Functional lumen imaging of the gastrointestinal tract
Abstract This nonsystematic review aims to describe recent developments in the use of functional lumen imaging in the gastrointestinal tract stimulated by the introduction of the functional lumen imaging probe. When ingested food in liquid and solid form is transported along the gastrointestinal tract, sphincters provide an important role in the flow and control of these contents. Inadequate function of sphincters is the basis of many gastrointestinal diseases. Despite this, traditional methods of sphincter diagnosis and measurement such as fluoroscopy, manometry, and the barostat are limited in what they can tel...
Source: Journal of Gastroenterology - October 1, 2015 Category: Gastroenterology Source Type: research

An alternative option for “resect and discard” strategy, using magnifying narrow-band imaging: a prospective “proof-of-principle” study
Abstract Background The “resect and discard” strategy is beneficial for cost savings on screening and surveillance colonoscopy, but it has the risk to discard lesions with advanced histology or small invasive cancer (small advanced lesion; SALs). The aim of this study was to prove the principle of new “resect and discard” strategy with consideration for SALs using magnifying narrow-band imaging (M-NBI). Methods Patients undergoing colonoscopy at a tertiary center were involved in this prospective trial. For each detected polyp
Source: Journal of Gastroenterology - October 1, 2015 Category: Gastroenterology Source Type: research

Gastric cancer stem cells: evidence, potential markers, and clinical implications
Abstract Gastric cancer is a significant global health problem. It is the fifth most common cancer and third leading cause of cancer-related death worldwide (Torre et al. in CA Cancer J Clin 65(2):87–108, 2015). Despite advances in treatment, overall prognosis remains poor, due to tumour relapse and metastasis. There is an urgent need for novel therapeutic approaches to improve clinical outcomes in gastric cancer. The cancer stem cell (CSC) model has been proposed to explain the high rate of relapse and subsequent resistance of cancer to current systemic treatments (Vermeulen et al. in Lancet Oncol 13(2)...
Source: Journal of Gastroenterology - October 1, 2015 Category: Gastroenterology Source Type: research

Migration of splenic lymphocytes promotes liver fibrosis through modification of T helper cytokine balance in mice
Conclusions The present study demonstrated that Th2-dominant splenic lymphocytes migrate into the liver and promote liver fibrosis by shifting the cytokine balance towards Th2 dominance. Splenectomy suppresses the progression of fibrosis at least partly by restoring the Th1/Th2 balance. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 1, 2015 Category: Gastroenterology Source Type: research

Helicobacter pylori infection causes hepatic insulin resistance by the c-Jun/miR-203/SOCS3 signaling pathway
Conclusions Our results demonstrated that H. pylori infection induced hepatic insulin resistance by the c-Jun/miR-203/SOCS3 signaling pathway and provide possible implications with regard to resolving insulin resistance. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 1, 2015 Category: Gastroenterology Source Type: research

A thymine–adenine dinucleotide repeat polymorphism near IL28B is associated with spontaneous clearance of hepatitis C virus
Conclusions A long TA repeat in the promoter region of IL28B was associated with spontaneous HCV clearance. Although its efficacy may be limited in Japanese population because of its allele distribution, this novel genetic factor will be useful for predicting HCV clearance especially for the African Americans. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 1, 2015 Category: Gastroenterology Source Type: research

Risk of bleeding after endoscopic submucosal dissection for colorectal tumors in patients with continued use of low-dose aspirin
Conclusions Our data suggest that continued use of LDA increased the risk of bleeding after ESD for colorectal tumors compared with nonuse of anticoagulant/antiplatelets. No significant difference was seen between the LDA-continued group and the LDA-interrupted group. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 1, 2015 Category: Gastroenterology Source Type: research

Can serum albumin level affect the pharmacological action of tolvaptan in patients with liver cirrhosis? A post hoc analysis of previous clinical trials in Japan
Abstract Background Patients with hypoalbuminemia often fail to respond to increased doses of loop diuretics. We therefore performed a post hoc analysis to investigate the pharmacological action of tolvaptan and whether it is dependent on the serum albumin level. Methods This analysis was based on four previous clinical trials of tolvaptan in patients with liver cirrhosis who exhibited insufficient response to conventional diuretics. We analyzed the correlation between the change in the initial 24-h cumulative urine volume from baseline and the se...
Source: Journal of Gastroenterology - October 1, 2015 Category: Gastroenterology Source Type: research

