AIM:To investigate the effectiveness of phenol for the relief of cancer pain by endoscopic ultrasound-guided celiac plexus neurolysis(EUS-CPN).METHODS:Twenty-two patients referred to our hospital with cancer pain from...AIM:To investigate the effectiveness of phenol for the relief of cancer pain by endoscopic ultrasound-guided celiac plexus neurolysis(EUS-CPN).METHODS:Twenty-two patients referred to our hospital with cancer pain from August 2009 to July 2011for EUS-CPN were enrolled in this study.Phenol was used for 6 patients with alcohol intolerance and ethanol was used for 16 patients without alcohol intolerance.The primary endpoint was the positive response rate(pain score decreased to≤3)on postoperative day 7.Secondary endpoints included the time to onset of pain relief,duration of pain relief,and complication rates.RESULTS:There was no significant difference in the positive response rate on day 7.The rates were 83%and 69%in the phenol and ethanol groups,respectively.Regarding the time to onset of pain relief,in the phenol group,the median pre-treatment pain score was 5,whereas the post-treatment scores decreased to 1.5,1.5,and 1.5 at 2,8,and 24 h,respectively(P<0.05).In the ethanol group,the median pre-treatment pain score was 5.5,whereas the post-treatment scores significantly decreased to 2.5,2.5,and 2.5 at 2,8,and24 h,respectively(P<0.01).There was no significant difference in the duration of pain relief between the phenol and ethanol groups.No significant difference was found in the rate of complications between the 2groups;however,burning pain and inebriation occurred only in the ethanol group.CONCLUSION:Phenol had similar pain-relieving effects to ethanol in EUS-CPN.Comparing the incidences of inebriation and burning pain,phenol may be superior to ethanol in EUS-CPN procedures.展开更多
Oxidative stress has been investigated in the context of alcoholic liver injury for many years and shown to be a causal factor of chronic hepatitis C(CHC), nonalcoholic steatohepatitis(NASH), drug-induced liver injury...Oxidative stress has been investigated in the context of alcoholic liver injury for many years and shown to be a causal factor of chronic hepatitis C(CHC), nonalcoholic steatohepatitis(NASH), drug-induced liver injury, Wilson's disease, and hemochromatosis. In CHC, it has been demonstrated that oxidative stress plays an important role in hepatocarcinogenesis. In cases with persistent hepatitis due to failure of hepatitis C virus eradication,or chronic liver disease, such as NASH, the treatment of which remains unestablished, it is important to reduce serum alanine aminotransferase levels and prevent liver fibrosis and development of hepatocellular carcinoma. This also suggests the importance of antioxidant therapy. Among treatment options where it would be expected that anti-inflammatory activity plays a role in their confirmed efficacy for chronic hepatitis, iron depletion therapy, glycyrrhizin, ursodeoxycholic acid, Sho-Saiko-To, and vitamin E can all be considered antioxidant therapies. To date, however, the ability of these treatments to prevent cancer has been confirmed only in CHC. Nevertheless, anti-inflammatory and antifibrotic effects have been demonstrated in other liver diseases and these therapies may potentially be effective for cancer prevention.展开更多
BACKGROUND Hereditary diffuse gastric cancer(HDGC)is a familial cancer syndrome often associated with germline mutations in the CDH1 gene.However,the frequency of CDH1 mutations is low in patients with HDGC in East As...BACKGROUND Hereditary diffuse gastric cancer(HDGC)is a familial cancer syndrome often associated with germline mutations in the CDH1 gene.However,the frequency of CDH1 mutations is low in patients with HDGC in East Asian countries.Herein,we report three cases of HDGC harboring a missense CDH1 variant,c.1679C>G,from a single Japanese family.CASE SUMMARY A 26-year-old female(Case 1)and a 51-year-old male(father of Case 1),who had a strong family history of gastric cancer,were diagnosed with advanced diffuse gastric cancer.After genetic counselling,a 25-year-old younger brother of Case 1 underwent surveillance esophagogastroduodenoscopy that detected small signet ring cell carcinoma foci as multiple pale lesions in the gastric mucosa.Genetic analysis revealed a CDH1 c.1679C>G variant in all three patients.CONCLUSION It is important for individuals suspected of having HDGC to be actively offered genetics evaluation.This report will contribute to an increased awareness of HDGC.展开更多
