查看更多>>摘要：AIM:To clarify the efficiency of the criterion of metabolic syndrome to detecting non-alcoholic fatty liver disease (NAFLD).METHODS:Authors performed a cross-sectional study involving participants of a medical health checkup program including abdominal ultrasonography.This study involved 11 714 apparently healthy Japanese men and women,18 to 83 years of age.NAFLD was defined by abdominal ultrasonography without an alcohol intake of more than 20 g/d,known liver disease,or current use of medication.The revised criteria of the National Cholesterol Education Program Adult Treatment Panel Ⅲ were used to characterize the metabolic syndrome.RESULTS:NAFLD was detected in 32.2％ (95％ CI:31.0％-33.5％) of men (n =1874 of 5811) and in 8.7％(95％ CI:8.0％-9.5％) of women (n =514 of 5903).Among obese people,the prevalence of NAFLD was as high as 67.3％ (95％ CI:64.8％-69.7％) in men and 45.8％ (95％ CI:41.7％-50.0％) in women.Although NAFLD was thought of as being the liver phenotype of metabolic syndrome,the prevalence of the metabolic syndrome among subjects with NAFLD was low both in men and women.66.8％ of men and 70.4％ of women with NAFLD were not diagnosed with the metabolic syndrome.48.2％ of men with NAFLD and 49.8％ of women with NAFLD weren't overweight [body mass index (BMI) ≥ 25 kg/m2].In the same way,68.6％ of men with NAFLD and 37.9％ of women with NAFLD weren't satisfied with abdominal classification (≥ 90cm for men and ≥ 80 cm for women).Next,authors defined it as positive at screening for NAFLD when participants satisfied at least one criterion of metabolic syndrome.The sensitivity of the definition "at least 1 criterion" was as good as 84.8％ in men and 86.6％ in women.Separating subjects by BMI,the sensitivity was higher in obese men and women than in non-obese men and women (92.3％ vs 76.8％ in men,96.1％ vs 77.0％ in women,respectively).CONCLUSION:Authors could determine NAFLD effectively in epidemiological study by modifying the usage of the criteria for metabolic syndrome.
查看更多>>摘要：AIM:To compare efficacy of proton pump inhibitors (PPIs) with H2-receptor antagonists (H2RAs) plus prokinetics (Proks) for dysmotility-like symptoms in functional dyspepsia (FD).METHODS:Subjects were randomized to receive openlabel treatment with either rabeprazole 10 mg od (n =57) or famotidine 10 mg bid plus mosapride 5 mg tid (n =57) for 4 wk.The primary efficacy endpoint was change (％) from baseline in total dysmotility-like dyspepsia symptom score.The secondary efficacy endpoint was patient satisfaction with treatment.RESULTS:The improvement in dysmotility-like dyspepsia symptom score on day 28 was significantly greater in the rabeprazole group (22.5％ ± 29.2％ of baseline)than the famotidine + mosapride group (53.2％ ±58.6％ of baseline,P ＜ 0.0001).The superior benefit of rabeprazole treatment after 28 d was consistent regardless of Helicobacter pylori status.Significantly more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine + mosapride group (87.7％ vs 59.6％,P =0.0012).Rabeprazole therapy was the only significant predictor of treatment response (P ＜ 0.0001),defined as a total symptom score improvement ≥ 50％.CONCLUSION:PPI monotherapy improves dysmotility-like symptoms significantly better than H2RAs plus Proks,and should be the treatment of first choice for Japanese FD.
Hye Ran YangHae Ryoung KimMyung Jin KimJae Sung Ko...
1525-1530页
查看更多>>摘要：AIM:To evaluate the noninvasive parameters and hepatic fibrosis scores in obese children with nonalcoholic fatty liver disease (NAFLD).METHODS:A total of 77 children diagnosed with NAFLD via liver biopsy were included and divided into 2 subgroups according to the histopathologic staging of hepatic fibrosis:mild (stage 0-1) vs significant fibrosis (stage 2-4).Clinical and laboratory parameters were evaluated in each patient.The aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio,AST/platelet ratio index (APRI),PGA index,Forns index,FIB-4,NAFLD fibrosis score,and pediatric NAFLD fibrosis index (PNFI) were calculated.RESULTS:No clinical or biochemical parameter exhibited a significant difference between patients with mild and significant fibrosis.Among noninvasive hepatic fibrosis scores,only APRI and FIB4 revealed a significant difference between patients with mild and significant fibrosis (APRI:0.67 ± 0.54 vs 0.78 ± 0.38,P =0.032and FIB4:0.24 ± 0.12 vs 0.31 ± 0.21,P =0.010).The area under the receiving operating characteristic curve of FIB4 was 0.81,followed by Forns index (0.73),APRI (0.70),NAFLD fibrosis score (0.58),AST/ALT ratio (0.53),PGA score (0.45),and PNFI (0.41).CONCLUSION:APRI and FIB4 might be useful noninvasive hepatic fibrosis scores for predicting hepatic fibrosis in children with NAFLD.
