The Superiority of Vonoprazan-based First-line Triple Therapy with Clarithromycin: A Prospective Multi-center Cohort Study on Helicobacter pylori Eradication.

Objective We evaluated the safety and efficacy of vonoprazan-based amoxicillin and clarithromycin 7-day triple therapy (VAC) in comparison to proton pump inhibitor (PPI)-based (PAC) as a first-line treatment and vonoprazan-based amoxicillin and metronidazole 7-day triple therapy (VAM) in comparison to PPI-based (PAM) as a second-line treatment for the eradication of Helicobacter pylori in Japan. Methods We performed a non-randomized, multi-center, parallel-group study to compare first-line VAC to PAC and second-line VAM to PAM. A pre-planned subgroup analysis on CAM resistance was also performed.

Treatment outcomes of endoscopic resection for rectal carcinoid tumors: an analysis of the resectability and long-term results from 46 consecutive cases.

Aim: In Japan, most of colorectal carcinoid tumors developed in rectum. The choice of treatment is important because surgical treatment may need to construct artificial anus. Although curative endoscopic resection (ER) is desirable from the point of quality of life, sufficient evidence of endoscopic treatment for rectal carcinoid tumors is not fully obtained.

Coagulation syndrome: Delayed perforation after colorectal endoscopic treatments.

Various procedure-related adverse events related to colonoscopic treatment have been reported. Previous studies on the complications of colonoscopic treatment have focused primarily on perforation or bleeding. Coagulation syndrome (CS), which is synonymous with transmural burn syndrome following endoscopic treatment, is another typical adverse event.

Impact of the early detection of esophageal neoplasms in hypopharyngeal cancer patients treated with concurrent chemoradiotherapy.

Aims: We examined the risk factors and prognostic factors for synchronous esophageal neoplasia (SEN) by comparing the characteristics of hypopharyngeal cancer (HPC) patients with and without SEN.

Methods: We examined 183 patients who were treated with definitive radiotherapy for HPC. Lugol chromoendoscopy screening of the esophagus was performed in all patients before chemoradiotherapy.

Adenocarcinoma arising from short-segment Barrett's esophagus in a young man.

We report herein a case of adenocarcinoma arising from short-segment Barrett's esophagus (SSBE) in a 36-year-old man. An elevated tumor was found at the esophagogastric junction, and a histological evaluation of the biopsy specimen led to a diagnosis of adenocarcinoma. The tumor was found to be confined to the mucosa surrounding the SSBE, and endoscopic submucosal dissection was done without complications.

Antithrombotic drugs are risk factors for delayed postoperative bleeding after endoscopic submucosal dissection for gastric neoplasms.

Background: The discontinuation of antithrombotic drugs is recommended during endoscopic submucosal dissection (ESD) for gastric neoplasms; however, controversy remains as to whether antithrombotic drugs are risk factors for postoperative bleeding.

Objective: To determine the risk factors for post-ESD bleeding.

Design: Single-institution, retrospective review.

Determining early gastric cancer lesions appropriate for endoscopic submucosal dissection trainees: a proposal related to curability.

Endoscopic submucosal dissection (ESD) was introduced worldwide as a new treatment option for early gastric cancer. Our objective was to discuss the limited ESD reports available and to determine the lesions suitable for use in training endoscopists on which lesions are appropriate for ESD. We reviewed a series of ESD reports that have been written on various risk factors related to the resectability or curability of a variety of lesions.

Risk assessment chart for curability of early gastric cancer with endoscopic submucosal dissection.

Background: Endoscopic submucosal dissection (ESD) was introduced worldwide as a new treatment option for early gastric cancer, but curability prediction has not been evaluated on an individual basis.

Objective: To analyze factors contributing to the curability of early gastric cancer after ESD and to construct a risk assessment chart for the probability of curability.

Design: Single-institution retrospective review.

Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older.

Background: Little information is available on the long-term outcomes of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) in patients of advanced age (≥80 years).

Methods: A multicenter study was conducted at 10 Japanese institutions concerning their results for ESD. Data on 440 patients of advanced age (≥80 years) with EGC (470 lesions) were collected and reviewed.

