bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sonic hedgehog and CDX2 expression in the stomach
Authors: Shiotani Akiko , Kamada Tomoari , Yamanaka Yoshiyuki , Manabe Noriaki , Kusunoki Hiroaki , Hata Jiro , Haruma Ken 
Published: December 2008

AbstractSonic hedgehog (Shh) is an essential regulator of patterning processes throughout development, and CDX proteins act as the master regulators for intestinal development and differentiation. Shh and CDX2 seem to be interdependently linked with cellular differentiation through different signal cascades. We have recently shown that the loss of Shh and aberrant expression of CDX2 in Helicobacter pylori (H. pylori)–associated atrophic gastritis can be modified by H. pylori eradication prior to incomplete intestinal metaplasia. On the other hand, abnormal signaling of the hedgehog pathway has been reported in gastric cancer, especially diffuse‐type cancer and advanced gastric cancer, and Shh acts as a proliferation factor in both the normal mucosa and malignant lesions. CDX2 expressed in the early stage of gastric carcinogenesis is associated with the intestinal phenotypic region and thus with a better outcome. However, it remains unclear how Shh and CDX2 are involved with intestinal transformation and further carcinogenesis.
Tailored eradication therapy based on fecalHelicobacter pyloriclarithromycin sensitivities
Authors: Kawai Takashi , Yamagishi Tetsuya , Yagi Kenji , Kataoka Mikinori , Kawakami Kohei , Sofuni Atsushi , Itoi Takao , Sakai Yoshihiro , Moriyasu Fuminori , Osaka Yoshiaki , Takagi Yu , Aoki Tatsuya , Rimbara Emiko , Noguchi Norihisa , Sasatsu Masanori 
Published: December 2008

AbstractBackground and Aim: Helicobacter pylori(H. pylori) eradication rates using the PPI/AC regimen (proton pump inhibitor + amoxicillin + clarithromycin) are declining. We trialed tailoring eradication regimens according to clarithromycin (CAM) susceptibility.Methods: The subjects were 70H. pyloripositive adults. They were randomly allocated to a tailored group and a control group. In the tailored group, subjects with CAM‐sensitive strains were given PPI/AC eradication therapy, and those with CAM‐resistant strains were given PPI/AM (metronidazole instead of clarithromycin) therapy. The control group were all given PPI/AC therapy. CAM sensitivity was measured by collecting fecal specimens, and extracting the DNA. The 23S rRNA domain, associated with CAM susceptibility inH. pylori, was amplified using a nested polymerase chain reaction (PCR), and DNA sequencing was used to detect point mutations at A2143G and A2144G.Results: Eradication rates were 94.3% in the tailored group and 71.4% in the control group. In particular, the eradication rate was 100% for CAM‐resistant strains in the tailored group.Conclusions: In Japan, where CAM‐resistantH. pyloristrains are expected to continue to increase, tailored eradication therapy according to CAM sensitivity will be of benefit.
The spectra of functional gastrointestinal disorders (FGID) in a Japanese hospital outpatient department according to the ROME II Integrative Questionnaire
Authors: Nakajima Shigemi 
Published: December 2008

AbstractBackground and Aim:  To investigate the spectra of functional gastrointestinal disorders (FGID) in outpatients in Japan, FGID were diagnosed and classified using ROME II.Methods:  Patients who visited Social Insurance Shiga Hospital with symptoms lasting >12 weeks over a 12‐month period without organic diseases were enrolled. A total of 61 patients answered the ROME II Integrative Questionnaire. The answers were analyzed automatically by a computer program according to the Codes for Rome II Integrative Questionnaire. Age‐adjusted ratios of FGID patients were investigated.Results:  Of 61 patients, 54 were diagnosed as having FGID. The ratio of male/female was 29/25, and the age was distributed from 26 to 92 years (mean, 57.8 years). There was no significant difference in age between the sexes. The adjusted ratio of FGID patients increased with age with significant correlation (P = 0.00385). Of the 54 patients, 23 (42.6%) had overlapping FGID. A total of 85 FGID were diagnosed in 54 patients (including 15 cases of unspecified functional bowel disorder, 14 of irritable bowel syndrome [IBS], 13 of functional fecal incontinence, 12 of functional abdominal bloating, and eight of functional dyspepsia [FD]). The adjusted ratio of patients was significantly correlated to age in cases of unspecified functional bowel disorder, functional fecal incontinence, and functional abdominal bloating, but not in IBS or FD.Conclusions:  The ROME II Integrative Questionnaire and automatic analyzer were useful tools in diagnosing and classifying FGID. Approximately 40% FGID patients had overlapping conditions. The adjusted ratio of patients in some FGID was significantly correlated with age.
Evaluation of EORTC QLQ‐C30 questionnaire in patients undergoing in‐hospital chemotherapy for gastrointestinal cancer in Japan
Authors: Kato Junko , Nagahara Akihito , Iijima Katsuyori , Yoshimura Miho , Osada Taro , Yoshizawa Takashi , Watanabe Sumio 
Published: December 2008

