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Esophageal carcinoma originating in the surface epithelium with immunohistochemically proven esophageal gland duct differentiation: A case report 预览
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作者 Hiromi Tamura Hirotsugu Saiki +7 位作者 Takahiro Amano Masashi Yamamoto Shiro Hayashi Hiroka Ando Reiko Doi Tsutomu Nishida Katsumi Yamamoto Shiro Adachi 《世界胃肠病学杂志:英文版》 SCIE CAS 2017年第21期3928-3933,共6页
A case of esophageal carcinoma exclusively composed of adenocarcinoma simulating an esophageal gland duct in a 61-year-old man is presented. The tumor arose as a slightly elevated lesion in the middle intrathoracic es... A case of esophageal carcinoma exclusively composed of adenocarcinoma simulating an esophageal gland duct in a 61-year-old man is presented. The tumor arose as a slightly elevated lesion in the middle intrathoracic esophagus. It was almost completely overlaid with nonneoplastic stratified squamous epithelial cells. Beneath the overlying surface epithelium, an adenocarcinoma that was bilayered in structure diffusely invaded both the mucosal and submucosal layers. Although the tumor consisted exclusively of adenocarcinomatous cells, a keratinizing squamous cell carcinoma component was focally observed. The invasive carcinoma was focally continuous with the small area of the surface squamous epithelial layer, which was confirmed to be neoplastic by immunohistochemistry. Morphological and immunohistochemical examinations suggested that the adenocarcinomatous component arose from the esophageal surface epithelium and clearly differentiated into an esophageal gland duct. It is important to consider the possibility of this type of adenocarcinoma when diagnosing a ductal or glandular lesion of the esophagus in small biopsy specimens. 展开更多
关键词 食道的腺癌 Bilayered 结构 食道的腺管
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Combination of two-hour post-endoscopic retrograde cholangiopancreatography amylase levels and cannulation times is useful for predicting post-endoscopic retrograde cholangiopancreatography pancreatitis 预览
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作者 Shiro Hayashi Tsutomu Nishida +10 位作者 Hiromi Shimakoshi Akiyoshi Shimoda Takahiro Amano Aya Sugimoto Kei Takahashi Kaori Mukai Tokuhiro Matsubara Masashi Yamamoto Sachiko Nakajima Koji Fukui Masami Inada 《世界胃肠内镜杂志:英文版(电子版)》 2016年第20期777-784,共8页
AIMTo estimate the efficacy of 2 h post-endoscopic etrograde cholangiopancreatography (ERCP) serum mylase levels and other factors for predicting post-ERCP pancreatitis.METHODS his was a etrospective, single-center co... AIMTo estimate the efficacy of 2 h post-endoscopic etrograde cholangiopancreatography (ERCP) serum mylase levels and other factors for predicting post-ERCP pancreatitis.METHODS his was a etrospective, single-center cohort study f consecutive patients who underwent ERCP from January 2010 to December 2013. Serum amylase levels were measured 2 h post-procedure, and patient- and procedure-related pancreatitis (PEP) risk factors were analyzed using a logistic model. RESULTS A total of 1520 cases (average age 72 ± 12 years, 60% male) were initially enrolled in this study, and 1403cases (725 patients) were ultimately analyzed after the exclusion of 117 cases. Fifty-five of these cases developed PEP. We established a 2 h serum amylase cutoff level of two times the upper limit of normal for predicting PEP. Multivariate analysis revealed that a cannulation time of more than 13 min [odds ratio (OR) 2.28, 95%CI: 1.132-4.651, P = 0.0210] and 2h amylase levels greater than the cutoff level (OR =24.1, 95%CI: 11.56-57.13, P < 0.0001) were significant predictive factors for PEP. Forty-seven of the 55 patients who developed PEP exhibited 2 h amylase levels greater than the cutoff level (85%), and six of the remaining eight patients who developed PEP (75%) required longer cannulation times. Only 2 of the 1403 patients (0.14%) who developed PEP did not exhibit concerning 2 h amylase levels or require longer cannulation times.CONCLUSION These findings indicate that the combination of 2 h post-ERCP serum amylase levels and cannulation times represents a valuable marker for identifying patients at high risk for PEP. 展开更多
关键词 Serum AMYLASE LEVELS CANNULATION time Post-endoscopic retrograde CHOLANGIOPANCREATOGRAPHY PANCREATITIS Predictor
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Current state of practice for colonic diverticular bleeding in 37 hospitals in Japan: A multicenter questionnaire study 预览
