記述言語：英語   掲載種別：研究論文（学術雑誌）  

Genetic analysis and culturing techniques for gastric non-Helicobacter pylori Helicobacter (NHPH) are progressing. NHPH is reported to accompany nodular gastritis, gastric MALT lymphoma, and mild gastritis. However, only a few gastric cancer cases infected by NHPH have been reported. PCR analysis specific for NHPH and H. pylori was performed for DNA from gastric mucosa of 282 Korean gastric cancer patients, who were treated with endoscopic submucosal dissection. For more precise strain detection of NHPH, NHPH-positive mucosa was stained by immunohistochemistry specific for Helicobacter suis. The Cancer Genome Atlas (TCGA) classification was analyzed for these 3 gastric cancer sub-groups by in situ hybridization and immunohistochemistry. Among 281 patients, 3 patients (1.1%) were positive for NHPH. One patient (Patient 1) was also positive for H. pylori by PCR, another patient (Patient 3) was positive for serum IgG for H. pylori, and the other patient (Patient 2) had no evidence for H. pylori infection. Gastric mucosa of Patients 2 and 3 were positive for H. suis staining. All three NHPH-positive gastric cancers were located in the antrum, and belonged to the Chromosomal Instability Type of TCGA classification. Gastric NHPH can be a cause of gastric cancer, although likely with lower pathogenesis than H. pylori.

DOI： 10.1038/s41598-022-08962-y

PubMed

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Helicobacter suis, a bacterial species naturally hosted by pigs, can colonize the human stomach in the context of gastric diseases such as gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Because H. suis has been successfully isolated from pigs, but not from humans, evidence linking human H. suis infection to gastric diseases has remained incomplete. In this study, we successfully in vitro cultured H. suis directly from human stomachs. Unlike Helicobacter pylori, the viability of H. suis decreases significantly on neutral pH; therefore, we achieved this using a low-pH medium for transport of gastric biopsies. Ultimately, we isolated H. suis from three patients with gastric diseases, including gastric MALT lymphoma. Successful eradication of H. suis yielded significant improvements in endoscopic and histopathological findings. Oral infection of mice with H. suis clinical isolates elicited gastric and systemic inflammatory responses; in addition, progression of gastric mucosal metaplasia was observed 4 mo postinfection. Because H. suis could be isolated from the stomachs of infected mice, our findings satisfied Koch's postulates. Although further prospective clinical studies are needed, H. suis, like H. pylori, is likely a gastric pathogen in humans. Furthermore, comparative genomic analysis of H. suis using complete genomes of clinical isolates revealed that the genome of each H. suis isolate contained highly plastic genomic regions encoding putative strain-specific virulence factors, including type IV secretion system-associated genes, and that H. suis isolates from humans and pigs were genetically very similar, suggesting possible pig-to-human transmission.

DOI： 10.1073/pnas.2026337118

PubMed

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記述言語：英語   出版者・発行元：(一社)日本胃癌学会  

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：英語   出版者・発行元：(一社)日本癌学会  

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記述言語：日本語   出版者・発行元：日本膵・胆管合流異常研究会  

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記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

目的:抗血栓薬内服患者における消化器外科手術において,その取扱いに関するコンセンサスはないのが現状である.今回,腹部緊急手術症例を対象として抗血栓薬内服が術後合併症のリスクとなりうるか検討した.方法:2012年1月から2017年9月までの腹部緊急手術454例を対象とし,抗血栓薬内服症例(A群,58例)と非内服症例(B群,396例)に分け,背景因子,周術期因子を比較検討した.結果:抗血栓薬内服症例は経年的に増加していた.全症例における術後合併症率(Clavien-Dindo分類 ≧III),出血性合併症率,および死亡率はそれぞれ24.2%, 2.0%, 3.3%であった.A群はB群に比べ高齢で併存疾患が多く,輸血施行率が高かった.術後合併症,死亡率はともにA群で高かった(41.4% vs 21.7%;P<0.01, 8.62% vs 2.52%;P=0.031).しかし,出血性合併症は両群間で有意差を認めなかった.多変量解析ではASA ≧3,開腹手術,輸血が術後合併症のリスク因子として抽出されたが,抗血栓薬内服は有意差を認めなかった.結語:抗血栓薬内服は独立した出血性合併症を含めた術後合併症のリスク因子として選択されず,併存疾患,手術侵襲などとの複合的要因が術後合併症の発生に関与していることが示唆された.(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01117&link_issn=&doc_id=20190509270002&doc_link_id=10.5833%2Fjjgs.2018.0083&url=https%3A%2F%2Fdoi.org%2F10.5833%2Fjjgs.2018.0083&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Society of Gastroenterological Surgery  