Superficial adenocarcinoma of the esophagogastric junction: long-term results of endoscopic submucosal dissection.

Background: Endoscopic submucosal dissection (ESD) was recently introduced as a treatment option for superficial adenocarcinoma of the esophagogastric junction (EGJ); however, its long-term clinical outcomes have not been fully evaluated.

Objective: To assess the long-term outcomes of ESD for patients with superficial adenocarcinoma of the EGJ.

Design: Retrospective review from a single institution.

Successful initial ablation therapy contributes to survival in patients with hepatocellular carcinoma.

Aim: To evaluate the outcome predictors of percutaneous ablation therapy in patients with unresectable hepatocellular carcinoma (HCC), especially to identify whether the initial treatment response contributes to the survival of the patients.

Methods: The study cohort included 153 patients with single (102) and two or three (51) HCC nodules 5 cm or less in maximum diameter. As an initial treatment, 110 patients received radiofrequency ablation and 43 patients received percutaneous ethanol injection.

[Radiofrequency ablation and percutaneous ethanol injection in patients with unresectable hepatocellular carcinoma--a comparative study using Japan Integrated Staging Score (JIS score) system].

The patients were classified according to the Japan Integrated Staging (JIS) score and a comparison examination of the long-term therapeutic response of 149 unresectable hepatocellular carcinomas: 90 of them given percutaneous ethanol injection (PEI), and 59 of them given radiofrequency ablation (RFA) who were diagnosed with 3 cm or less in diameters of tumor and less than three nodules, or 5 cm or less single nodule, was carried out in retrospective. To all the tumors exceeding 3 cm in diameter, we added transcatheter arterial embolization (TAE) prior to PEI or RFA. Ninety four percent of PEI cases and 25% of RFA cases received a combination therapy with TAE, respectively.

Extension of radiofrequency ablation of the liver by transcatheter arterial embolization with iodized oil and gelatin sponge: results in a pig model.

Purpose: To determine whether transcatheter arterial embolization (TAE) with iodized oil and gelatin sponge particles can be used to expand radiofrequency (RF)-induced coagulation necrosis, the morphology and histologic characteristics of ablation lesions were evaluated in the normal pig liver after three different TAE procedures.

Materials And Methods: Ten consecutive animals with 33 ablation lesions produced with an RF ablation system were randomly assigned to one of three treatment groups and a control group: a group treated with TAE with iodized oil, a group treated with TAE with gelatin sponge, a group treated with TAE with iodized oil and gelatin sponge, and a control group in which TAE was not performed. After the completion of ablation, the lesions were excised for gross and histologic examination.

Evaluation using contrast-enhanced harmonic gray scale sonography after radio frequency ablation of small hepatocellular carcinoma: sonographic-histopathologic correlation.

Objective: To evaluate the usefulness of contrast-enhanced harmonic wideband gray scale sonographic images obtained after radio frequency-induced coagulation necrosis, we compared the morphologic and histopathologic characteristics of the ablated tumors with sonographic images of the tumors.

Methods: Forty-eight patients with 72 hepatocellular carcinomas with a maximal diameter of 3 cm or less were treated percutaneously using radio frequency ablation. Six treated tumors in 4 patients were resected 1 month after ablation; the remaining 66 treated tumors were evaluated by a biopsy procedure performed with an 18-gauge fine needle 1 month after ablation.

Retrograde transvenous obliteration of gastric varices associated with large collateral veins or a large gastrorenal shunt.

Balloon-occluded retrograde transvenous obliteration of gastric varices by a microcatheter insertion method was performed in eight patients with large collateral veins or a large gastrorenal shunt. A 3-F microcatheter was selectively inserted into the gastric varices through a 6-F balloon catheter wedged in the left adrenal vein. Selective venography of the gastric varices and injection of the sclerosing agent, a mixture of 10% ethanolamine oleate and iopamidol, through the microcatheter system without occluding the collateral veins was accomplished in one treatment session in all patients.

[Radiofrequency ablation combined with transcatheter arterial chemoembolization for hepatocellular carcinoma--CT examination during the follow-up period].

