this,alternative staging systems such as the positive lymph node ratio(LNR)and log odds of positive lymph nodes(LODDS)were *** To assess the prognostic accuracy and stratification efficacy of three nodal staging systems in *** A systematic review identified 12 studies,from which hazard ratios(HRs)for overall survival(OS)were *** analyses,subgroup analyses,publication bias assessments,and quality evaluations were *** enhance comparability,data from studies with identical cutoff values for pN,LNR,and LODDS were *** stratification was then applied to generate Kaplan-Meier(KM)survival curves,assessing the stratification efficacy of three staging *** The HRs and 95%confidence intervals for pN,LNR,and LODDS were 2.16(1.72-2.73),2.05(1.65-2.55),and 3.15(2.15-4.37),respectively,confirming all three as independent prognostic risk factors for *** analysis of HRs demonstrated that LODDS had superior prognostic predictive power over LNR and *** curves for pN(N0,N1,N2,N3a,N3b),LNR(0.1/0.2/0.5),and LODDS(-1.5/-1.0/-0.5/0)revealed significant differences(P<0.001)among all prognostic *** differences and standard deviations in 60-month relative survival were 27.93%±0.29%,41.70%±0.30%,and 26.60%±0.28%for pN,LNR,and LODDS,*** All three staging systems are independent prognostic factors for *** demonstrated the highest specificity,making it especially useful for predicting outcomes,while pN was the most effective in homogeneous stratification,offering better patient *** findings highlight the complementary roles of LODDS and pN in enhancing prognostic accuracy and stratification.

关键词： Gastric cancer Prognostic predictor Overall survival Meta-analysis Pathological lymph nodes Positive lymph node ratio Log odds of positive lymph nodes

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Pretreatment AKR1B10 expression predicts the risk of hepatocellular carcinoma development after hepatitis C virus eradication

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World Journal of Gastroenterology 2016年第33期22卷 7569-7578页

作者： Ayato Murata Takuya Genda Takafumi Ichida Nozomi Amano Sho Sato Hironori Tsuzura Shunsuke Sato Yutaka Narita Yoshio Kanemitsu Yuji Shimada Katsuharu Hirano Katsuyori Iijima Ryo Wada Akihito Nagahara Sumio Watanabe Department of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital Department of Hepatology Shonan-East General Hospital Department of Pathology Juntendo University Shizuoka Hospital Department of Gastroenterology Juntendo University School of Medicine

AIM To clarify the association between aldo-keto reductase family 1 member B10(AKR1B10) expression and hepatocarcinogenesis after hepatitis C virus *** In this study,we enrolled 303 chronic hepatitis C patients who had achieved sustained virological response(SVR) through interferon-based antiviral therapy. Pretreatment AKR1B10 expression in the liver was immunohistochemically assessed and quantified as a percentage of positive staining area by using image-analysis software. A multivariate Cox analysis was used to estimate the hazard ratios(HRs) of AKR1B10 expression for hepatocellular carcinoma(HCC) development after achieving SVR. The cumulative incidences of HCC development were evaluated using Kaplan-Meier analysis and the log-rank *** Of the 303 chronic hepatitis C patients,153(50.5%) showed scarce hepatic AKR1B10 expression,quantified as 0%,which was similar to the expression in control normal liver tissues. However,the remaining 150 patients(49.5%) exhibited various degrees of AKR1B10 expression in the liver,with a maximal AKR1B10 expression of 73%. During the median follow-up time of 3.6 years(range 1.0-10.0 years),8/303 patients developed HCC. Multivariate analysis revealed that only high AKR1B10 expression(≥ 8%) was an independent risk factor for HCC development(HR = 15.4,95%CI: 1. 8- 1 3 2. 5,P = 0. 0 1 2). T h e 5- y e a r c u m u l a t i v e incidences of HCC development were 13.7% and 0.5% in patients with high and low AKR1B10 expression,respectively(P < 0.001). During the follow-up period after viral eradication,patients expressing high levels of AKR1B10 expressed markedly higher levels of alanine aminotransferase and α-fetoprotein than did patients exhibiting low AKR1B10 *** Chronic hepatitis C patients expressing high levels of hepatic AKR1B10 had an increased risk of HCC development even after SVR.