查看更多>>摘要：AIM:To evaluate for the first time the protein and mRNA expression of 14-3-3ε in gastric carcinogenesis.METHODS:14-3-3ε protein expression was determined by western blotting,and mRNA expression was examined by real-time quantitative RT-PCR in gastric tumors and their matched non-neoplastic gastric tissue samples.RESULTS:Authors observed a significant reduction of 14-3-3ε protein expression in gastric cancer (GC) samples compared to their matched non-neoplastic tissue.Reduced levels of 14-3-3ε were also associated with diffuse-type GC and early-onset of this pathology.Our data suggest that reduced 14-3-3ε may have a role in gastric carcinogenesis process.CONCLUSION:Our results reveal that the reduced 14-3-3ε expression in GC and investigation of 14-3-3ε interaction partners may help to elucidate the carcinogenesis process.
查看更多>>摘要：Pancreatic schwannomas are rare neoplasms.Authors briefly describe a 64-year-old female patient with cystic pancreatic schwannoma mimicking other cystic tumors and review the literature.Databases for PubMed were searched for English-language articles from 1980 to 2010 using a list of keywords,as well as references from review articles.Only 41 articles,including 47 cases,have been reported in the English literature.The mean age was 55.7 years (range 20-87 years),with 45％ of patients being male.Mean tumor size was 6.2 cm (range 1-20 cm).Tumor location was the head (40％),head and body (6％),body (21％),body and tail (15％),tail (4％),and uncinate process (13％).Thirty-four percent of patients exhibited solid tumors and 60％ of patients exhibited cystic tumors.Treatment included pancreaticoduodenectomy (32％),distal pancreatectomy (21％),enucleation (15％),unresectable (4％),refused operation (2％) and the detail of resection was not specified in 26％ of patients.No patients died of disease with a mean follow-up of 15.7 mo (range 3-65 mo),although 5 (11％) patients had a malignancy.The tumor size was significantly related to malignant tumor (13.8 ± 6.2 cm for malignancy vs 5.5 ± 4.4 cm for benign,P =0.001)and cystic formation (7.9 ± 5.9 cm for cystic tumor vs 3.9± 2.4 cm for solid tumor,P =0.005).The preoperative diagnosis of pancreatic schwannoma remains difficult.Cystic pancreatic schwannomas should be considered in the differential diagnosis of cystic neoplasms and pseudocysts.In our case,intraoperative frozen section confirmed the diagnosis of a schwannoma.Simple enucleation may be adequate,if this is possible.
查看更多>>摘要：Primary esophageal combined carcinoma is very rare.The authors herein report 2 cases.Case 1 was a combined squamous cell carcinoma and small cell carcinoma,and case 2 was a combined squamous cell carcinoma,adenocarcinoma,and small cell carcinoma.Case 1 was a 67-year-old man with complaints of dysphagia.Endoscopic examination revealed an ulcerated tumor in the middle esophagus,and 6 biopsies were obtained.All 6 biopsies revealed a mixture of squamous cell carcinoma and small cell carcinoma.Both elements were positive for cytokeratin,epithelial membrane antigen,and p53 protein,and had high Ki-67 labeling.The small cell carcinoma element was positive for synaptophysin,CD56,KIT,and platelet-derived growth factor-α (PDG-FRA),while the squamous cell carcinoma element was not.Genetically,no mutations of KIT and PDGFRA were recognized.The patient died of systemic carcinomatosis 15 mo after presentation.Case 2 was a 74-year-old man presenting with dysplasia.Endoscopy revealed a polypoid tumor in the distal esophagus.Seven biopsies were taken,and 6 showed a mixture of squamous cell carcinoma,small cell carcinoma,and adenocarcinoma.The 3 elements were positive for cytokeratins,epithelial membrane antigen,and p53 protein,and had high Ki-67 labeling.The adenocarcinoma element was positive for mucins.The small cell carcinoma element was positive for CD56,synaptophysin,KIT,and PDGFRA,but the other elements were not.Mutations of KIT and PDGFRA were not recognized.The patient died of systemic carcinomatosis 7 mo after presentation.These combined carcinomas may arise from enterochromaffin cells or totipotential stem cell in the esophagus or transdifferentiation of one element to another.A review of the literature was performed.
查看更多>>摘要：Ascaris lumbricoides is the largest intestinal nematode parasite of man,which can lead to various complications because of its mobility.As the esophagus is not normal habitat of Ascaris,the report of esophageal ascariasis is rare.An old female presented with dysphagia after an intake of several red bean buns and haw jellies.The barium meal examination revealed a spherical defect in the lower esophagus.Esophageal bezoar or esophageal carcinoma was considered at the beginning.The patient fasted,and received fluid replacement treatment as well as some oral drugs such as proton pump inhibitor and sodium bicarbonate.Then upper gastrointestinal endoscopy was done to further confirm the diagnosis and found a live Ascaris lumbricoides in the gastric antrum and two in the duodenal bulb.The conclusive diagnosis was ascariasis.The esophageal space-occupying lesion might be the entangled worm bolus.Anthelmitnic treatment with mebendazole improved patient's clinical manifestations along with normalization of the radiological findings during a 2-wk follow-up.Authors report herein this rare case of Ascaris lumbricoides in the esophagus,emphasizing the importance of awareness of this parasitic infection as it often presents with different and unspecific symptoms.
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