Japanese journal of gastroenterology and hepatology最新文献

{"title":"Dynamic Changes in Serum AFP, Albumin and ALBI after Radioembolization in Patients with Unresectable Hepatocellular Carcinoma with High or Low Alpha-Fetoprotein Levels.","authors":"B I Carr, H G Gozukara Bag, R Kutlu, V Ince, S Yilmaz","doi":"10.47829/jjgh.2025.11105","DOIUrl":"10.47829/jjgh.2025.11105","url":null,"abstract":"<p><strong>Background: </strong>1.1.Yttrium-90 trans arterial radioembolization (TARE) is an established locoregional therapy for unresectable hepatocellular carcinoma (HCC). Baseline biomarkers are widely used for prognosis, but the clinical significance of post-TARE changes in tumour and liver-function biomarkers remains uncertain. ALBI and related measures have emerged as objective prognostic indices of hepatic reserve and HCC.</p><p><strong>Aim: </strong>1.2.To identify early post-TARE biomarker changes associated with overall survival.</p><p><strong>Methods: </strong>1.3.We retrospectively analysed 276 nonsurgical patients with HCC who underwent TARE and had available survival data. Changes in routinely measured tumour, inflammatory, hematologic, and liver-function variables were assessed at 1, 3, 6, and 12 months, when available.</p><p><strong>Results: </strong>1.4.Biomarker changes were evident by 1 month, particularly in AFP, albumin, and ALBI grade, in patients with both low and high baseline AFP. Changes in PALBI, mALBI, GGT, CRP, and bilirubin were also observed. Increased or stable albumin was associated with longer survival at all assessed time points in both baseline AFP strata. Decreased AFP was associated with longer survival consistently in patients with high baseline AFP and at later time points in patients with low baseline AFP. Early bilirubin decreases were also associated with longer survival. Patients whose NPS phenotype decreased had substantially longer median survival than those with increased phenotype.</p><p><strong>Conclusions: </strong>1.5.Early post-TARE changes in albumin and AFP were associated with overall survival in this retrospective cohort. These findings support future prospective validation of dynamic biomarker changes.</p>","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13607324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factor and Serum Biomarker Changes in Non-Surgical Hepatocellular Carcinoma Patients Treated with Radioembolization.","authors":"B I Carr, H G Gozukara Bag, R Kutlu, E Karabulut, V Ince, S Yilmaz","doi":"10.47829/jjgh.2025.11103","DOIUrl":"10.47829/jjgh.2025.11103","url":null,"abstract":"<p><strong>Background: </strong>1.1:Transarterial radioembolization (TARE) with 90Y is a primary therapy for hepatocellular carcinoma (HCC), including patients with portal vein thrombosis (PVT). Patient survival subgroups post TARE have not been clearly defined.</p><p><strong>Aims: </strong>1.2.To identify prognostic factors in patients treated with TARE.</p><p><strong>Methods: </strong>1.3.Non-surgical HCC patients (n=116) were treated with TARE and prospectively followed for survival and changes in blood parameters relating to inflammation and tumor indices.</p><p><strong>Results: </strong>1.4.Baseline parameters with the highest hazard ratios (HR>2) for survival were C-reactive protein, alpha-fetoprotein (AFP), maximum tumor diameter (MTD) and PVT. A 2-parameter prognostic model was developed, consisting of serum AFP and C-reactive protein, which was especially significant in patients with PVT. Temporal changes post TARE in ALBI and serum gamma glutamyl transferase (GGT) levels occurred in patients with both high and low serum AFP. A network phenotyping strategy (NPS) showed that patient phenotypes also change after TARE. Post TARE reduction in AFP or GGT or increase in albumin levels were associated with improved survival.</p><p><strong>Conclusions: </strong>1.5.Changes in serum CRP, AFP, GGT, albumin, ALBI, and NPS phenotype occurred early after TARE. Changes in AFP, GGT and albumin related to survival and may be useful in selecting patients for additional treatment.