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| 1 | Age-dependent eradication of Helicobacter pylori in Japanese patients显示文摘AIM:To determine the general risk factors affecting the failure rate of first-line eradication therapy in Japanese patients with Helicobacter pylori(H.pylori)infection.METHODS:The present study enrolled 253 patients who had an H.pylori infection,underwent gastroendoscopy,and were treated with H.pylori eradication therapy.Eradication therapy consisted of 30 mg lansoprazole plus 750 mg amoxicillin and 400 mg clarithromycin twice daily for 7 d.All of the patients underwent a 13 C urea breath test at least 1 mo after the completion of eradication therapy.The current study investigated the independent factors associated with successful H.pylori eradication using a multiple logistic regression analysis.RESULTS:The overall success rate in the patients was 85.8%.Among the general factors examined in the multivariate analyses,only having an age less than 50 years was found to be significantly associated with a poor response to H.pylori eradication.Moreover,side effects were the only clinical factors in the patients who were under 50 years of age that significantly influenced the poor response to H.pylori eradication.CONCLUSION:H.pylori-positive elderly patients should undergo eradication therapy.In addition,it is necessary to improve H.pylori eradication therapy in younger patients. | Satoshi Mamori Akihiro Higashida Fumiaki Kawara Katsuhiro Ohnishi Akihiko Takeda Eri Senda Cho Ashida Hajime Yamada | 2010 | World Journal of Gastroenterology2010，16，33： | 7 |
| 2 | Feasibility and safety of endoscopic submucosal dissection for lower rectal tumors with hemorrhoids显示文摘AIM: To evaluate the feasibility and safety of endoscopic submucosal dissection(ESD) for lower rectal lesions with hemorrhoids.METHODS: The outcome of ESD for 23 lesions with hemorrhoids(hemorrhoid group) was compared with that of 48 lesions without hemorrhoids extending to the dentate line(non-hemorrhoid group) during the same study period. RESULTS: Median operation times(ranges) in the hemorrhoid and non-hemorrhoid groups were 121(51-390) and 130(28-540) min. The en bloc resection rate and the curative resection rate in the hemorrhoid group were 96% and 83%, and they were 100% and 90% in the non-hemorrhoid group, respectively. In terms of adverse events, perforation and postoperative bleeding did not occur in both groups. In terms of the clinical course of hemorrhoids after ESD, the rate of complete recovery of hemorrhoids after ESD in lesions with resection of more than 90% was significantly higher than that in lesions with resection of less than 90%.CONCLUSION: ESD on lower rectal lesions with hemorrhoids could be performed safely, similarly to that on rectal lesions extending to the dentate line without hemorrhoids. In addition, all hemorrhoids after ESD improved to various degrees, depending on the resection range. | Shinwa Tanaka Takashi Toyonaga Yoshinori Morita Namiko Hoshi Tsukasa Ishida Yoshiko Ohara Tetsuya Yoshizaki Fumiaki Kawara Eiji Umegaki Takeshi Azuma | 2016 | World Journal of Gastroenterology2016，22，27： | 6 |
| 3 | Factors associated with residual gastroesophageal reflux disease symptoms in patients receiving proton pump inhibitor maintenance therapy显示文摘AIM To elucidate the factors associated with residual gastroesophageal reflux disease(GERD) symptoms in patients receiving proton pump inhibitor(PPI) maintenance therapy in clinical practice.METHODS The study included 39 GERD patients receiving maintenance PPI therapy. Residual symptoms were assessed using the Frequency Scale for Symptoms of GERD(FSSG) questionnaire and the Gastrointestinal Symptom Rating Scale(GSRS). The relationships between the FSSG score and patient background factors, including the CYP2C19 genotype, were analyzed.RESULTS The FSSG scores ranged from 1 to 28 points(median score: 7.5 points), and 19 patients(48.7%) had a score of 8 points or more. The patients' GSRS scores were significantly correlated