关键词： Human AKR1B10 protein Hepatocellular carcinoma Chronic hepatitis C Immunohistochemistry Risk factor Sustained virological response

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Clinicopathological features of alpha-fetoprotein producing early gastric cancer with enteroblastic differentiation

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World Journal of Gastroenterology 2016年第36期22卷 8203-8210页

作者： Kohei Matsumoto Hiroya Ueyama Kenshi Matsumoto Yoichi Akazawa Hiroyuki Komori Tsutomu Takeda Takashi Murakami Daisuke Asaoka Mariko Hojo Natsumi Tomita Akihito Nagahara Yoshiaki Kajiyama Takashi Yao Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine Department of Esophageal and Gastroenterological Surgery Juntendo University School of Medicine Department of Gastroenterology Juntendo University Shizuoka Hospital Department of Pathology Juntendo University School of Medicine

AIM To investigate clinicopathological features of early stage gastric cancer with enteroblastic differentiation(GCED).METHODS We retrospectively investigated data on 6 cases of early stage GCED and 186 cases of early stage conventional gastric cancer(CGC: well or moderately differentiated adenocarcinoma) who underwent endoscopic submucosal dissection or endoscopic mucosal resection from September 2011 to February 2015 in our *** was defined as a tumor having a primitive intestine-like structure composed of cuboidal or columnar cells with clear cytoplasm and immunohistochemical positivity for either alpha-fetoprotein, Glypican 3 or SALL4. The following were compared between GCED and CGC: age, gender, location and size of tumor, macroscopic type, ulceration, depth of invasion, lymphatic and venous invasion, positive horizontal and vertical margin, curative resection *** Six cases(5 males, 1 female; mean age 75.7 years; 6 lesions) of early gastric cancer with a GCED component and 186 cases(139 males, 47 females; mean age 72.7 years; 209 lesions) of early stage CGC were investigated. Mean tumor diameters were similar but rates of submucosal invasion, lymphatic invasion, venous invasion, and non-curative resection were higher in GCED than CGC(66.6% vs 11.4%, 33.3% vs 2.3%, 66.6% vs 0.4%, 83.3% vs 11% respectively, P < 0.01). Deep submucosal invasion was not revealed endoscopically or by preoperative biopsy. Histologically, in GCED the superficial mucosal layer was covered with a CGC component. The GCED component tended to exist in the deeper part of the mucosa to the submucosa by lymphatic and/or venous invasion, without severe stromal reaction. In addition, Glypican 3 was the most sensitive marker for GCED(positivity, 83.3%), *** Even in the early stage GCED has high malignant potential, and preoperative diagnosis is considered difficult. Endoscopists and pathologists should know the clinicopathological features of this h

关键词： Alpha-fetoprotein-producing gastric cancer Gastric cancer with enteroblastic differentiation Early gastric cancer Glypican 3 SALL4

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Three-dimensional stereotactic surface projection in the statistical analysis of single photon emission computed tomography data for distinguishing between Alzheimer's disease and depression

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World Journal of Psychiatry 2017年第2期7卷 121-127页

作者： Eiji Kirino Department of Psychiatry Juntendo University School of Medicine Department of Psychiatry Juntendo University Shizuoka Hospital juntendo Institute of Mental Health

AIM To evaluate usefulness of single photon emission computed tomography(SPECT) with three-dimensional stereotactic surface projection(3D-SSP) in distinguishing between Alzheimer's disease(AD) and *** We studied 43 patients who presented with both depressive symptoms and memory disturbance. Each subject was evaluated using the following:(1) the Minimal Mental State Examination;(2) the Hamilton Rating Scale for Depression;(3) Clinical Global Impression-Severity scale(CGI-S); and(4) SPECT imaging with *** The MMSE scores correlated significantly with the maximum Z-scores of AD-associated regions. CGI-S scores correlated significantly with the maximum Z-scores of depression-associated regions. Factor analysis identified three significant factors. Of these, Factor 1 could be interpreted as favouring a tendency for AD, Factor 2 as favouring a tendency for pseudo-dementia, and Factor 3 as favouring a depressive *** We investigated whether these patients could be categorized as types: Type A(true AD), Type B(pseudodementia), Type C(occult AD), and Type D(true depression). The factor scores in factor analysis supported the validity of this classification. Our results suggest that SPECT with 3D-SSP is highly useful for distinguishing between depression and depressed mood in the early stage of AD.

