Comprehensive Prospective Analysis of the Factors Contributing to Aspiration Pneumonia Following Endoscopic Submucosal Dissection in Patients with Early Gastric Neoplasms.

Endoscopic submucosal dissection (ESD) has become the first-line treatment for early gastric neoplasms; however, a subset of patients treated by this method develop aspiration pneumonia. We conducted a comprehensive prospective analysis of the factors contributing to post-ESD aspiration pneumonia in early gastric neoplasms in this study, with special focus on whether pre-treatment oral care can prevent aspiration pneumonia. Sixty-one patients who underwent ESD for gastric neoplasms were randomly assigned to the oral care or control groups.

Gastric mucormycosis complicated by a gastropleural fistula: A case report and review of the literature.

Rationale: Mucormycosis is a rare opportunistic fungal infection with poor prognosis. The incidence of mucormycosis has been increasing, and it is a threat to immunocompromised hosts. We present a case of gastric mucormycosis complicated by a gastropleural fistula during immunosuppressive treatment for adult-onset Still disease (AOSD).

Successful Treatment with Adalimumab for Intestinal Behcet's Disease during Pregnancy.

A 36-year-old Japanese woman with intestinal Behcet's disease was admitted to our hospital due to a recurrent ileocecal ulcer. Because infliximab (IFX) showed secondary failure, IFX was switched to adalimumab (ADA). After the third injection of ADA, she was unexpectedly 4-weeks pregnant.

Advantages of fecal lactoferrin measurement during granulocyte and monocyte adsorptive apheresis therapy in ulcerative colitis.

Background: Fecal lactoferrin has been introduced as a useful tool for the diagnosis and monitoring of inflammatory bowel disease (IBD). The aim of this study was to assess if fecal lactoferrin can be employed to predict or estimate the effect of granulocyte and monocyte adsorptive apheresis (GMA) in ulcerative colitis (UC).

Methods: This was a prospective study involving 21 patients with UC.

Efficacy of long-term 4.0 g/day mesalazine (Pentasa) for maintenance therapy in ulcerative colitis.

Background: High-dose (4.0 g/day) mesalazine is typically used for induction therapy, but its efficacy as maintenance therapy remains to be determined. We conducted a multicenter retrospective study to investigate the efficacy of continuous treatment with 4.

Possible diagnostic role of antibodies to Crohn's disease peptide (ACP): results of a multicenter study in a Japanese cohort.

Background: Various noninvasive tests have been studied to screen for patients with Crohn's disease (CD), and were found to have limited accuracy and sensitivity, particularly in Asian populations. The aim of our study was to explore the possible diagnostic utility of antibodies to the CD peptide (ACP) in patients with CD.

Methods: In a multicenter study using enzyme-linked immunosorbent assay, serum ACP levels were determined in 196 patients with CD, 210 with ulcerative colitis, 98 with other intestinal diseases, 132 with other inflammatory diseases, and 183 healthy controls.

Frequency of elevated biomarkers in patients with cryptogenic hepatocellular carcinoma.

Background: The incidence of hepatocellular carcinoma (HCC) continues to increase in Japan, but the clinical characteristics of Japanese patients with HCC have not been well described. The aim of this study was to determine the frequencies and utilities of elevated a-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) levels as biomarkers in cryptogenic HCC.

Material/methods: A total of 2638 patients with HCC diagnosed between 1999 and 2010 in the Nagasaki Association Study of Liver (NASLD) were recruited for this study.

Baseline serum cholesterol is associated with a response to pegylated interferon alfa-2b and ribavirin therapy for chronic hepatitis C genotype 2.

Background. HCV infection is associated with lipid disorders because this virus utilizes the host lipid metabolism to sustain its life cycle. Several studies have indicated that higher concentrations of serum cholesterol and LDL before treatment are important predictors of higher rates of sustained virological response (SVR).

[A case of hepatic portal venous gas caused by transient type ischemic enteritis].

