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  • 1
    Online Resource
    Online Resource
    Clinicopathological and Endoscopic Features of Raspberry-Shaped Gastric Cancer in Helicobacter pylori-Uninfected Patients
    S. Karger AG ; 2021
    In:  Digestion Vol. 102, No. 1 ( 2021), p. 41-48
    Details
    In: Digestion, S. Karger AG, Vol. 102, No. 1 ( 2021), p. 41-48
    Abstract: Background: Gastric adenocarcinoma of foveolar type (GA-FV) is a raspberry-shaped gastric cancer (RSGC) and garners much attention as H. pylori (Hp)-uninfected gastric cancer. However, the classification and clinicopathological and endoscopic features of RSGCs in Hp-uninfected patients are poorly defined. We designed a new histopathological classification of RSGC and compared them via endoscopic and clinicopathological characteristics. Summary: From 996 patients with early gastric cancers resected by endoscopy in our hospital, we studied 24 RSGC lesions from 21 (2.4%) Hp-uninfected patients. RSGCs were classified into 3 histological types as follows: GA-FV (n = 19), gastric adenocarcinoma of fundic gland type (GA-FG, n = 2), and gastric adenocarcinoma of fundic gland mucosa type (GA-FGM, n = 3). Most of the lesions were found at the greater curvature of the upper or middle third of the stomach. GA-FV lesions were homogeneously reddish and frequently accompanied with a whitish area around the tumor and an irregular microvascular (MV) pattern; these features were confirmed histopathologically by the presence of homogeneous neoplastic foveolar epithelium with foveolar hyperplasia around the tumors. GA-FG lesions might be heterogeneously reddish with a submucosal tumor shape and regular MV pattern; these were confirmed by the presence of covered or mixed nonneoplastic epithelium on deeper regions of tumors. GA-FGM lesions might be homogeneously reddish and occasionally had a submucosal tumor shape and irregular MV pattern; these were confirmed by the presence of homogeneous neoplastic foveolar epithelium on deeper regions of the tumors. Key Messages: RSGCs in Hp-uninfected patients are classified into 3 histopathological types. For accurate diagnosis of RSGCs, it may be necessary to fully understand endoscopic features of these lesions based on these histological characteristics and to take a precise biopsy.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000511907
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1482218-0
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  • 2
    Online Resource
    Online Resource
    A Diagnostic Predictive Model of Bronchoscopy with Radial Endobronchial Ultrasound for Peripheral Pulmonary Lesions
    S. Karger AG ; 2022
    In:  Respiration Vol. 101, No. 12 ( 2022), p. 1148-1156
    Details
    In: Respiration, S. Karger AG, Vol. 101, No. 12 ( 2022), p. 1148-1156
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Several factors have been reported to affect the diagnostic yield of bronchoscopy with radial endobronchial ultrasound (R-EBUS) for peripheral pulmonary lesions (PPLs). However, it is difficult to accurately predict the diagnostic potential of bronchoscopy for each PPL in advance. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 Our objective was to establish a predictive model to evaluate the diagnostic yield before the procedure. 〈 b 〉 〈 i 〉 Method: 〈 /i 〉 〈 /b 〉 We retrospectively analysed consecutive patients who underwent diagnostic bronchoscopy with R-EBUS between April 2012 and October 2015. We assessed the factors that were predictive of successful bronchoscopic diagnosis of PPLs with R-EBUS using a multivariable logistic regression model. The accuracy of the predictive model was evaluated using the receiver operator characteristic area under the curve (ROC AUC). Internal validation was analysed using 10-fold stratified cross-validation. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 We analysed a total of 1,634 lesions; the median lesion size was 25.0 mm. Of these, 1,138 lesions (69.6%) were successfully diagnosed. In the predictive logistic model, significant factors affecting the diagnostic yield were lesion size, lesion structure, bronchus sign, and visible on chest X-ray. The predictive model consisted of seven factors: lesion size, lesion lobe, lesion location from the hilum, lesion structure, bronchus sign, visibility on chest X-ray, and background lung. The ROC AUC of the predictive model was 0.742 (95% confidence interval: 0.715–0.769). Internal validation using 10-fold stratified cross-validation revealed a mean ROC AUC of 0.734. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The predictive model using the seven factors revealed a good performance in estimating the diagnostic yield.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    URL: Article
    DOI: 10.1159/000526574