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作者 Ryota Niikura Naoyoshi Nagata +10 位作者 Hisashi Doyama Ryosuke Ota Naoki Ishii Katsuhiro Mabe Tsutomu Nishida Takuto Hikichi Kazuki Sumiyama Jun Nishikawa Toshio Uraoka Shu Kiyotoki Mitsuhiro Fujishiro 《世界胃肠内镜杂志:英文版(电子版)》 2016年第20期785-794,共10页
AIMTo clarify the current state of practice for colonic iverticular bleeding (CDB) in Japan.METHODS e conducted multicenter questionnaire surveys of the ractice for CDB including clinical settings (8 questions),diagno... AIMTo clarify the current state of practice for colonic iverticular bleeding (CDB) in Japan.METHODS e conducted multicenter questionnaire surveys of the ractice for CDB including clinical settings (8 questions),diagnoses (8 questions), treatments (7 questions), and utcomes (4 questions) in 37 hospitals across Japan.The answers were compared between hospitals with igh and low number of inpatient beds to investigate which factor influenced the answers.RESULTS Endoscopists at all 37 hospitals answered the questions,and the mean number of endoscopists at these hospitals was 12.7. Of all the hospitals, computed tomography was performed before colonoscopy in 67%of the hospitals. The rate of bowel preparation was 46.0%. Early colonoscopy was performed within 24h in 43.2% of the hospitals. Of the hospitals, 83.8%performed clipping as first-line endoscopic therapy.More than half of the hospitals experienced less than 20% rebleeding events after endoscopic hemostasis. No significant difference was observed in the annual number of patients hospitalized for CDB between high- (≥ 700 beds) and low-volume hospitals. More emergency visits (p = 0.012) and endoscopists (p =0.015), and less frequent participation of nursing staffin early colonoscopy (p = 0.045) were observed in the high-volume hospitals.CONCLUSION Some practices unique to Japan were found, such as performing computed tomography before colonoscopy,no bowel preparation, and clipping as first-line therapy.Although, the number of staff differed, the practices forCDB were common irrespective of hospital size. 展开更多
关键词 COLONIC diverticular HEMORRHAGE lower gastrointestinal BLEEDING COMPUTED tomography endoscopy BOWEL preparation
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Clinical problems with antithrombotic therapy for endoscopic submucosal dissection for gastric neoplasms 预览
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作者 Toshiyuki Yoshio Tsutomu Nishida +4 位作者 Yoshito Hayashi Hideki Iijima Masahiko Tsujii Junko Fujisaki Tetsuo Takehara 《世界胃肠内镜杂志:英文版(电子版)》 2016年第20期756-762,共7页
Endoscopic submucosal dissection (ESD) is minimally invasive and thus has become a widely accepted treatment for gastric neoplasms, particularly for patients with comorbidities. Antithrombotic agents are used to preve... Endoscopic submucosal dissection (ESD) is minimally invasive and thus has become a widely accepted treatment for gastric neoplasms, particularly for patients with comorbidities. Antithrombotic agents are used to prevent thrombotic events in patients with comorbidities such as cardio-cerebrovascular diseases and atrial fibrillation. With appropriate cessation, antithrombotic therapy does not increase delayed bleeding in low thrombosis-risk patients. However, high thrombosisrisk patients are often treated with combination therapy with antithrombotic agents and occasionally require the continuation of antithrombotic agents or heparin bridge therapy (HBT) in the perioperative period.Dual antiplatelet therapy (DAPT), a representative combination therapy, is frequently used after placement of drug-eluting stents and has a high risk of delayed bleeding. In patients receiving DAPT, gastric ESD may be postponed until DAPT is no longer required. HBT is often required for patients treated with anticoagulants and has an extremely high bleeding risk. The continuous use of warfarin or direct oral anticoagulants may be possible alternatives. Here, we show that some antithrombotic therapies in high thrombosis-risk patients increase delayed bleeding after gastric ESD, whereas most antithrombotic therapies do not. The management of high thrombosis-risk patients is crucial for improved outcomes. 展开更多
关键词 ANTITHROMBOTIC THERAPY Endoscopic SUBMUCOSAL DISSECTION HEPARIN bridge THERAPY Dual ANTIPLATELET THERAPY Delayed bleeding
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Endoscopic submucosal dissection in early gastric cancer inelderly patients and comorbid conditions 预览 被引量:1