</p>","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"11 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13183389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Adolescent with Vomiting and Weight Loss","authors":"None Oleas JA, None Wali PD","doi":"10.47829/jjgh.2023.92005","DOIUrl":"https://doi.org/10.47829/jjgh.2023.92005","url":null,"abstract":"Pediatric Achalasia is a rare condition in children, often presents with common symptoms of vomiting and weight loss. We present a case of a 15-year-old female with persistent vomiting and weight loss who was initially diagnosed with eosinophilic esophagitis (EoE) due to endoscopic findings and elevated eosinophils on esophageal histology. After clinical worsening with EoE therapy, a broader workup showed classic bird beak on upper gastrointestinal series and subsequent esophageal manometry confirmed a diagnosis of achalasia. Our case report reinforces the need to review the differential diagnosis of esophageal eosinophilia from common disorders such as gastroesophageal reflux disease and EoE to rare conditions such as achalasia.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135798966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of C-Reactive Protein (CRP) as a Predictive Marker of Anastomotic Leak in Colorectal Surgery: Is it Still Reliable?","authors":"Chen L, Mathew R","doi":"10.47829/jjgh.2023.92001","DOIUrl":"https://doi.org/10.47829/jjgh.2023.92001","url":null,"abstract":"Introduction: Anastomotic leaks after colorectal surgery is associated with serious morbidity and early diagnosis is critical. C-reactive protein (CRP) on postoperative day (POD) 3 to 5 has been described as a good predictor of anastomotic leak. Therefore, this study aims to review if CRP level of greater than 150mg/l is a reliable predictor of anastomotic leak. 1.2. Methodology: The study was conducted using a prospectively held database from Department of Colorectal Surgery, Singapore General Hospital. From 1 January 2011 to 31 October 2017, all patients who had anastomotic leaks after colorectal resection surgery were analysed retrospectively. Patients without postoperative CRP levels were excluded.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70928193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registry to Understand Patient Characteristics, Treatment Patterns, and Therapy Outcomes in Adults with Chronic Hepatitis C Virus Infection in Asia, Africa, and Eastern Europe","authors":"Choudhry Aa, O. C., Purnomo Hd, Sollano JJr, M. K, Katsidzira L, Nath P, Ravishankar Ac, Hadigal S, Pirathvisuth T, Ismoilov U, Pandey V, Watanna S, Ul Haque Z","doi":"10.47829/jjgh.2023.91501","DOIUrl":"https://doi.org/10.47829/jjgh.2023.91501","url":null,"abstract":"Background: Several patient, government, payer, and provider-level barriers to Hepatitis C virus (HCV) treatment have been identified in regions like Asia, Africa, and the Commonwealth of Independent States (CIS). A patient registry was created in these regions to understand the patterns of clinical care and outcomes in real-world settings. Methods: This prospective study was conducted between 2018 to 2021 across 14 centers. Adult patients considered eligible for treatment with directly acting antivirals (DAAs) were included in the study. The primary endpoint was to understand the prevalence of HCV genotypes (GTs) and DAA treatment strategies The secondary endpoint was to evaluate efficacy and safety of various DAA regimens. Results: A total of 476 patients were enrolled of which 386 (81.1%) completed the study and remaining 90 were lost to follow-up. The most prevalent GT were GT 3 (30.5%) and GT 1 (19%). Patients with GT1 and GT 6 have demonstrated high SVR 12 cure rates(100%; n=55, n=24) followed by GT3 (95.9%, n=94). The most commonly prescribed DAAs were Daclatasvir (60mg)/ Sofosbuvir (SOF/DCV; 43.7%, n=208), Sofosbuvir/Ledipasvir (SOF/LDV; 16.2%, n=77), and Sofosbuvir/Velpatasvir (SOF/VEL; 14.3%, n=68). The SVR12 rates were as follows: SOF/LED, 98.2%, n= 54/55; SOF/VEL, 97.6%, n=35/36; and SOF/DCV, 90.8%, n=128/141. Adverse events were reported in 13 patients, with one death that was not considered treatment-related. Conclusion: Overall, sofosbuvir-based regimens were found to be safe and efficacious. GT 3 and 1 were the most prevalent HCV genotypes.