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1464419-8
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  • 3
    Online Resource
    Online Resource
    Clinicopathological Features and Magnifying Chromoendoscopic Findings of Non-Ampullary Duodenal Epithelial Tumors
    S. Karger AG ; 2018
    In:  Digestion Vol. 97, No. 3 ( 2018), p. 219-227
    Details
    In: Digestion, S. Karger AG, Vol. 97, No. 3 ( 2018), p. 219-227
    Abstract: 〈 b 〉 〈 i 〉 Background and Aims: 〈 /i 〉 〈 /b 〉 We aimed to investigate an association between clinicopathological features, including immunohistochemical mucin phenotypes, and magnifying chromoendoscopic findings with crystal violet staining (ME-CV) in non-ampullary duodenal epithelial tumors (NADETs). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A total of 55 patients with NADET were divided into 3 groups by mucin phenotype: intestinal, gastrointestinal, or gastric. ME-CV findings were classified into 4 patterns: convoluted, leaf-like, reticular/sulciolar, and pinecone. The clinicopathological features and ME-CV findings were compared among the mucin phenotypes. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Tumors of the gastric type were located in the duodenal bulb ( 〈 i 〉 p 〈 /i 〉   & #x3c; 0.001), and contained pyloric gland adenoma ( 〈 i 〉 p 〈 /i 〉   & #x3c; 0.001) more frequently than the other types. White-light endoscopy indicated that milk-white mucosa was less frequent in tumors of the gastric type than in those of the gastrointestinal type ( 〈 i 〉 p 〈 /i 〉  = 0.006) and the intestinal type ( 〈 i 〉 p 〈 /i 〉   & #x3c; 0.001). ME-CV findings were significantly different between the gastric type and the other type ( 〈 i 〉 p 〈 /i 〉  = 0.028). Totally, 5 of 8 tumors of the gastric type manifested a pinecone pattern, 4 of which were compatible with pyloric gland adenoma. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The endoscopic findings of NADETs differ according to mucin phenotype. A pinecone pattern under ME-CV may be characteristic of NADETs of the gastric type, especially pyloric gland adenoma.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000485505
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1482218-0
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  • 4
    Online Resource
    Online Resource
    Laparoscopic-Assisted Intraperitoneal Chemotherapy for Patients with Scirrhous Gastric Cancer
    S. Karger AG ; 2005
    In:  Chemotherapy Vol. 51, No. 1 ( 2005), p. 15-20
    Details
    In: Chemotherapy, S. Karger AG, Vol. 51, No. 1 ( 2005), p. 15-20
    Abstract: 〈 i 〉 Background: 〈 /i 〉 The prognosis for patients with scirrhous gastric cancer (SGC) is extremely poor. To improve the patients’ prognosis, laparoscopic-assisted intraperitoneal chemotherapy (IPC) was introduced for SGC. In this study, we analyzed whether IPC reduced the number of cancer cells in the peritoneal cavity of patients or changed the gene expression levels of cytokines in the peritoneal cavity. We also investigated whether IPC improved the prognosis of patients with SGC. 〈 i 〉 Methods: 〈 /i 〉 Total RNA was extracted from 50 ml of peritoneal wash from 11 SGC patients before and after cisplatin-based IPC. The gene expression levels of survivin, c-myc, transforming growth factor-β (TGF-β), interleukin-2 (IL-2), IL-6, and IL-12 were analyzed using real-time reverse transcription-polymerase chain reaction (RT-PCR) assays. Also, carcinoembrionic antigen (CEA) messenger RNA (mRNA) was used to identify the number of gastric cancer cells in peritoneal washes by the real-time RT-PCR method. The gene expression levels of cytokines and the number of cancer cells in the peritoneal cavity were compared before and after cisplatin-based IPC treatment. 〈 i 〉 Results: 〈 /i 〉 Before IPC, the gene expression of IL-2 from peritoneal washes of patients was significantly suppressed compared to the controls (p = 0.029); however, other gene expression levels did not differ. In 7 cases, more than 90% of the cancer cells were removed from the peritoneal cavity after cisplatin-based IPC. These 7 cases were named the IPC effective group, and the remaining 4 cases were named the IPC ineffective group. In the IPC effective group, elevated IL-2 and IL-6 genes were detected in 5 (71%) and in 6 (86%) after IPC. The correlation between IPC effectiveness and elevated gene expression after IPC (IL-2: p = 0.137, and IL-6: p = 0.044) was observed. However, the 50% survival period of the IPC effective group (9 months) was not different from that of that of the IPC ineffective group (6 months, p = 0.267). 〈 i 〉 Conclusion: 〈 /i 〉 IPC effectiveness may correlate with elevation of gene expression of inflammatory cytokines, such as IL-2 and IL-6 in the peritoneal cavity after IPC. However, the prognostic benefits of IPC for SGC patients remain unclear.