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作者 Tsutomu Nishida Motohiko Kato +8 位作者 Toshiyuki Yoshio Tomofumi Akasaka Teppei Yoshioka Tomoki Michida Masashi Yamamoto Shiro Hayashi Yoshito Hayashi Masahiko Tsujii Tetsuo Takehara. 《世界胃肠内镜杂志:英文版(电子版)》 2015年第5期524-531,共8页
The prognosis of early gastric cancer (EGC) is goodif there is no concomitant lymph node metastasis.Therefore, the early detection of EGC is important toimprove the prognosis of patients with gastric cancer.In Japan... The prognosis of early gastric cancer (EGC) is goodif there is no concomitant lymph node metastasis.Therefore, the early detection of EGC is important toimprove the prognosis of patients with gastric cancer.In Japan, 40% to 50% of all gastric cancers areEGC, and endoscopic submucosal dissection (ESD) iswidely accepted as a local treatment for these lesions,particularly for large lesions that at one time were anindication for gastrectomy because of the difficultyof en-bloc resection. Consequently, this procedurecan preserve the entire stomach and the patient'spostoperative quality of life. ESD has become a generaltechnique with improved procedures and devices, andhas become the preferred treatment for EGC ratherthan gastrectomy. Therefore, ESD may demonstratemany advantages in patients who have several comorbidities,particularly elderly population, patients takingantithrombotic agents, or patients with chronic kidneydisease, or liver cirrhosis. However, it is not yet clearwhether patients with both EGC and comorbidities arefeasible candidates for ESD and whether they wouldconsequently be able to achieve a survival benefitafter ESD. In this review, we discuss the clinical problemsof ESD in patients with EGC and those comorbidconditions. 展开更多
关键词 Endoscopic SUBMUCOSAL DISSECTION Gastriccancer ELDERLY PERSON ANTITHROMBOTIC agents LIVERCIRRHOSIS Chronic kidney disease
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Colorectal endoscopic submucosal dissection: Recent technical advances for safe and successful procedures 预览
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作者 Katsumi Yamamoto Tomoki Michida +3 位作者 Tsutomu Nishida Shiro Hayashi Masafumi Naito Toshifumi Ito 《世界胃肠内镜杂志:英文版(电子版)》 2015年第14期1114-1128,共15页
Endoscopic submucosal dissection(ESD) is very useful in en bloc resection of large superficial colorectal tumors but is a technically difficult procedure because the colonic wall is thin and endoscopic maneuverability... Endoscopic submucosal dissection(ESD) is very useful in en bloc resection of large superficial colorectal tumors but is a technically difficult procedure because the colonic wall is thin and endoscopic maneuverability is poor because of colonic flexure and extensibility. A high risk of perforation has been reported in colorectal ESD. To prevent complications such as perforation and unexpected bleeding, it is crucial to ensure good visualization of the submucosal layer by creating a mucosal flap, which is an exfoliated mucosa for inserting the tip of the endoscope under it. The creation of a mucosal flap is often technically difficult; however, various types of equipment, appropriate strategy, and novel procedures including our clip-flap method, appear to facilitate mucosal flap creation, improving the safety and success rate of ESD. Favorable treatment outcomes with colorectal ESD have already been reported in many advanced institutions, and appropriate understanding of techniques and development of training systems are required for world-wide standardization of colorectal ESD. Here, we describe recent technical advances for safe and successful colorectal ESD. 展开更多
关键词 Endoscopic SUBMUCOSAL DISSECTION Colo- RECTAL tumo
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Endoscopic surveillance strategy after endoscopic resection for early gastric cancer 预览
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作者 Tsutomu Nishida Masahiko Tsujii +4 位作者 Motohiko Kato Yoshito Hayashi Tomofumi Akasaka Hideki Iijima Tetsuo Takehara 《世界胃肠病理生理学杂志:英文版(电子版)》 2014年第2期100-106,共7页
Early detection of early gastric cancer(EGC)is important to improve the prognosis of patients with gastric cancer.Recent advances in endoscopic modalities and treatment devices,such as image-enhanced endoscopy and hi... Early detection of early gastric cancer(EGC)is important to improve the prognosis of patients with gastric cancer.Recent advances in endoscopic modalities and treatment devices,such as image-enhanced endoscopy and high-frequency generators,may make endoscopic treatment,such as endoscopic submucosal dissection,a therapeutic option for gastric intraepithelial neoplasia.Consequently,short-term outcomes of endoscopic resection(ER)for EGC have improved.Therefore,surveillance with endoscopy after ER for EGC is becoming more important,but how to perform endoscopic surveillance after ER has not been established,even though the follow-up strategy for more advanced gastric cancer has been outlined.Therefore,a surveillance strategy for patients with EGC after ER is needed. 展开更多
