Recent understanding of the pathophysiology of functional dyspepsia: role of the duodenum as the pathogenic center
AbstractOver almost 30  years since functional dyspepsia (FD) was defined, researchers have endeavored to elucidate the pathophysiology of functional gastrointestinal disorders. Now a consensus is emerging that the gastric symptoms of FD are caused mainly by gastric motility abnormalities and gastric hypersensitivity. Th e involvement of other causative factors including acid,Helicobacter pylori, psychological factors, and diet has been debated, but how they are involved in the manifestation of dyspeptic symptoms remains unclear. We believe that most of those factors cause FD symptoms by inducing gastric motility abno...
Source: Journal of Gastroenterology - February 14, 2019 Category: Gastroenterology Source Type: research

Comprehensive analysis of genetic aberrations linked to tumorigenesis in regenerative nodules of liver cirrhosis
ConclusionAnalyses of RNs constructing cirrhotic liver indicated that a variety of genetic aberrations accumulate in the cirrhotic liver before the development of clinically and histologically overt HCC. These aberrations in RNs could provide the basis of tumorigenesis in patients with liver cirrhosis. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - February 12, 2019 Category: Gastroenterology Source Type: research

Combination treatment with highly bioavailable curcumin and NQO1 inhibitor exhibits potent antitumor effects on esophageal squamous cell carcinoma
ConclusionsThese findings suggest the potential usefulness of THC and its combination with NQO1 inhibitor as a therapeutic option for ESCC. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - February 8, 2019 Category: Gastroenterology Source Type: research

Serum aldo –keto reductase family 1 member B10 predicts advanced liver fibrosis and fatal complications of nonalcoholic steatohepatitis
ConclusionAKR1B10 is a useful serum biomarker for advanced liver fibrosis in NASH and, combined with serum WFA(+)-M2BP, can predict HCC development, gastroesophageal varix formation, and poor prognosis. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - February 1, 2019 Category: Gastroenterology Source Type: research

Acknowledgements
(Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - January 30, 2019 Category: Gastroenterology Source Type: research

Combinations of two drugs among NS3/4A inhibitors, NS5B inhibitors and non-selective antiviral agents are effective for hepatitis C virus with NS5A-P32 deletion in humanized-liver mice
ConclusionTherapies combining at least two drugs among NS3/4A inhibitors, NS5B inhibitors and non-selective antiviral agents may be effective for HCV-infected patients with NS5A-P32del. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - January 25, 2019 Category: Gastroenterology Source Type: research

Liver disease in adults with severe alpha-1-antitrypsin deficiency
AbstractBackgroundThe proportion of adults with liver disease due to severe alpha-1-antitrypsin deficiency (AATD), with PiZZ phenotype, is not clear. The markers of the AATD liver disease, how it progresses, and measures for its prevention have not been established. The aim of this study was to analyze the risk of liver disease in individuals with severe AAT deficiency (PiZZ).MethodsLongitudinal clinical and laboratory data were obtained from the Swedish National registers, by cross-linkage between the Swedish national AATD register, the Swedish National Patient Register, the National Cancer Register and the National Cause...
Source: Journal of Gastroenterology - January 24, 2019 Category: Gastroenterology Source Type: research

Proton pump inhibitor monotherapy is effective to attenuate dyspepsia symptoms associated with gastroesophageal reflux disease: a multicenter prospective observational study
ConclusionFD symptoms associated with more severe GERD symptoms are supposed to be acid-related dyspepsia, and PPI monotherapy is recommended as the treatment of first choice in such patients. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - January 23, 2019 Category: Gastroenterology Source Type: research

Molecular subtype switching in early-stage gastric cancers with multiple occurrences
ConclusionsDespite multiple tumors occurring in the same patient simultaneously or several years apart, clonal origin was totally different. ‘Switching’ or ‘mixing’ of dMMR and pMMR, EBV or CIN occurred, which had clinical relevance with regard to immunotherapy. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - January 21, 2019 Category: Gastroenterology Source Type: research

