2021/10/25 更新

写真a

ヨコヤマ ジュンジ
横山 純二
YOKOYAMA Junji
所属
医歯学総合病院 光学医療診療部 准教授
職名
准教授
外部リンク

学位

  • 博士(医学) ( 2002年3月   新潟大学 )

経歴(researchmap)

  • 新潟大学   医歯学総合病院 光学医療診療部   准教授

    2017年4月 - 現在

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  • 新潟大学   医歯学総合病院 消化器内科   講師

    2016年4月 - 2017年3月

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  • 新潟大学   医歯学総合病院 消化器内科   助教

    2015年6月 - 2016年3月

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  • 新潟大学   医歯学総合病院 消化器内科   特任助教

    2012年11月 - 2015年5月

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  • 新潟大学   医歯学総合病院 第三内科   特任助教

    2010年10月 - 2012年11月

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経歴

  • 新潟大学   医歯学総合病院 光学医療診療部   准教授

    2017年4月 - 現在

  • 新潟大学   医歯学総合病院 消化器内科   講師

    2016年4月 - 2017年3月

  • 新潟大学   医歯学総合病院 消化器内科   助教

    2015年6月 - 2016年3月

  • 新潟大学   医歯学総合病院 消化器内科   特任助教

    2012年11月 - 2015年5月

  • 新潟大学   第三内科   特任助教

    2010年10月 - 2012年11月

 

論文

  • A case of Helicobacter pylori -negative early gastric adenocarcinoma with gastrointestinal phenotype. 国際誌

    Masafumi Takatsuna, Rie Azumi, Takeshi Mizusawa, Hiroki Sato, Ken-Ichi Mizuno, Takashi Kato, Junji Yokoyama, Yoichi Ajioka, Shuji Terai

    Endoscopy international open   9 ( 6 )   E863-E866   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 40-year-old man with slightly depressed (0-IIc) type gastric cancer of the pyloric anterior gastric area underwent pre-operative screening for tetralogy of Fallot and endoscopic submucosal dissection (ESD) and was tested for Helicobacter pylori antigens and antibodies. Both tests were negative. He did not have a history of eradication. Pathological diagnosis of ESD showed a well-differentiated adenocarcinoma. The tumor was CD10-positive, MUC5AC-negative, and MUC6-confocal positive; it showed differentiation with gastrointestinal phenotype. Moreover, the tumor cells were lysozyme-positive, resembling Paneth cells. Mucosal glands exhibited intestinal metaplasia on the anal side of the tumor lesion. On the oral side of the tumor, metaplasia was non-existent, with normal pyloric glands present in the mucosal layer. The patient was not infected with H. pylori ; however, intestinal metaplasia existed around the early gastric cancer. This suggested that the intestinal metaplasia occurred due to bile reflux, and the gastric neoplasia arose with the metaplasia without an H. pylori infection. This case may potentially help explain gastric cancer development in the absence of H. pylori infection.

    DOI: 10.1055/a-1396-3854

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  • Rapid decline in visceral adipose tissue over 1 month is associated with poor prognosis in patients with unresectable pancreatic cancer. 国際誌

    Oki Nakano, Hirokazu Kawai, Takamasa Kobayashi, Junji Kohisa, Satoshi Ikarashi, Kazunao Hayashi, Junji Yokoyama, Shuji Terai

    Cancer medicine   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Involuntary weight loss related to cachexia is common in patients with advanced cancer, but the association between body composition changes and survival is still unclear in pancreatic cancer. METHODS: We retrospectively reviewed the clinical outcomes of 55 patients with advanced pancreatic cancer undergoing palliative therapy or best supportive care (BSC). The skeletal muscle index (SMI), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral to subcutaneous adipose tissue area ratio (VSR) were calculated based on the cross-sectional area on two sets of computed tomography images obtained at cancer diagnosis and 1 month later before treatment. The prognostic value of body composition indexes at diagnosis and the changes in those indexes over 1 month was then evaluated. RESULTS: In total, 45 patients (81.8%) received chemotherapy, chemoradiation, or radiation therapy, whereas the remaining patients underwent BSC. There were 27 patients (49.1%) who had low SMI at cancer diagnosis. Univariate analysis showed no significant associations between the baseline body composition indexes including SMI, VATI, SATI, and VSR and survival. Meanwhile, male sex (HR, 2.79; 95% CI, 1.16-6.71, p = 0.022) and higher decrease in VATI over 1 month (HR, 2.41; 95% CI, 1.13-5.13, p = 0.023) were identified as independent risk factors for mortality in multivariate analysis. CONCLUSION: Rapid decline in VAT over 1 month is closely associated with poorer survival in unresectable advanced pancreatic cancer. A short-term assessment of body composition changes may be a rational approach to predict prognosis in these patients.

    DOI: 10.1002/cam4.3964

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  • Evaluation of intestinal microbiota, short-chain fatty acids, and immunoglobulin a in diversion colitis. 国際誌

    Kentaro Tominaga, Atsunori Tsuchiya, Takeshi Mizusawa, Asami Matsumoto, Ayaka Minemura, Kentaro Oka, Motomichi Takahashi, Tomoaki Yosida, Yuzo Kawata, Kazuya Takahashi, Hiroki Sato, Satoshi Ikarashi, Kazunao Hayashi, Ken-Ichi Mizuno, Yosuke Tajima, Masato Nakano, Yoshifumi Shimada, Hitoshi Kameyama, Junji Yokoyama, Toshifumi Wakai, Shuji Terai

    Biochemistry and biophysics reports   25   100892 - 100892   2021年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    It is reported that an increase in aerobic bacteria, a lack of short-chain fatty acids (SCFAs), and immune disorders in the diverted colon are major causes of diversion colitis. However, the precise pathogenesis of this condition remains unclear. The aim of the present study was to examine the microbiota, intestinal SCFAs, and immunoglobulin A (IgA) in the diverted colon. Eight patients underwent operative procedures for colostomies. We assessed the diverted colon using endoscopy and obtained intestinal samples from the diverted colon and oral colon in these patients. We analyzed the microbiota and SCFAs of the intestinal samples. The bacterial communities were investigated using a 16S rRNA gene sequencing method. The microbiota demonstrated a change in the proportion of some species, especially Lactobacillus, which significantly decreased in the diverted colon at the genus level. We also showed that intestinal SCFA values were significantly decreased in the diverted colon. Furthermore, intestinal IgA levels were significantly increased in the diverted colon. This study was the first to show that intestinal SCFAs were significantly decreased and intestinal IgA was significantly increased in the diverted colon. Our data suggest that SCFAs affect the microbiota and may play an immunological role in diversion colitis.

    DOI: 10.1016/j.bbrep.2020.100892

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  • Molecular Mechanisms and Treatment of Sarcopenia in Liver Disease: A Review of Current Knowledge. 国際誌

    Hiroteru Kamimura, Takeki Sato, Kazuki Natsui, Takamasa Kobayashi, Tomoaki Yoshida, Kenya Kamimura, Atsunori Tsuchiya, Toshiko Murayama, Junji Yokoyama, Hirokazu Kawai, Masaaki Takamura, Shuji Terai

    International journal of molecular sciences   22 ( 3 )   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength that occurs with aging or in association with various diseases. The condition is prevalent worldwide and occurs more frequently in patients with chronic diseases owing to the intrinsic relationship of muscles with glucose, lipid, and protein metabolism. Liver cirrhosis is characterized by the progression of necro-inflammatory liver diseases, which leads to fibrosis, portal hypertension, and a catabolic state, which causes loss of muscle tissue. Sarcopenia is of significant concern in the state of liver cirrhosis because sarcopenia has been associated with higher mortality, increased hospital admissions, worse post-liver transplant outcomes, decreased quality of life, and increased risk for other complications associated with cirrhosis. Therefore, sarcopenia is also an important feature of liver cirrhosis, representing a negative prognostic factor and influencing mortality. An increased understanding of sarcopenia could lead to the development of novel therapeutic approaches that could help improve the cognitive impairment of cirrhotic patients; therefore, we present a review of the mechanisms and diagnosis of sarcopenia in liver disease and existing therapeutic approaches.