BACKGROUND Liver resection has become safer as it has become less invasive.However,the minimum residual liver volume(RLV)required to maintain homeostasis is unclear.Furthermore,the formulae used to calculate standard ...BACKGROUND Liver resection has become safer as it has become less invasive.However,the minimum residual liver volume(RLV)required to maintain homeostasis is unclear.Furthermore,the formulae used to calculate standard liver volume(SLV)are complex.AIM To review previously reported SLV formulae and the methods used to evaluate the minimum RLV,and explore the association between liver volume and mortality.METHODS A systematic review of Medline,PubMed,and grey literature was performed.References in the retrieved articles were cross-checked manually to obtain further studies.The last search was conducted on January 20,2019.We developed an SLV formula using data for 86 consecutive patients who underwent hepatectomy at our institution between July 2009 and August 2011.RESULTS Linear regression analysis revealed the following formula:SLV(mL)=822.7×body surface area(BSA)?183.2(R2=0.419 and R=0.644,P<0.001).We retrieved 25 studies relating to SLV formulae and 12 studies about the RLV required for safe liver resection.Although the previously reported formulae included various coefficient and constant values,a simplified version of the SLV,the common SLV(cSLV),can be calculated as follows:cSLV(mL)=710 or 770×BSA.The minimum RLV for normal and damaged livers ranged from 20%-40%and 30%-50%,respectively.The Sapporo score indicated that the minimum RLV ranges from 35%-95%depending on liver function.CONCLUSION We reviewed SLV formulae and the minimum RLV required for safe liver resection.The Sapporo score is the only liver function-based method for determining the minimum RLV.展开更多
文摘AIM:To investigate the effectiveness of phenol for the relief of cancer pain by endoscopic ultrasound-guided celiac plexus neurolysis(EUS-CPN).METHODS:Twenty-two patients referred to our hospital with cancer pain from August 2009 to July 2011for EUS-CPN were enrolled in this study.Phenol was used for 6 patients with alcohol intolerance and ethanol was used for 16 patients without alcohol intolerance.The primary endpoint was the positive response rate(pain score decreased to≤3)on postoperative day 7.Secondary endpoints included the time to onset of pain relief,duration of pain relief,and complication rates.RESULTS:There was no significant difference in the positive response rate on day 7.The rates were 83%and 69%in the phenol and ethanol groups,respectively.Regarding the time to onset of pain relief,in the phenol group,the median pre-treatment pain score was 5,whereas the post-treatment scores decreased to 1.5,1.5,and 1.5 at 2,8,and 24 h,respectively(P<0.05).In the ethanol group,the median pre-treatment pain score was 5.5,whereas the post-treatment scores significantly decreased to 2.5,2.5,and 2.5 at 2,8,and24 h,respectively(P<0.01).There was no significant difference in the duration of pain relief between the phenol and ethanol groups.No significant difference was found in the rate of complications between the 2groups;however,burning pain and inebriation occurred only in the ethanol group.CONCLUSION:Phenol had similar pain-relieving effects to ethanol in EUS-CPN.Comparing the incidences of inebriation and burning pain,phenol may be superior to ethanol in EUS-CPN procedures.
