Predictive Factors for Future Onset of Reflux Esophagitis: A Longitudinal Case-control Study Using Health Checkup Records.

Background/aims: Although risk factors of reflux esophagitis (RE) have been investigated in numerous cross-sectional studies, little is known about predictive factors associated with future onset of RE. We investigated time courses of clinical parameters before RE onset by a longitudinal case-control study using health checkup records.

Methods: We used health checkup records between April 2004 and March 2014 at 9 institutions in Japan.

A multicenter randomized trial comparing rabeprazole and itopride in patients with functional dyspepsia in Japan: the NAGOYA study.

The aims of this study were to compare the therapeutic effects of a proton pump inhibitor (PPI), rabeprazole (RPZ), and a prokinetic agent, itopride (ITO), and to investigate the role of PPI in the treatment strategy for Japanese functional dyspepsia (FD) patients. We randomly assigned 134 patients diagnosed by Rome III criteria to 4 weeks treatment with RPZ 10 mg/day ( = 69) or ITO 150 mg/day ( = 65). Dyspeptic symptoms were evaluated using FD scores at baseline and after 1, 2 and 4 weeks of treatment.

Histology of symptomatic gastroesophageal reflux disease: is it predictive of response to proton pump inhibitors?

Background And Aim: To examine the differences in esophageal histopathology between non-erosive reflux disease (NERD) and reflux esophagitis (RE), and to investigate whether baseline esophageal histopathology can predict the therapeutic response to proton pump inhibitors (PPIs).

Method: The subjects comprised 94 patients with NERD (n = 71) or mild RE (n = 23). Tissue was biopsied from 5 cm above the squamo-columnar junction (SCJ), and the degree or presence of nine histopathological markers was assessed.

Elevated serum uric acid predicts chronic kidney disease.

Introduction: The question of whether elevated serum uric acid is an independent risk factor for chronic kidney disease in a longitudinal manner was assessed in Japanese subjects undergoing a health checkup.

Methods: A total of 14,399 participants (8,161 men and 6,238 women) without medication for hyperuremia in both 2000 and 2005 were included. After exclusion of participants taking treatments influencing serum uric acid and having chronic kidney disease defined as estimated glomerular filtration rate <60 mL/min/1.

Elevated serum uric acid is an independent risk factor for nonalcoholic fatty liver disease in Japanese undergoing a health checkup.

Background And Study Aims: The question of whether elevated serum uric acid is an independent risk factor for nonalcoholic fatty liver disease evident on ultrasonography was investigated by longitudinal approach in Japanese undergoing a health checkup.

Patients And Methods: A total of 1,386 male and 3,453 female nondrinkers participating in health checkups in both 2000 and 2005 were included. Multiple logistic regression analyses were performed for 1,042 men (51.

An endocrine cell carcinoma with gastric-and-intestinal mixed phenotype adenocarcinoma component in the stomach.

A 77-year-old man complained of bodyweight loss, and a Borrmann 3 type lesion was observed endoscopically in the anterior wall of angular region of the stomach. The endocrine cell carcinoma (ECC) having the cytoplasmic staining of chromogranin A (CgA) was detected pathologically in the biopsy samples. The patient underwent distal gastrectomy plus systemic lymph node (LN) dissection (D2 LN dissection), and pathological examination revealed ECC invading the subserosa, and no LN metastasis (pT2N0M0).

Blockage of angiotensin II type 1 receptor regulates TNF-alpha-induced MAdCAM-1 expression via inhibition of NF-kappaB translocation to the nucleus and ameliorates colitis.

Mucosal vascular addressin cell adhesion molecule 1 (MAdCAM-1) is an important target in the treatment of inflammatory bowel disease (IBD). Recently, treatment of IBD with an antibody to alpha4beta7-integrin, a ligand for MAdCAM-1, has been an intense focus of research. Our aim was to clarify the mechanism by which MAdCAM-1 is regulated via angiotensin II type 1 receptor (AT1R), and to verify if AT1R might be a novel target for IBD treatment.