    DOI: 10.3390/ijms22031425

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  • Comparison of Oral and Esophageal Microbiota in Patients with Achalasia Before and After Peroral Endoscopic Myotomy. 国際誌

    Kazuya Takahashi, Hiroki Sato, Takeshi Mizusawa, Kentaro Tominaga, Satoshi Ikarashi, Kazunao Hayashi, Ken-Ichi Mizuno, Satoru Hashimoto, Junji Yokoyama, Shuji Terai

    The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology   32 ( 1 )   42 - 52   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND/AIMS: Patients with achalasia have a high incidence of esophageal squamous cell carcinoma (ESCC), which may be associated with alterations in oral and esophageal microbiota caused by food stasis. This study compared the oral and esophageal microbiota of patients with achalasia before and after peroral endoscopic myotomy (POEM). It also compared patients with achalasia to those with ESCC. MATERIALS AND METHODS: The study prospectively examined 6 patients with achalasia and 14 with superficial ESCC. Oral samples obtained from the buccal mucosa using a swab and esophageal samples obtained from the mid-esophagus using a brush via endoscopy were analyzed by 16S rRNA metagenome sequencing. Additionally, endoscopic and histological findings of patients with achalasia before and after POEM were prospectively compared. RESULTS: In patients with achalasia, Streptococcus was most abundant in both the oral and the esophageal microbiota, and these microbiota were significantly different. Although the overall structure of the oral and esophageal microbiota did not change after POEM, the relative abundance rate of Haemophilus and Neisseria increased in the esophagus, and endoscopic findings of inflammation improved after POEM (P = .04). The relative abundance of microbiota was not different among patients with achalasia from those with ESCC. CONCLUSIONS: The oral and esophageal microbiota were significantly different in patients with achalasia, and some of the composition of the esophageal microbiota changed after POEM. However, these findings and disease-specific microbiota should be further evaluated in large-scale studies.

    DOI: 10.5152/tjg.2020.19995

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  • Visceral Adipose Tissue Index and Hepatocellular Carcinoma Are Independent Predictors of Outcome in Patients with Cirrhosis Having Endoscopic Treatment for Esophageal Varices. 査読 国際誌

    Naruhiro Kimura, Atsunori Tsuchiya, Chiyumi Oda, Atsushi Kimura, Kazunori Hosaka, Kentaro Tominaga, Kazunao Hayashi, Junji Yokoyama, Shuji Terai

    Digestive diseases (Basel, Switzerland)   39 ( 1 )   58 - 65   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The relationship between the amount of adipose tissue and advanced-stage liver cirrhosis with esophageal varices (EV) is unknown. We aimed to reveal the prognostic significance of adipose tissues in patients with liver cirrhosis. METHODS: We enrolled 87 patients with EV who received initial endoscopic treatment and underwent scheduled treatments in our hospital. Computed tomography (CT) images were obtained of a 5-mm slice at the umbilical level. We evaluated the effect of mortality based on the visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral to subcutaneous adipose tissue ratio (VSR). RESULTS: Cox hazard multivariate analysis showed that the presence of hepatocellular carcinoma (HCC; hazard ratio [HR]: 4.650, 95% confidence interval [CI]: 1.750-12.353, p = 0.002), γ-GTP (HR: 1.003, 95% CI: 1.001-1.006, p = 0.026), and VATI (HR: 1.057, 95% CI: 1.030-1.085, p < 0.001) significantly affected mortality. Cox hazard multivariate analysis for liver-related death was also significantly affected by HCC (HR: 1.057, 95% CI: 1.030-1.085, p < 0.001) and VATI (HR: 1.052, 95% CI: 1.019-1.086, p = 0.002). The difference between the Child-Pugh scores 12 months after treatment and that during initial treatment were significantly positively correlated with VATI (r = 0.326, p = 0.027). Patients with high VATI had a significantly higher frequency of HCC after EV treatment by Kaplan-Meier analysis (p = 0.044). CONCLUSION: Our findings suggest that VATI measured by CT could significantly predict mortality in cirrhosis patients through decreasing liver function and increasing HCC frequency, and appropriately controlling VATI could improve their prognosis.

    DOI: 10.1159/000508867

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  • Increase in muscle mass associated with the prebiotic effects of 1-kestose in super-elderly patients with sarcopenia.

    Kentaro Tominaga, Atsunori Tsuchiya, Oki Nakano, Yasutoshi Kuroki, Kentaro Oka, Ayaka Minemura, Asami Matsumoto, Motomichi Takahashi, Yoshihiro Kadota, Takumi Tochio, Yusuke Niwa, Tomoaki Yoshida, Masatoshi Sato, Takeshi Yokoo, Satoru Hashimoto, Junji Yokoyama, Jun Matsuzawa, Katsuya Fujimori, Shuji Terai

    Bioscience of microbiota, food and health   40 ( 3 )   150 - 155   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Sarcopenia causes functional disorders and decreases the quality of life. Thus, it has attracted substantial attention in the aging modern world. Dysbiosis of the intestinal microbiota is associated with sarcopenia; however, it remains unclear whether prebiotics change the microbiota composition and result in the subsequent recovery of muscle atrophy in elderly patients with sarcopenia. This study aimed to assess the effects of prebiotics in super-elderly patients with sarcopenia. We analyzed the effects of 1-kestose on the changes in the intestinal microbiota and body composition using a next-generation sequencer and a multi-frequency bioimpedance analysis device. The Bifidobacterium longum population was significantly increased in the intestine after 1-kestose administration. In addition, in all six patients after 12 weeks of 1-kestose administration, the skeletal muscle mass index was greater, and the body fat percentage was lower. This is the first study to show that administration of a prebiotic increased the population of B. longum in the intestinal microbiota and caused recovery of muscle atrophy in super-elderly patients with sarcopenia.

    DOI: 10.12938/bmfh.2020-063

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  • Monitoring chronological change by liver-to-spleen attenuation ratio for secondary hepatic steatosis for a short term. 査読

    Hiroteru Kamimura, Kunihiko Yokoyama, Shunsuke Nojiri, Yuko Komoro, Toshiko Murayama, Yu Koyama, Kenya Kamimura, Masaaki Takamura, Junji Yokoyama, Shuji Terai

    Clinical journal of gastroenterology   13 ( 6 )   1219 - 1224   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Parenteral nutrition-associated liver disease (PNALD) causes hepatic steatosis and moderate liver enzyme elevation due to lack of enteral nutrition and deficiency of some nutrients. However, the period for recovery from PNALD after a nutritional intervention is unknown with no report. Herein, we report a case of a 44-year-old Japanese woman with severe fatty infiltration of the liver due to malnutrition. Our nutritional support team administered appropriate total parenteral, especially fat and carnitine, nutrition to improve her malnutrition. Chronological changes in liver-to-spleen attenuation ratio were also considered because of her disease state. Computed tomography demonstrated improved attenuation of the liver, and the liver enzymes level normalized after 5 weeks from appropriate nutrition. Understanding the nutritional condition of a patient may help in elucidating an appropriate treatment strategy.

    DOI: 10.1007/s12328-020-01165-w

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  • Usefulness of ultrasonography to assess the response to steroidal therapy for the rare case of type 2b immunoglobulin G4-related sclerosing cholangitis without pancreatitis: A case report. 国際誌

    Yuto Tanaka, Kenya Kamimura, Ryota Nakamura, Marina Ohkoshi-Yamada, Yohei Koseki, Takeshi Mizusawa, Satoshi Ikarashi, Kazunao Hayashi, Hiroki Sato, Akira Sakamaki, Junji Yokoyama, Shuji Terai

    World journal of clinical cases   8 ( 22 )   5821 - 5830   2020年11月

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    記述言語:英語  

    BACKGROUND: A type 2b immunoglobulin G4 (IgG4)-related sclerosing cholangitis (SC) without autoimmune pancreatitis is a rare condition with IgG4-SC. While the variety of the imaging modalities have tested its usefulness in diagnosing the IgG4-SC, however, the usage of ultrasonography for the assessment of the response to steroidal therapy on the changes of bile duct wall thickness have not been reported in the condition. Therefore, the information of our recent case and reported cases have been summarized. CASE SUMMARY: We report the case of an 82-year-old Japanese man diagnosed with isolated IgG4-related SC based on the increase of serum IgG4, narrowing of the bile duct, its wall thickness, no complication of autoimmune pancreatitis, and IgG4 positive inflammatory cell infiltration to the wall with the fibrotic changes. The cholangiogram revealed type 2b according to the classification. Corticosteroid treatment showed a favorable effect, with the smooth decrease in serum IgG4 and the improvement of the bile duct wall thickness. CONCLUSION: As isolated type 2b, IgG4-SC is rare, the images, histological findings, and clinical course of our case will be helpful for physicians to diagnose and treat the new cases appropriately.