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70928087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheostomy in the Management of Pre-Operative Respiratory Failure in Liver Transplant Candidates","authors":"Ward LM, Hahn K, Feduska N, Farmer D, Wang T, Agopian V, Kaldas F, Barjaktarevic I","doi":"10.47829/jjgh.2023.91901","DOIUrl":"https://doi.org/10.47829/jjgh.2023.91901","url":null,"abstract":"","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70928136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Protocol of the Most Common Anorectal Pathologies with Association between Micronized Purified Flavonoid Fraction and Sucralfate for Local Application","authors":"Nando Galles","doi":"10.47829/jjgh.2021.8202","DOIUrl":"https://doi.org/10.47829/jjgh.2021.8202","url":null,"abstract":"1. Summary (Aim) The author proposes to test the effectiveness of the combined action of 1Micronized Purified Flavonoid Fraction MPFF associated with topical action \"barrier effect\" of 2 Sucralfate (as SOS Sucralfate Ointment with Soothing Herbs) for some of the most common anal pathological situations with two main objectives: 1 microcirculation optimization (reduction of edema, congestion and mucous permeability) 2 barrier effect with control of irritative stimuli and reduction of severity of inflammation lesions, with reduction of traumatism due to the transit of the stool and the chemical action of the stool itself reduction of the microbial load in direct contact with the rectal and anal wall reduction of wall permeability (always in synergy with MPFF) 2. Introduction Anus-rectal diseases are numerous and varied in relation to causative factors and morphological and symptomatologic expression, even if usually trivialized by simplistic or frankly incorrect diagnoses including, too often, that of \"hemorrhoids\" or \"hemorrhoidal disease\", widely abused terms. The difference between a \"real\" proctologist and a \"surgeon of ass hole\" can be understood from how many times \"hemorrhoids\" are said during the visit and in subsequent diagnostic and therapeutic discussions, including the surgical option: \" the measure of proctological competence is inversely proportional to the number of times the term \"hemorrhoids\" (personal aphorism) is used [1-10]. To be tackled in the best way, each disease requires the identification of the pathogenetic causes, a precise diagnostic framework, a correct setting of the diagnostic-therapeutic process, with a targeted therapy, suitable for the previous concepts. of course, this methodology of behavior is the prerogative of only the most expert Specialists and, in the daily practice of the non-dedicated Doctor, it may be useful to make use of guidelines or protocol schemes, adaptable to different situations, able to mitigate the impact of injuries and related symptoms, even before of a proctological consultation, but with almost complete guarantee, not to add iatrogenic damage to the patient's clinical picture.The author, on the basis of over forty years of experience, in the last two decades completely dedicated to colorectal-anal and perineal pathologies, has developed a treatment protocol useful in the management of acute, subacute and chronic anal disease situations. A broad-spectrum treatment protocol of the most common anal pathological situations is proposed, by means of micronized diosmin or, more precisely, of the Purified and Micronized Flavonoid Fraction (MPFF in the continuation of the treatment) for the known reintegration characteristics of the microcirculation (with reduction of edema and congestion), in association with topical application of an ointment based on Sucralfate and soothing herbs (SOS below), capable of perform a \"barrier effect\" with protection of mucous, anal and skin tissues, adjuvanted by ","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70927494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Approach to Diarrhea in Long Term Care Hospitals","authors":"K. Hong","doi":"10.47829/jjgh.2021.8101","DOIUrl":"https://doi.org/10.47829/jjgh.2021.8101","url":null,"abstract":"1. Clinical Approach to Diarrhea in Long Term Care Hospitals Diarrhea is common in long term care hospitals but at many times get underdiagnosed. Symptomatic treatment of diarrhea is sometimes effective but tends to relapse after treatment is seized and also side effects are seen. The root cause of diarrhea must be evaluated in order to treat diarrhea effectively and efficiently. Here are some commonly encountered causes of diarrhea in long term care hospitals and how to approach. 