关键词 Early GASTRIC CANCER Endoscopic RESECTION SYNCHRONOUS GASTRIC CANCER METACHRONOUS GASTRIC CANCER SURVEILLANCE
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Comparative study of esomeprazole and lansoprazole in triple therapy for eradication of Helicobacter pylori in Japan 预览 被引量:1
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作者 Tsutomu Nishida Masahiko Tsujii +20 位作者 Hirohisa Tanimura Shusaku Tsutsui Shingo Tsuji Akira Takeda Atsuo Inoue Hiroyuki Fukui Toshiyuki Yoshio Osamu Kishida Hiroyuki Ogawa Masahide Oshita Ichizo Kobayashi Shinichiro Zushi Makoto Ichiba Naoto Uenoyama Yuichi Yasunaga Ryu Ishihara Mamoru Yura Masato Komori Satoshi Egawa Hideki Iijima Tetsuo Takehara 《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS 2014年第15期4362-4369,共8页
AIM:To evaluate the efficacy and safety of esomeprazole-based triple therapy compared with lansoprazole therapy as first-line eradication therapy for patients with Helicobacter pylori(H.pylori)in usual post-marketing ... AIM:To evaluate the efficacy and safety of esomeprazole-based triple therapy compared with lansoprazole therapy as first-line eradication therapy for patients with Helicobacter pylori(H.pylori)in usual post-marketing use in Japan,where the clarithromycin(CAM)resistance rate is 30%.METHODS:For this multicenter,randomized,openlabel,non-inferiority trial,we recruited patients(≥20years of age)with H.pylori infection from 20 hospitals in Japan.We randomly allocated patients to esomeprazole therapy(esomeprazole 20 mg,CAM 400 mg,amoxicillin(AC)750 mg for the first 7 d,with all drugs given twice daily)or lansoprazole therapy(lansoprazole30 mg,CAM 400 mg,AC 750 mg for the first 7 d,with all drugs given twice daily)using a minimization method with age,sex,and institution as adjustment factors.Our primary outcome was the eradication rate by intention-to-treat(ITT)and per-protocol(PP)analyses.H.pylori eradication was confirmed by a urea breath test from 4 to 8 wk after cessation of therapy.RESULTS:ITT analysis revealed the eradication rates of 69.4%(95%CI:61.2%-76.6%)for esomeprazole therapy and 73.9%(95%CI:65.9%-80.6%)for lansoprazole therapy(P=0.4982).PP analysis showed eradication rate of 76.9%(95%CI:68.6%-83.5%)for esomeprazole therapy and 79.8%(95%CI:71.9%-86.0%)for lansoprazole therapy(P=0.6423).There were no differences in adverse effects between the two therapies.CONCLUSION:Esomeprazole showed non-inferiority and safety in a 7 day-triple therapy for eradication of H.pylori compared with lansoprazole. 展开更多
关键词 HELICOBACTER PYLORI ERADICATION ESOMEPRAZOLE Lanso
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Esophageal early basaloid squamous carcinoma with unusual narrowband imaging magnified endoscopy findings 预览
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作者 Yugo Kai Motohiko Kato +6 位作者 Yoshito Hayashi Tomofumi Akasaka Shinichiro Shinzaki Tsutomu Nishida Masahiko Tsujii Eiichi Morii Tetsuo Takehara 《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS 2014年第35期12673-12677,共5页
Basaloid squamous carcinoma(BSC)is a rare variant of esophageal cancer.There are very few reports of'early'BSC.Here we report a case of early BSC with unusual findings by narrowband imaging magnified endoscopy... Basaloid squamous carcinoma(BSC)is a rare variant of esophageal cancer.There are very few reports of'early'BSC.Here we report a case of early BSC with unusual findings by narrowband imaging magnified endoscopy(NBI-ME).A 70-year-old man with a middle thoracic esophageal tumor was referred to our hospital.White-light endoscopy revealed a reddish depressed lesion 5 mm in diameter having a subepithelial tumor-like prominence with a gentle rising slope.NBI-ME revealed irregular loop-shaped microvessels coexistent with thick irregularly branched non-looped vessels.Iodine staining revealed a pale brown lesion.We performed endoscopic submucosal dissection for diagnostic treatment.Histologic examination showed the proliferation of basal cell-like hyperchromatic tumor cells in the lamina propria and with slight