文摘Oxidative stress has been investigated in the context of alcoholic liver injury for many years and shown to be a causal factor of chronic hepatitis C(CHC), nonalcoholic steatohepatitis(NASH), drug-induced liver injury, Wilson's disease, and hemochromatosis. In CHC, it has been demonstrated that oxidative stress plays an important role in hepatocarcinogenesis. In cases with persistent hepatitis due to failure of hepatitis C virus eradication,or chronic liver disease, such as NASH, the treatment of which remains unestablished, it is important to reduce serum alanine aminotransferase levels and prevent liver fibrosis and development of hepatocellular carcinoma. This also suggests the importance of antioxidant therapy. Among treatment options where it would be expected that anti-inflammatory activity plays a role in their confirmed efficacy for chronic hepatitis, iron depletion therapy, glycyrrhizin, ursodeoxycholic acid, Sho-Saiko-To, and vitamin E can all be considered antioxidant therapies. To date, however, the ability of these treatments to prevent cancer has been confirmed only in CHC. Nevertheless, anti-inflammatory and antifibrotic effects have been demonstrated in other liver diseases and these therapies may potentially be effective for cancer prevention.
文摘BACKGROUND Hereditary diffuse gastric cancer(HDGC)is a familial cancer syndrome often associated with germline mutations in the CDH1 gene.However,the frequency of CDH1 mutations is low in patients with HDGC in East Asian countries.Herein,we report three cases of HDGC harboring a missense CDH1 variant,c.1679C>G,from a single Japanese family.CASE SUMMARY A 26-year-old female(Case 1)and a 51-year-old male(father of Case 1),who had a strong family history of gastric cancer,were diagnosed with advanced diffuse gastric cancer.After genetic counselling,a 25-year-old younger brother of Case 1 underwent surveillance esophagogastroduodenoscopy that detected small signet ring cell carcinoma foci as multiple pale lesions in the gastric mucosa.Genetic analysis revealed a CDH1 c.1679C>G variant in all three patients.CONCLUSION It is important for individuals suspected of having HDGC to be actively offered genetics evaluation.This report will contribute to an increased awareness of HDGC.
基金Supported by a Grant-in-Aid for Scientific Research from the Ministry of Education,Culture,Sports,Science,and Technology,Japan,No.23591993 to TM,and No.24791437 to MM,No17K10672to T Mizuguchi+8 种基金supported by Astellas Pharma,Inc.,No.RS2018A000763,Tokyo,JapanDaiichi Sankyo Company,No.1800461,Tokyo,JapanShionogi&Co.,No.RS2018A000439931,Osaka,JapanMerk Serono,No.MSJS20180613001,Tokyo,JapanSapporo Doto Hospital,No.30037656,Sapporo,JapanNoguchi Hospital,No.30047663,Otaru,JapanDoki-kai Tomakomai Hospital,No.30047674,Tomakomai,JapanTsuchida Hospital,No.30057704,Sapporo,JapanIkuta Hospital,No.30057704,Shiraoi,Japan was given to TM
文摘BACKGROUND Liver resection has become safer as it has become less invasive.However,the minimum residual liver volume(RLV)required to maintain homeostasis is unclear.Furthermore,the formulae used to calculate standard liver volume(SLV)are complex.AIM To review previously reported SLV formulae and the methods used to evaluate the minimum RLV,and explore the association between liver volume and mortality.METHODS A systematic review of Medline,PubMed,and grey literature was performed.References in the retrieved articles were cross-checked manually to obtain further studies.The last search was conducted on January 20,2019.We developed an SLV formula using data for 86 consecutive patients who underwent hepatectomy at our institution between July 2009 and August 2011.RESULTS Linear regression analysis revealed the following formula:SLV(mL)=822.7×body surface area(BSA)?183.2(R2=0.419 and R=0.644,P<0.001).We retrieved 25 studies relating to SLV formulae and 12 studies about the RLV required for safe liver resection.Although the previously reported formulae included various coefficient and constant values,a simplified version of the SLV,the common SLV(cSLV),can be calculated as follows:cSLV(mL)=710 or 770×BSA.The minimum RLV for normal and damaged livers ranged from 20%-40%and 30%-50%,respectively.The Sapporo score indicated that the minimum RLV ranges from 35%-95%depending on liver function.CONCLUSION We reviewed SLV formulae and the minimum RLV required for safe liver resection.The Sapporo score is the only liver function-based method for determining the minimum RLV.