Fatty liver predicts impaired fasting glucose and type 2 diabetes mellitus in Japanese undergoing a health checkup.

Background And Aim: The question of whether fatty liver might predict impaired fasting glucose or type 2 diabetes mellitus in a longitudinal manner was assessed in Japanese subjects undergoing a health checkup.

Methods: A total of 12 375 individuals (6799 men and 5576 women) without hyperglycemia or type 2 diabetes mellitus in 2000 and participating in 2005 were included. Multiple logistic regression analyses were performed for both sexes, adjusted for age, body mass index, elevated blood pressure or hypertension, family history of diabetes mellitus, alcohol drinking and smoking.

Gastric schwannoma with adjacent external progression harbored aberrant NF2 gene.

Gastric schwannomas are rare benign mesenchymal tumors. We describe a schwannoma of gastric origin with adjacent external progression. Sections showed a spindle cell tumor arranged in interlaced bundles and fascicles that was S-100 and CD34 positive but c-KIT protein negative.

Combination chemotherapy with cisplatin and gemcitabine in malignant peritoneal mesothelioma.

Malignant peritoneal mesothelioma is a rare neoplasm with a rapidly fatal course. The response of this disease to treatment is poor because it tends to be advanced at diagnosis and tends to have inherent resistance to chemotherapeutic treatment. We describe three patients with malignant peritoneal mesothelioma who received combination chemotherapy with cisplatin and gemcitabine.

Lentinan with S-1 and paclitaxel for gastric cancer chemotherapy improve patient quality of life.

Background/aims: Lentinan (LNT), a purified beta-glucan, is a biological and immunological modifier and has been used as an anticancer drug in combination with 5-fluorouracil for gastric cancer in Japan. In this prospective randomized study, we evaluated the effects of LNT combination with regard to quality of life (QOL) and LNT binding ratio in monocytes.

Methodology: Twenty patients were evaluated for 12 weeks.

Gastric phenotypic expression and histogenesis of metachronous gastric cancers endoscopically resected.

Background/aims: Endoscopic Resection (ER) has been performed for early gastric cancers, and metachronous gastric cancers (MGCs) were occasionally observed. Most MGCs were classified histologically as the differentiated type. However, there have been no data on the gastric and intestinal phenotypic classification of MGCs.

Advanced stomach and pancreas cancer successfully treated with combination chemotherapy with S-1/paclitaxel/lentinan.

We report a case of stomach and pancreas cancers that showed marked responses to combination chemotherapy consisting of S-1, paclitaxel (PTX), and lentinan (LNT). A 67-year-old Japanese man was referred to our hospital in July 2005, diagnosed with advanced gastric cancer. Subsequent examination revealed the existence of cancers in the stomach and pancreas, with lymph nodes and peritoneal metastasis and ascites.

Impaired gastric motility and its relationship to reflux symptoms in patients with nonerosive gastroesophageal reflux disease.

Background: More than half of patients with refluxrelated symptoms have no endoscopic evidence of mucosal breaks. These patients are considered to have nonerosive gastroesophageal reflux disease (NERD). The pathogenesis of NERD may be multifactorial, but the role played by gastric motility in symptom generation in patients with NERD has not been examined.

Gastric-and-intestinal mixed endocrine cell phenotypic expression of carcinoid tumors in the rectum.

We have previously demonstrated that gastric and intestinal endocrine cell (End-cell) marker expression is important for assessment of the histogenesis of endocrine cell tumors. However, the End-cell phenotypes of carcinoid tumors in the rectum remain largely unclear. We therefore examined marker expression of rectal carcinoid tumors.

[Case of duodenal stenosis due to hematoma after rupture of the inferior pancreaticoduodenal artery aneurysm treated by coil embolization].