    DOI: 10.12998/wjcc.v8.i22.5821

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  • Esophageal High-Resolution Manometry for Diagnosing the Severity of the Chronic Intestinal Pseudo-Obstruction: A Case Series. 国際誌

    Hiroki Sato, Kenya Kamimura, Hideaki Matsui, Takashi Owaki, Shinichi Morita, Yuto Tanaka, Natsuki Ishikawa, Yoshifumi Shimada, Junji Yokoyama, Toshifumi Wakai, Shuji Terai

    Digestive diseases and sciences   2020年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Chronic intestinal pseudo-obstruction (CIPO) is a severe and refractory intestinal motility disorder. However, due to its rarity and difficult histological investigation, its pathophysiology has not been characterized. AIM: Therefore, in this study, we aimed to determine the role of esophageal high-resolution manometry (HRM) in CIPO and the histological and clinical characteristics of the disease. METHODS: Patients with CIPO were analyzed for clinical characteristics; histological findings; and clinical courses after therapeutic intervention. In addition, HRM was performed to determine the esophageal involvement. RESULTS: Eleven patients were diagnosed with CIPO, and five required the long period of parenteral nutrition showing impaired esophageal motility including achalasia and absent contractility diagnosed with HRM. The four of these five cases showed acute onset of the CIPO following the triggering events of pregnancy, appendicitis, and surgery. In contrast, other six patients with normal or Jackhammer esophagus on HRM had moderate severity of CIPO with gradual onset. The histological analyses revealed that the loss of the intestinal neural ganglion cells and layers by inflammation, destruction, and atrophy are related to the severity of the clinical course of the disease and esophageal HRM findings of achalasia and absent contractility. CONCLUSIONS: HRM may be useful to diagnose the severity of the clinical course and to determine the therapeutic options for CIPO.

    DOI: 10.1007/s10620-020-06701-9

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  • 被包化膵壊死への真菌感染による敗血症性ショックをきたした一例

    山田 麻理奈[大越], 上村 顕也, 石川 夏生, 小関 洋平, 田中 裕登, 水澤 健, 佐藤 裕樹, 五十嵐 聡, 林 和直, 坂牧 僚, 横山 純二, 寺井 崇二

    日本消化器病学会甲信越支部例会抄録集   67回   26 - 26   2020年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-甲信越支部  

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  • Esophageal Ulcers Associated with Ulcerative Colitis: A Case Series and Literature Review. 査読

    Kentaro Tominaga, Atsunori Tsuchiya, Hiroki Sato, Takeshi Mizusawa, Shinichi Morita, Yui Ishii, Nobutaka Takeda, Kazuki Natsui, Yuzo Kawata, Naruhiro Kimura, Yoshihisa Arao, Kazuya Takahashi, Kazunao Hayashi, Junji Yokoyama, Shuji Terai

    Internal medicine (Tokyo, Japan)   59 ( 16 )   1983 - 1989   2020年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Ulcerative colitis, a chronic and recurrent inflammatory disease, is localized to the colonic mucosa but can affect other organs and lead to various complications. Gastroduodenitis associated with ulcerative colitis has been reported. However, little is known about esophageal ulcers. We herein report two rare cases of esophageal ulcers associated with ulcerative colitis. Furthermore, the clinical and histological characteristics of 18 previously reported cases are summarized. This case series and literature review will encourage the accurate diagnosis and treatment of esophageal ulcers associated with ulcerative colitis.

    DOI: 10.2169/internalmedicine.4437-20

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  • Advanced squamous cell carcinoma in an asymptomatic, large, epiphrenic esophageal diverticulum.

    Tomoaki Yoshida, Satoru Hashimoto, Ken-Ichi Mizuno, Hiroshi Ichikawa, Junji Yokoyama, Hajime Umezu, Shuji Terai

    Clinical journal of gastroenterology   13 ( 4 )   477 - 482   2020年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    An asymptomatic epiphrenic diverticulum (ED) was diagnosed in a man undergoing annual esophagogastroduodenoscopy (EGD) at another hospital 40 years before he presented to our hospital at age 63 years for his annual EGD. However, because substantial food retention was found in the ED, we could not confirm a lesion. After the retained food was removed endoscopically, a second EGD showed a reddish, flat lesion with an elevated mass within the ED. Endoscopic ultrasonography indicated that the elevated mass was deep in the submucosal layer. An esophagram showed that the ED was approximately 80 mm in diameter, which is considered large. An endoscopic biopsy of the lesion confirmed squamous cell carcinoma. Total esophagectomy was performed. Microscopic examination revealed well-differentiated to moderately differentiated squamous cell carcinoma invading the adventitia at the elevated lesion. The final pathological stage was pT3N0M0. There was no evidence of recurrence for 3 years during the quarterly follow-up examinations. To our knowledge, this case involved the longest asymptomatic term (40 years) since the ED was detected. A review of 18 reported cases of carcinoma in an ED indicated that advanced cancer has a poor prognosis. Periodic follow-up of ED patients is essential for early diagnosis.

    DOI: 10.1007/s12328-020-01098-4

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  • 側方発育型大腸腫瘍と肥満ならびに代謝指数に関する検討

    高綱 将史, 水野 研一, 川田 雄三, 冨永 顕太郎, 水澤 健, 佐藤 裕樹, 五十嵐 聡, 林 和直, 横山 純二, 橋本 哲, 寺井 崇二

    Gastroenterological Endoscopy   62 ( Suppl.1 )   1332 - 1332   2020年8月

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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  

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  • Rare case of circumferential esophageal peeling. 査読 国際誌

    Kentaro Tominaga, Atsunori Tsuchiya, Hiroki Sato, Yui Ishii, Nobutaka Takeda, Kazuki Natsui, Yuzo Kawata, Naruhiro Kimura, Yoshihisa Arao, Suguru Takeuchi, Kazunao Hayashi, Junji Yokoyama, Shuji Terai

    Clinical case reports   8 ( 7 )   1306 - 1308   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    This report highlights the easy peeling of the esophageal epithelium with Nikolsky phenomenon after swallowing the foreign body and the healing status of the esophagus only 3 days later in a patient of pemphigus vulgaris.

    DOI: 10.1002/ccr3.2846

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  • Cytapheresis for pyoderma gangrenosum associated with inflammatory bowel disease: A review of current status. 査読 国際誌

    Kentaro Tominaga, Kenya Kamimura, Hiroki Sato, Masayoshi Ko, Yuzo Kawata, Takeshi Mizusawa, Junji Yokoyama, Shuji Terai

    World journal of clinical cases   8 ( 11 )   2092 - 2101   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Pyoderma gangrenosum (PG) is a neutrophilic dermatosis clinically characterized by the presence of painful skin ulcerations with erythematous. As it is frequently associated with inflammatory bowel diseases, including ulcerative colitis, gastroenterologists should be familiar with the disease including therapeutic options. Therefore, we have conducted a review focusing on the cytapheresis for PG in cases of inflammatory bowel diseases. A literature search was conducted to extract studies published in the last 20 years, with information on demographics, clinical symptoms, treatment, and the clinical course from a total of 22 cases reported and our recent case. In most patients, cytapheresis was associated with improvement or resolution of PG after failure of conventional therapeutic options such as corticosteroids, antibiotics, immunosuppressive agents and immunoglobulin. Based on the information summarized, cytapheresis is helpful in the majority of patients with PG refractory to medical treatment associated with inflammatory bowel diseases and could be further studied in a multicenter, randomized trial.

    DOI: 10.12998/wjcc.v8.i11.2092

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  • Small Intestinal Bacterial Overgrowth Diagnosed by a Breath Test and Improved by Rifaximin in a Patient with Hepatic Encephalopathy and Alcoholic Liver Cirrhosis: A Case Report. 査読

    Akira Sakamaki, Kunihiko Yokoyama, Fusako Yamazaki, Hiroteru Kamimura, Kenya Kamimura, Masaaki Takamura, Junji Yokoyama, Shuji Terai

    Internal medicine (Tokyo, Japan)   59 ( 15 )   1849 - 1853   2020年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 66-year-old Japanese man was admitted to our hospital with grade 2 hepatic encephalopathy (HE). Abdominal computed tomography and laboratory examinations revealed decompensated liver cirrhosis. Intravenous administration of branched-chain amino acids immediately ameliorated the HE, and lactulose was initiated. However, a breath test revealed small intestinal bacterial overgrowth (SIBO); therefore, rifaximin was additionally initiated. The breath test was repeated after discharge, when no evidence of SIBO or overt HE was identified. This case suggested that a breath test is effective for the identification of SIBO and that the administration of a poorly absorbed antibiotic should be considered in SIBO-positive HE patients taking lactulose.