AbstractBackground and Aim:  There have been few studies in Japan of the utility of quality of life (QOL) questionnaires as an evaluation of chemotherapy for gastrointestinal (GI) cancer. The present study investigated whether QOL can be an indicator of the clinical benefit of chemotherapy, by analyzing the changes in the QOL scores of patients who underwent in‐hospital chemotherapy for GI cancer.Methods:  From August 2004 to August 2006, 75 patients with GI cancer who were scheduled to undergo in‐hospital chemotherapy were studied. The QOL score was measured with a questionnaire, the European Organization for Research Treatment of Cancer (EORTC) QLQ‐C30 (version 3.0, Japanese version), before chemotherapy, and at 2 weeks and 1 month after the initiation of chemotherapy. Patients were divided into three groups according to the clinical response to chemotherapy (partial response [PR], no change [NC], and progressive disease [PD]).Results:  In total, 65 patients were included in the analysis. Global QOL and physical functioning scores worsened significantly at 2 weeks. Pain and constipation scores improved significantly at 1 month. Nausea and vomiting, appetite loss, and diarrhea scores worsened significantly at 2 weeks. The global QOL score improved significantly after chemotherapy in the PR group. The pain score improved significantly in the PR and NC groups after chemotherapy. QOL scores improved in the NC group to almost the same level as in the PR group, whereas QOL worsened in the PD group.Conclusions:  Measurement of QOL score is a meaningful marker of the benefit of chemotherapy, other than tumor reduction. The NC group could be considered to have responded with improved QOL.
Extracellular HSP70 blocks CD40L‐induced apoptosis and tubular formation in endothelial cells
Authors: Futagami Seiji , Hiratsuka Tetsuro , Shindo Tomotaka , Hamamoto Tatsuhiko , Horie Akane , Ueki Nobue , Kusunoki Masafumi , Gudis Katya , Miyake Kazumasa , Tsukui Taku , Sakamoto Choitsu 
Published: December 2008

AbstractBackground:  Recent studies have shown that CD40, a key player in angiogenesis and tubular formation, is an extracellular receptor of the heat shock protein 70 (HSP70)–peptide complex in endothelial cells. The aim of the present study was to determine the effect of extracellular HSP70 treatment on CD40L‐suppressed apoptosis and CD40L‐induced tubular formation in human umbilical vein endothelial cells (HUVEC).Methods:  The apoptotic index of CD40L‐stimulated HUVEC with or without recombinant human HSP70 was evaluated using terminal deoxynucleotidyl transferase biotin‐dUTP nick end labeling assay analysis. Binding of HSP70‐peptide complex to CD40 on HUVEC was determined by double‐labeling immunofluorescence methods. To evaluate the biological activity of CD40 engagement pretreated with rhHSP70 (0.5, 1 and 3 ng/mL), the extent of new capillary‐like networking structure (tubular formation) formation in HUVEC was counted using an Olympus digital camera. Vascular invasion into MNK‐28 cell clusters was assessed by counting the number of tubular structures extending from the HUVEC into growth factor‐depleted Matrigel. Scores for CD34, HSP70 and CD40L expression levels in gastric cancer tissues were determined by immunostaining.Results:  CD40L stimulation inhibited vincristine‐induced apoptosis of HUVEC in a dose‐dependent manner. Extracellular HSP70 treatment significantly blocked the inhibition of apoptosis by CD40L in HUVEC exposed to vincristine. HSP70–peptide complex bound to CD40 on HUVEC. Extracellular HSP70 treatment also significantly reduced CD40L‐induced tubular formation in a dose‐dependent manner. HSP70 treatment also suppressed invasive tubular formation into MKN‐28 cells clusters by CD40L‐activated HUVEC. There was a significant relationship between CD40L expression levels and microvessel density; however, the relationship between HSP70 expression level and microvessel density in gastric cancer tissues was not significant.Conclusions:  Extracellular HSP70 treatment blocks CD40L inhibition of apoptosis and CD40L induction of tubular formation in HUVEC.
Involvement of bone marrow‐derived stromal cells in gastrointestinal cancer development and metastasis
Authors: Ishii Shuji , Tsuji Shingo , Tsujii Masahiko , Kanazawa Yoshiyuki , Nishida Tsutomu , Iijima Hideki , Yasumaru Masakazu , Irie Takanobu , Yamamoto Katsumi , Tsutsui Shusaku , Eguchi Hiroshi , Kawano Sunao , Hayashi Norio 
Published: December 2008