关键词： Alzheimer’s disease Three-dimensional stereotactic surface projection Single photon emission computed tomography Pseudo-dementia Depression

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Effectiveness and safety of a laparoscopic training system combined with modified reconstruction techniques for total laparoscopic distal gastrectomy

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World Journal of Gastroenterology 2020年第13期26卷 1490-1500页

作者： Shun Zhang Hajime Orita Hiroyuki Egawa Ryota Matsui Suguru Yamauchi Yukinori Yube Sanae Kaji Toru Takahashi Shinichi Oka Noriyuki Inaki Tetsu Fukunaga Department of Gastroenterology and Minimally Invasive Surgery Juntendo University HospitalTokyo 113-8431Japan Department of Gastrointestinal Surgery Shanghai East HospitalTongji UniversityShanghai 200120China Department of Surgery Juntendo Urayasu HospitalJuntendo UniversityChiba 2790021Japan

BACKGROUND Total laparoscopic distal gastrectomy(TLDG)is increasing due to some advantages over open surgery,which has generated interest in gastrointestinal ***,TLDG is technically demanding especially for lymphadenectomy and gastrointestinal *** the course of training,trainee surgeons have less chances to perform open gastrectomy compared with that of senior *** To evaluate an appropriate,efficient and safe laparoscopic training procedures suitable for trainee *** Ninety-two consecutive patients with gastric cancer who underwent TLDG plus Billroth I reconstruction using an augmented rectangle technique and involving trainees were *** trainees were taught a laparoscopic view of surgical anatomy,standard operative procedures and practiced essential laparoscopic *** TLDG procedure was divided into regional lymph node dissections and gastrointestinal reconstruction for analyzing trainee *** surgical outcomes were compared between trainees and trainers to clarify the feasibility and safety of TLDG performed by *** curves were used to assess the utility of our training *** Five trainees performed a total of 52 TLDGs(56.5%),while 40 TLDGs were conducted by two trainers(43.5%).Except for depth of invasion and pathologic stage,there were no differences in clinicopathological *** performed more D2 gastrectomies than *** total operation time was significantly longer in the trainee *** time spent during the lesser curvature lymph node dissection and the Billroth I reconstruction were similar between the two *** difference was found in postoperative complications between the two *** learning curve of the trainees plateaued after five TLDG *** Preparing trainees with a laparoscopic view of surgical anatomy,standard operative procedures and practice in essential laparoscopic skills enabled trainees to perform TLDG sa

关键词： Gastric cancer Total laparoscopic gastrectomy Education system Trainees Augmented rectangle technique Standard procedure

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Differences between Istradefylline Responders and Non-Responders in Parkinson’s Disease

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Advances in Parkinson's Disease 2017年第2期6卷 45-51页

作者： Asako Yoritaka Nobutaka Hattori Department of Neurology Juntendo University Koshigaya Hospital Saitama Japan Department of Neurology Juntendo University School of Medicine Tokyo Japan

Background: Istradefylline is a selective adenosine A2A receptor antagonist approved for Parkinson’s disease (PD) patients with wearing-off symptoms. The Japanese phase III trial showed that 20 mg of orally administrated istradefylline decreased the Off-time. However, istradefylline showed prominent effects in some patients and no benefits in others. We examined the differences in characteristics between responders and non-responders who received 8 weeks of 20 mg/day istradefylline. Methods: Thirty-one patients were enrolled (age, 65.4 [SD 10.4] years;disease duration, 10.4 [SD 6.1] years;daily levodopa dosage, 553.2 [SD 228.7] mg;frequency of levodopa consumption, 4.7 [SD 1.5] times;levodopa equivalent dose, 811.2 [SD 307.5] mg). Results: There were significant differences (p Conclusions: Younger or female patients who are not excessively sleepy during daytime are better candidates for the istradefylline therapy.