Efficacy and safety of a crystalline lactulose preparation (SK-1202) in Japanese patients with chronic constipation: a randomized, double-blind, placebo-controlled, dose-finding study
AbstractBackgroundClinical evidence of lactulose for chronic constipation in Japan was lacking. We performed a randomized, double-blind, placebo-controlled, dose-finding study in Japanese patients with chronic constipation to estimate the optimal clinical dose of lactulose.MethodsOverall, 250 patients were randomized to receive SK-1202 (13, 26, or 39  g/day, as crystalline lactulose dosage) or placebo twice daily (morning and evening) orally for 2 weeks. The primary endpoint was the change from baseline frequency of spontaneous bowel movements (SBMs) at Week 1. The secondary endpoints included the change from bas...
Source: Journal of Gastroenterology - January 14, 2019 Category: Gastroenterology Source Type: research

Alcoholic and non-alcoholic steatohepatitis: global perspective and emerging science
AbstractAlcohol and high-fat diet are two major risk factors responsible for metabolic diseases, which are manifested as steatohepatitis and liver cancer in the liver, and chronic pancreatitis and pancreatic adenocarcinoma (PDAC) in the pancreas. These metabolic diseases are becoming increasingly prevalent around the globe, and more importantly, their two major etiologies commonly coexist to precipitate the disease processes. To highlight the importance of these metabolic diseases, Japanese Society of Gastroenterology (JSGE) and National Institute on Alcoholism and Alcohol Abuse of National Institute of Health cosponsored ...
Source: Journal of Gastroenterology - January 14, 2019 Category: Gastroenterology Source Type: research

NS5A-P32 deletion as a factor involved in virologic failure in patients receiving glecaprevir and pibrentasvir
ConclusionsGLE/PIB was effective for patients with HCV who failed to achieve an SVR after prior DAA therapies except in those with GT-1b HCV carrying NS5A-P32del even when such strains became undetectable by direct sequencing. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - January 5, 2019 Category: Gastroenterology Source Type: research

Epidemiological analysis of achalasia in Japan using a large-scale claims database
AbstractBackgroundAchalasia is a well-known esophageal motility disorder, but epidemiological studies in Japan are lacking. We investigated the incidence and period prevalence of achalasia in Japan, including the rate of coexistence of esophageal carcinoma, and evaluated treatment trends.MethodsTo estimate the nationwide number of patients with achalasia, a large-scale insurance claims database from 2005 to 2017 were used for our analyses. Patients with achalasia and coexistence of esophageal carcinoma were identified based on the diagnosis code registered. Interventional treatment was also evaluated.ResultsOf the total 5,...
Source: Journal of Gastroenterology - January 3, 2019 Category: Gastroenterology Source Type: research

Feasibility of a simplified narrow-band imaging classification system for Barrett ’s esophagus for novice endoscopists
AbstractBackgroundNarrow-band imaging (NBI) classifications for Barrett ’s esophagus have been proposed for the detection of early esophageal adenocarcinoma. We developed a simplified classification system with demonstrated high diagnostic accuracy and reproducibility among experienced endoscopists, but the feasibility of this system among novice endoscopists was uncl ear.MethodsIn the present study, eight novice endoscopists with no experience of magnification endoscopy were asked to review 248 images of Barrett ’s esophagus (72 dysplastic, 176 non-dysplastic) obtained using high-definition magnification endos...
Source: Journal of Gastroenterology - January 2, 2019 Category: Gastroenterology Source Type: research

Marked impact of tumor location on the appropriate cutoff values and the prognostic significance of the lymph node ratio in stage III colon cancer: a multi-institutional retrospective analysis
ConclusionsWe demonstrated the difference in the appropriate cutoffs of LNR between right and left colon cancer. Categorization by location-specific cutoff of LNR may be useful for risk stratification of patients with stage III cancer. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - January 1, 2019 Category: Gastroenterology Source Type: research