AbstractBackground:  The involvement of bone marrow (BM) in tumor‐stroma reactions or tumor development has not been examined in a cancer allograft, which has otherwise been appropriate for assessing therapeutic modalities. We investigated the fate of BM‐derived cells in colon cancer allografts and liver metastases in mice.Methods:  C57BL/6 mice were irradiated and rescued by BM transplantation from green fluorescent protein (GFP)‐transgenic mice. MC38 colon cancer cells were stably transfected with the pDsRed gene in order to identify tumor cells by fluorescence. These were inoculated into the mice to generate subcutaneous allografted tumors or liver metastases. The tumors were observed under confocal microscopy and fluorescent immunohistochemistry to determine the fate of tumor versus BM‐derived cells.Results:  GFP‐positive (GFP+) cells were consistently identified as vimentin+, α‐smooth muscle actin (αSMA)+, spindle‐shaped stromal cells in both the subcutaneous tumors and the liver metastases. GFP+ cells of leukocyte lineage also infiltrated the tumors. Neither GFP+ CD31+ endothelial cells nor GFP+ DsRed+ cells were detected in the tumor.Conclusions:  BM‐derived cells frequently and consistently infiltrated the tumor allografts and metastases as interstitial cells and leukocytes. Cells derived from the fusion of BM cells and tumor cells were not observed. This model may be appropriate for the clarification of the effects of anticancer therapies and the study of BM‐derived cells in tumor–host interactions.
Normalization of pH level and gastric mucosa after eradication of H. pylori in the remnant stomach
Authors: Kato Shunji , Matsukura Norio , Matsuda Noriko , Tsuchiya Shinichi , Naito Zenya , Tajiri Takashi 
Published: December 2008

AbstractBackground:  The Updated Sydney System (USS) is used to evaluate chronic gastritis and chronic atrophic gastritis (CAG) due to H. pylori infection. Here, we investigated USS scores and gastric juice pH levels in H. pylori infection‐positive or ‐eradicated patients with remnant stomach after surgery.Methods:  Gastric juice pH levels were measured using pH test‐tape in 197 patients (112 H. pylori‐positive and 85 H. pylori‐negative after eradication) who had undergone distal gastrectomy and conventional H. pylori eradication therapy.Results:  In H. pylori infection‐positive remnant stomach cases, gastric juice pH showed a reverse correlation with pepsinogen I/II ratio, and H. pylori infection‐negative patients following eradication showed associations with the degree of atrophy and intestinal metaplasia at both the anastomosis and in the corpus. Further, pH levels in these patients were normalized time depending after the eradication in the remnant stomach.Conclusions:  Eradication therapy for the remnant stomach contributes to the possible improvement of stomach conditions by controlling the pH level of gastric juice. This effect will be protective against the risk of secondary stomach carcinogenesis in the remnant stomach.
Impact of transnasal ultrathin esophagogastroduodenoscopy (UT‐EGD) in the evaluation of esophageal peristaltic function
Authors: Kawai Takashi , Yamagishi Tetsuya , Yagi Kenji , Kataoka Mikinori , Kawakami Kohei , Sofuni Atsushi , Itoi Takao , Sakai Yoshihiro , Moriyasu Fuminori , Osaka Yoshiaki , Takagi Yu , Aoki Tatsuya 
Published: December 2008