with their FSSG scores(correlation coefficient = 0.47, P < 0.005). In erosive esophagitis patients, the FSSG scores of the CYP2C19 rapid metabolizers(RMs) were significantly higher than the scores of the poor metabolizers and intermediate metabolizers(total scores: 16.7 ± 8.6 vs 7.8 ± 5.4, P < 0.05; acid reflux-related symptom scores: 12 ± 1.9 vs 2.5 ± 0.8, P < 0.005). In contrast, the FSSG scores of the CYP2C19 RMs in the non-erosive reflux disease patients were significantly lower than those of the other patients(total scores: 5.5 ± 1.0 vs 11.8 ± 6.3, P < 0.05; dysmotility symptom-related scores: 1.0 ± 0.4 vs 6.0 ± 0.8, P < 0.01). CONCLUSION Approximately half of the GERD patients receiving maintenance PPI therapy had residual symptoms associated with a lower quality of life, and the CYP2C19 genotype appeared to be associated with these residual symptoms. | Fumiaki Kawara Tsuyoshi Fujita Yoshinori Morita Atsushi Uda Atsuhiro Masuda Masaya Saito Makoto Ooi Tsukasa Ishida Yasuyuki Kondo Shiei Yoshida Tatsuya Okuno Yoshihiko Yano Masaru Yoshida Hiromu Kutsumi Takanobu Hayakumo Kazuhiko Yamashita Takeshi Hirano Midori Hirai Takeshi Azuma | 2017 | World Journal of Gastroenterology2017，23，11： | 5 |
| 4 | Gastric plexiform fibromyxoma resected by endoscopic submucosal dissection after observation of chronological changes:A case report显示文摘A 66-year-old man was diagnosed with a gastric submucosal tumor. Endoscopic ultrasound(EUS) revealed an iso/hypoechoic mass in the third layer. No malignant cells were detected in a histological examination. Yearly follow-up endoscopy and EUS showed the slow growth of the tumor. Endoscopic submucosal dissection(ESD) was performed and a glistening tumor was resected. The lesion showed a multinodular plexiform growth pattern consisting of spindle cells with an abundant fibromyxoid stroma that was rich in small vessels. The tumor was diagnosed as plexiform fibromyxoma(PF) by immunohistochemistry. Although difficulties are associated with reaching a diagnosis preoperatively, chronological changes on EUS may contribute to the diagnosis of PF. ESD may also be useful in the diagnosis and treatment of PF. | Fumiaki Kawara Shinwa Tanaka Takashi Yamasaki Yoshinori Morita Yoshiko Ohara Yoshihiro Okabe Namiko Hoshi Takashi Toyonaga Eiji Umegaki Hiroshi Yokozaki Takanori Hirose Takeshi Azuma | 2017 | World Journal of Gastrointestinal Oncology2017，9，6： | 3 |
| 5 | Esophageal diverticulum exposed during endoscopic submucosal dissection of superficial cancer显示文摘Endoscopic submucosal dissection(ESD) is now widely accepted as a strategy to treat superficial esophageal neoplasms.The rate of adverse events,such as perforation,has been decreasing with the improvement of devices and techniques.In this paper,we report a case of esophageal cancer that had a diverticulum under cancerous epithelium.The diverticulum was not detected during preoperative examination,and led to perforation during the ESD procedure.Our case shows that,although rare,some diverticula can exist underneath the mucosal surface without obvious depression.If there is any sign of hidden diverticula during ESD,surgeons should proceed with caution or,depending on the case,the procedure should be discontinued to avoid adverse events. | Shinwa Tanaka Takashi Toyonaga Yoshiko Ohara Tetsuya Yoshizaki Fumiaki Kawara Tsukasa Ishida Namiko Hoshi Yoshinori Morita Takeshi Azuma | 2015 | World Journal of Gastroenterology2015，21，10： | 2 |
| 6 | Endoscopic submucosal dissection for early gastric cancer in anastomosis site after distal gastrectomy显示文摘 | Shinwa Tanaka Takashi Toyonaga Yoshinori Morita Tsuyoshi Fujita Tetsuya Yoshizaki Fumiaki Kawara Chika Wakahara Daisuke Obata Aya Sakai Tsukasa Ishida Nobunao Ikehara Takeshi Azuma | 2014 | Gastric Cancer2014，，2： | 2 |
| 7 | Feasibility and Safety of Endoscopic Submucosal Dissection for Large Colorectal Tumors显示文摘 | Shinwa Tanaka Takashi Toyonaga Yoshinori Morita Namiko Hoshi Tsukasa Ishida Yoshiko Ohara Tetsuya Yoshizaki Fumiaki Kawara Takeshi Azuma | 2015 | Surgical Laparoscopy, Endoscopy & Percutaneous Techniques2015，，3： | 1 |
