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Yoichi Akazawa, Hiroya Ueyama, Takashi Yao, Hiroyuki Komori, Tsutomu Takeda, Kohei Matsumoto, Kenshi Matsumoto, Daisuke Asaoka, Mariko Hojo, Sumio Watanabe, Akihito Nagahara
BACKGROUND/AIMS: Early gastric cancer after Helicobacter pylori (Hp) eradication is difficult to demarcate. We used the vessel plus surface classification system (VSCS) to determine whether magnifying endoscopy with narrow-band imaging (ME-NBI) could demarcate differentiated-type early gastric cancers after Hp eradication, and to identify causes of an unclear demarcation line (DL). METHODS: Among 100 lesions of differentiated-type early gastric cancer resected endoscopically, 34 lesions in the Hp-eradicated group and 66 in the Hp-infected group were retrospectively compared...
June 5, 2018: Digestion
Yu Hatano, Ken Haruma, Tomoari Kamada, Akiko Shiotani, Kosuke Takahari, Masatoshi Matsumoto, Osamu Uchida
BACKGROUND/AIMS: Previous studies have reported a possible relevance between proton pump inhibitor (PPI) use and 3 new gastric mucosal changes: black spots (BSs), white flat elevated mucosa (WFEM), and cobblestone-like mucosa (CLM). The aim of this study was to investigate the association between these mucosal changes and multiple factors including PPI use. METHODS: All subjects who underwent a routine esophagogastroduodenoscopy (EGD) were successively enrolled...
June 5, 2018: Digestion
Marcel Vetter, Markus F Neurath
BACKGROUND: Crohn's disease (CD) is a chronic immune-mediated disorder of the gastrointestinal tract. The pathophysiological understanding of this disease is limited and no curative therapy is available so far. Therefore, most patients require long-lasting or even life-long immunosuppressive therapies for the suppression of symptoms to improve quality of life and reduction of long-term risks. However, in a relevant subgroup of patients, these therapeutic goals cannot be sufficiently attained...
June 5, 2018: Digestion
Doron Boltin, Hemda Schmilovitz-Weiss, Rachel Gingold-Belfer, Haim Leibovitzh, Yifat Snir, Tsachi Tsadok Perets, Ram Dickman, Zohar Levi, Yaron Niv
BACKGROUND/AIMS: Although the efficacy of first-line treatment for Helicobacter pylori infection should aim to be > 90%, it is unclear whether this target has been achieved in Israel. We aimed to determine the success rate of treatment for H. pylori and to describe temporal changes in our region. Methods: Adult patients who underwent a first-time -C13-urea breath test (C13-UBT) at Clalit Health Services between January 1, 2010 and December 31, 2015 were included. In order to isolate a naïve "test-and-treat" population who were unlikely to have undergone an initial endoscopy-based H...
June 5, 2018: Digestion
Koji Miyahara, Waku Hatta, Masahiro Nakagawa, Tsuneo Oyama, Noboru Kawata, Akiko Takahashi, Yoshikazu Yoshifuku, Shu Hoteya, Masaaki Hirano, Mitsuru Esaki, Mitsuru Matsuda, Ken Ohnita, Ryo Shimoda, Motoyuki Yoshida, Osamu Dohi, Jun Takada, Keiko Tanaka, Shinya Yamada, Tsuyotoshi Tsuji, Hirotaka Ito, Hiroyuki Aoyagi, Tooru Shimosegawa
BACKGROUND/AIMS: The role of an undifferentiated component in submucosal invasion and submucosal invasion depth (SID) for lymph node metastasis (LNM) of early gastric cancer (EGC) with deep submucosal invasion (SID ≥500 μm from the muscularis mucosa) after endoscopic submucosal dissection (ESD) has not been fully understood. This study aimed to clarify the risk factors (RFs), including these factors, for LNM in such patients. METHODS: We enrolled 513 patients who underwent radical surgery after ESD for EGC with deep submucosal invasion...
June 5, 2018: Digestion
Claudia Ott, Michael Gerken, Daniela Hirsch, Petra Fest, Stefan Fichtner-Feigl, Stefan Munker, Elisabeth Schnoy, Christian Stroszczynski, Martin Vogelhuber, Wolfgang Herr, Matthias Evert, Michael Reng, Hans Jürgen Schlitt, Monika Klinkhammer-Schalke, Andreas Teufel
BACKGROUND: The clinicopathological significance of the mucinous subtype of colorectal cancer (CRC) remains controversial. As of today, none of the current guidelines differentiate treatment with respect to mucinous or nonmucinous cancer. Due to the lack of substantiated data, best treatment remains unclear and the mucinous subtype of CRC is usually treated along the lines of recommendations for adenocarcinoma of the colon. METHODS: We investigated an East-Bavarian cohort of 8,758 patients with CRC...
