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Ryota Niikura, Atsuo Yamada, Mitsuhiro Fujishiro, Kiyohito Tanaka, Koji Matsuda, Yutaka Saito, Kazuo Ohtsuka, Ichiro Oda, Chikatoshi Katada, Masayuki Kato, Mitsuhiro Kida, Kiyonori Kobayashi, Shu Hoteya, Takahiro Horimatsu, Shinya Kodashima, Takahisa Matsuda, Manabu Muto, Hironori Yamamoto, Shomei Ryozawa, Ryuichi Iwakiri, Hiromu Kutsumi, Hiroaki Miyata, Mototsugu Kato, Ken Haruma, Kazuma Fujimoto, Naomi Uemura, Michio Kaminishi, Tomohiro Shinozaki, Hisao Tajiri, Kazuhiko Koike
AIM: To clarify whether antithrombotic drugs affect diagnosis using the immunochemical faecal occult blood test -(iFOBT) of colorectal neoplasia. METHODS: Using the Japan Endoscopy Database from 8 centres between 2015 and 2017, we analyzed data about patients who were iFOBT positive and had received direct oral anticoagulants (DOAC), warfarin, aspirin or thienopyridine. One-to-one matching-analogue propensity score weighted analyses were performed to compare the positive predictive value (PPV) of all neoplasms, invasive and non-invasive colorectal cancers and adenomas between drug users and non-users...
November 8, 2018: Digestion
Yasuhiro Fujiwara, Atsushi Hashimoto, Risa Uemura, Akinari Sawada, Koji Otani, Fumio Tanaka, Hirokazu Yamagami, Tetsuya Tanigawa, Toshio Watanabe, Daijiro Kabata, Yuko Kuwae, Ayumi Shintani, Masahiko Ohsawa
OBJECTIVE: Recent guidelines propose that both proton pump inhibitor (PPI) responders and nonresponders are included in eosinophilic esophagitis (EoE). Although multiple biopsies should be required to diagnose EoE because of patchy distribution of esophageal eosinophils, it is unclear whether multiple biopsies are required to evaluate histological effectiveness of PPI therapy. This study aimed to determine the optimal biopsy protocol after PPI therapy in patients with EoE. METHODS: Of 110 EoE patients, 22 PPI nonresponders were enrolled...
November 8, 2018: Digestion
Hiroshi Yamawaki, Seiji Futagami, Keiko Kaneko, Shuhei Agawa, Kazutoshi Higuchi, Makoto Murakami, Mako Wakabayashi, Noriko Sakasegawa, Yasuhiro Kodaka, Nobue Ueki, Katya Gudis, Chiaki Kawamoto, Katsuhiko Iwakiri
BACKGROUND/AIMS: The aims of the study are to clarify the pathophysiological differences among early chronic pancreatitis (ECP), functional dyspepsia with pancreatic (FD-P) enzyme abnormalities and FD patients and to determine whether camostat mesilate, pancrelipase, and rabeprazole triple therapy improve FD symptoms in the ECP patients and FD-P patients in cross-over way. METHODS: We enrolled 84 consecutive patients presenting with typical symptoms of FD patients (n = 42), ECP patients (n = 15), and FD-P patients (n = 27)...
November 2, 2018: Digestion
Heng Xiao, Sheng Deng, Xiong Deng, Shaojuan Gu, Zhijian Yang, Hang Yin, Hao Deng
BACKGROUND: Wilson's disease (WD) is an autosomal recessive disease, which is characterized by an excessive copper accumulation in the liver and brain, leading to subsequent hepatic and/or neurological disorders. The causative gene for WD has been identified as the ATPase Cu2+ transporting beta polypeptide gene (ATP7B), which encodes a protein called copper-transporting ATPase 2. ATP7B mutations may lead to reduced biliary excretion of excess copper and disrupted copper homeostasis, resulting in various clinical symptoms of WD...