Purpose: No standardized management of patients receiving antithrombotic drugs, and undergoing gastroenterological surgery, has been established. We investigated whether antithrombotic drugs usage could be a risk factor for postoperative complications after emergency abdominal surgery. Materials and Methods: A total of 454 patients who underwent abdominal emergency surgeries between Jan 2012 and Sep 2017, were retrospectively identified and included in this study. Patients were divided according to whether they had antithrombotic drugs treatment (n=58
Group A), or not (n=396
Group B). Background and perioperative variables were investigated. Result: Patients receiving antithrombotics have increased with time. Postoperative complications (Clavien-Dindo Classification ≥III), bleeding complications, and mortality rates were 24.2%, 2.0%, and 3.3%, respectively. Patients in Group A were older, with more comorbidity and higher transfusion rates than those in Group B. Postoperative complication and mortality rates in Group A were significantly higher than those in Group B (41.4% vs 21.7%
P &lt
0.01, 8.62% vs 2.52%
P=0.031, respectively), but no statistical difference was observed in bleeding complication rates. Multivariate analysis identified variables of ASA ≥3, open surgery, and transfusion, but not antithrombotic drug usage as independent predictive factors for postoperative complications. Conclusion: Antithrombotic drug usage was not identified as an independent risk factor for postoperative complications. Complication factors, including comorbidity and surgical stress, may contribute to the occurrence.

DOI： 10.5833/jjgs.2018.0083

Scopus

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

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記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

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記述言語：日本語   出版者・発行元：(一社)日本内視鏡外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

症例は86歳,女性.主訴は,数年前からの食後上腹部不快感と嘔吐.胸部X線検査にて左胸腔内に異常ガス像を認めた.上部消化管内視鏡検査では,胃の変形が高度で,胃体中部から幽門側への内視鏡到達は困難であった.上部消化管造影および胸部CT検査では,横隔膜上の縦隔内に全胃が軸偏位を伴って脱出していた.Upside down stomachを呈したIII型食道裂孔ヘルニアと診断し,腹腔鏡下に胃還納,食道裂孔縫縮,メッシュ留置による食道裂孔の補強,噴門形成術を施行した.術後経過は順調で,再発は認めていない.食道裂孔ヘルニアは比較的頻度の高い疾患であるが,軸捻転を伴うupside down stomachを呈したIII型食道裂孔ヘルニアは稀な疾患であり,今回われわれは腹腔鏡下手術を施行した1例を経験したので,若干の文献的考察を加えて報告する.(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J03156&link_issn=&doc_id=20150612050013&doc_link_id=10.3919%2Fjjsa.76.998&url=https%3A%2F%2Fdoi.org%2F10.3919%2Fjjsa.76.998&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

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記述言語：日本語   出版者・発行元：The Medical Association of Nippon Medical School  

Laparoscopic incisional hernia repair with mesh is widely performed in Western countries as a treatment that is considered more reliable than conventional open repair. However, this procedure is not common in Japan. We report our experiences with this procedure using a new type of mesh (Ventralight ST ^TM, Medicon, Osaka, Japan). This procedure is indicated for almost all patients with incisional hernia but was difficult to perform for patients with giant hernia of the flank after nephrectomy. The procedure is performed with the patient in the supine position and 4 or 5 ports. One port is a 12-mm port, and the others are 5-mm ports. First, the 12-mm port is inserted in the left hypochondrium by the optical method. After pneumoperitoneum is established, we observe the abdominal cavity with a 5-mm flexible endoscope and insert the other ports, while dissecting peritoneal adhesions as necessary. We measure the hernia and trim the mesh to secure at least a 3-cm overlap with the normal abdominal wall. We insert the mesh through the 12-mm port, lift it to make tight contact with the abdominal wall by means of a transfixed thread, and fix the mesh with spiral tackers. We have performed this procedure for 14 patients. The mean operative duration was 127 minutes, and the average postoperative hospital stay was 5.9 days. There were no complications except for seroma, and the patient satisfaction was extremely high. In conclusion, laparoscopic incisional hernia repair with mesh is a useful and promising treatment that will, we believe, be introduced in many institutions in Japan.

DOI： 10.1272/manms.11.16

CiNii Books

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その他リンク： https://jlc.jst.go.jp/DN/JLC/20007059658?from=CiNii

記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

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