Establishment of a system to evaluate the therapeutic effect and the dynamics of an investigational drug on ulcerative colitis using human colonic organoids
ConclusionsThe establishment of in vitro UC model using human colonic organoid could reveal the effects and targets of investigational drugs in intestinal epithelial cells under inflammation conditions. Further maturation of this system might be more efficient to predict the effect on UC, as compared with the use of animal model, for the development of new drugs. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - January 1, 2019 Category: Gastroenterology Source Type: research

Long-awaited treatment for hepatitis C virus decompensated cirrhosis
(Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - January 1, 2019 Category: Gastroenterology Source Type: research

Gut microbiota dysbiosis worsens the severity of acute pancreatitis in patients and mice
ConclusionsThis study identifies the gut microbiota as an important mediator during AP and its dysbiosis is associated with AP severity, which suggests its role as potential therapeutic target. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - December 5, 2018 Category: Gastroenterology Source Type: research

Usefulness of transabdominal ultrasonography for assessing ulcerative colitis: a prospective, multicenter study
AbstractBackgroundTransabdominal ultrasonography (US) has been reported to be a useful tool for evaluating ulcerative colitis (UC) although with less well-established data than for Crohn ’s disease. This prospective multicenter study aimed to establish the usefulness of US compared with colonoscopy (CS) for assessing disease extent and activity of UC.MethodsAltogether, 173 patients with UC were prospectively enrolled, among whom 156 were eligible for this study. All patients underwent US and CS within 2  days at five facilities. We divided the colon into six segments and examined each segment and the rectum usin...
Source: Journal of Gastroenterology - December 5, 2018 Category: Gastroenterology Source Type: research

Pancreatic cancer arising from the remnant pancreas after pancreatectomy: a multicenter retrospective study by the Kyushu Study Group of Clinical Cancer
ConclusionsThis study found that repeated pancreatectomy for remnant PC can prolong patient survival, andRAS mutation analysis indicated that many remnant PCs are developed from metachronous multifocal origins. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - December 4, 2018 Category: Gastroenterology Source Type: research

Independent and additive effects of PNPLA3 and TM6SF2 polymorphisms on the development of non-B, non-C hepatocellular carcinoma
This study was aimed at evaluating the association between single nucleotide polymorphisms (SNPs) in thePNPLA3,NCAN,TM6SF2 andMBOAT7 and hepatocellular carcinoma (HCC) development in Thai patients according to underlying etiologies of liver disease.MethodsThese SNPs were determined by allelic discrimination in blood samples of 105 healthy controls and 530 patients with HCC [270 with hepatitis B virus (HBV-HCC), 131 with hepatitis C virus (HCV-HCC), and 129 with non-B, non-C HCC (NBNC-HCC) matched for age and gender].ResultsG allele ofPNPLA3 rs738409 variant was significantly higher in NBNC-HCC (49%) compared to healthy con...
Source: Journal of Gastroenterology - November 30, 2018 Category: Gastroenterology Source Type: research

A nationwide survey on non-B, non-C hepatocellular carcinoma in Japan: 2011 –2015 update
ConclusionsThe proportion of HCC patients with non-viral etiologies continues to increase in Japan. Lifetime total amount of alcohol consumption may be a risk factor. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - November 29, 2018 Category: Gastroenterology Source Type: research

Characterization of fungal dysbiosis in Japanese patients with inflammatory bowel disease
ConclusionThe fecal fungal microbiome of a Japanese population differed considerably from that of a Western population. We identified fungal dysbiosis in Japanese patients with IBD. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - November 26, 2018 Category: Gastroenterology Source Type: research

