[Evaluation of the surveillance program for hepatocellular carcinoma].

We examined the compliance with, and efficacy of, the clinical guideline for the diagnosis of hepatocellular carcinoma (HCC). We classified 74 patients with HCC into 3 categories;23 surveillance cases, 18 non-surveillance cases, and 33 incidental cases. Patients from affiliated hospitals included more non-surveillance and incidental cases than in university hospital-treated cases. HCC was diagnosed at an earlier stage in the surveillance group than the incidental group, and the surveillance group had a better outcome than the incidental group. There was no significant difference in HCC stage or outcome between surveillance and non-surveillance groups. The guidelines appeared to be useful for early diagnosis of HCC except for the fact that some in the surveillance group were diagnosed at an advanced stage and around 30% of the incidental group had some risk factors of HCC. Those conducting surveillance must improve their skills for early diagnosis of HCC and both doctors and patients must increase compliance with the guidelines.

Efficacy and Safety of a Novel Mouthpiece for Esophagogastroduodenoscopy: A Multi-Center, Randomized Study.

This randomized trial aimed to compare the safety and efficacy of the GAGLESS mouthpiece for esophagogastroduodenoscopy (EGD) with that of the conventional mouthpiece. In all, 90 participants were divided into the GAGLESS mouthpiece and conventional mouthpiece groups. The primary endpoint was the severity of pain using the visual analog scale (VAS), and secondary endpoints were examination time, past history of endoscopy, success of the procedure, systolic (SBP) and diastolic (DBP) blood pressure, oxygen saturation, pulse rate before and after EGD, and adverse events. Endoscopy was completed in all cases, and no complications were observed. VAS, when passing the scope through the pharynx, was 2.5 ± 2.4 and 2.0 ± 1.9 cm (p = 0.24) in the conventional and GAGLESS groups, respectively, and that, throughout the examination, was 2.5 ± 2.4 and 1.7 ± 1.5 cm (p = 0.06), respectively. The difference in blood pressure between the GAGLESS and conventional groups was not significant for SBP (p = 0.08) and significant for DBP (p = 0.03). The post-EGD difference in DBP was significantly lower in the GAGLESS group than in the conventional group. The results indicate that GAGLESS mouthpieces had a lower VAS during endoscopy than the conventional mouthpieces, and the changes in blood pressure were smaller with the GAGLESS mouthpiece.

[Effectiveness of S-1 therapy for unresectable/advanced pancreas cancer].

PURPOSE: Although the susceptibility to chemotherapy of unresectable/advanced pancreatic cancer is very poor, the usefulness of new anticancer drugs, such as S-1, has been reported in recent years. We clinically investigated whether or not S-1 would prolong survival in this study. OBJECTIVE: 17 unresectable pancreatic cancer patients who came for consultation between November 2001 and August 2008 (ten men, seven women). The average age was 72.5 years and performance statuses before medical treatment were 0-2. METHOD: A group of 8 patients did not use S-1 (non-S-1 group) and a group of a patients (S-1 group)did. The average survival period, one-year survival rate, and hospitalization rate were examined. RESULT: The average survival period of the non-S-1 group was 173.1 days, and its one-year survival rate was 12.5%, compared to 435.1 days and 55.6% in the S-1 group. The hospitalization rate was 25.6% in the S-1 group, against 53.1% in the non-S-1 group. DISCUSSION: S-1 treatment for unresectable/advanced pancreatic cancer served to prolong the survival period, suggesting it enabled extension of the recuperation-at-home period.

[Corrigendum] Preventive effect of caffeine and curcumin on hepato-carcinogenesis in diethylnitrosamine-induced rats.

Following the publication of this article, an interested reader drew to our attention an anomaly associated with the presentation of Figs. 3 and 4; essentially, there was the direct duplication of a panel between Fig. 3B, upper left­hand panel (the G1-10W data) and Fig. 4B, also the upper left-hand panel (the G1-14W data). In the upper-left panels of Fig. 3B and 4B, we wanted to demon-strate microscopic features of the control liver at 10 weeks and 14 weeks, respectively. After having re-examined our original data, we note that we inadvertently duplicated the picture of the control liver at 14 weeks in the upper­left panel of Fig. 3B. A corrected version of Fig. 3 is presented below, in which the G1-10W data in Fig. 3B are now correctly shown. Since G1-10W and G1-14W are control images of the liver, exhibiting a normal appearance, this error did not affect the findings in the study. We sincerely apologize for this mistake, and thank the reader of our article who drew this matter to our attention. Furthermore, we regret any inconvenience this mistake has caused. [the original article was published in the International Journal of Oncology 40: 1779-1788, 2012; DOI: 10.3892/ijo.2012.1343].

Preventive Effect of Geraniol on Diethylnitrosamine-Induced Hepatocarcinogenesis in Rats.

BACKGROUND: Geraniol is a plant-derived phytochemical possessing anti-cancer action. The anti-carcinogenic effect of geraniol was investigated in the diethylnitrosamine (DEN)-induced hepatocarcinogenic rat model. METHODS: Male Wistar rats were intraperitoneally injected with 300 µL of phosphate-buffered saline (PBS) (G1; n = 4) or DEN (100 mg/kg body weight) dissolved in PBS (G2; n = 8) every 2 weeks on experimental weeks 2, 4 and 6. The rats were treated with a low concentration (0.07%) of geraniol (G3; n = 9) and high concentration (0.35%) of geraniol (G4; n = 7) for 12 weeks. To evaluate the effects of geraniol on the DEN-induced hepatocarcinogenesis, we compared the relative liver weight, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) levels and expression levels of proliferating cell nuclear antigen (PCNA) and glutathione S transferase-P (GST-P) by immunohistochemical analyses among each group. RESULTS: Relative liver weight was significantly higher in G2 than in G1 (P < 0.01). Both serum AST and ALT levels were significantly higher in G2 than in G3 and in G4 (P < 0.05). Serum ALP levels did not show a significant difference among each group. Percentages of both PCNA- and GST-P- positive area were significantly decreased in G3 and in G4 compared to in G2 (P < 0.001, respectively), suggesting anti-hepatocarcinogenic effects of geraniol. CONCLUSION: Geraniol is a promising compound useful for suppression of hepatocellular carcinoma. The mechanisms of action are required to be clarified in the future intensive study.