November 1, 2018: Digestion
Johanna Backhus, Thomas Seufferlein, Lukas Perkhofer, Patrick C Hermann, Alexander Kleger
BACKGROUND: IgG4-related diseases are a rare but an important entity. Due to the variable clinical presentation, this multiorgan disease was attributed to single-organ systems for many years. Also, it often remains a challenge to differentiate between IgG4-related diseases and malignancies. The pathogenesis seems to be a mixture of Th1- and Th2- immune responses, whereas the role of the non-pathogenic IgG4 antibodies is still unclear. Histopathological characteristics are a lymphoplasmacellular infiltrate with IgG4+ plasma cells, a storiform fibrosis and an obliterative phlebitis...
November 1, 2018: Digestion
Yuki Sekido, Yoshiaki Yasumizu, Junichi Nishimura, Hisako Kayama, Hiroshi Matsuno, Takayuki Ogino, Norikatsu Miyoshi, Hidekazu Takahashi, Naotsugu Haraguchi, Taishi Hata, Chu Matsuda, Yuichiro Doki, Masaki Mori, Kiyoshi Takeda, Naganari Ohkura, Shimon Sakaguchi, Tsunekazu Mizushima
BACKGROUND/AIMS: There is a heterogeneous subset innate myeloid cells, such as macrophages and dendritic cells, in the human intestinal lamina propria. Several studies have demonstrated that these cells contribute to the maintenance of gut homeostasis through the induction of inflammatory responses and tolerance via cell type-specific mechanisms; whereas, disrupted innate immune responses are implicated in the pathogenesis of Crohn's disease (CD). However, the detailed mechanisms by which each innate myeloid subset regulates gut homeostasis and inflammation largely remain unknown...
October 19, 2018: Digestion
Caizhao Lin, Xiaolu Cai, Jing Zhang, Weibing Wang, Qinsong Sheng, Hanju Hua, Xile Zhou
Human guts harbor abundant microbes that regulate many aspects of host physiology. However, bacterial imbalance or dysbiosis in the gut due to the dietary or environmental changes may cause colorectal cancer (CRC). Increasing studies show that gut microbiota plays an important role in the occurrence and development of CRC, as a result of virulence factors, bacterial metabolites, or inflammatory pathways. In the future, probiotics or targeting the microbiota will probably be a powerful weapon in the battle against CRC...
October 17, 2018: Digestion
Marisa Iborra, Inés Moret, Francisco Rausell, Enrique Busó, Elena Cerrillo, Esteban Sáez-González, Pilar Nos, Belén Beltrán
BACKGROUND/AIMS: Increased oxidative stress and decreased immune cell apoptosis have been reported to be important factors in the pathogenesis of Crohn's disease (CD). Our aim was to characterize the genetic expression of molecules implicated in the regulation of oxidative stress and apoptosis in peripheral white mononuclear cells of 18 healthy volunteers (controls) and 20 patients at the onset of CD (active CD [aCD]): 10 who achieved remission (inactive CD [iCD]) and 10 who did not present a complete and deep response to treatment (aCD-T)...
October 9, 2018: Digestion
Junyi Li, Fei Sun, Yanchao Guo, Heng Fan
BACKGROUND: Gastrointestinal (GI) diseases are known to be largely influenced by one's lifestyle and dietary uptake. A high-salt diet (HSD) is well recognized as a risk factor for cardiovascular complications, hypertension, and metabolic syndromes. However, the relationship between an HSD and the GI system, which is the compartment that comes in direct contact with exogenous stimulants, has not been fully explored. AIMS: We seek to better understand the complexity of the pathogenic effects of an HSD in the context of GI disorders...