We report a case of hepatic portal venous gas (HPVG) caused by transient type ischemic enteritis. The patient was a 65-year-old woman, previously given a diagnosis of hypertension and diabetes mellitus. She was admitted to our hospital because of vomiting and epigastric pain.

Intraosseous fat necrosis associated with alcoholic pancreatitis.

A 50-year-old man with a 30-year history of alcohol abuse was admitted because of abdominal pain. Based on an elevated serum amylase level and abdominal computed tomography findings, a diagnosis of alcoholic pancreatitis was made. The pancreatitis improved after 1 month of conservative therapy, but the patient complained of a tender right ankle that showed no abnormal findings on X-ray examination.

Evaluation of new prognostic staging systems (SLiDe score) for hepatocellular carcinoma patients who underwent hepatectomy.

Background/aims: A new prognostic staging system, the SLiDe (S, stage; Li, liver damage; De, des-gamma-carboxy prothrombin) score was recently proposed. We examined 207 HCC patients following hepatic resection to determine the usefulness of this staging system for HCC patients after surgery.

Methodology: Disease-free and overall survival rates were calculated according to the Kaplan-Meier method, and differences between groups were tested for significance using the log-rank test.

[A case of groove pancreatitis observed from initial stage].

We report a case of groove pancreatitis. A 60-year-old man was admitted to our hospital because of nausea and vomitting. CT showed a mass lesion in the groove between the pancreas head, duodenum and common bile duct.

Surgical treatment and adjuvant chemotherapy in hepatocellular carcinoma patients with advanced vascular involvement.

Background/aims: In advanced hepatocellular carcinoma (HCC) with vascular involvement of major vessels, patients have a poor prognosis after surgical treatment.

Methodology: Patient outcomes after surgical resection and the usefulness of adjuvant chemotherapy were examined in 12 patients with major hepatic vessel involvement who underwent hepatectomy with combined resection of major blood vessels.

Results: The main portal vein was resected in 8 patients, the inferior vena cava in 3, hilar bile duct in 2 and hepatic artery in 1.

Clinical implications of antimitochondrial antibodies in type 1 autoimmune hepatitis: a longitudinal study.

Background/aims: Autoimmune hepatitis (AIH) is a chronic liver disease characterized by the presence of antinuclear antibodies. However, antimitochondrial antibodies (AMA) and bile duct changes, which are the characteristics of primary biliary cirrhosis (PBC), can be detected in AIH patients.

Methodology: Twenty patients with definite AIH were prospectively followed-up, and the serial changes in AMA profiles were determined.

[A case of double common bile duct with gastric ulcer].

A 51-year-old man visited the Sasebo General Hospital because of a niche and a ductal lesion with reflux of barium in the lesser curvature of the gastric body in the upper gastrointestinal series of an annual medical checkup. Endoscopic examination showed an ulcer and a depressed lesion draining yellowish serous liquid in the stomach. Abdominal CT scan and MRCP revealed the ductal structure reached from the lesser curvature of the gastric body to the left lobe of the liver besides the ordinary pancreatobiliary system.

Clinicopathological study of nonalcoholic fatty liver disease in Japan: the risk factors for fibrosis.

Background/aims: We evaluated patients with nonalcoholic fatty liver disease (NAFLD) and compared the clinical and pathological features to identify the risk factors for NAFLD with severe fibrosis.

Methods: One hundred and eighty-two patients with biopsy-confirmed NAFLD from various medical centres were recruited into this study.

Results: The variables that were significantly associated with severe steatosis were male gender (mild:severe=36%:53%, P=0.

Sarcoidosis accompanied by systemic lupus erythematosus and autoimmune hepatitis.