invasion into the submucosa at a depth of 320μm.The tumor cells formed solid nests and microcystic structures,containing an Alcian blue-positive mucoid matrix.The surface was covered with squamous epithelium without cellular atypia.Thin vessels were observed in the intra-epithelial papilla and thick vessels were observed around the solid nests beneath the epithelium.Based on these findings together,we diagnosed the lesion as BSC.In this case,the NBI-ME findings differed from those of typical squamous cell carcinoma in that both non-invasive cancer-like irregular loop-shaped microvessels coexisted with massively invasive cancerlike thick non-looped vessels.We speculate that the looped and non-looped vessels observed by NBI-ME histologically corresponded to thin vessels in the intraepithelial papilla and thick vessels around the tumor nests,respectively.These NBI-ME findings might be a feature of early esophageal BSC. 展开更多
关键词 BASALOID SQUAMOUS carcinoma NARROWBAND IMAGING Eso
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Choroidal and cutaneous metastasis from gastric adenocarcinoma 预览 被引量:1
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作者 Shoichiro Kawai Tsutomu Nishida +11 位作者 Yoshito Hayashi Hisao Ezaki Takuya Yamada Shinichiro Shinzaki Masanori Miyazaki Kei Nakai Takayuki Yakushijin Kenji Watabe Hideki Iijima Masahiko Tsujii Kohji Nishida Tetsuo Takehara 《世界胃肠病学杂志:英文版(电子版)》 SCIE CAS 2013年第9期1485-1488,共4页
Choroidal or cutaneous metastasis of gastric cancer is rare. Gastrointestinal cancer was found in only 4% in patients with uveal metastasis. Choroidal metastasis from gastric cancer was reported in two cases in earli... Choroidal or cutaneous metastasis of gastric cancer is rare. Gastrointestinal cancer was found in only 4% in patients with uveal metastasis. Choroidal metastasis from gastric cancer was reported in two cases in earlier literature. The frequency of gastric cancer as a primary lesion was 6% in cutaneous metastasis of men, and cutaneous metastasis occurs in 0.8% of all gastric cancers. We report a patient with gastric adenocarcinoma who presented with visual disorder in his left eye and skin pain on his head as his initial symptoms. These symptoms were diagnosed to be caused by choroidal and cutaneous metastasis of gastric adenocarcinoma. Two cycles of chemotherapy consisted of oral S-1 and intravenous cisplatin (SPIRITS regimen); this was markedly effective to reduce the primary gastric lesion and almost all the metastatic lesions. 展开更多
关键词 STOMACH NEOPLASMS NEOPLASM METASTASIS CHOROID NEOPLASMS SKIN NEOPLASMS
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为胃的非侵略的 intraepithelial 瘤形成的治疗策略由内视镜的活体检视诊断了 预览 被引量:2
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作者 Tsutomu Nishida Shusaku Tsutsui +9 位作者 Motohiko Kato Takuya Inoue Shunsuke Yamamoto Yoshito Hayashi Tomofumi Akasaka Takuya Yamada Shinichiro Shinzaki Hideki Iijima Masahiko Tsujii Tetsuo Takehara 《世界胃肠病理生理学杂志:英文版(电子版)》 2011年第6期93-99,共7页
Treatment strategies,whether as follow-up or'total incisional biopsy'for gastric noninvasive intraepithelial neoplasia diagnosed by examination of an endoscopic forceps biopsy specimen,are controversial due t... Treatment strategies,whether as follow-up or'total incisional biopsy'for gastric noninvasive intraepithelial neoplasia diagnosed by examination of an endoscopic forceps biopsy specimen,are controversial due to problems associated with the diagnostic accuracy of endoscopic forceps biopsy and questions about the safety and efficacy of endoscopic treatment.Based on the histological findings of the biopsy specimen,it is difficult to differentiate between reactive or regenerative changes,inflammation and neoplastic changes,intraepithelial and invasive tumors.Therefore,gastric neoplasia diagnosed as noninvasive intraepithelial often develop into invasive carcinoma during follow-up.Recent advances in endoscopic modalities and treatment devices,such as image-enhanced endoscopy and highfrequency generators,may make endoscopic treatment,such as endoscopic submucosal dissection(ESD),a therapeutic option for gastric intraepithelial neoplasia,including low-grade neoplasms.Future studies are required to evaluate whether ESD is a valid strategy for gastric intraepithelial neoplasm with regard to safety and cost effectiveness. 展开更多
关键词 Gastric intraepithelial NEOPLASIA Adenoma DYSPLASIA ENDOSCOPIC SUBMUCOSAL dissection ENDOSCOPIC MUCOSAL RESECTION ENDOSCOPIC RESECTION Adenocarcinoma
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