October 5, 2018: Digestion
Mark Op den Winkel, Dorothea Nagel, Philip Op den Winkel, Philipp M Paprottka, Laura Schmidt, Hélène Bourhis, Jörg Trojan, Markus Goeller, Florian P Reiter, Stephanie-Susanne Stecher, Enrico N De Toni, Alexander L Gerbes, Frank T Kolligs
BACKGROUND/AIMS: The recently proposed Munich-transarterial chemoembolisation-score (M-TACE) was tailored to suit hepatocellular Carcinoma (HCC) patients evaluated for TACE. M-TACE outperformed the established HCC-staging-systems and successfully passed external validation. Modifications of staging-systems through the rearrangement of stages or by adding prognostic factors are methods of improving prognostic power. M-TACEs performance compared to scores modified this way should be tested...
October 3, 2018: Digestion
Matthias Buechter, Jonas Thimm, Hideo A Baba, Stefanie Bertram, Katharina Willuweit, Guido Gerken, Alisan Kahraman
AIM: To assess the diagnostic accuracy of liver maximum capacity (LiMAx®) test compared to transient elastography (TE) and serum biomarkers for the noninvasive detection of different stages of liver fibrosis and cirrhosis. PATIENTS AND METHODS: We retrospectively correlated LiMAx®, TE, aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), AST-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) score with histological specimens in 102 patients with chronic liver disease (CLD) who underwent liver biopsy (either percutaneously or via mini-laparoscopy) at the University Clinic of Essen between 10/2016 and 12/2017...
October 2, 2018: Digestion
Xiaoxue Li, Ning Chen, Peng You, Tao Peng, Guodong Chen, Jiangyuan Wang, Jing Li, Yulan Liu
AIMS: This cross-sectional study is to investigate the presence of Epstein-Barr virus (EBV) in colonic mucosa of inflammatory bowel disease (IBD) patients and its correlation with the clinical disease activities and therapeutic regimens. METHODS: Subjects undergoing colonoscopy for screening of polyps were recruited as control. EBV DNA load was analyzed by means of quantitative real-time polymerase chain reaction and EBV-encoded RNAs were tested by in situ hybridization in intestinal mucosa of IBD patients...
September 20, 2018: Digestion
Naohisa Yoshida, Ken Inoue, Ritsu Yasuda, Ryohei Hirose, Osamu Dohi, Yuji Naito, Takaaki Murakami, Yutaka Inada, Kiyoshi Ogiso, Yukiko Morinaga, Mitsuo Kishimoto, Eiichi Konishi, Yoshito Itoh
BACKGROUND/AIMS: Settings of structure and color enhancement (CE) change view of white light imaging and a preset low enhancement setting is used regularly. The aim of this study was to investigate whether higher enhancement settings increased colorectal lesions' visibility with endoscopists' visibility scoring and objective color difference (CD) value. METHODS: From April 2015 to September 2015, we analyzed 27 pictures and 100 videos of colorectal lesions. Combinations of structure enhancement (B3, A3, A5) and CE (CE 0, 1, 3) were evaluated and CD values of 2 corresponding modes (high enhancement: A5 + CE3, preset low enhancement: A3 + CE0) were calculated using marketed software...
September 18, 2018: Digestion
Tomoko Kitaichi, Osamu Dohi, Yasuko Fujita, Atsushi Majima, Yusuke Horii, Yuriko Yasuda-Onozawa, Kentaro Suzuki, Akira Tomie, Tetsuya Okayama, Naohisa Yoshida, Kazuhiro Kamada, Kazuhiko Uchiyama, Takeshi Ishikawa, Osamu Handa, Hideyuki Konishi, Mitsuo Kishimoto, Nobuaki Yagi, Yuji Naito, Akio Yanagisawa, Yoshito Itoh
BACKGROUND/AIMS: Gastric-type differentiated adenocarcinoma (GDA) of the stomach is a rare variant of gastric cancer that is highly infiltrating and exhibits early metastasis. However, the endoscopic and pathological features of "early-stage" GDA remain unknown. The aim of this study is to characterize early-stage GDA. METHODS: We retrospectively enrolled 479 differentiated-type early gastric cancer cases who underwent endoscopic submucosal dissection (ESD)...