Gastric cancer stem cells: evidence, potential markers, and clinical implications
Abstract Gastric cancer is a significant global health problem. It is the fifth most common cancer and third leading cause of cancer-related death worldwide (Torre et al. in CA Cancer J Clin 65(2):87–108, 2015). Despite advances in treatment, overall prognosis remains poor, due to tumour relapse and metastasis. There is an urgent need for novel therapeutic approaches to improve clinical outcomes in gastric cancer. The cancer stem cell (CSC) model has been proposed to explain the high rate of relapse and subsequent resistance of cancer to current systemic treatments (Vermeulen et al. in Lancet Oncol 13(2)...
Source: Journal of Gastroenterology - October 1, 2015 Category: Gastroenterology Source Type: research

Increase in plasma acyl ghrelin levels is associated with abatement of dyspepsia following Helicobacter pylori eradication
Abstract Background Ghrelin has been indicated as one of the etiological factors in functional dyspepsia (FD). Methods We analyzed 179 patients with FD (based on the Rome III criteria) and 103 asymptomatic healthy individuals (controls) who had undergone endoscopy at Seoul National University Bundang Hospital from February 2011 to June 2014. FD patients were classified into three groups by means of a self-reported questionnaire: patients with postprandial distress syndrome (PDS; n = 49), patients with epigastric pain syndrome (EPS; n =&nbs...
Source: Journal of Gastroenterology - September 28, 2015 Category: Gastroenterology Source Type: research

Vaniprevir plus peginterferon alfa-2b and ribavirin in treatment-naive Japanese patients with hepatitis C virus genotype 1 infection: a randomized phase III study
Abstract Background Vaniprevir is a potent macrocyclic hepatitis C virus (HCV) nonstructural protein 3/4A protease inhibitor. This phase III study evaluated the safety and efficacy of vaniprevir in combination with peginterferon alfa-2b and ribavirin (PR) for 24 weeks compared with PR alone for 48 weeks in treatment-naive Japanese patients with HCV genotype 1 infection. Methods Treatment-naive Japanese patients with HCV genotype 1 infection were randomly assigned to receive vaniprevir (300 mg twice daily) plus PR for 12 ...
Source: Journal of Gastroenterology - September 25, 2015 Category: Gastroenterology Source Type: research

Factors affecting recurrence and prognosis after R0 resection for colorectal cancer with peritoneal metastasis
Conclusions Harvesting of more than eight lymph nodes and administration of intense adjuvant chemotherapy after R0 surgery are recommended for greater prediction accuracy and improved prognosis. Intensive follow-up should be performed within 18 months after R0 surgery for colorectal cancer with synchronous peritoneal metastases. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - September 16, 2015 Category: Gastroenterology Source Type: research

Kupffer phase image of Sonazoid-enhanced US is useful in predicting a hypervascularization of non-hypervascular hypointense hepatic lesions detected on Gd-EOB-DTPA-enhanced MRI: a multicenter retrospective study
Conclusions Kupffer-phase images in Sonazoid-enhanced US and tumor diameter can predict hypervascularization of hypointense borderline lesions detected on hepatobiliary-phase Gd-EOB-DTPA-enhanced MRI. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - September 15, 2015 Category: Gastroenterology Source Type: research

Mouse model of proximal colon-specific tumorigenesis driven by microsatellite instability-induced Cre -mediated inactivation of Apc and activation of Kras
Conclusions These results demonstrated the validity of the G22Cre;Apc flox/flox ;Kras G12D mice as a new mouse model with oncogenic Kras activation. We believe that this model can facilitate efforts to define novel factors that contribute to the pathogenesis of human colorectal cancer with KRAS mutations. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - September 11, 2015 Category: Gastroenterology Source Type: research

N -Acetylglucosaminyltransferase V exacerbates murine colitis with macrophage dysfunction and enhances colitic tumorigenesis
Conclusions Overexpression of GnT-V exacerbated murine experimental colitis by inducing macrophage dysfunction, thereby enhancing colorectal tumorigenesis. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - September 8, 2015 Category: Gastroenterology Source Type: research

