Association between dietary sugar intake and colorectal adenoma among cancer screening examinees in Japan.

Although intake of highly sugary foods is considered to be a potential risk factor for colorectal cancer through hyperinsulinemia, the association of sugar intake and colorectal adenoma, a precursor lesion to most colorectal cancer, is poorly understood, particularly in Asian populations. We undertook a cross-sectional study in a Japanese population to investigate the association between dietary sugar intake and the prevalence of colorectal adenoma. Study subjects were selected from participants who underwent magnifying colonoscopy with dye spraying as part of a cancer screening program and who responded to a self-administered questionnaire before the colonoscopy.

CodonAdjust: a software for in silico design of a mutagenesis library with specific amino acid profiles.

In protein engineering, generation of mutagenesis libraries is a key step to study the functions of mutants. To generate mutants with a desired composition of amino acids (AAs), a codon consisting of a mixture of nucleotides is widely applied. Several computational methods have been proposed to calculate a codon nucleotide composition for generating a given amino acid profile based on mathematical optimization.

Protocol for a single-arm confirmatory trial of adjuvant chemoradiation for patients with high-risk rectal submucosal invasive cancer after local resection: Japan Clinical Oncology Group Study JCOG1612 (RESCUE study).

Introduction: Intestinal resection with lymph node dissection is the current standard treatment for high-risk lower rectal submucosal invasive cancer after local resection; however, surgery affects patients' quality of life due to stoma placement or impaired anal sphincter function. A recent study demonstrated that adjuvant chemoradiation yields promising results.

Methods And Analysis: This study aims to confirm the non-inferiority of adjuvant chemoradiation, consisting of capecitabine and concurrent radiotherapy (45 Gy in 25 fractions), measured by 5-year relapse-free survival (RFS), over standard surgery in patients with high-risk lower rectal submucosal invasive cancer after local resection.

Minimally invasive hybrid surgery: A salvage tumor enucleation for local recurrence of thoracic esophageal carcinoma after definitive chemoradiotherapy.

Local recurrence after definitive chemoradiation for esophageal carcinoma is associated with poor outcomes. Although salvage esophagectomy is a standard treatment that offers a chance of long-term survival, the procedure is associated with high morbidity and mortality. Minimally invasive hybrid surgery (MIHS) employs thoracoscopic and esophagoscopic procedures and is generally used to treat benign esophageal submucosal tumors.

Endocytoscopy: technology and clinical application in the lower GI tract.

Endocytoscopy (EC) is now one of the valuable technologies in diagnosing colorectal tumors. Providing ultra-high-resolution white light images (520×), endocytoscopy attains the so called virtual histology or optical biopsy, making it a promising tool to diagnose colorectal lesions. Recent studies about artificial intelligence (AI) or computer aided diagnosis (CAD) are also increasingly reported.

Secondary frozen shoulder after traumatic anterior shoulder instability.

Background: Secondary frozen shoulder after traumatic anterior shoulder instability is rare. The therapeutic management and clinical outcome of this condition are not well known. This study aimed to investigate the characteristics of such rare cases and verify treatment outcomes.

A new reliable acoustic respiratory monitoring technology during upper gastrointestinal tract therapeutic endoscopy with CO insufflation.

Previous studies documented the effectiveness and benefits of capnography monitoring during propofol-based sedation for colonoscopy to reduce the incidence of hypoxemia. However, the performance of capnography during longer duration endoscopic therapy of upper gastrointestinal tract cancers under CO insufflation it is not well known. In this study, we compare a new device with acoustic monitoring technology to standard capnography monitoring.

Recurrence with malignancy after endoscopic resection of large colon polyps with high-grade dysplasia: incidence and risk factors.

Background: In the West, piecemeal endoscopic resection remains the primary treatment for large colon polyps (LCP), as most recurrences are believed to be benign and resectable with follow-up endoscopy. However, invasive malignancy at the site of prior piecemeal endoscopic mucosal resection has been reported in the Asian literature. This study aims to identify the incidence of and the risk factors for local recurrence with malignancy after endoscopic resection of LCP with high-grade dysplasia (HGD).

Safety and usefulness of endoscopic submucosal dissection for early esophageal cancers in elderly patients aged 80 years or older.

Background And Aim: Endoscopic submucosal dissection (ESD) for early gastrointestinal (GI) cancers is widely performed as a standard treatment in Japan. Given the increasing life expectancy worldwide, it is naturally regarded that the rate of elderly patients diagnosed with early GI cancer has increased. Available guidelines do not specifically outline how to manage endoscopic therapy for the elderly.