    DOI: 10.2169/internalmedicine.4593-20

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  • Rare Genotype of His/His in NUDT15 Codon 139 and Thiopurine-associated Adverse Events in a Case of Ulcerative Colitis. 査読

    Kei Tomiyoshi, Hiroki Sato, Kentaro Tominaga, Yuzo Kawata, Daisuke Okamoto, Yoichi Kakuta, Junji Yokoyama, Shuji Terai

    Internal medicine (Tokyo, Japan)   2020年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Thiopurine drugs are commonly used to treat immunologic diseases. However, the narrow therapeutic safety margin demands evidence-based precision medicine approaches. NUDT15 variants are associated with thiopurine-induced adverse events, particularly in Asians. We herein report a rare genotype of His/His in NUDT15 codon 139 in a case of ulcerative colitis and review the relevant literature. The patient experienced severe thiopurine-associated adverse events, including leukopenia and alopecia. There is no literature on the His/His genotype in NUDT15 codon 139, and our case suggests cautious use or the contraindication of thiopurines for patients with this genotype.

    DOI: 10.2169/internalmedicine.4261-19

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  • Variation in small bowel transit time on capsule endoscopy. 査読 国際誌

    Kentaro Tominaga, Hiroki Sato, Hiroshi Yokomichi, Atsunori Tsuchiya, Tomoaki Yoshida, Yuzo Kawata, Takeshi Mizusawa, Junji Yokoyama, Shuji Terai

    Annals of translational medicine   8 ( 6 )   348 - 348   2020年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AME Publ Co  

    Background: Small bowel motility remains inadequately understood because of the complex and various functions as well as its anatomical position. The aimed of the study was to investigate the small bowel transit time (SBTT) of capsule endoscopy (CE) and to analyze the clinical factors affecting SBTT. Methods: SBTT was analyzed in patients who underwent small bowel CE. Factors contributing to SBTT and CE retention were investigated. Results: Among 397 patients enrolled in this study, 336 (84.6%) completed CE. The mean SBTT (± standard deviation) was 282.1±132.2 min. According to the univariate and multivariate analyses, aging and small bowel stenosis extended SBTT. In 38 patients who underwent multiple CE studies, considerable variation in SBTT were observed [mean of standard deviations (SDs) =97.97 min, SD of the SDs =81.99 min]. CE retention was observed in 61 patients (13.3%), and it was statistically associated to small bowel lesion. Conclusions: Aging and small bowel stenosis were associated with longer SBTT. Furthermore, SBTT analyzed by CE should be interpreted carefully considering the intra-individual differences in SBTT.

    DOI: 10.21037/atm.2020.02.40

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  • Efficacy of gelatin hydrogels incorporating triamcinolone acetonide for prevention of fibrosis in a mouse model. 査読 国際誌

    Nao Nakajima, Satoru Hashimoto, Hiroki Sato, Kazuya Takahashi, Takuro Nagoya, Kenya Kamimura, Atsunori Tsuchiya, Junji Yokoyama, Yuichi Sato, Hanako Wakatsuki, Masayuki Miyata, Yusuke Akashi, Ryusuke Tanaka, Ken Matsuda, Yasuhiko Tabata, Shuji Terai

    Regenerative therapy   11   41 - 46   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Introduction: Triamcinolone acetonide (TA), a steroid, is often used clinically to prevent dysfunctions associated with fibrosis. The objective of this study was to examine whether TA can be suspended in a gelatin sheet for tissue engineering using a mouse skin wound model. Methods: TA was suspended in biodegradable gelatin and freeze-dried in a sheet form. The sheet was analyzed for homogeneity and controlled release of TA by high-performance liquid chromatography. We made two skin wounds on the dorsal side of mice. Gelatin sheets with TA (TA sheet) and without TA (control sheet) were attached to each skin wound. To determine the efficacy of the prepared TA sheet on the skin wounds, TA-sheet versus TA-injection experiments were conducted. Hematoxylin and eosin staining was performed to assess the grade of epithelialization and alpha smooth muscle actin (α-SMA) immunohistochemical staining was conducted to evaluate myofibroblast infiltration. Results: In the TA-release test in vitro, 7.7 ± 2.3% of TA was released from the sheet by 24 h. After replacing the initial phosphate-buffered saline (PBS) with collagenase PBS, the amount of released TA increased over time. The wound area/original skin wound area after 15 days with the TA sheet was significantly larger than that with the control sheet (26.9 ± 5.5% vs 10.7 ± 2.6%, p = 0.023). The α-SMA positive area/whole area with the TA sheet was significantly lower than that with the control sheet (4.65 ± 0.66% vs 7.24 ± 0.7%, p = 0.023). Furthermore, the α-SMA positive area/whole area with the TA sheet was significantly lower than that with TA injection (5.32 ± 0.45% vs 7.93 ± 0.75%, p = 0.013). Conclusions: We developed a TA sheet and confirmed both the homogeneity of the suspended TA and controlled-release of the TA in the presence of collagenase in vitro. The TA sheet caused less myofibroblast infiltration into the tissue than the control sheet or TA injection did.

    DOI: 10.1016/j.reth.2019.04.001

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  • Methotrexate-related lymphoproliferative disorders in the liver: Case presentation and mini-review. 査読 国際誌

    Takeshi Mizusawa, Kenya Kamimura, Hiroki Sato, Takeshi Suda, Hiroyuki Fukunari, Go Hasegawa, Osamu Shibata, Shinichi Morita, Akira Sakamaki, Junji Yokoyama, Yu Saito, Yoshihisa Hori, Yuduru Maruyama, Fumitoshi Yoshimine, Takahiro Hoshi, Shinichi Morita, Tsutomu Kanefuji, Masaaki Kobayashi, Shuji Terai

    World journal of clinical cases   7 ( 21 )   3553 - 3561   2019年11月

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    記述言語:英語  

    BACKGROUND: Immunosuppression is effective in treating a number of diseases, but adverse effects such as bone marrow suppression, infection, and oncogenesis are of concern. Methotrexate is a key immunosuppressant used to treat rheumatoid arthritis. Although it is effective for many patients, various side effects have been reported, one of the most serious being methotrexate-related lymphoproliferative disorder. While this may occur in various organs, liver involvement is rare. Information on these liver lesions, including clinical characteristics, course, and imaging studies, has not been summarized to date. CASE SUMMARY: We present a case of 70-year-old woman presented with a 2-wk history of fever and abdominal pain. She had had rheumatoid arthritis for 5 years and was being treated with medication including methotrexate. Contrast-enhanced computed tomography revealed multiple low density tumors in the liver and the histological analyses showed significant proliferation of lymphocytes in masses that were positive on immunohistochemical staining for CD3, CD4, CD8, and CD79a but negative for CD20 and CD56. Staining for Epstein-Barr virus-encoded RNA was negative. And based on these findings, the liver tumors were diagnosed as Methotrexate-related lymphoproliferative disorders. A time-dependent disappearance of the liver tumors after stopping methotrexate supported the diagnoses. CONCLUSION: The information obtained from our case and a review of 9 additional cases reported thus far assist physicians who may face the challenge of diagnosing and managing this disorder.

    DOI: 10.12998/wjcc.v7.i21.3553

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  • Overlap in disease concept of functional esophageal disorders and minor esophageal motility disorders. 査読 国際誌

    Hiroki Sato, Kazuya Takahashi, Ken-Ichi Mizuno, Satoru Hashimoto, Yuzo Kawata, Takeshi Mizusawa, Kentaro Tominaga, Junji Yokoyama, Shuji Terai

    Journal of gastroenterology and hepatology   34 ( 11 )   1940 - 1945   2019年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIM: Functional gastrointestinal disorders are the most common disorders in gastroenterology and are currently considered as gut-brain interaction disorders with multiple related factors including motility disturbance. However, high-resolution manometry (HRM) had revealed a new disease concept known as minor esophageal motility disorders. This study aimed to investigate the correlation between functional esophageal disorders (FEDs) and minor esophageal motility disorders. METHODS: Functional esophageal disorders were diagnosed using upper endoscopy, pH monitoring, and HRM, to exclude achalasia, esophago-gastric junction outflow obstruction, and other major esophageal motility disorders. FEDs with or without minor esophageal motility disorders were compared using the Chicago classification. RESULTS: Twelve healthy volunteers also subjected to HRM showed no minor esophageal motility disorders. Of the 40 patients with FEDs, 15 (37.5%) were diagnosed with minor esophageal motility disorders. Characteristics were not different between patients with and without minor esophageal motility disorders (sex: P = 0.609, age: P = 0.054, body mass index: P = 0.137, and presence of psychiatric disorders: P = 0.404). The type and location of symptoms were not related to the comorbidity rate of minor esophageal motility disorders (P = 0.744 and 0.094). No patients with FEDs developed major esophageal motility disorders. CONCLUSIONS: Minor esophageal motility disorders were frequently observed in FEDs, but the causal relationship between esophageal symptoms remains unclear. The disease concepts of FEDs and minor esophageal motility disorders are considered to overlap and are both independent of major esophageal motility disorders.