    Type of Medium: Online Resource
    ISSN: 0009-3157 , 1421-9794
    URL: Article
    DOI: 10.1159/000084018
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2005
    detail.hit.zdb_id: 1482111-4
    SSG: 15,3
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  • 5
    Online Resource
    Online Resource
    Budd-Chiari Syndrome: Two Cases with Different Courses
    S. Karger AG ; 2008
    In:  Case Reports in Gastroenterology Vol. 2, No. 2 ( 2008-8-15), p. 256-261
    Details
    In: Case Reports in Gastroenterology, S. Karger AG, Vol. 2, No. 2 ( 2008-8-15), p. 256-261
    Abstract: We report two cases of Budd-Chiari syndrome. Case 1: A 57-year-old man presented with leg edema and esophageal varices. Cavography showed obstruction of the inferior vena cava with antiphospholipid syndrome. Further, the patient showed positive serology for hepatitis C virus and consumed large quantities of alcohol. Percutaneous transluminal angioplasty was performed on this patient and anticoagulants administered; leg edema and esophageal varices were ameliorated although liver biopsy showed cirrhosis without evident congestion. More than 9 months since the diagnosis, restenosis of the inferior vena cava has not occurred. Case 2: A 73-year-old woman presented abdominal pain but no edema or varices. Cavography showed membranous obstruction of the inferior vena cava which required no therapy. Manifestation of portal hypertension was not present and liver function was maintained although liver biopsy showed obvious congestion. These cases showed untypical features against histopathology, and careful observation will be required for emergence of hepatocellular carcinoma.
    Type of Medium: Online Resource
    ISSN: 1662-0631
    URL: Article
    DOI: 10.1159/000146063
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 2440540-1
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  • 6
    Online Resource
    Online Resource
    Gastrointestinal Lymphoma: Recent Advances in Diagnosis and Treatment
    S. Karger AG ; 2013
    In:  Digestion Vol. 87, No. 3 ( 2013), p. 182-188
    Details
    In: Digestion, S. Karger AG, Vol. 87, No. 3 ( 2013), p. 182-188
    Abstract: The recent trends in the diagnosis and management of gastrointestinal lymphoma are reviewed. Primary gastrointestinal lymphoma accounts for 30-40% of all extranodal lymphomas, while it comprises only 1-8% of all gastrointestinal malignancies. The most common histological type is mucosa-associated lymphoid tissue lymphoma, followed by diffuse large B-cell lymphoma. Recently, the incidence of intestinal follicular lymphoma has been increasing. Balloon-assisted endoscopy and capsule endoscopy are essential tools for the assessment of small bowel lymphomas. Treatment modalities for gastrointestinal lymphomas include ‘watch and wait' strategy, antibiotics (e.g. 〈 i 〉 Helicobacter pylori 〈 /i 〉 eradication), radiotherapy, chemotherapy, surgical resection, immunotherapy (e.g. rituximab), and combinations of these. Optimal therapeutic strategies should be determined based on the involved site, histological type, and clinical stage. It should be noted that accurate pretreatment diagnosis of the disease is most important.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000350051
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 1482218-0
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  • 7
    Online Resource
    Online Resource
    Clinicopathologic Features of Inverted Serrated Lesions of the Large Bowel
    S. Karger AG ; 2016
    In:  Digestion Vol. 93, No. 4 ( 2016), p. 280-287
    Details
    In: Digestion, S. Karger AG, Vol. 93, No. 4 ( 2016), p. 280-287