A 52-year-old woman was admitted to our hospital for further examination of blurred vision, abnormal lung shadows and an elevated level of angiotensin-converting enzyme. Sarcoidosis was suspected, however, careful history taking revealed the existence of photosensitivity and polyarthralgia. Laboratory tests showed lymphocytopenia, liver dysfunction, hypergammaglobulinemia, and positive anti-nuclear, anti-double stranded DNA and anti-smooth muscle antibodies.

Intracellular balance of oxidative stress and cytoprotective molecules in damaged interlobular bile ducts in autoimmune hepatitis and primary biliary cirrhosis: In situ detection of 8-hydroxydeoxyguanosine and glutathione-S-transferase-pi.

Aim: Bile duct injury has been thought to be absent in autoimmune hepatitis (AIH), but recent studies have indicated that AIH patients do have bile duct injury. In this study, the intracellular balance of oxidative stress and cytoprotection in biliary epithelial cells was investigated to clarify the pathogenesis of bile duct injury in AIH.

Methods: The intracellular status of oxidative DNA damage caused by oxidative stress and glutathione, an endogenous cytoprotective molecule, were examined in patients with AIH, primary biliary cirrhosis (PBC), and normal controls by immunostaining of 8-hydroxydeoxyguanosine (8-OHdG) and glutathione-S-transferase-pi.

Relation among plasma ghrelin level, gastric emptying, and psychologic condition in patients with functional dyspepsia.

Background And Goals: Neurohormonal factors might play a role in the pathogenesis of functional dyspepsia (FD). However, the role of ghrelin, a gastrointestinal hormone that stimulates gastric motility, in FD is not yet clearly defined. The present study was designed to investigate plasma ghrelin levels and their relation with gastric emptying and psychologic status in FD.

Autoimmune pancreatitis with extreme elevation of DUPAN-2.

An 80-year-old woman was admitted to our hospital with complaints of jaundice and liver dysfunction. She was found to have a high titer of serum IgG4, positive rheumatoid factor and marked elevation of DUPAN-2 (11,148 U/ml). Computed tomography showed swelling of the pancreas, and endoscopic retrograde cholangiopancreatography revealed diffuse irregular narrowing of the main pancreatic duct, which are typical findings of autoimmune pancreatitis.

High plasma osteopontin levels in patients with inflammatory bowel disease.

Background: Osteopontin (OPN) plays a key role in the progression of T(H)1-immune-mediated disease in models of multiple sclerosis and rheumatoid arthritis.

Aim: To determine whether plasma OPN levels in patients with inflammatory bowel disease are associated with disease activity.

Methods: Plasma samples were obtained from patients with ulcerative colitis (UC, n=30), Crohn's disease (CD, n=30), and healthy volunteers (controls, n=30) and enzyme immunoassay was performed.

IgA class antibodies to 2-oxo-acid dehydrogenase complex are not predictive markers of histopathological progression in primary biliary cirrhosis.

Although antimitochondrial antibody (AMA) is the characteristic serological feature of primary biliary cirrhosis (PBC), its pathogenic role remains unclear. In our previous study, we reported a positive correlation between immunoglobulin (Ig) A class anti-2-oxo-acid dehydrogenase complex (2-OADC) and histopathological stage. To determine whether the appearance of IgA class anti-2-OADC by immunoblotting represents an early marker of more aggressive disease or whether it is late finding during the disease course of PBC, we tested not only the entire IgA class but also IgA1, IgA2 and secretory IgA class anti-2-OADC in serial serum samples from 15 patients with PBC.

Dechlorination/hydrogenation and destruction reactions of PCDDs in OCDD-added fly ash heated under vacuum.

Octachlorodibenzo-p-dioxin (OCDD)-added, pretreated fly ash was heated under vacuum at sample temperatures ranging from T(s)=450 to 650 K. The fly ash and liquid nitrogen-cooled trap samples were analyzed for DD/DF through OCDD/DF. The total amounts of DD through OCDD decrease with increasing T(s), which indicates that dechlorination/hydrogenation (DCH) reactions are not the only reaction channels.