Fluid sequestration is a useful parameter in the early identification of severe disease of acute pancreatitis
ConclusionsFS24 was a simple and easily calculated parameter with high predictive accuracy for discriminating patients who needed intensive care. Patients with FS24  ≥ 1.6 L had an increased risk of developing severe disease. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - November 26, 2018 Category: Gastroenterology Source Type: research

Short- and long-term outcomes of endoscopic submucosal dissection for early gastric cancer in the remnant stomach after gastrectomy
ConclusionsThe long-term outcomes of ESD for EGC in the remnant stomach were favorable. However, ESD involving the anastomosis was a technically demanding procedure due to the low en bloc resection rate and high perforation rate. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - November 9, 2018 Category: Gastroenterology Source Type: research

Response to the letter by Dr. Naoya Yamada, and Dr. Koichi Mizuta regarding our manuscript: “Mac-2 binding protein glycan isomer (M2BPGi) is a new serum biomarker for assessing liver fibrosis: more than a biomarker of liver fibrosis”
(Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - November 9, 2018 Category: Gastroenterology Source Type: research

Advanced assessment of serum Mac-2 binding protein glycosylation isomer in patients with biliary atresia
(Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - November 9, 2018 Category: Gastroenterology Source Type: research

Diagnostic efficacy of dual-focus endoscopy with narrow-band imaging using simplified dyad criteria for superficial esophageal squamous cell carcinoma
AbstractBackgroundOur previous studies have shown the diagnostic utility of a newly developed dual-focus endoscope with narrow-band imaging (DF-NBI) and simplified dyad criteria for detection of superficial esophageal squamous cell carcinoma (SESCC). This clinical trial aimed to study the diagnostic efficacy of DF-NBI with dyad criteria for detecting SESCC compared to white light imaging (WLI).MethodsThis was a single-arm prospective comparative trial. We enrolled 170 consecutive high-risk patients for esophageal squamous cell carcinoma. Patients were initially examined with WLI by one independent endoscopist and then the ...
Source: Journal of Gastroenterology - November 8, 2018 Category: Gastroenterology Source Type: research

Impact of endoscopic ultrasonography on diagnosis of pancreatic cancer
AbstractAccumulated evidence has revealed that endoscopic ultrasonography (EUS) has had a great impact on the clinical evaluation of pancreatic cancers. EUS can provide high-resolution images of the pancreas with a quality regarded as far surpassing that achieved on transabdominal ultrasound (US), computed tomography (CT), or magnetic resonance imaging (MRI). EUS is particularly useful for the detection of small pancreatic lesions, while EUS and its related techniques such as contrast-enhanced EUS (CE-EUS), EUS elastography, and EUS-guided fine needle aspiration (EUS-FNA) are also useful in the differential diagnosis of so...
Source: Journal of Gastroenterology - November 7, 2018 Category: Gastroenterology Source Type: research

Antimicrobial proteins: intestinal guards to protect against liver disease
AbstractAlterations of gut microbes play a role in the pathogenesis and progression of many disorders including liver and gastrointestinal diseases. Both qualitative and quantitative changes in gut microbiota have been associated with liver disease. Intestinal dysbiosis can disrupt the integrity of the intestinal barrier leading to pathological bacterial translocation and the initiation of an inflammatory response in the liver. In order to sustain symbiosis and protect from pathological bacterial translocation, antimicrobial proteins (AMPs) such as a-defensins and C-type lectins are expressed in the gastrointestinal tract....
Source: Journal of Gastroenterology - November 3, 2018 Category: Gastroenterology Source Type: research

Deletion of IP 3 R1 by Pdgfrb-Cre in mice results in intestinal pseudo-obstruction and lethality
ConclusionsHere, we provided a novel mouse model for impaired GI motility and demonstrated that IP3R1 plays a critical role in regulating physiological function of GI tract in vivo. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 31, 2018 Category: Gastroenterology Source Type: research