关键词： Parkinson’s Disease Istradefylline Adenosine A2A Receptor Antagonist Wearing-Off Sleepiness

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A study of the effects of saliva stimulation by nizatidine on dry mouth symptoms of primary biliary cirrhosis

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World Journal of Hepatology 2013年第3期5卷 90-96页

作者： Tetsu Kikuchi Katsuharu Hirano Takuya Genda Hironori Tsuzura Shunsuke Sato Yoshio Kanemitsu Yutaka Narita Katsuyori Iijima Takafumi Ichida Department of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital

AIM: To elucidate the effect of saliva stimulation by nizatidine on oral symptoms of primary biliary cirrhosis (PBC) by administering it to PBC cases. METHODS: From among 73 cases that had been definitively diagnosed as PBC at our hospital by February 2010, we selected 27 cases of PBC, 4 males and 23 females, as subjects. We obtained subjects' consent after giving them a full explanation of the administration of nizatidine. Nizatidine 150 mg was administered internally twice daily, after morning and evening meals. To observe changes in the quantity of saliva secreted, chewing gum tests were carried out four times: before the initial dose, and after 6 mo, 12 mo and 24 mo of administration. For subjective dry mouth symptoms, a visual analog scale (VAS) method was used to assess their feelings of oral dryness and eating difficulty, five times: before the initial dose, and after 1, 6, 12 and 24 mo of administration in 8 cases. The nutritional condition and the hepatic functional reserve were compared between before and after the nizatidine ***: The result of a chewing gum test on the subjects before the administration of nizatidine showed that 50% produced less than 10 mL of saliva, i.e. , the standard under which cases are considered to have hyposalivation. The results of these tests showed that the quantity of saliva secreted was 10.5 ± 6.8 mL before administration of nizatidine, 10.9 ± 6.0 mL after 6 mo, 10.6 ± 4.9 mL after 12 mo, and 11.8 ± 6.8 mL after 24 mo administration. Thus, there was a slowly increasing trend in the quantity of saliva in the whole group. The percentage of subjects with saliva production above 10 mL was 45.8% after 6 mo administration of nizatidine, that is, only a slight change from before its administration, but it was 64.3% after 12 mo, that is, a significant increase. The saliva secretion by subject patients was examined before the beginning of administration of nizatidine, 12 mo later, and 24 mo later, and Fisher's combined

关键词： Primary biliary cirrhosis Nizatidine Dry mouth Sicca syndrome Visual analog scale

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Penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive man: A case report

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World Journal of Clinical Cases 2023年第24期11卷 5811-5816页

作者： Daisuke Usuda Nobuyoshi Kaminishi Masashi Kato Yuto Sugawara Runa Shimizu Tomotari Inami Shiho Tsuge Riki Sakurai Kenji Kawai Shun Matsubara Risa Tanaka Makoto Suzuki Shintaro Shimozawa Yuta Hotchi Ippei Osugi Risa Katou Sakurako Ito Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Clinical Training Center Juntendo University Nerima HospitalNerima 177-8521TokyoJapan Sports Medicine Juntendo UniversityBunkyo 113-8421TokyoJapan

BACKGROUND Penoscrotal constriction devices are either used as autoerotic stimuli or to increase sexual pleasure or performance by maintaining an erection for a longer period,and a variety of metallic and non-metallic objects are *** the other hand,penile strangulation is a rare urologic emergency that requires prompt evaluation and intervention to prevent long-term *** goal of treating penile incarceration is to remove the foreign object as soon as *** the other hand,removal can be very challenging,and often requires resourcefulness and a multidisciplinary *** SUMMARY A 47-year-old man who has sex with men was transferred to our hospital for persistent phallodynia and scrotal pain,accompanying swelling due to strangulation by stainless steel *** medical history included acquired immunodeficiency *** day prior,he had put three stainless steel rings on his penis and scrotum before sexual *** sexual intercourse,he was unable to remove them,due to swelling of his penis and *** swelling persisted,and he felt pain in the affected area the next day,then he was transferred to our hospital by *** emergency department found that his penis and scrotum were markedly engorged and *** established a diagnosis of penile and scrotal strangulation by stainless steel *** unsuccessfully attempted to cut the rings using a cutter,then requested a rescue team via emergency medical *** cut through each ring in two places,using an electric-powered angle grinder,and successfully removed all of the ***,he was discharged and went *** We report the first case of penile and scrotal strangulation by stainless steel rings in an human immunodeficiency virus positive person.