AbstractBackground:  We used transnasal ultrathin esophagogastroduodenoscopy (UT‐EGD) to simultaneously perform realtime esophageal manometry and observe esophageal peristalsis.Methods:  The subjects were 22 healthy volunteers and 10 patients with proton‐pump inhibitor (PPI) dependent gastroesophageal reflux disease (GERD). We induced the primary peristaltic wave associated with swallowing and observed it endoscopically in the lower esophagus, at the same time measuring the intraesophageal pressure using a manometry catheter.Results:  The mean primary peristaltic amplitude associated with swallowing was 65.6 ± 47.4 mmHg in the volunteer group, and 28.0 ± 25.6 mmHg in the GERD group. Although peristalsis was observed endoscopically in the GERD group, in some cases incomplete peristalsis left a small but definite lumen and in these subjects, the primary peristaltic wave was almost flat.Conclusions:  The use of an ultrathin transnasal endoscope makes possible simultaneous manometry and endoscopic observation of the esophagus. This combination should prove useful in the evaluation of esophageal peristaltic function, such as in the diagnosing of GERD.
Taishotoyama Symposium Barriers to colorectal cancer screening: Economics, capacity and adherence
Authors: Inadomi John M 
Published: December 2008

AbstractColorectal cancer is the second leading cause of cancer death in the United States (U.S.). Fecal occult blood testing has been shown in randomized controlled trials to decrease mortality from colorectal cancer. The incidence and mortality associated with colorectal cancer has also been illustrated to be decreased with sigmoidoscopy and colonoscopy through case‐control and prospective cohort studies. Current research focuses on determining which screening strategy is optimal, and how we may improve implementation. Primary screening colonoscopy may be most effective; however, this strategy would require up to 2.6 procedures per patient over their lifetime. Based on the U.S. census this equates to 7.5 million procedures annually; the current capacity in the U.S. is insufficient to provide this strategy for all eligible persons. Computed tomographic or magnetic resonance colonography (virtual colonoscopy) may be an attractive alternative, but capacity is also insufficient for implementation. Moreover, since virtual colonoscopy is a diagnostic but not therapeutic test, economic analysis has illustrated that this strategy will not be cost‐effective compared to conventional colonoscopy unless it becomes much less expensive or is associated with greater adherence. Fecal DNA testing is a promising technology but current biomarkers are insufficiently sensitive to constitute a viable strategy. Newer tests such as self‐propelled, self‐guided endoscopes (Aer‐O‐Scope), ‘active’ endoscopes that decrease looping (Neoguide) and colon capsule endoscopy require formal evaluation through clinical trials prior to endorsement for colorectal cancer screening. Less than half of all eligible persons in the U.S. adhere to screening recommendations. Factors associated with screening adherence include the patient's level of education, income, access to health care, a family history of colon cancer, male gender and recommendation from the primary care physician. Conversely, non‐adherence is associated with concern over the bowel preparation and fear of discomfort and embarrassment with the procedure. Moreover, it appears that the presence of multiple strategies may be the cause of non‐adherence in many cases. Patients who are given a choice of several strategies are less likely to adhere to any strategy than patients who are recommended a single strategy. To increase adherence to colorectal cancer screening it is recommended that the patient be instructed to undergo the test to which they are most likely to adhere. Future research should focus on interventions to improve patient adherence to screening, and on developing accurate tests that will achieve high levels of adherence.
Proton pump inhibitors and recurrent bleeding in peptic ulcer disease
Authors: Tajima Akihiro , Koizumi Kazuhito , Suzuki Kazuyoshi , Higashi Naoko , Takahashi Morio , Shimada Tadahito , Terano Akira , Hiraishi Hideyuki , Kuwayama Hajime 
Published: December 2008