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Serrated lesions (SLs) of the large bowel occasionally manifest as inverted growths with endophytic expansion within the muscularis mucosa. The aims of this investigation were to investigate the incidence of inverted SLs (ISLs) among SLs and to describe the clinicopathologic features. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We reviewed the colonoscopy records from 2006 to 2014 at our institution and identified cases of endoscopically or surgically resected SLs, including hyperplastic polyps (HPs), sessile serrated adenomas/polyps (SSA/Ps) and traditional serrated adenomas (TSAs). The incidence of ISLs among the SLs and their colonoscopic findings were investigated retrospectively. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 There were 35 HPs in 30 patients, 80 SSA/Ps in 65 patients and 70 TSAs in 65 patients. The incidence of ISLs was significantly higher among SSA/Ps (8.8%) and HPs (5.7%) than among TSAs (0%; p = 0.04). A predominant right-sided location, a flat-elevated configuration with a central depression and round-open pit pattern or expanded crypt openings were characteristic of ISLs of the SSA/P type. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Right-sided flat lesions with a central depression and round or expanded crypts are indicative of ISLs of the SSA/P type.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000446394
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 1482218-0
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  • 8
    Online Resource
    Online Resource
    Therapeutic Strategy for Crohn's Disease with a Loss of Response to Infliximab: A Single-Center Retrospective Study
    S. Karger AG ; 2015
    In:  Digestion Vol. 91, No. 1 ( 2015), p. 50-56
    Details
    In: Digestion, S. Karger AG, Vol. 91, No. 1 ( 2015), p. 50-56
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Infliximab (IFX) is an effective treatment for maintaining clinical remission in patients with initially moderate-to-severe Crohn's disease (CD). However, a certain number of patients become unresponsive to IFX, subsequently requiring intensified therapy. The aim of this study was to compare the short- and long-term therapeutic efficacy of intensified regimens in CD patients who fail to respond to IFX. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The clinical courses of 33 CD patients who failed to respond to treatment with IFX were investigated retrospectively. An intensified regimen involving doubling the dose of IFX was chosen in 13 patients (DD group) versus shortening the IFX interval in 13 patients (SI group) and switching to adalimumab (ADA) in 7 patients (SA group). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The clinical response and rate of clinical remission at 4 weeks were 62 and 54% in the DD group, 77 and 62% in the SI group and 57 and 43% in the SA group, respectively (p = 0.59 for clinical response, p = 0.90 for clinical remission). The rate of sustained remission at 48 weeks was 44% in the DD group, 54% in the SI group and 33% in the SA group (p = 0.88). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The short- and long-term efficacy of doubling the dose of IFX, shortening the interval of IFX or switching to ADA is similar for CD patients who no longer respond to IFX.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    URL: Article
    DOI: 10.1159/000368815
    RVK:
    XA 40650
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1482218-0
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  • 9
    Online Resource
    Online Resource
    Treatment of Orthostatic Hypotension in Shy-Drager Syndrome with DL-Threo-3,4-dihydroxyphenylserine: A Case Report
    S. Karger AG ; 1985
    In:  European Neurology Vol. 24, No. 5 ( 1985), p. 330-334
    Details
    In: European Neurology, S. Karger AG, Vol. 24, No. 5 ( 1985), p. 330-334
    Type of Medium: Online Resource
    ISSN: 0014-3022 , 1421-9913
    URL: Article
    DOI: 10.1159/000115820
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1985
    detail.hit.zdb_id: 1482237-4
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