    DOI: 10.1111/jgh.14691

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  • IgG4関連硬化性胆管炎の一例

    中村 涼太, 田中 裕登, 大越 麻里奈, 小関 洋平, 水澤 健, 五十嵐 聡, 林 和直, 佐藤 裕樹, 坂牧 僚, 上村 顕也, 横山 純二, 寺井 崇二

    日本消化器病学会甲信越支部例会抄録集   65回   81 - 81   2019年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-甲信越支部  

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  • Wavy mucosal tear in the sigmoid colon. 査読 国際誌

    Kentaro Tominaga, Junji Yokoyama, Kazunao Hayashi, Atsunori Tsuchiya, Shuji Terai

    Clinical case reports   7 ( 9 )   1825 - 1826   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Although linear mucosal tears have been reported, we found a relatively rare case of wavy mucosal tear in collagenous colitis. This may be related to the mutual weak adhesiveness between the epithelium and collagen band. This complication necessitates great care to be taken while performing colonoscopy in patients suspected of collagenous colitis.

    DOI: 10.1002/ccr3.2275

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  • Change in body composition in patients with achalasia before and after peroral endoscopic myotomy. 査読 国際誌

    Takeshi Mizusawa, Hiroki Sato, Kenya Kamimura, Satoru Hashimoto, Ken-Ichi Mizuno, Hiroteru Kamimura, Satoshi Ikarashi, Kazunao Hayashi, Masaaki Takamura, Junji Yokoyama, Shuji Terai

    Journal of gastroenterology and hepatology   35 ( 4 )   601 - 608   2019年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIM: Patients with achalasia experience weight loss because of dysphagia caused by impaired relaxation of the lower esophageal sphincter. This study aimed to use dual bioelectrical impedance analysis (BIA) to determine the change in bodyweight and body composition in patients with achalasia before and after peroral endoscopic myotomy (POEM). METHODS: Patients with achalasia who underwent POEM from 2013 to 2018 (n = 72) were retrospectively analyzed for change in bodyweight before and after 3 months. Additionally, change in body composition was prospectively investigated in the final 10 of 72 patients using non-radiation dual BIA. RESULTS: Twenty patients (27.8%) were underweight (body mass index < 18.5) before undergoing POEM. No clinical parameters were identified to be associated with the underweight condition before POEM and be predictive of an increase in bodyweight after POEM. Low visceral fat volume observed on dual BIA correlated closely with the result obtained using computed tomography (Pearson correlation coefficient: r = 0.850, P < 0.01). Patients with achalasia had a statistically significant increase in visceral (P < 0.01) and subcutaneous fat volumes (P < 0.01) after POEM. Skeletal muscle mass index slightly increased (P = 0.02), although the value after POEM was still low. No blood biomarkers were indicators for low bodyweight or low visceral fat volume. CONCLUSIONS: Dual BIA is an effective non-invasive tool to evaluate the change in body composition of underweight patients with achalasia. Skeletal muscle volume was not enough after POEM, although a rapid increase in the intra-abdominal fat volume was observed. Additional studies are warranted to understand the pathological implications.

    DOI: 10.1111/jgh.14847

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  • Co-existent ulcerative colitis and Guillain-Barré syndrome: a case report and literature review. 査読

    Tominaga K, Tsuchiya A, Sato H, Kimura A, Oda C, Hosaka K, Kawata Y, Kimura N, Hayashi K, Yokoyama J, Terai S

    Clinical journal of gastroenterology   12 ( 3 )   243 - 246   2019年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s12328-019-00939-1

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  • Evaluating the effect of injecting triamcinolone acetonide in two sessions for preventing esophageal stricture after endoscopic submucosal dissection. 査読 国際誌

    Satoru Hashimoto, Ken-Ichi Mizuno, Kazuya Takahashi, Hiroki Sato, Junji Yokoyama, Manabu Takeuchi, Yuichi Sato, Masaaki Kobayashi, Shuji Terai

    Endoscopy international open   7 ( 6 )   E764-E770 - E770   2019年6月

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    記述言語:英語  

    Background and study aims  Several previous reports indicate that endoscopic injection of triamcinolone acetonide (TA) after widespread endoscopic submucosal dissection (ESD) is effective for preventing esophageal stricture. We investigated the efficacy of injecting TA in two sessions for preventing stricture formation post-ESD. Patients and methods  Sixty-six consecutive patients with widespread mucosal defects that affected more than three-fourths of the circumference of the esophagus were included. The study group (n = 40) received TA injections over two sessions: immediately after and 14 days after ESD. The control group (n = 26) did not receive a TA injection. This study was performed retrospectively against historical controls. The primary endpoint of this study was frequency of stricture after TA injection. The secondary endpoint was number of required endoscopic balloon dilations (EBDs) after TA injection. Results  The post-ESD stricture rate among patients who had subcircumferential mucosal defects was 45.7 % in the study group (16/35 patients), which was significantly lower than the rate of 73.9 % in the control group (17/23 patients; P  = 0.031). The number of EBD procedures required was significantly lower in the study group (median 0, range 0 - 7) than in the control group (median 4, range 0 - 20; P  < 0.001). There was no significant difference between the study and control groups among the patients who had full circumferential mucosal defects. Conclusion  This study showed that performing two sessions of TA injection is an effective and safe treatment for prevention of esophageal stricture following subcircumferential ESD.

    DOI: 10.1055/a-0894-4374

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  • Early injection of human adipose tissue-derived mesenchymal stem cell after inflammation ameliorates dextran sulfate sodium-induced colitis in mice through the induction of M2 macrophages and regulatory T cells. 査読 国際誌

    Yuzo Kawata, Atsunori Tsuchiya, Satoshi Seino, Yusuke Watanabe, Yuichi Kojima, Shunzo Ikarashi, Kentaro Tominaga, Junji Yokoyama, Satoshi Yamagiwa, Shuji Terai

    Cell and tissue research   376 ( 2 )   257 - 271   2019年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Inflammatory bowel diseases (IBDs) are sometimes refractory to current therapy or associated with severe adverse events during immunosuppressive therapy; thus, new therapies are urgently needed. Recently, mesenchymal stem cells (MSCs) have attracted attention based on their multitude of functions including anti-inflammatory effects. However, proper timing of MSC therapy and the mechanisms underlying the therapeutic effects of MSCs on colitis are not fully elucidated. Human adipose tissue-derived mesenchymal stem cells (hAdMSCs; 1 × 106) were administrated via the tail vein on day 3 (early) or 11 (delayed) using a 7-day dextran sulfate sodium (DSS)-induced mouse model of colitis. The effects were evaluated based on colon length, disease activity index (DAI) and histological score. Cytokine-encoding mRNA levels T cells and macrophages were evaluated by real-time PCR and flow cytometry. Regarding the timing of administration, early (day 3) injection significantly ameliorated DSS-induced colitis in terms of both DAI and histological score, compared to those parameters with delayed (day 11) injection. With early cell injection, the tissue mRNA levels of anti-inflammatory cytokine genes (Il10, Tgfb) increased, whereas those of inflammatory cytokine genes (Il6, Tnfa and Il17a) decreased significantly. Regarding the associated mechanism, hAdMSCs suppressed T cell proliferation and activation in vitro, increased the number of regulatory T cells in vivo and changed the polarity of macrophages (into the anti-inflammatory M2 phenotype) in vitro. Timing of injection is critical for the effective therapeutic effects of hAdMSCs. Furthermore, part of the associated mechanism includes T cell activation and expansion and altered macrophage polarization.