A 59-year-old woman was admitted because of vomiting, CT examinations it was determined that the cause of vomiting was duodenal stenosis due to hematoma after rupture of the inferior pancreaticoduodenal artery aneurysm. In addition, it was believed that the aneurysm had been caused by obstruction of the celiac artery. The aneurysm of the inferior pancreaticoduodenal artery was detected by angiography, and embolization was performed using coils.

Gastroesophageal and laryngopharyngeal reflux symptoms correlate with histopathologic inflammation of the upper and lower esophagus.

Background: The presence of laryngopharyngeal reflux disease is controversial when abnormal sensation of the laryngopharynx is felt without heartburn.

Goals: The aims of this study were to investigate the relationship between abnormal sensation of the laryngopharynx and gastroesophageal reflux, and to elucidate the pathology of laryngopharyngeal reflux disease by investigating histopathologic findings of the upper and lower esophagus.

Study: Upper and lower esophageal tissues were biopsied by endoscopy in 300 consenting patients, excluding those with serious diseases.

Gastric phenotype signet-ring cell carcinoma of the stomach with multiple bone metastases effectively treated with sequential methotrexate and 5-fluorouracil.

A 63-year-old woman presented with an abnormal serum alkaline phosphatase (ALP) level. Computed tomography (CT) scan of the abdomen and pelvis and radioisotope (RI) examination led to a strong suspicion of systemic bone metastatic tumors, although the origin was not known. Biopsies from bone metastatic lesions in the left ilium were performed under CT scan, and signet-ring cell carcinoma cells were detected pathologically.

[The efficacy of probiotics in gastrointestinal disease].

Probiotics are live microbial feed supplement which beneficially affects the host animals by improving its microbial balance. Probiotics have been used in the treatment of bacterial or viral induced acute intestinal infection. In recent years, some clinical studies have shown the therapeutic effects of probiotics in the treatment of chronic inflammatory bowel disease (IBD) or prevention of allergic disease.

Effect of plaunotol in combination with clarithromycin against clarithromycin-resistant Helicobacter pylori in vitro and in vivo.

Objectives: Recently, there has been a decrease in the eradication rate of Helicobacter pylori due to the increase in antibiotic resistance of this bacterium. Plaunotol, a cytoprotective anti-ulcer agent, exhibits antibacterial activity against H. pylori.

Validity of endoscopic classification of nonerosive reflux disease.

Background: Minimal changes, such as erythema without sharp demarcation or whitish turbidity of the lower esophageal mucosa, have recently been used for endoscopic classification of nonerosive reflux disease (NERD) in Japan. This study examined the usefulness of such changes in characterizing the pathophysiology of NERD.

Methods: Physicians specializing in esophageal endoscopy performed endoscopy on 115 patients with NERD.

Advantages of endoscopic submucosal dissection over conventional endoscopic mucosal resection.

Background: Endoscopic mucosal resection is an established method for treating intramucosal gastric neoplasms. Conventional endoscopic mucosal resection has predominantly been performed using strip biopsy, but local recurrence sometimes occurs due to such piecemeal resection. Endoscopic submucosal dissection has recently been performed in Japan using new devices such as an insulation-tip diathermic knife.

[Histopathological diagnosis in gastroesophageal reflux disease].

We reviewed the histopathological features for the diagnosis of gastroesophageal reflux disease (GERD). The presence of infiltration inflammatory cells, thickened basal cell layer, increased papillary height was histopathologically evaluated in GERD patients. It is often difficult to diagnose GERD symptoms when there were few endoscopic findings, such as lack of hiatal hernia and erosive esophagitis.

Oral vaccination against Helicobacter pylori with recombinant cholera toxin B-subunit.

Background: The innocuous pure recombinant cholera toxin B-subunit (rCTB) is very attractive as a strong adjuvant for host immunization, but little is known about rCTB's gastric mucosal immunoadjuvanticity against Helicobacter pylori. The immunoadjuvanticity of rCTB against H. pylori was tested.