Prevalence of serrated lesions, risk factors, and their association with synchronous advanced colorectal neoplasia in asymptomatic screened individuals.

Background And Aim: Serrated lesions (SLs) have attracted attention as precursors of colorectal cancer (CRC). However, their prevalence, risk factors, and clinical significance have not been satisfactorily elucidated. This study used high-quality colonoscopy data to determine the prevalence of SLs and to identify their risk factors and relationship with synchronous advanced colorectal neoplasia (ACN) in asymptomatic screened individuals.

Neurologically favourable outcomes of cardiogenic out-of-hospital cardiac arrest with relation to the type of witness in Japan.

Aim: To assess the current situation and neurologically favourable outcomes after out-of-hospital cardiac arrest (OHCA) with respect to the type of witness.

Methods: This retrospective observational study used data from the All-Japan Utstein Registry of the Fire and Disaster Management Agency collected between January 1, 2016, and December 31, 2016. Patients with cardiogenic OHCA aged ≥18 years who were witnessed by bystanders were included.

Clinicopathologic and Molecular Characteristics of Familial Adenomatous Polyposis-associated Traditional Serrated Adenoma.

Colorectal carcinogenesis in familial adenomatous polyposis (FAP) follows a conventional adenoma-carcinoma sequence. However, previous studies have also reported the occurrence of traditional serrated adenomas (TSAs) in patients with FAP. In the present study, we analyzed the clinicopathologic and molecular features of 37 TSAs from 21 FAP patients.

Long-term outcomes of patients with recurrent squamous cell carcinoma of the esophagus undergoing salvage endoscopic resection after definitive chemoradiotherapy.

Background: Salvage endoscopic resection (ER) has been reported to be effective for patients with local failure of esophageal squamous cell carcinoma (ESCC) after definitive chemoradiotherapy (dCRT). This study aimed to evaluate the long-term outcomes of salvage ER for patients with local failure of ESCC and to identify risk factors associated with disease recurrence after salvage ER.

Methods: This study included 45 patients undergoing salvage ER after dCRT during 2000 to 2017.

Cost savings in colonoscopy with artificial intelligence-aided polyp diagnosis: an add-on analysis of a clinical trial (with video).

Background And Aims: Artificial intelligence (AI) is being implemented in colonoscopy practice, but no study has investigated whether AI is cost saving. We aimed to quantify the cost reduction using AI as an aid in the optical diagnosis of colorectal polyps.

Methods: This study is an add-on analysis of a clinical trial that investigated the performance of AI for differentiating colorectal polyps (ie, neoplastic versus non-neoplastic).

A novel endoscopic hand-suturing technique for defect closure after colorectal endoscopic submucosal dissection: a pilot study.

Background: This study aimed to demonstrate the feasibility of endoscopic hand-suturing (EHS) and attainability of sustained closure after colorectal endoscopic submucosal dissection (ESD).

Methods: EHS was defined as uninterrupted endoscopic suturing of the mucosal defect after colorectal ESD using an absorbable barbed suture and a through-the-scope needle holder. Following individual EHS training using an ex vivo porcine colonic model, two experienced endoscopists performed EHS.

Novel endoscopic technique for trisegment drainage in patients with unresectable hilar malignant biliary strictures (with video).

Background And Aims: Three or more stents may be needed in patients with extensive stricturing in Bismuth type IIIa/IV hilar malignant strictures. Partial stent-in-stent (PSIS) deployment has been the primary intervention for hilar malignant biliary stricture (MBS). However, simultaneous side-by-side (SBS) stent placement has become feasible with the development of the <6F diameter stent delivery system.

Cost-effectiveness analysis of colorectal cancer screening using colonoscopy, fecal immunochemical test, and risk score.

Background And Aim: A risk-stratification score may be useful for colorectal cancer (CRC) screening, alongside screening colonoscopy (CS) and fecal immunochemical test (FIT). This study aimed to evaluate the effectiveness and cost-effectiveness of population-based CRC screening strategies using CS, FIT, and the Japanese CRC screening score.

Methods: The effectiveness in quality-adjusted life years (QALYs), cost-effectiveness, and required number of CS procedures were evaluated for screening strategies with primary screening CS (strategy 1), FIT (strategy 2), and the risk score (strategy 3), using a simulation model analysis with two scenarios.