    DOI: 10.1007/s00441-018-02981-w

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  • Utility of measuring paraesophageal varices using computed tomography to select endoscopic treatment for patients with esophageal varices. 査読

    Kimura N, Yokoyama J, Terai S

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   31 ( 3 )   335   2019年5月

  • 膵癌術前胆道ドレナージにおける大口径プラスチックステントの役割

    五十嵐 聡, 林 和直, 寺井 崇二, 水澤 健, 川田 雄三, 冨永 顕太郎, 佐藤 裕樹, 水野 研一, 橋本 哲, 横山 純二, 高村 昌昭

    Gastroenterological Endoscopy   61 ( Suppl.1 )   981 - 981   2019年5月

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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  

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  • 慢性膵炎による膵管狭窄に対するステント治療の現状と課題

    林 和直, 五十嵐 聡, 寺井 崇二, 水澤 健, 冨永 顕太郎, 佐藤 裕樹, 水野 研一, 橋本 哲, 横山 純二

    Gastroenterological Endoscopy   61 ( Suppl.1 )   1000 - 1000   2019年5月

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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  

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  • Management of endoscopic submucosal dissection for ulcerative colitis‐associated neoplasia: Tips and pitfalls

    Ken‐ichi Mizuno, Junji Yokoyama, Shuji Terai

    Digestive Endoscopy   31 ( S1 )   44 - 45   2019年4月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Wiley  

    DOI: 10.1111/den.13324

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    その他リンク: https://onlinelibrary.wiley.com/doi/full-xml/10.1111/den.13324

  • Esophageal diverticulum: New perspectives in the era of minimally invasive endoscopic treatment. 査読 国際誌

    Hiroki Sato, Manabu Takeuchi, Satoru Hashimoto, Ken-Ichi Mizuno, Koichi Furukawa, Akito Sato, Junji Yokoyama, Shuji Terai

    World journal of gastroenterology   25 ( 12 )   1457 - 1464   2019年3月

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    記述言語:英語  

    Esophageal diverticula are rare conditions that cause esophageal symptoms, such as dysphagia, regurgitation, and chest pain. They are classified according to their location and characteristic pathophysiology into three types: epiphrenic diverticulum, Zenker's diverticulum, and Rokitansky diverticulum. The former two disorders take the form of protrusions, and symptomatic cases require interventional treatment. However, the esophageal anatomy presents distinct challenges to surgical resection of the diverticulum, particularly when it is located closer to the oral orifice. Since the condition itself is not malignant, minimally invasive endoscopic approaches have been developed with a focus on alleviation of symptoms. Several types of endoscopic devices and techniques are currently employed, including peroral endoscopic myotomy (POEM). However, the use of minimally invasive endoscopic approaches, like POEM, has allowed the development of new disorder called iatrogenic esophageal diverticula. In this paper, we review the pathophysiology of each type of diverticulum and the current state-of-the-art treatment based on our experience.

    DOI: 10.3748/wjg.v25.i12.1457

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  • Diverse perspectives to address for the future treatment of heterogeneous hepatocellular carcinoma. 査読 国際誌

    Tsuchiya A, Ogawa M, Watanabe T, Takeuchi S, Kojima Y, Watanabe Y, Kimura N, Hayashi K, Yokoyama J, Terai S

    Heliyon   5 ( 3 )   e01325   2019年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.heliyon.2019.e01325

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  • 当院における切除不能局所進行膵癌の治療の現況

    林 和直, 五十嵐 聡, 水澤 健, 川田 雄三, 冨永 顕太郎, 佐藤 裕樹, 水野 研一, 橋本 哲, 横山 純二, 寺井 崇二

    日本消化器病学会雑誌   116 ( 臨増総会 )   A468 - A468   2019年3月

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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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  • 術後再建腸管例におけるEUS-FNAの現状と工夫

    五十嵐 聡, 林 和直, 水澤 健, 川田 雄三, 冨永 顕太郎, 佐藤 裕樹, 水野 研一, 橋本 哲, 横山 純二, 高村 昌昭, 寺井 崇二

    日本消化器病学会雑誌   116 ( 臨増総会 )   A299 - A299   2019年3月

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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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  • Clinical and pathological profile of eosinophilic gastroenteritis. 査読 国際誌

    Hiroki Sato, Terasu Honma, Takashi Owaki, Kentaro Tominaga, Junji Yokoyama, Shuji Terai

    European journal of gastroenterology & hepatology   31 ( 2 )   157 - 162   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Eosinophilic gastroenteritis (EoGE) can be diagnosed on the basis of histologic criteria; however, the pathology is considered to be heterogeneous. There is no consensus on the management of this enigmatic disorder with an unknown etiology. PATIENTS AND METHODS: Data for patients diagnosed with EoGE and followed up over a 1-year period were analyzed. Their symptoms, patterns of flares, and type of treatment were documented. The shift in peripheral blood eosinophil levels was also examined. RESULTS: A total of 10 (mean age, 44 years; range: 31-70 years; women, 5) patients were diagnosed with EoGE. The most frequent presenting symptom was abdominal pain, and eight patients were classified with mucosal type of EoGE. Chronic disease or multiple flares were observed in seven out of 10 (70.0%) patients, and all of them had a history of allergy. Four were corticosteroid dependent (three relapsed during corticosteroid tapering and one following corticosteroid withdrawal). One of them received anti-IL5 monoclonal antibody that enabled corticosteroid dose tapering. In four patients with highly elevated initial eosinophil levels at diagnosis, the peripheral eosinophil level correlated with the amelioration and deterioration of their symptoms. The remaining three patients had a single flare without relapse. Two had no history of allergy. CONCLUSION: EoGE is a unique disorder with a variable clinical course. Although further studies are required to confirm our observations, the presence of other allergic disorders is associated with chronicity or multiple flares. Peripheral eosinophil level may be an effective biomarker for recurrence in patients with severe systemic disorders at diagnosis.

    DOI: 10.1097/MEG.0000000000001241

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  • Novel Magnified Single-Balloon Enteroscopy Enables Observation of Jejunal White Spots Associated with Lymphangiectasia. 査読 国際誌

    Kentaro Tominaga, Atsunori Tsuchiya, Yuzo Kawata, Junji Yokoyama, Shuji Terai

    Digestive diseases (Basel, Switzerland)   37 ( 2 )   170 - 174   2019年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 59-year-old woman was diagnosed with primary intestinal lymphangiectasia (PIL), with characteristic findings on capsule enteroscopy and confirmation by histopathological examination of biopsy specimens. We viewed the abnormal jejunal mucosa using a newly developed magnifying single-balloon enteroscope (SIF-Y0007). Conventional observation showed leakage of chyle. However, using this new scope, we could see scattered white villi, representing dilated lymphatic vessels within the intestinal villi protruding from the dilated submucosal lymphoid vessels (D2-40 positive) within an edematous jejunal lesion. This report is the first to describe the white villi in a patient with PIL observed clearly using a newly developed magnifying enteroscope. Technological advancements and the accumulation of reported pathological data would further improve our understanding of the pathophysiological aspects of this disease entity, even in the jejunum.

    DOI: 10.1159/000493578

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  • 肝胆膵疾患に対する低侵襲治療の工夫 当院におけるWalled-off necrosis(WON)に対する内視鏡治療成績の検討

    林 和直, 五十嵐 聡, 河久 順志, 横山 純二, 寺井 崇二

    ENDOSCOPIC FORUM for digestive disease   34 ( 2 )   189 - 189   2018年12月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

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  • Gastrointestinal: A case of hypereosinophilic syndrome with esophageal involvement. 査読

    Takahashi K, Sato H, Tominaga K, Kohisa J, Ikarashi S, Hayashi K, Miuzno K, Hashimoto S, Yokoyama J, Terai S

    Journal of gastroenterology and hepatology   33 ( 11 )   1817   2018年11月

  • Usefulness of Capsule Endoscopy and Double-balloon Enteroscopy for the Diagnosis of Multiple Carcinoid Tumors in the Small Intestine: Case Reports and a Literature Review. 査読

    Tominaga K, Kamimura K, Yokoyama J, Terai S

    Internal medicine (Tokyo, Japan)   58 ( 5 )   655 - 659   2018年10月

  • ステロイド使用例における胆管結石治療の現状

    五十嵐 聡, 林 和直, 河久 順志, 冨永 顕太郎, 高橋 一也, 水野 研一, 橋本 哲, 横山 純二, 山際 訓, 寺井 崇二

    Gastroenterological Endoscopy   60 ( Suppl.2 )   2086 - 2086   2018年10月

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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  

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  • 超音波内視鏡における音速補正モードの有用性

    林 和直, 五十嵐 聡, 河久 順志, 高橋 一也, 冨永 顕太郎, 水野 研一, 橋本 哲, 横山 純二, 山際 訓, 寺井 崇二

    Gastroenterological Endoscopy   60 ( Suppl.2 )   2110 - 2110   2018年10月

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  • A case of inferior vena cava thrombosis caused by compression due to growing giant liver cyst. 査読

    Kimura N, Tsuchiya A, Ogawa M, Watanabe Y, Hayashi K, Yokoyama J, Umezu H, Terai S

    Clinical journal of gastroenterology   12 ( 1 )   71 - 75   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Management decision based on lymphovascular involvement leads to favorable outcomes after endoscopic treatment of esophageal squamous cell carcinoma 査読