June 5, 2018: Digestion
Noriyuki Kawami, Shintaro Hoshino, Yoshimasa Hoshikawa, Nana Takenouchi, Mariko Umezawa, Yuriko Hanada, Mitsuru Kaise, Katsuhiko Iwakiri
BACKGROUND: The present study examined the pathogenesis of potassium-competitive acid blocker (P-CAB)-resistant non-erosive reflux disease (NERD). METHODS: Forty-three patients with NERD, who had persistent reflux symptoms despite the administration of P-CAB, were included in this study. After excluding eosinophilic esophagitis and primary esophageal motility disorders, esophageal impedance-pH monitoring was performed. In symptom index (SI)-positive patients, the mechanism of SI-positivity and percent time with intragastric pH > 4 and with esophageal pH < 4 were investigated according to the presence or absence of Helicobacter pylori infection...
June 5, 2018: Digestion
Yasutaka Kuribayashi, Toshiro Iizuka, Kosuke Nomura, Tsukasa Furuhata, Satoshi Yamashita, Akira Matsui, Daisuke Kikuchi, Toshifumi Mitani, Mitsuru Kaise, Shu Hoteya
BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) for superficial esophageal cancer is sometimes extensive, and in our experience, patients not infrequently present with dysphagia after ESD even in the absence of esophageal stricture. The aim of this study was to evaluate esophageal motility using high-resolution manometry (HRM) in patients with and without dysphagia after extensive circumferential ESD. METHODS: HRM was performed in a total of 52 patients who had undergone ESD for superficial esophageal cancer and a mucosal defect after ESD exceeded more than two-thirds of the esophageal circumference...
June 5, 2018: Digestion
Akihiro Yamada, Mitsuru Kaise, Naoko Inoshita, Takahito Toba, Kosuke Nomura, Yasutaka Kuribayashi, Satoshi Yamashita, Tsukasa Furuhata, Daisuke Kikuchi, Akira Matsui, Toshifumi Mitani, Osamu Ogawa, Toshiro Iizuka, Shu Hoteya
AIM: Helicobacter pylori-naïve gastric cancers(GCs) have not been well documented. We aimed to characterize early H. pylori-naïve GCs. SUBJECTS AND METHODS: Of 666 patients with GC resected by endoscopic submucosal dissection, H. pylori-naïve patients were extracted according to the definition: no H. pylori eradication history, negative for serum H. pylori-antibody and current H. pylori-infection tests, and no gastric atrophy by pepsinogen (PG) test, endoscopy, and histology...
May 2, 2018: Digestion
Gianluca Tamagno, Vanessa Scherer, Alberto Caimo, Simona R Bergmann, Peter H Kann
AIM: Pancreatic neuroendocrine tumors (pNETs) can occur in patients with a familial syndrome either as multiple endocrine neoplasia type 1 (MEN-1) or as sporadic tumors. Endoscopic ultrasound (EUS) has become one of the first-line investigations for pNET characterization. The ultrasonographic features of pNETs may differ depending on the familial versus sporadic pathogenesis of the tumor. Therefore, the EUS findings could help and direct the definition of a pNET with an impact on the most appropriate diagnostic and therapeutic patient management...
April 26, 2018: Digestion
Caspar Franck, Peter Hass, Peter Malfertheiner, Jens Ricke, Max Seidensticker, Marino Venerito
BACKGROUND: Prospective data on the optimal management of patients with pancreatic ductal adenocarcinoma (PDA) and isolated local manifestation (ILM) after surgery are lacking. Hence, no statements with respect to this entity have been released from most international guidelines including European Society for Medical Oncology, National Comprehensive Cancer Network, and American Society for Clinical Oncology. METHODS: We report for the first time a case-series of 3 patients with PDA and ILM receiving combined systemic chemotherapy and CT-guided high-dose-rate interstitial brachytherapy (CT-HDRBT)...
April 26, 2018: Digestion
Hidejiro Kawahara, Takashi Mouri, Kota Ishida, Nori Matsumoto, Tadashi Akiba, Katsuhiko Yanaga
AIM: We have developed an imaging functional assessment of defecation after partial intersphincteric resection (ISR) by fecoflowgram obtained by defecography. PATIENTS AND METHODS: Between January 2012 and December 2014, 6 patients with temporary ileostomy who underwent partial ISR for lower rectal cancer at our hospital were enrolled in this study. Defecography was performed 2 weeks after closure of the ileostomy. The defecation of all patients was evaluated by defecography and a fecoflowgram calculated from defecography...
April 26, 2018: Digestion
Kazeo Ninomiya, Takashi Hisabe, Yuki Okado, Yasumichi Takada, Rino Yamaoka, Yuho Sato, Masahiro Kishi, Noritaka Takatsu, Toshiyuki Matsui, Toshiharu Ueki, Kenshi Yao, Fumihito Hirai
BACKGROUND: Capsule endoscopy (CE) has allowed the characterization of small bowel lesions. However, small bowel lesions in ulcerative colitis (UC) have not been elucidated and no studies have compared between UC and Crohn's disease (CD). AIM: The objective of this study was to investigate the small bowel lesions in UC, and to characterize UC lesions by comparison with CD. METHODS: Subjects comprised 54 UC patients and 39 CD patients who underwent CE...