TLL1 variant associated with development of hepatocellular carcinoma after eradication of hepatitis C virus by interferon-free therapy
ConclusionsTheTLL1 variant was independently associated with HCC development after HCV eradication by IFN-free regimen. It might be involved in hepatic fibrogenesis and thereby carcinogenesis. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 31, 2018 Category: Gastroenterology Source Type: research

A multicenter observational study on the clinicopathological features of gastric cancer in young patients
This study aimed to clarify the clinicopathological features and prognosis of gastric cancer in young patients.MethodsFrom January 2007 to January 2016, patients in their 20s and 30s who were diagnosed with primary gastric cancer at 4 hospitals were enrolled. Their clinical characteristics and prognosis were evaluated.ResultsThe total number of patients was 72. The median age was 36  years, and the ratio of males to females was 1:1. The dominant histological type was undifferentiated type (66/72, 92%).Helicobacter pylori (H. pylori) was positive in 81% (54/67). Although there were some asymptomatic patients in stages ...
Source: Journal of Gastroenterology - October 29, 2018 Category: Gastroenterology Source Type: research

Real-world efficacy of glecaprevir plus pibrentasvir for chronic hepatitis C patient with previous direct-acting antiviral therapy failures
ConclusionsGLE/PIB treatment for HCV-infected patients who did not respond to prior DAA treatments was highly effective regardless of liver fibrosis stage. However, some genotype 1b HCV-infected patients, especially those with NS5A-P32del, may have low susceptibility to the treatment. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 17, 2018 Category: Gastroenterology Source Type: research

Sequential H. pylori eradication and radiation therapy with reduced dose compared to standard dose for gastric MALT lymphoma stages IE & amp; II1E: a prospective randomized trial
ConclusionsMostH. pylori-positive low grade gastric MALT lymphoma stage IE and II1E respond with stable CR after eradication therapy. In patients with refractory disease orH. pylori negative low grade gastric MALT lymphoma a dosage-reduced radiation therapy with 25.2  Gy is an effective standard dose in stage IE and II1E.Trial registrationClinicalTrials.gov: NCT00154440. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 16, 2018 Category: Gastroenterology Source Type: research

Predictive factors of the treatment outcome in patients with advanced biliary tract cancer receiving gemcitabine plus cisplatin as first-line chemotherapy
AbstractBackgroundFew studies have clearly identified the prognostic factors in patients with advanced biliary tract cancer (BTC) receiving gemcitabine plus cisplatin (GC) which is acknowledged as standard chemotherapy regimen.ObjectivesThe aim of this study was to identify predictive factors of the overall survival (OS) in advanced BTC patients receiving GC therapy.MethodsData of 307 patients with advanced BTC who received GC therapy as the first-line chemotherapy at our institution from January 2007 to June 2017 were reviewed retrospectively. The patients were randomly assigned to the investigation or the validation data...
Source: Journal of Gastroenterology - October 8, 2018 Category: Gastroenterology Source Type: research

Linked color imaging can enhance recognition of early gastric cancer by high color contrast to surrounding gastric intestinal metaplasia
ConclusionsLCI images have higher color contrast between early gastric cancers and surrounding mucosa compared to WLI. A characteristic purple color around gastric cancers using LCI represents intestinal metaplasia. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 5, 2018 Category: Gastroenterology Source Type: research

Clinical significance of hepatic steatosis according to coronary plaque morphology: assessment using controlled attenuation parameter
ConclusionCAP-defined NAFLD is independently associated with coronary plaques, especially non-calcified plaques. The association between NAFLD and non-calcified plaques suggests that particular attention should be given to the subjects with NAFLD for primary prevention. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 4, 2018 Category: Gastroenterology Source Type: research

Detection of gastritis by a deep convolutional neural network from double-contrast upper gastrointestinal barium X-ray radiography
ConclusionsDeep learning techniques may be effective for evaluation of gastritis/non-gastritis. Collaborative use of DCNN-based gastritis detection systems and ABC (D) stratification will provide more reliable gastric cancer risk information. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 3, 2018 Category: Gastroenterology Source Type: research