    Kazuya Takahashi, Satoru Hashimoto, Ken-Ichi Mizuno, Takamasa Kobayashi, Kentaro Tominaga, Hiroki Sato, Junji Kohisa, Satoshi Ikarashi, Kazunao Hayashi, Manabu Takeuchi, Junji Yokoyama, Hirokazu Kawai, Yuichi Sato, Masaaki Kobayashi, Shuji Terai

    Endoscopy   50 ( 7 )   662 - 670   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Georg Thieme Verlag  

    Background Esophageal squamous cell carcinoma (ESCC) invading the muscularis mucosae (MM) and submucosa up to 200μm (SM1) has a risk of metastasis. The aims of this study were to investigate the long-term outcome of endoscopic submucosal dissection (ESD) for MM/SM1 ESCC and to assess the management after ESD in our hospital. Methods This was a retrospective cohort study conducted at a single institution. Patients with MM or SM1 ESCC who were treated with ESD were included. Additional prophylactic therapy was added if lymphovascular involvement (LVI) was noted in the ESD specimens. Results A total of 102 patients were analyzed. The median length of follow-up was 71.5 months (range 9-144 months) and the median number of CTs was 6 (range 0-24). LVI was found in 21 patients (20.6%), and 12 patients underwent additional prophylactic therapy. The 5-year overall survival, disease-specific survival, and tumor-free survival rates were 84.1%, 97.5%, and 82.1%, respectively. A total of 26 patients died, but only 2 of them died from ESCC. The cumulative metastasis rate was 11.8%, and LVI was a significant predictor of metastasis (hazard ratio 5.42, 95% confidence interval 1.39-21.18
    P =0.02). There were no differences between patients with MM ESCC and those with SM1 ESCC. Conclusions The long-term outcome after ESD for MM/SM1 ESCC was favorable with additional prophylactic therapy and strict adherence to follow-up.These results indicate that our management decision based on LVI is a valid approach and that ESD can be offered as a therapeutic option to MM/SM1 ESCCs.

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  • ENDOSCOPIC MANAGEMENT OF UNRESECTABLE MALIGNANT HILAR STRICTURES USING THREADED INSIDE STENTS VERSUS METALLIC STENTS 査読

    Hayashi Kazunao, Ikarashi Satoshi, Kohisa Junji, Takahashi Kazuya, Tominaga Kentaro, Mizuno Ken-ichi, Hashimoto Satoru, Yokoyama Junji, Yamagiwa Satoshi, Terai Shuji

    GASTROINTESTINAL ENDOSCOPY   87 ( 6 )   AB208   2018年6月

  • IS ENDOSCOPIC SUBMUCOSAL DISSECTION VALUABLE FOR ELDERLY PATIENTS WITH SUPERFICIAL ESOPHAGEAL SQUAMOUS CELL CARCINOMA? 査読

    Hashimoto Satoru, Mizuno Kenichi, Takahashi Kazuya, Sato Hiroki, Tominaga Kentaro, Kohisa Junji, Ikarashi Satoshi, Hayashi Kazunao, Yokoyama Junji, Terai Shuji

    GASTROINTESTINAL ENDOSCOPY   87 ( 6 )   AB287   2018年6月

  • IS ENDOSCOPIC SUBMUCOSAL DISSECTION A FEASIBLE TREATMENT FOR ESOPHAGOGASTRIC JUNCTION CANCER? 査読

    Takahashi Kazuya, Hashimoto Satoru, Mizuno Kenichi, Sato Hiroki, Tominaga Kentaro, Kohisa Junji, Ikarashi Satoshi, Hayashi Kazunao, Yokoyama Junji, Terai Shuji

    GASTROINTESTINAL ENDOSCOPY   87 ( 6 )   AB396 - AB397   2018年6月

  • SAFETY AND EFFICACY OF PROPOFOL-BASED SEDATION FOR BALLOON ENTEROSCOPE-ASSISTED ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN ELDERLY PATIENTS 査読

    Kohisa Junji, Ikarashi Satoshi, Hayashi Kazunao, Takahashi Kazuya, Tominaga Kentaro, Mizuno Kenichi, Hashimoto Satoru, Yokoyama Junji, Yamagiwa Satoshi, Terai Shuji

    GASTROINTESTINAL ENDOSCOPY   87 ( 6 )   AB229   2018年6月

  • How do you treat this diversion ileitis and pouchitis? 査読

    Kentaro Tominaga, Atsunori Tsuchiya, Junji Yokoyama, Shuji Terai

    Gut   2018年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BMJ Publishing Group  

    DOI: 10.1136/gutjnl-2017-315591

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  • Diversion colitis and pouchitis: A mini-review 査読

    Kentaro Tominaga, Kenya Kamimura, Kazuya Takahashi, Junji Yokoyama, Satoshi Yamagiwa, Shuji Terai

    World Journal of Gastroenterology   24 ( 16 )   1734 - 1747   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Baishideng Publishing Group Co., Limited  

    Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment
    however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management.

    DOI: 10.3748/wjg.v24.i16.1734

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  • A case of Behçet's disease with various gastrointestinal findings. 査読

    Tominaga K, Kamimura K, Takahashi K, Yokoyama J, Terai S

    Clinical journal of gastroenterology   1 - 5   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s12328-018-0860-6

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  • A clinical study of peroral endoscopic myotomy reveals that impaired lower esophageal sphincter relaxation in Achalasia is not only defined by high-resolution manometry 査読

    Hiroki Sato, Kazuya Takahashi, Ken-Ichi Mizuno, Satoru Hashimoto, Junji Yokoyama, Shuji Terai

    PLoS ONE   13 ( 4 )   e0195423   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Public Library of Science  

    Background and aim Achalasia is an esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation. On high-resolution manometry (HRM), impaired LES relaxation is defined by elevated integrated relaxation pressure (IRP). However, a new category of Achalasia within the normal IRP range has been suggested. Methods HRM was performed using a Starlet device and an IRP threshold of 26 mmHg. Peroral endoscopic myotomy (POEM) was performed for cases of Achalasia diagnosed using established methods. During POEM, the histology of the LES was assessed. Follow-up was performed 2 months post-operatively. Results Forty-one patients with Achalasia (18 women, mean age 53 ± 18.6 years) were included. Among them, 27 were placed in the IRP &gt
    26 mmHg subgroup (impaired LES relaxation on HRM) and 14 in the IRP ≤ 26 mmHg subgroup (normal LES relaxation on HRM). In the IRP ≤ 26 mmHg subgroup, patients were older, had longer symptom duration, and had more esophageal dilation. The IRP ≤ 26 mmHg subgroup had the same symptom severity as the higher IRP subgroup and POEM significantly improved symptoms and IRP, although four patients still had severe LES fibrosis. Conclusions The clinical presentation of Achalasia has a gap between a HRM-defined impaired LES relaxation, with aging or disease progression considered reasons for a lowered LES pressure. POEM can be a feasible treatment option, even for cases of Achalasia with a normal IRP. However, patients with severe LES fibrosis need more attention for the therapeutic indication.

    DOI: 10.1371/journal.pone.0195423

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  • Esophageal motility disorders: new perspectives from high-resolution manometry and histopathology 査読

    Hiroki Sato, Kazuya Takahashi, Ken-ichi Mizuno, Satoru Hashimoto, Junji Yokoyama, Go Hasegawa, Shuji Terai

    Journal of Gastroenterology   53 ( 4 )   484 - 493   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Tokyo  

    High-resolution manometry (HRM) and peroral endoscopic myotomy (POEM) have contributed significantly to the field of esophageal motility disorders in recent years. The development of HRM has categorized various esophageal motility disorders with a focus on a diverse range of manometric anomalies. Additionally, the Chicago classification criteria is widely used for manometric diagnosis. Moreover, POEM was introduced as a minimally invasive radical therapy for achalasia and shows promise for other spastic esophageal motility disorders as well. POEM has also enabled a transluminal endoscopic approach for determining the histology of the esophageal muscle layer, which is expected to assist in elucidating the etiology of disorders associated with esophageal motility. The purpose of this review is to update the diagnosis, pathology, and treatment of esophageal motility disorders, with a focus on the recent advances in this field.