Role of gastrointestinal hormones in feeding behavior and obesity treatment
Abstract Food intake regulation is generally evaluated by many aspects consisting of complex mechanisms, including homeostatic regulatory mechanism, which is based on negative feedback, and hedonic regulatory mechanism, which is driven by a reward system. One important aspect of food intake regulation is the peripheral hormones that are secreted from the gastrointestinal tract. These hormones are secreted from enteroendocrine cells as feedback to nutrient and energy intake, and will communicate with the brain directly or via the vagus nerve. Gastrointestinal hormones are very crucial in maintaining a steady body w...
Source: Journal of Gastroenterology - September 7, 2015 Category: Gastroenterology Source Type: research

Long-term prognosis of patients with chronic hepatitis C who did not receive interferon-based therapy: causes of death and analysis based on the FIB-4 index
Abstract Background Interferon (IFN)-based therapy has been reported to reduce the liver-related mortality rate in patients with chronic hepatitis C virus (HCV) infection. However, predictors of survival and causes of death, including non-liver-related causes, have not been sufficiently investigated in chronic HCV patients who have not received IFN-based therapy. Methods A total of 1723 patients with chronic HCV infection who were not treated with IFN-based therapy were enrolled. Survival from liver-related diseases and non-liver-related diseases and cau...
Source: Journal of Gastroenterology - September 5, 2015 Category: Gastroenterology Source Type: research

The impact of PNPLA3 and JAZF1 on hepatocellular carcinoma in non-viral hepatitis patients with type 2 diabetes mellitus
Conclusions PNPLA3 and JAZF1 were associated with non-HBV and non-HCV-related HCC development among Japanese patients with T2DM. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - September 3, 2015 Category: Gastroenterology Source Type: research

ABCB4 mutations in adult patients with cholestatic liver disease: impact and phenotypic expression
Conclusions Cholangiopathies attributable to highly penetrant ABCB4 mutant alleles are identifiable in a substantial proportion of adults that generally have PFH-CLD. In PSC and ICC phenotypes, patients with MDR3 deficiency have early onset of disease. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - September 1, 2015 Category: Gastroenterology Source Type: research

Reply to the letter by Fujishiro et al. concerning “Controversy regarding gastric cancer and diabetes”
(Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - August 29, 2015 Category: Gastroenterology Source Type: research

Controversy regarding gastric cancer and diabetes
(Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - August 29, 2015 Category: Gastroenterology Source Type: research

Prevalence of nonalcoholic steatohepatitis in Japanese patients with morbid obesity undergoing bariatric surgery
Conclusion The prevalence of NASH was 77.5 % in this prospective Japanese cohort. The prevalence of NASH in Japanese morbidly obese patients was extremely high, and early intervention should be undertaken. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - August 28, 2015 Category: Gastroenterology Source Type: research

Vitamin K deficiency leads to exacerbation of murine dextran sulfate sodium-induced colitis
Conclusions Vitamin K exerts a protective effect against DSS colitis; this effect is associated with IL-6 downregulation. Vitamin K could be a potential treatment target for IBD. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - August 28, 2015 Category: Gastroenterology Source Type: research

Body mass index association with functional gastrointestinal disorders: differences between genders. Results from a study in a tertiary center
Abstract Background Obesity is considered as a risk factor for many functional gastrointestinal disorders. The aim of the study was to evaluate if functional digestive disorders are associated with specific body mass index groups and gender. Methods A total of 1074 patients (50.3 ± 16.5 years, 67 % females) filled out a standard Rome III questionnaire (79 % acceptance rate). The patients were assigned to five groups according to their body mass index: underweight (6 %), normal (49 %), overweight (28 %), obes...
Source: Journal of Gastroenterology - August 12, 2015 Category: Gastroenterology Source Type: research

Significance of variants associated with resistance to NS5A inhibitors in Japanese patients with genotype 1b hepatitis C virus infection as evaluated using cycling-probe real-time PCR combined with direct sequencing
Conclusions NS5A-Y93H mutation was associated with sex, serum AFP levels, and IL28B-related gene polymorphisms in patients infected with genotype 1b HCV. The indications for NS5A inhibitor use should be determined based on these factors, since mutant strains seem to be sensitive to interferon. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - August 6, 2015 Category: Gastroenterology Source Type: research