April 26, 2018: Digestion
Keita Fukaura, Eikichi Ihara, Haruei Ogino, Yoichiro Iboshi, Kazumasa Muta, Bai Xiaopeng, Shohei Hamada, Yoshitaka Hata, Tsutomu Iwasa, Akira Aso, Kazuhiko Nakamura, Yoshihiro Ogawa
BACKGROUND AND AIM: Although basic research has shown that certain cytokines affect gastrointestinal motility, the clinical evidence is lacking. The objective of this study was to explore the association between mucosally expressed cytokines and the esophageal motility function in humans. METHODS: We enrolled a total of 57 patients with suspected esophageal motility disorders (EMDs) who underwent high-resolution manometry. RESULTS: The diagnoses of the patients were as follows: normal esophageal motility (n = 25), ineffective esophageal motility (n = 5), esophagogastric junction outflow obstruction (EGJOO; n = 10), distal esophageal spasm (n = 5), achalasia (n = 10), absent contractility (n = 1), and jackhammer esophagus (n = 1)...
April 26, 2018: Digestion
Li Yang, Yong Li, Gao-Feng Shi, Tao Zhou, Bi-Bo Tan
OBJECTIVE: This study aims to explore the association between iodine concentration (IC) in perigastric adipose tissue (PAT), quantified by dual-energy computed tomography (DECT) and serosal invasion (SI) in patients with gastric cancer post-neoadjuvant chemotherapy (NAC). METHODS: Forty-three patients with T4-staged gastric cancer were enrolled. IC and standardized IC in PAT (ICPAT and SICPAT) were quantified by DECT pre and post NAC. A postoperative pathologic examination was performed to stage gastric cancer...
April 26, 2018: Digestion
Koshiro Tsutsumi, Chika Kusano, Sho Suzuki, Takuji Gotoda, Kazunari Murakami
BACKGROUND/AIMS: Serologic tests are commonly used for screening Helicobacter pylori infection because they not only provide quick results but also are inexpensive. A new latex agglutination serum antibody assay (LZ test) has been developed and it is expected to be as effective as conventional assays. This study aimed to calculate a reliable cutoff value for the LZ test and to estimate the sensitivity and specificity of the cutoff value in screening adolescents for H. pylori infection in Japan...
April 26, 2018: Digestion
Olympia E Anastasiou, Betül Dogan-Cavus, Ozlem Kucukoglu, Hideo Baba, Alisan Kahraman, Guido Gerken, Christoph Schramm, Ali Canbay
BACKGROUND/AIMS: Autoimmune hepatitis (AIH) is a relatively rare cause of liver dysfunction and may lead in some cases to acute liver failure (ALF). The aim of our study was to evaluate the clinical course and outcome of patients with AIH-induced ALF. METHODS: We retrospectively enrolled 32 patients with AIH-induced ALF and 93 age- and sex-matched patients with chronic AIH (cAIH) who were enrolled at the University Clinic Essen from 1988 to 2014. All ALF patients were treated with corticosteroids after diagnosis...
April 26, 2018: Digestion
Hiroyuki Aihara, Nitin Kumar, Christopher C Thompson
BACKGROUND: An education system for narrow band imaging (NBI) interpretation requires sufficient exposure to key features. However, access to didactic lectures by experienced teachers is limited in the United States. AIM: To develop and assess the effectiveness of a colorectal lesion identification tutorial. METHODS: In the image analysis pretest, subjects including 9 experts and 8 trainees interpreted 50 white light (WL) and 50 NBI images of colorectal lesions...
April 19, 2018: Digestion
Doeun Kim, Jung Nam Kim, Joo Hyun Nam, Jong Rok Lee, Sang Chan Kim, Byung Joo Kim
BACKGROUND: The Gamisoyo-san (GSS) has been used for -improving the gastrointestinal (GI) symptoms. The purpose of this study was to investigate the effects of GSS, a traditional Chinese herbal medicine, on the pacemaker potentials of mouse small intestinal interstitial cells of Cajal (ICCs). METHODS: ICCs from the small intestines were dissociated and cultured. Whole-cell patch-clamp configuration was used to record pacemaker potentials and membrane currents. RESULTS: GSS depolarized ICC pacemaker potentials in a dose-dependent manner...
April 19, 2018: Digestion
Lukas Winkelsett, Peter Malfertheiner, Thomas Wex, Arne Kandulski
BACKGROUND: Activation of protease-activated receptor-2 (PAR2) is involved in the mucosal immune pathogenesis of gastroesophageal reflux disease (GERD) that is characterized by proinflammatory cytokines such as interleukin-8 (IL-8). PAR2 activation on epithelial cells induces epithelial IL-8 secretion and initiates mucosal inflammation. METHODS: A human primary esophageal epithelial cell model was established to investigate the effects of repeated stimulation with weakly acidic solutions and subsequent PAR2 activation...
April 19, 2018: Digestion
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