September 18, 2018: Digestion
Yuga Komaki, Shuji Kanmura, Fumisato Sasaki, Hidehito Maeda, Kohei Oda, Shiho Arima, Shiroh Tanoue, Yuichiro Nasu, Shinichi Hashimoto, Seiichi Mawatari, Hirohito Tsubouchi, Akio Ido
BACKGROUND/AIMS: Esophageal mucosal damage often causes scar tissue, leading to refractory stricture. The aim of this study was to clarify the effect of hepatocyte growth factor (HGF) on esophageal mucosal repair and fibrosis leading to stricture in a rat model of esophageal ulcer. METHODS: Esophageal ulcers were induced in rats by topical exposure of the lower esophageal serosa to acetic acid, followed by intraperitoneal administration of HGF (200 µg/day) using an osmotic pump for 7 days...
September 18, 2018: Digestion
Rachel Gray, Joaquin Cagliani, Leo I Amodu, Peter Nauka, Benjamin Villacres, Tabia Santos, Alex Castenada, Joanna Fishbein, Nibras Ahmed, Gene Coppa, Horacio L Rodriguez Rilo
BACKGROUND/AIMS: No single classification system has so far effectively predicted the severity for Acute Pancreatitis (AP). This study compares the effectiveness of classification systems: Original Atlanta (OAC), Revised Atlanta (RAC), Determinant based classification (DBC), PANC 3, Harmless AP Score (HAPS), Japanese Severity Score (JSS), Symptoms Nutrition Necrosis Antibiotics and Pain (SNNAP), and Beside Index of Severity for AP (BISAP) in predicting outcomes in AP. METHODS: Scores for BISAP, Panc 3, HAPS, SNNAP, OAC, RAC, and DBC were calculated for 221 adult patients hospitalized for AP...
September 18, 2018: Digestion
Makiko Urabe, Tsutomu Nishida, Hiromi Shimakoshi, Akiyoshi Shimoda, Takahiro Amano, Aya Sugimoto, Kei Takahashi, Kaori Mukai, Tokuhiro Matsubara, Masashi Yamamoto, Shiro Hayashi, Sachiko Nakajima, Koji Fukui, Tsukasa Tanida, Takamichi Komori, Shunji Morita, Masami Inada
BACKGROUND/AIMS: It is unclear why colonic diverticular bleeding and diverticulitis rarely coexist. This study compared the characteristics of these conditions. METHODS: This single-center retrospective study examined 310 consecutive patients hospitalized with an episode of diverticular disease (cases) and outpatients without a diverticular episode (controls) from January 2012 to December 2015. We investigated distinct clinical factors in hospitalized patients with diverticular bleeding and diverticulitis...
September 14, 2018: Digestion
Benjamin Misselwitz, Mark Fox
No abstract text is available yet for this article.
September 13, 2018: Digestion
Tilman Sauerbruch, Florence Wong
BACKGROUND: The development of cirrhosis with resultant portal hypertension can lead to oesophageal varices at a rate of 7% per annum. Bleeding from varices happens when the portal pressure is ≥12 mm Hg and can threaten life. SUMMARY: Eliminating the aetiology of cirrhosis is a pivotal step to prevent the formation of varices. In patients with established varices, primary prophylaxis with non-selective beta blockers (NSBB) may slow down the progression of varices and prevent the first variceal bleed...
September 13, 2018: Digestion
Runalia Bahar, Asha Gupta, Surinder K Mann
BACKGROUND: An effective bowel cleanse can improve the imaging quality of video capsule endoscopy (VCE). We aimed to further investigate the optimal small bowel cleanse method by comparing the efficacy of 4 L of clear liquids, 2 L of polyethylene glycol (PEG), and 4 L of PEG on the image quality of VCE. METHODS: A randomized controlled, non-inferiority trial was performed comparing 4 L of clear liquids (Group A), 2 L of PEG (Group B), and 4 L of PEG (Group C). The primary endpoint was image quality between the groups...
September 13, 2018: Digestion
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