Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.

In this study, we aimed to develop foods with antitumor and complementary effects against cisplatin (CDDP)-resistant bladder cancer. UMUC3, a human bladder cancer cell line was exposed to CDDP and cultured over a prolonged period to prepare UMUC3-CR, a CDDP-resistant subline. Androgen receptor mRNA expression was high in the UMUC3-CR subline. Genistein and vitamin C suppressed UMUC3-CR tumor growth. Additionally, the liberal intake of cheese in parental cell UMUC3-transplanted mice was associated with prolonged survival. Therefore, we created konjac jelly (KIK300) containing soy milk, cheese, and vitamin C as the main ingredients. Liberal administration of KIK300 to UMUC3-CR-transplanted mice suppressed tumor growth and reduced vascular endothelial growth factor mRNA expression. Furthermore, we observed no weight loss in the animals, their skin condition improved, and exercise capacity was improved. In conclusion, this study suggests that KIK300 may show antitumor and complementary effects on CDDP-resistant bladder cancer.

Gastric cancer remains one of the most common causes of cancer-related death worldwide, although the incidence is declining gradually. The primary risk factor for gastric cancer is Helicobacter pylori infection. The Kyoto global consensus report recommends eradication of H. pylori in all infected patients. However, because it is difficult to stratify the risk of carcinogenesis among patients with a history of H. pylori infection, annual endoscopic surveillance is performed for everyone after eradication. This review summarizes the current approaches used to screen for novel molecules that could assist in the diagnosis of gastric cancer and reduce mortality. Most well-studied molecules are tissue protein biomarkers expressed by the gastric epithelium and associated with metaplasia-dysplasia-carcinoma sequences. Other strategies focus on the origin of cancer stem cell-related markers, such as CD44, and immune reaction-related markers, such as matrix metallopeptidases. Noninvasive methods such as blood-based approaches are more attractive. Serum pepsinogen levels predict the severity of gastric mucosal atrophy before H. pylori eradication, whereas plasma ghrelin levels are associated with atrophy even after eradication.Cell-free DNAs and RNAs are attractive tools for the early detection of cancer. These ideas could lead to the development of more personalized strategies for cancer prevention based on cuttingedge technologies.

Background/Aims: The recovery room used after endoscopy has limited capacity, and an efficient flow of the endoscopy unit is desired. We investigated the duration of hospital stay after endoscopy and the risk factors for prolonged hospital stay among outpatients. Methods: We retrospectively studied consecutive patients who underwent esophagogastroduodenoscopy or colonoscopy at the Toyoshima Endoscopy Clinic. We collected data on age, sex, body weight, midazolam and pethidine dosage, respiratory depression during endoscopy, and duration of hospital stay after endoscopy (scope out to check out). Risk factors for prolonged hospital stay (>100 minutes) were identified using multiple logistic regression analysis. Results: We enrolled 3,898 patients, including 3,517 (90.2%) patients tested under sedation and 381 (9.8%) patients tested without sedation. Overall, 442 (11.3%) patients had prolonged stay (>100 min). The mean time difference between sedation group and non-sedation group was 44.2 minutes for esophagogastroduodenoscopy and 39.1 minutes for colonoscopy. Age (odds ratio [OR], 1.025; 95% confidence interval [CI], 1.014−1.036), female sex (OR, 1.657; 95% CI, 1.220−2.249), and midazolam dose (OR, 1.019; 95% CI, 1.013−1.026) were independently associated with prolonged hospital stay after esophagogastroduodenoscopy, with similar results for colonoscopy. Conclusions Old age, female sex, and midazolam dose were independent risk factors for prolonged hospital stay after endoscopy.

Esophageal achalasia is a primary motility disorder characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. Achalasia is a chronic disease that causes progressive irreversible loss of esophageal motor function. The recent development of high-resolution manometry has facilitated the diagnosis of achalasia, and determining the achalasia subtypes based on high-resolution manometry can be important when deciding on treatment methods. Peroral endoscopic myotomy is less invasive than surgery with comparable efficacy. The present guidelines (the “2019 Seoul Consensus on Esophageal Achalasia Guidelines”) were developed based on evidence-based medicine; the Asian Neurogastroenterology and Motility Association and Korean Society of Neurogastroenterology and Motility served as the operating and development committees, respectively. The development of the guidelines began in June 2018, and a draft consensus based on the Delphi process was achieved in April 2019. The guidelines consist of 18 recommendations: 2 pertaining to the definition and epidemiology of achalasia, 6 pertaining to diagnoses, and 10 pertaining to treatments. The endoscopic treatment section is based on the latest evidence from meta-analyses. Clinicians (including gastroenterologists, upper gastrointestinal tract surgeons, general physicians, nurses, and other hospital workers) and patients could use these guidelines to make an informed decision on the management of achalasia.