Effect of PNPLA3 rs738409 variant (I148 M) on hepatic steatosis, necroinflammation, and fibrosis in Japanese patients with chronic hepatitis C
Conclusions The PNPLA3 rs738409 variant influences histological liver damage in Japanese patients with chronic hepatitis C. The G allele homozygotes are at higher risk for hepatic steatosis, severe necroinflammation, and advanced fibrosis. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - August 1, 2015 Category: Gastroenterology Source Type: research

The impact of an inosine triphosphate pyrophosphatase genotype on bilirubin increase in chronic hepatitis C patients treated with simeprevir, pegylated interferon plus ribavirin
Conclusions Hyperbilirubinemia develops at early time points after simeprevir administration in most cases and is dependent on the ITPA genotype. Careful attention should be paid to hyperbilirubinemia, which occurs at later time points or in patients with an ITPA non-CC genotype so that a diagnosis of liver damage with hyperbilirubinemia is not missed. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - July 30, 2015 Category: Gastroenterology Source Type: research

Endoscopic and clinical evaluation of treatment and prognosis of Cronkhite–Canada syndrome: a Japanese nationwide survey
Conclusions The prognosis of CCS has greatly improved through the use of improved medical treatment. Although CCS continues to be relentlessly progressive, carrying a high cancer risk, a sufficient dose and duration of corticosteroid therapy accompanied by nutritional support and periodic endoscopic surveillance appears to improve its natural history. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - July 28, 2015 Category: Gastroenterology Source Type: research

Emergence of hepatitis C virus NS5A L31V plus Y93H variant upon treatment failure of daclatasvir and asunaprevir is relatively resistant to ledipasvir and NS5B polymerase nucleotide inhibitor GS-558093 in human hepatocyte chimeric mice
Conclusions Treatment failure with asunaprevir/daclatasvir may limit further treatment options. This population may represent a growing unmet medical need. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - July 25, 2015 Category: Gastroenterology Source Type: research

Suppression of SHIP2 contributes to tumorigenesis and proliferation of gastric cancer cells via activation of Akt
Conclusions This study demonstrates, for the first time, that SHIP2 is frequently downregulated in gastric cancer, and reduced SHIP2 expression promotes tumorigenesis and proliferation of gastric cancer via activation of the PI3K/Akt signaling. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - July 23, 2015 Category: Gastroenterology Source Type: research

Beneficial effects of combined ursodeoxycholic acid and angiotensin-II type 1 receptor blocker on hepatic fibrogenesis in a rat model of nonalcoholic steatohepatitis
Conclusions UDCA and ARB have a synergistic repressive effect on hepatic fibrogenesis by counteracting endotoxemia induced by intestinal barrier dysfunction and suppressing the activation of Ac-HSC. Because both agents are currently used in clinical practice, combined UDCA and ARB may represent a promising novel therapeutic approach for NASH. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - July 21, 2015 Category: Gastroenterology Source Type: research

Evaluation of inflammation-based prognostic scores in patients undergoing hepatobiliary resection for perihilar cholangiocarcinoma
Abstract Background Inflammation-based prognostic scores have prognostic value in several kinds of cancer. However, little is known about their value in perihilar cholangiocarcinoma. We evaluated whether inflammation-based prognostic scores are associated with survival of patients with perihilar cholangiocarcinoma. Methods Inflammation-based scores (i.e., the modified Glasgow Prognostic Score (mGPS), neutrophil–lymphocyte ratio, platelet–lymphocyte ratio, and prognostic nutritional index) were retrospectively evaluated in 534 patients who und...
Source: Journal of Gastroenterology - July 18, 2015 Category: Gastroenterology Source Type: research

Clinical pharmacology of daikenchuto assessed by transit analysis using radiopaque markers in patients with colon cancer undergoing open surgery: a multicenter double-blind randomized placebo-controlled study (JFMC39-0902 additional study)
Conclusions Daikenchuto has a positive effect on the resolution of delayed gastric emptying, but has a limited effect on the resolution of postoperative paralytic ileus after open surgery in patients with sigmoid or rectosigmoid cancer. Daikenchuto may contribute to early oral intake in the postoperative course. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - July 11, 2015 Category: Gastroenterology Source Type: research