A scoring model for predicting advanced colorectal neoplasia in a screened population of asymptomatic Japanese individuals
This study was performed to build a new useful scoring model for CRC screening.MethodsData were reviewed from 5218 asymptomatic Japanese individuals who underwent their first screening colonoscopy. Multivariate logistic regression was used to investigate risk factors for advanced colorectal neoplasia (ACN), and a new scoring model for the prediction of ACN was developed based on the results. The discriminatory capability of the new model and the modified APCS score were assessed and compared. Internal validation was also performed.ResultsACN was detected in 225 participants. An 8-point scoring model for the prediction of A...
Source: Journal of Gastroenterology - October 1, 2018 Category: Gastroenterology Source Type: research

Germline variants in pancreatic cancer patients with a personal or family history of cancer fulfilling the revised Bethesda guidelines
ConclusionsThese findings showed that these guidelines could be useful for identifying PC patients with DNA damage repair genes as well as MMR genes. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 1, 2018 Category: Gastroenterology Source Type: research

Induction of PIR-A/B + DCs in the in vitro inflammatory condition and their immunoregulatory function
ConclusionsPIR-A/B+ cDCs induced in an in vitro inflammatory environment model showed a suppressive function against activated T cells by producing an inhibitory cytokine. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 1, 2018 Category: Gastroenterology Source Type: research

Risk assessment of metachronous squamous cell carcinoma after endoscopic resection for esophageal carcinoma based on the genetic polymorphisms of alcoholdehydrogense-1B aldehyde dehydrogenase-2: temperance reduces the risk
ConclusionsContinued alcohol consumption is an important risk factor for the onset of metachronous SCC and is a risk factor for the third and subsequent SCCs. Strict advice in favor of temperance is crucial. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 1, 2018 Category: Gastroenterology Source Type: research

Real-world efficacy and safety of ledipasvir and sofosbuvir in patients with hepatitis C virus genotype 1 infection: a nationwide multicenter study by the Japanese Red Cross Liver Study Group
AbstractBackgroundWe aimed to describe the real-world efficacy and safety of combination therapy with ledipasvir and sofosbuvir (LDV/SOF) for chronic hepatitis C virus (HCV) genotype 1 (GT1) infection.MethodsThis retrospective analysis of a prospective, nationwide, multicenter registry included GT1-infected patients treated with LDV/SOF for 12  weeks. We assessed the rate of sustained virological response at 12 weeks post-treatment (SVR12), incidence of adverse events, and serum markers of hepatocellular carcinoma (HCC).ResultsAmong the 1461 patients included (mean age, 69  years; 29.5% aged > &thi...
Source: Journal of Gastroenterology - October 1, 2018 Category: Gastroenterology Source Type: research

The “real-world” efficacy and safety of DAAs for the treatment of HCV patients throughout Japan
(Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 1, 2018 Category: Gastroenterology Source Type: research

Is patient-reported outcome improved by nalfurafine hydrochloride in patients with primary biliary cholangitis and refractory pruritus? A post-marketing, single-arm, prospective study
ConclusionsThis study demonstrated that nalfurafine improved pruritus in patients with PBC, independent of their clinical characteristics, but had a limited effect on the PRO. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - October 1, 2018 Category: Gastroenterology Source Type: research

Helicobacter pylori status and risks of metachronous recurrence after endoscopic resection of early gastric cancer: a systematic review and meta-analysis
In conclusion, based on the best available evidence, eradication ofH. pylori can provide protection against secondary gastric neoplasm, and this quantitative benefit seemed greater than among asymptomatic individuals. Metachronous risk seems comparable betweenH. pylori-eradicated and -negative population, or betweenH. pylori-negative and -persistent patients. (Source: Journal of Gastroenterology)
Source: Journal of Gastroenterology - September 24, 2018 Category: Gastroenterology Source Type: research