Radiofrequency ablation (RFA) combined with transcatheter arterial embolization (TAE) can increase the volume of coagulation necrosis to treat patients with hepatocellular carcinoma. Furthermore, in clinical practice, RFA combined with TAE using iodized oil and gelatin sponge often induced the sub-segmental or segmental necrosis toward the liver periphery of the ablated lesion. In this study, we compared the CT findings and histological characteristics of peripherally spreading necrosis induced by this combination therapy for 12 patients with hepatocellular carcinoma.

Contrast-enhanced harmonic gray-scale sonographic-histologic correlation of the therapeutic effects of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma.

Objective: We evaluated the usefulness of contrast-enhanced harmonic wideband gray-scale sonography in the assessment of the therapeutic effects of transcatheter arterial chemoembolization in patients with hepatocellular carcinoma and compared the performance of this imaging modality with the histologic findings for the patients.

Subjects And Methods: Twenty-nine patients with 29 hepatocellular carcinoma lesions were examined. Tumor vascularity was evaluated before and 7 days after transcatheter arterial chemoembolization with contrast-enhanced harmonic wideband gray-scale sonography performed after injection of the contrast agent Levovist.

[A case of AFP-producing gastric cancer with multiple liver metastases responding to CPT-11 and cisplatin combination chemotherapy].

A case of AFP-producing gastric cancer successfully treated with CPT-11 and cisplatin combined therapy is reported together with a review of the literature. A 52-year-old male was admitted with complaints of upper abdominal pain and body weight loss. Gastric cancer with multiple liver metastases was diagnosed based on endoscopy and computed tomography findings.

Hepatocellular carcinoma: percutaneous radiofrequency ablation using expandable needle electrodes and the double-insertion technique.

The authors present a case of percutaneous radiofrequency ablation for the treatment of a confirmed hepatocellular carcinoma using expandable needle electrodes and the double-insertion technique. The patient underwent radiofrequency ablation for a 5.0-cm-in-diameter hepatocellular carcinoma in liver segment VIII.

Radiofrequency ablation in a pig liver model: effect of transcatheter arterial embolization on coagulation diameter and histologic characteristics.

To determine whether transcatheter arterial embolization (TAE) can alter radiofrequency (RF)-induced coagulation necrosis, we evaluated the morphology and histologic characteristics of RF ablation lesions combined with TAE in normal pig liver. Using a RF ablation system, consisting of a RF generator and 2-cm expandable LeVeen needle electrodes, nine lesions were generated by RF ablation combined with TAE and 11 lesions by RF ablation alone in five animals. On completion of treatment, the lesions were excised for gross and histologic examination.

Hepatocellular carcinoma: therapeutic experience with percutaneous ethanol injection under real-time contrast-enhanced color Doppler sonography with the contrast agent Levovist.

Objective: To describe our experience with percutaneous ethanol injection under real-time contrast-enhanced color Doppler sonography with Levovist (SH U 508A; Nihon Schering, Osaka, Japan) for hepatocellular carcinoma after transcatheter arterial infusion.

Methods: Twenty patients (17 men and 3 women; mean age, 58.4 years) with 23 hepatocellular carcinoma nodules (mean +/- SD, 2.

Hepatocellular carcinoma: a case of extrahepatic seeding after percutaneous radiofrequency ablation using an expandable needle electrode.

A 2.5-cm diameter, exophytic seeding of hepatocellular carcinoma was detected by contrast-enhanced computed tomography in a 76-year-old man. He had previously undergone a radiofrequency ablation therapy with an expandable, ten-hook needle electrode for the treatment of a 1.

Treatment of hepatocellular carcinoma with radiofrequency ablation: radiologic-histologic correlation during follow-up periods.

To determine whether radiographic images after radiofrequency (RF)-induced coagulation necrosis are correlated with the pathologic effects, we evaluated the morphology and histologic characteristics of RF ablation lesions over a 6-month follow-up period and compared the results with those of radiologic studies. Thirty-three hepatocellular carcinoma (HCC) tumors with a maximum diameter of 3 cm or less were treated percutaneously by using RF ablation in 26 patients. Six treated tumors were resected 4 weeks after ablation; the remaining 27 treated tumors underwent a biopsy procedure by using an 18-gauge fine needle 3 days, 4 weeks, and 24 weeks after ablation.