关键词： Penile strangulation Stainless steel ring Human immunodeficiency virus Urologic emergency Management Case report

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Effects of Prolonged Night Shifts on Salivary <i>α</i>-Amylase, Secretory Immunoglobulin, Cortisol, and Chromogranin A Levels in Nurses

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Health 2014年第15期6卷 2014-2025页

作者： Yosuke Morita Hideko Aida Takuji Yamaguchi Masakazu Azuma Sennichi Suzuki Nobuhiro Suetake Takehiko Yukishita Keiko Lee Hiroyuki Kobayashi Center for Advanced Kampo Medicine and Clinical Research Juntendo University Graduate School of Medicine Tokyo Japan Department of hospital Administration Juntendo University Graduate School of Medicine Tokyo Japan juntendo university koshigaya hospital Saitama Japan

Prolonged night shift is associated with high burnout rate, but the physiological effects of a 16 h shift remain undetermined. Here we evaluated fatigue and stress via salivary assays to determine the correlation between stress and fatigue and prolonged night shifts. Twenty-five nurses (9 men, 16 women;16 h night shift (n = 13), 8 h day shift (n = 12)) from juntendo university koshigaya hospital were evaluated for four consecutive workdays separated by off days. Salivary samples were collected upon waking and before sleep on non-working days, before and after the day and night shifts, and before and after the break during the nocturnal schedule, and analyzed for levels of cortisol, chromogranin A, α-amylase activity and secretory immunoglobulin A (sIgA). On non-working days, cortisol levels showed similar kinetic pattern in both nurses. On working days, day-time nurses’ cortisol levels showed normal circadian pattern throughout the shift. Night nurses’ cortisol levels at the beginning of the shift were comparable to that of the normal morning elevation. α-Amylase activity in the night shift nurses was higher than day shift nurses through each period. No significant differences in chromogranin A and sIgA levels were detected between day and night shift workers. A 16 h night shift may cause marked circadian misalignment in cortisol levels.

关键词： Stress Salivary Markers Night Shift Work Nurse

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Inhibition of rheumatoid arthritis by blocking connective tissue growth factor

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World Journal of Orthopedics 2014年第5期5卷 653-659页

作者： Kazuhisa Nozawa Maki Fujishiro Yoshinari Takasaki Iwao Sekigawa Department of Rheumatology School of Medicine Juntendo University Institute for Environment and Gender Specific Medicine Juntendo University Graduate School of Medicine Department of Internal Medicine and Rheumatology Juntendo University Urayasu Hospital

The pathogenesis of rheumatoid arthritis(RA) remains to be completely elucidated so far; however, it is known that proinflammatory cytokines play a pivotal role in the induction of RA. Tumor necrosis factor(TNF-α), in particular, is considered to play a central role in bone destruction by mediating the abnormal activation of osteoclasts or the production of proteolytic enzymes through direct or indirect mechanisms. The use of TNF-α blocking agents has a significant impact on RA therapy. Anti-TNF-α blocking agents such as infliximab are very effective for treatment of RA, especially for the prevention of articular destruction. We have previously shown that several proteins exhibited extensive changes in their expression after amelioration of RA with infliximab treatment. Among the proteins, connective tissue growth factor(CTGF) has a significantrole for the development of RA. Herein, we review the function of CTGF in the pathogenesis of RA and discuss the possibility of a novel treatment for RA. We propose that CTGF is a potentially novel effector molecule in the pathogenesis of RA. Blocking the CTGF pathways by biological agents may have great beneficial effect in patients with RA.

关键词： Connective tissue growth facto Rheumatoid arthritis Osteoclasts Condrocytes Tumor necrosis factor-α

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