Development of a device for detecting target specimens from EUS-guided FNA samples.

BACKGROUND AND STUDY AIMS: Specimens collected by fine needle are microscopic and contain blood; therefore, the presence of a target specimen within a sample is often difficult to confirm. Although rapid on-site evaluation (ROSE) during endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNA) is beneficial, many health care facilities are unable to apply this technique due to a lack of cytopathologists. The aim of this study was to develop and validate a device that detects the target specimen within pancreatic tumor EUS-FNA samples. PATIENTS AND METHODS: Fifty-eight consecutive patients with solid pancreatic masses were studied for a preliminary case series at a tertiary-care university hospital (Tottori University Hospital, Yonago, Japan). The material collected was checked with a target sample check illuminator (TSCI) and was evaluated by one cytopathologist. RESULTS: The agreement rate between the TSCI and histopathology was 93.7 %. Further testing procedures were not needed in 91.4 % of patients, and the mean number of needle punctures was 1.2 after a single pass using TSCI. No adverse events were encountered with the procedure. CONCLUSIONS: With the introduction of the TSCI in EUS-FNA, it became possible to both collect the minimum necessary target samples by EUS-FNA and to end further procedures, even without performing ROSE.

Null anticarcinogenic effect of silymarin on diethylnitrosamine-induced hepatocarcinogenesis in rats.

The aim of this study was to investigate the anticarcinogenic effects of silymarin in diethylnitrosamine (DEN)-induced hepatocarcinogenic rat models. Severe and mild models of hepatocellular carcinoma (HCC) were generated by the intraperitoneal administration of 40 mg/kg DEN once a week for 18 weeks and 100 mg/kg DEN every 2 weeks for 6 weeks in male Wistar rats, respectively. In the severe and mild models of HCC, the rats were treated with 0.1 and 0.5% silymarin for 18 weeks and with 0.1% silymarin for 5 weeks, respectively. Serum transaminase levels were not significantly decreased by the silymarin treatment in either model. Macroscopic and microscopic features indicated that the silymarin-containing formulations did not significantly inhibit the hepatic tumor formation induced by DEN. Furthermore, immunohistochemical and western blot analyses demonstrated that the expression levels of proliferating cell nuclear antigen and glutathione S-transferase P, which are hepatocarcinogenic markers, were not significantly modified by the silymarin treatment. These results indicate that silymarin may not be considered as a candidate agent against hepatocarcinogenesis.

Preventive effect of caffeine and curcumin on hepato-carcinogenesis in diethylnitrosamine-induced rats.

Chemopreventive effects of caffeine and curcumin were evaluated in the diethylnitrosamine (DEN)-induced hepatocarcinogenic rat model. Animals injected with DEN for 10 weeks (G2-10w) and 14 weeks (G2-14w) were hepato-carcinogenic rats. Animals injected with DEN and treated with curcumin and caffeine for 10 weeks (G3-10w, G4-10w) and 14 weeks (G3-14w, G4-14w) were compared with those in G2. Macroscopic and microscopic features suggested that treatment with caffeine, but not curcumin, for 10 and 14 weeks was effective in inhibiting DEN-induced hepatocarcinogenesis. Immunohistochemical and western blot analysis with proliferating cell nuclear antigen and glutathione S-transferase-P antibodies also showed that expression levels of these hepato-carcinogenic markers were more efficiently reduced by treatment with caffeine than curcumin. Our data demonstrate that caffeine could be a more potent compound than curcumin for prevention of hepatocarcinogenesis in DEN-induced rats.

Sequential analysis of diethylnitrosamine-induced hepatocarcinogenesis in rats.

In the present study, we examined the sequential changes of diethylnitrosamine (DEN)-induced hepatocarcinogenesis in Wistar rats. After 14 weeks of DEN treatment, hyperplastic nodules developed as a consequence of the appearance of renewed hepatocytes, degenerated hepatocytes, oval cells and fibrotic changes. Total bilirubin and alanine aminotransferase levels were significantly higher in the DEN group compared to the control group throughout the experimental period. Our data may prove beneficial to future analyses of chemopreventive compounds during various stages of hepatocarcinogenesis in rats.

Chemoprevention against hepatocellular carcinoma.

Since the majority of hepatocellular carcinoma (HCC) arises from a background of chronic liver diseases caused by infection with hepatitis C virus (HCV) and hepatitis B virus (HBV), chemoprevention targeting patients at high risk of HCC is feasible. In this review article, we summarize current knowledge of chemoprevention against HCC mostly using phytochemicals which have less toxicity than pharmaceutical agents. We describe in vivo and in vitro evidence and proposed mechanisms of beneficial effects of several compounds on the liver, including acyclic retinoid (ACR), angiotensin-converting enzyme inhibitors (ACEIs), caffeine, capsaicin, cepharanthine (CEP), cinnamaldehyde, curcumin, diallyl sulfide (DAS), eicosapentaenoic acid (EPA), epigallocatechin-3-gallate (EGCG), genistein, lycopene, resveratrol, silymarin, sulforaphane (SFN), and xanthohumol (XN). Because antihepatocarcinogenic effects by these compounds are mostly based on experimental studies, clinical evidence is urgently necessary.