2. Constipation Constipation is probably the number one cause of diarrhea and is the most underdiagnosed condition. In these cases, diarrhea can be referred to as ‘tip of an iceberg’. With decreased production of intestinal mucus and hypoactive bowel movements, fecal materials gather surrounding the intestinal wall and form a ‘feces lumen’. Once this is formed, the solid material of feces gets added to the feces lumen and only liquid portion of feces are excreted. Evaluation of such conditions require abdomen x-rays. When lumen formation and fecal material clumps are found, treatment of diarrhea should follow that of constipation. 3. Clostridium Difficile In many cases of diarrhea in hospital settings especially after or while on antibiotic use, Clostridium difficile infection should always be suspected. Tests for Clostridium difficile include PCR test, toxin AB test and culture. Treatment is started when suspected or when test results are positive. Metronidazole po medications are first line of choice whereas in drug resistant forms vancomycin po medications are also used. Supportive medications such as dioctahedral smectite is often used but loperamide should be used with caution since it can promote retention of bacteria in the intestine. 4. SIBO (Small Interstinal Bacterial Overgrowth) In cases where Clostridium difficile has not been confirmed but diarrhea and bloating exists especially at the small bowel, SIBO should be suspected. SIBO requires relatively longer period of antibiotic use compared to clostridium difficile and many times require change in diet. Commonly used antibiotics are rifaximin or metronidazole. After a course of antibiotics, soluble fiber contents in medicine forms such as alginic acid is used to help maintain healthy microbiota. 5. Bile Acid Malabsorption/ Decreased Bile Production/ Increased Gastric Acid Production Bile acid malabsorption is commonly seen in the elderly and is hard to suspect. Easiest way to find out is to examine the color of the stool, if feces have green color it is suspected. It also presents with constant pain. Medications such as cholestyramine, UDCA, milk thitle extract can be used and additionally, alginic acid helps keep steady state. Decreased bile production is hard to suspect. Mostly it presents with sour smell in stool. The sour smell is due to lack of neutralization of gastric acid by bile acid. Evaluation of liver enzymes may be necessary as this could also be symptoms of GB stones. Treatments with milk thitle","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70927585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential of Absorption, Capillary Effect and Sponge-Effect in Endoscopic-Assisted Therapy for Leaks and Fistulas","authors":"KH Fuchs, B Sudarevic, Meining A","doi":"10.47829/jjgh.2022.8601","DOIUrl":"https://doi.org/10.47829/jjgh.2022.8601","url":null,"abstract":"1.1. Introduction: Anastomotic leaks and fistulas as well as perforations do lead to increased morbidity and mortality. Several interventional endoscopic techniques such as stents, clips, endoscopic suturing and endoscopic vacuum therapy, can help in reducing an unfavorable outcome of these patients, using a differentiated management of leakages. An important feature of these therapeutic options is the contineous removal of fluid from the fistula or abscess cavity in order to heal the defect and prevent subsequent complications. The objective of this study is the investigation of technical and conceptual modifications of the established Endo-sponge therapy and their feasibility.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70927957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Utility of Exosomal Micrornas for Colorectal Cancer","authors":"Cai X, Bao X, Xu C, Li T, Wang Q, Wang X, Li H","doi":"10.47829/jjgh.2022.8701","DOIUrl":"https://doi.org/10.47829/jjgh.2022.8701","url":null,"abstract":"Exosomes are nanometer-sized membrane vesicles secreted by normal or cancer cells, which participate in intercellular communication by transporting RNAs and proteins. Recent studies have found that some differentially expressed microRNAs (miRNAs) in exosomes play key roles in the initiation and development of Colorectal Cancer (CRC) and are potential candidates for CRC detection. In this review, we describe the role of exosomal miRNAs in the development of CRC. We also briefly summarize the methods used for exosome extraction and enrichment. Finally, we examine the potential roles of exosomal miRNAs as biomarkers for the diagnosis of and prognostic assessment of CRC, as well as novel molecules for targeted therapy","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70928004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}