| 8 | Efficacy of forced coagulation with low high-frequency power setting during endoscopic submucosal dissection显示文摘AIM To investigated the hemostatic ability of the S and F1-10 methods in clinical and ex vivo studies.METHODS The hemostatic abilities of the two methods were analyzed retrospectively in all six gastric endoscopic submucosal dissection cases. The treated vessel diameter, compressed vessel frequency, and bleeding frequency after cutting the vessels were noted by therecorded videos. The coagulation mechanism of the two power settings was evaluated using the data recording program and histological examination on macro-and microscopic levels in the ex vivo experiments using porcine tissues.RESULTS F1-10 method showed a significantly better hemostatic ability for vessels ≥ 2 mm in diameter and a trend of overall better coagulation effect, evaluated by the bleeding rate after cutting the vessels. F1-10 method could sustain electrical current longer and effectively coagulate the tissue wider and deeper than the S method in the porcine model.CONCLUSION F1-10 method is suggested to achieve a stronger hemostatic effect than the S method in clinical procedures and ex vivo models. | Tsukasa Ishida Takashi Toyonaga Yoshiko Ohara Tadao Nakashige Yasuaki Kitamura Ryusuke Ariyoshi Hiroshi Takihara Shinichi Baba Tetsuya Yoshizaki Fumiaki Kawara Shinwa Tanaka Yoshinori Morita Eiji Umegaki Namiko Hoshi Takeshi Azuma | 2017 | World Journal of Gastroenterology2017，23，29： | 1 |
| 9 | Usefulness of a novel slim type Flush Knife-BT over conventional Flush Knife-BT in esophageal endoscopic submucosal dissection显示文摘AIM To investigated the usefulness of a novel slim type balltipped Flush Knife (Flush Knife-BTS) over ball-tipped Flush Knife (Flush Knife-BT) in functional experiments and clinical practice.METHODS In order to evaluate the functionality of Flush KnifeBTS, water aspiration speed, resistance to knife insertion through the scope, and waterjet flushing speed were compared between Flush Knife-BTS and BT. In clinical practice, esophageal endoscopic submucosal dissection (ESD) performed using Flush Knife-BTS or BT by an experienced endoscopist between October 2015 and January 2016 were retrospectively reviewed. The treatment speed and frequency of removing and reinserting the knife to aspirate fluid and air during ESD sessions were analyzed.RESULTS Functional experiments revealed that water aspiration speed by the endoscope equipped with a 2.8-mm working channel with Flush Knife-BTS was 7.7-fold faster than that with conventional Flush Knife-BT. Resistance to knife insertion inside the scope with a 2.8-mm working channel was reduced by 40% with FlushK nife-BTS. The waterjet flushing speed was faster with the use of Flush Knife-BT. In clinical practice, a comparison of 6 and 7 ESD using Flush Knife-BT and BTS, respectively, revealed that the median treatment speed was 25.5 mm2/min (range 19.6-30.3) in the BT group and 44.2 mm2/min(range 15.5-55.4) in the BTS group (P = 0.0633). However, the median treatment speed was significantly faster with Flush Knife-BTS when the resection size was larger than 1000 m2(n = 4, median 24.2 mm2/min, range 19.6-27.7 vs n = 4, median 47.4 mm2/min, range 44.2-55.4, P = 0.0209). The frequency of knife replacement was less in the BTS group (median 1.76 times in one hour, range 0-5.45) than in the BT group (7.02 times in one hour, range 4.23-15)(P = 0.0065).CONCLUSION Our results indicate that FlushK nife-BTS enhances the performance of ESD, particularly for large lesions, by improving air and fluid aspiration and knife insertion during ESD and reducing the frequency of knife removal and reinsertion. | Yoshiko Ohara Takashi Toyonaga Namiko Hoshi Shinwa Tanaka Shinichi Baba Hiroshi Takihara Fumiaki Kawara Tsukasa Ishida Yoshinori Morita Eiji Umegaki Takeshi Azuma | 2017 | World Journal of Gastroenterology2017，23，9： | 0 |
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