First trough level of infliximab at week 2 predicts future outcomes of induction therapy in ulcerative colitis—results from a multicenter prospective randomized controlled trial and its post hoc analysis
Abstract Background Infliximab (IFX) is one of the treatments of choice for corticosteroid-refractory and corticosteroid-dependent ulcerative colitis (UC). A high serum trough level of IFX (TL) is reported to be associated with sustained efficacy during maintenance treatment. As part of a phase 3 randomized controlled trial of IFX in UC, we assessed the predictive value of the first TL at week 2 for short- and long-term response. Methods Patients received intravenous IFX 5 mg/kg or placebo at weeks 0, 2, and 6. Patients with evidence of a response b...
Source: Journal of Gastroenterology - July 11, 2015 Category: Gastroenterology Source Type: research

Recurrent Clostridium difficile infection and the microbiome
Abstract The diverse and densely populated gastrointestinal microbiota is essential for the regulation of host physiology and immune function. As our knowledge of the composition and function of the intestinal microbiota continues to expand, there is new interest in using these developments to tailor fecal microbiota transplantation (FMT) and microbial ecosystem therapeutics (MET) for a variety of diseases. The potential role of FMT and MET in the treatment of Clostridium difficile infection (CDI)—currently the leading nosocomial gastrointestinal infection—has proven highly effective for...
Source: Journal of Gastroenterology - July 8, 2015 Category: Gastroenterology Source Type: research

Current status of preoperative biliary drainage
Abstract Preoperative biliary drainage (PBD) has been thought to be preferable regardless of the site of biliary strictures, e.g., distal or proximal strictures because PBD by endoscopy or interventional radiology decreases postoperative mortality and morbidity rates. However, recently, several studies have revealed that PBD strategy showed an increased mortality rate or a high frequency of surgical site infection. Herein, we reviewed reports in the literature regarding the current status of PBD and investigated the effects of PBD on patients with distal and proximal biliary obstructions due to potentially resecta...
Source: Journal of Gastroenterology - July 3, 2015 Category: Gastroenterology Source Type: research

Role of epithelial cells in the pathogenesis and treatment of inflammatory bowel disease
Abstract In the past decades, continuous effort has been paid to deeply understanding the pathophysiology of inflammatory bowel diseases (IBD), such as ulcerative colitis or Crohn’s disease. As the disease typically arises as chronic inflammation of the gastrointestinal mucosa, research has been focused on how such an uncontrolled, deleterious immune response may arise and persist in a certain cohort of patients. Based on those immunologic analyses, the establishment of anti-TNF-α therapy, and the following series of biologic agents achieved great success and dramatically changed the therapeutic strate...
Source: Journal of Gastroenterology - July 3, 2015 Category: Gastroenterology Source Type: research

Comparison of gadoxetic acid-enhanced magnetic resonance imaging and contrast-enhanced computed tomography with histopathological examinations for the identification of hepatocellular carcinoma: a multicenter phase III study
Abstract Background Gadoxetic acid-enhanced magnetic resonance imaging (MRI) has an important role in preoperative evaluation of hepatocellular carcinoma (HCC). However, no studies have prospectively performed intraindividual comparison of gadoxetic acid-enhanced 3T MRI and multidetector-row computed tomography (MDCT) with histopathological examination for the detection of HCCs. We prospectively compared the efficacies of gadoxetic acid-enhanced MRI and multiphasic contrast-enhanced MDCT with that of histopathological examination, used as a reference standard, for the detection of HCC in surgi...
Source: Journal of Gastroenterology - July 1, 2015 Category: Gastroenterology Source Type: research

A novel method for screening colorectal cancer by infrared spectroscopy of peripheral blood mononuclear cells and plasma
Conclusions Joint analysis of the biochemical profile of two blood components rather than a single biomarker is a promising strategy for early detection of CRC. Additional studies are required to validate our preliminary clinical results. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - June 26, 2015 Category: Gastroenterology Source Type: research

Evaluation of Kampo medicine in the clinical practice guideline for irritable bowel syndrome
(Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - June 23, 2015 Category: Gastroenterology Source Type: research