AbstractPeptic ulcer disease (PUD) is one of the main lesions responsible for upper gastrointestinal (GI) bleeding, as well as esophageal varices and Mallory–Weiss tear. Helicobacter pylori and non‐steroidal anti‐inflammatory drugs (NSAIDs)/aspirin are the major responsible causes. In cases of upper GI bleeding, urgent endoscopy is performed after stabilization of vital signs. There are several modalities for controlling bleeding in PUD, such as ethanol injection or hypertonic saline with epinephrine. Recurrent bleeding occurs in 20% of patients after endoscopic therapy. The combination of endoscopic intervention and a proton pump inhibitor (PPI) is necessary to achieve hemostasis of active bleeding. It has been reported that high‐dose omeprazole (80 mg bolus injection, then 8 mg/h continuous infusion for 72 h, then 40 mg/day orally for 1 week) can reduce recurrent bleeding, the need for surgery and mortality from hemorrhagic shock in patients with high‐risk peptic ulcer bleeding, as compared with standard‐dose omeprazole. The metabolism of PPIs is dependent upon P450 2C19 genotypes and the clinical usefulness of genotypic analysis remains to be determined.
Confocal endomicroscopy in patients with ulcerative colitis
Authors: Watanabe Osamu , Ando Takafumi , Maeda Osamu , Hasegawa Motofusa , Ishikawa Daisuke , Ishiguro Kazuhiro , Ohmiya Naoki , Niwa Yasumasa , Goto Hidemi 
Published: December 2008

AbstractBackground:  Confocal endomicroscopy is a new technology that provides microscopic images of cellular morphology in the gastrointestinal tract in vivo. In particular, confocal microendoscopy allows histological diagnosis during the endoscopic examination. We examined patients with ulcerative colitis (UC) using confocal endoscopy and investigated the features of confocal endomicroscopic images of inflamed and non‐inflamed rectal mucosa.Methods:  Seventeen patients with UC, 12 in the active phase and 5 in the non‐active phase, and 14 non‐UC control patients who had colon polyps or colon cancer underwent colonoscopy, during which fluorescence images of the rectal mucosa were obtained with confocal endomicroscopy. Histological findings of rectal biopsy specimens were compared with the microendoscopic images.Results:  Confocal microendoscopy allowed observation of cellular and subcellular structures. The crypts of normal colonic mucosa were small, round and regularly arranged, and the crypt lumens of the colonic glands were small and round. The crypts of colonic mucosa in non‐active UC were small, round and slightly irregular in arrangement and the crypt lumens of the colonic glands were small and round. Inflammatory cells and capillaries were visible in the lamina propria. The crypts of colonic mucosa in active UC were large, variously shaped and irregular in arrangement. The crypt lumens of the colonic glands were large and the crypt structure could not be recognized in some areas. Numerous inflammatory cells and capillaries were visible in the lamina propria.Conclusions:  Images taken with the confocal microendoscope provided information that was equivalent to conventional histology, and improve our understanding of the differences in rectal tissues (crypts, capillaries and inflammatory cells) between normal controls and active and non‐active UC patients during ongoing endoscopy.
Development and evaluation of the quality of life instrument in chronic liver disease patients with minimal hepatic encephalopathy
Authors: Zhou Ying‐qun , Chen Shi‐yao , Jiang Lin‐di , Guo Chuan‐yong , Shen Zhen‐yu , Huang Pei‐xing , Wang Ji‐yao 
Published: December 2008

AbstractObjectives:  The objective was to develop a valid and reliable health‐related quality of life (HRQOL) assessment tool to measure the functional and health status of patients with minimal hepatic encephalopathy (mHE).Methods:  Items potentially affecting the HRQOL of these patients were identified, based on the responses from 53 patients with minimal hepatic encephalopathy, from seven liver experts, four epidemiologists and from a PubMed search of the literature. Results were explored using factor analysis and redundant questions were eliminated. The final stated questionnaire was used in 178 patients with mHE to evaluate its reliability and validity.Results:  Thirty‐five items proved to be important for 32 respondents in the item reduction sample. The final instrument included five domains (30 items) which were shown as follows: physical functioning (8 items), psychological well‐being (7 items), symptoms/side effects (7 items), social functioning (4 items) and general‐health (4 items). An inter‐item correlation for each of the five domains ranged from 0.220 to 0.776, with a mean of 0.280. Cronbach's alpha for above five domains was 0.8775, 0.8446, 0.8360, 0.7087 and 0.7016 respectively. The test‐retest coefficients for the five domains were 0.94, 0.93, 0.96, 0.82 and 0.83 respectively. Factor analysis showed preservation of five components structure. Cumulative variance of principal components was 63.12%. Patients with more advanced disease seemed to have more impairment of their well‐being, especially in the symptoms/side effects domain.Conclusions:  The instrument is short, easy to administer and is of good validity and reliability in patients with mHE.