    DOI: 10.1007/s00535-017-1413-3

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  • Efficacy of EUS for detection of a buried fish bone in the esophagus. 査読

    Kohisa J, Mizuno KI, Takahashi K, Yokoyama J, Terai S

    VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy   3 ( 4 )   125 - 126   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.vgie.2018.02.002

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  • 当院における非切除悪性肝門部胆管狭窄に対する内視鏡的ステント留置術の現状と課題

    林 和直, 五十嵐 聡, 河久 順志, 水野 研一, 橋本 哲, 横山 純二, 山際 訓, 寺井 崇二

    Gastroenterological Endoscopy   60 ( Suppl.1 )   797 - 797   2018年4月

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  • Gastric Cavernous Hemangioma Resected by Endoscopic Submucosal Dissection. 査読

    Watanabe Y, Takahashi K, Yokoyama J, Terai S

    Internal medicine (Tokyo, Japan)   57 ( 15 )   2269 - 2270   2018年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2169/internalmedicine.0611-17

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  • A case of panenteritis with massive IgG4-positive plasma cell infiltration developed 26 years after total proctocolectomy for ulcerative colitis 査読

    Kentaro Tominaga, Atsunori Tsuchiya, Yutaka Honda, Tatsuya Abe, Junji Yokoyama, Hajime Umezu, Shuji Terai

    American Journal of Gastroenterology   113 ( 2 )   173   2018年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Nature Publishing Group  

    DOI: 10.1038/ajg.2017.481

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  • Full-layer mucosal histology in achalasia: Histological epithelial wave is characteristic in “pinstripe pattern”-positive achalasia 査読

    H. Sato, K. Takahashi, N. Nakajima, G. Hasegawa, K. Mizuno, S. Hashimoto, S. Ikarashi, K. Hayashi, Y. Honda, J. Yokoyama, Y. Sato, S. Terai

    Neurogastroenterology and Motility   30 ( 1 )   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing Ltd  

    Background: Previously, the mucosal histology in achalasia has only been investigated using superficial biopsy or surgically resected esophageal specimens in end-stage cases. We investigated the histology of the full-layer mucosa in early and advanced achalasia. Methods: Endoscopy was performed for the pinstripe pattern (PSP) (an early achalasia indicator) and dilation and thickening of the mucosa (advanced achalasia indicators). A mucosal entry site for peroral endoscopic myotomy was created using cap-fitted endoscopic mucosal resection to access the full-layer mucosa and the submucosa. Key Results: Mucosal histology was compared between 32 patients with achalasia and 15 controls. Histological esophagitis with findings of inflammatory cell infiltration and dilated intercellular spaces was observed more in patients with achalasia than in controls (87.5% vs 13.3%, P&lt
    .001
    84.4% vs 46.7%, P=.049). Muscularis mucosae (MM) atrophy and epithelial wave were only observed in achalasia (40.6% vs 0%, P=.005
    28.1% vs 0%, P=.043). Fibrosis was more common in achalasia, but without statistical significance (31.3% vs 20.0%, P=.503). In achalasia with endoscopic dilation and thickening of the mucosa, MM atrophy was observed histologically, and in cases involving endoscopic PSP, the histological epithelial wave was observed. Conclusions &amp
    Inferences: Histological findings of esophagitis were observed endoscopically even in early achalasia. Pinstripe pattern corresponds to the epithelial wave observed histologically in achalasia, whereas endoscopic findings in advanced achalasia correspond to MM atrophy. Appropriate management is necessary during early achalasia to prevent progression to advanced achalasia with more severe histological changes.

    DOI: 10.1111/nmo.13168

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  • Jackhammer esophagus accompanied by esophageal intramural pseudodiverticulosis 査読

    Kazuya Takahashi, Satoshi Ikarashi, Junji Yokoyama, Shuji Terai

    Internal Medicine   57 ( 7 )   1051 - 1052   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society of Internal Medicine  

    DOI: 10.2169/internalmedicine.9734-17

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  • A rare case of concomitant type III achalasia and chronic idiopathic intestinal pseudo-obstruction. 査読

    Sato H, Abe H, Nagashima A, Yokoyama J, Terai S

    J Gastroenterol Hepatol   33 ( 3 )   559   2018年

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  • Endoscopic ultrasound-guided fine-needle aspiration for diagnosing a rare extraluminal duodenal gastrointestinal tumor. 査読 国際誌

    Hayashi K, Kamimura K, Hosaka K, Ikarashi S, Kohisa J, Takahashi K, Tominaga K, Mizuno K, Hashimoto S, Yokoyama J, Yamagiwa S, Takizawa K, Wakai T, Umezu H, Terai S

    World journal of gastrointestinal endoscopy   9 ( 12 )   583 - 589   2017年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.4253/wjge.v9.i12.583

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  • Changes in esophageal motility after endoscopic submucosal dissection for superficial esophageal cancer: A high-resolution manometry study 査読

    Kazuya Takahashi, Y. Sato, M. Takeuchi, H. Sato, N. Nakajima, S. Ikarashi, K. Hayashi, K. I. Mizuno, Y. Honda, S. Hashimoto, J. Yokoyama, S. Terai

    Diseases of the Esophagus   30 ( 11 )   1 - 8   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Oxford University Press  

    The effect of endoscopic submucosal dissection (ESD) on esophageal motility remains unknown. Therefore, the aim of this study is to elucidate changes in esophageal motility after ESD along with the cause of dysphagia using high-resolution manometry (HRM). This is a before-and-after trial of the effect of ESD on the esophageal motility. Twenty patients who underwent ESD for superficial esophageal carcinoma were enrolled in this study. Patients filled out a questionnaire about dysphagia and underwent HRM before and after ESD. Results before and after ESD were compared. Data were obtained from 19 patients. The number of patients who complained of dysphagia before and after ESD was 1/19 (5.3%) and 6/19 (31.6%), respectively (P = 0.131). Scores from the five-point Likert scale before and after ESD were 0.1 ± 0.5 and 1.0 ± 1.6, respectively (P = 0.043). The distal contractile integral (DCI) before and after ESD and the number of failed, weak, or fragmented contractions were not significantly different. However, in five patients with circumferential ESD, DCI was remarkably decreased and the frequency of fail, weak, or fragmented contractions increased. Univariate regression analysis showed a relatively strong inverse correlation ofΔDCI with the circumferential mucosal defect ratio [P &lt
    0.01, standardized regression coefficient (r) = -0.65], the number of stricture preventions (P &lt
    0.01, r = -0.601), and the number of stricture resolutions (P &lt
    0.01, r=-0.77). This HRMstudy showed that impairment of esophageal motility could be caused by ESD. The impairment of esophageal motility was conspicuous, especially in patients with circumferential ESD and subsequent procedures such as endoscopic triamcinolone injection and endoscopic balloon dilatation. Impaired esophageal motility after ESD might explain dysphagia.

    DOI: 10.1093/dote/dox057

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  • Changes in esophageal motility after endoscopic submucosal dissection for superficial esophageal cancer: a high-resolution manometry study 査読

    K. Takahashi, Y. Sato, M. Takeuchi, H. Sato, N. Nakajima, S. Ikarashi, K. Hayashi, K. -I. Mizuno, Y. Honda, S. Hashimoto, J. Yokoyama, S. Terai

    DISEASES OF THE ESOPHAGUS   30 ( 11 )   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS INC  

    The effect of endoscopic submucosal dissection (ESD) on esophageal motility remains unknown. Therefore, the aim of this study is to elucidate changes in esophageal motility after ESD along with the cause of dysphagia using high-resolution manometry (HRM). This is a before-and-after trial of the effect of ESD on the esophageal motility. Twenty patients who underwent ESD for superficial esophageal carcinoma were enrolled in this study. Patients filled out a questionnaire about dysphagia and underwent HRM before and after ESD. Results before and after ESD were compared. Data were obtained from 19 patients. The number of patients who complained of dysphagia before and after ESD was 1/19 (5.3%) and 6/19 (31.6%), respectively (P = 0.131). Scores from the five-point Likert scale before and after ESD were 0.1 +/- 0.5 and 1.0 +/- 1.6, respectively (P = 0.043). The distal contractile integral (DCI) before and after ESD and the number of failed, weak, or fragmented contractions were not significantly different. However, in five patients with circumferential ESD, DCI was remarkably decreased and the frequency of fail, weak, or fragmented contractions increased. Univariate regression analysis showed a relatively strong inverse correlation of Delta DCI with the circumferential mucosal defect ratio {P &lt; 0.01, standardized regression coefficient (r) = -0.65}, the number of stricture preventions (P &lt; 0.01, r = -0.601), and the number of stricture resolutions (P &lt; 0.01, r=-0.77). This HRM study showed that impairment of esophageal motility could be caused by ESD. The impairment of esophageal motility was conspicuous, especially in patients with circumferential ESD and subsequent procedures such as endoscopic triamcinolone injection and endoscopic balloon dilatation. Impaired esophageal motility after ESD might explain dysphagia.

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  • A Case of Hepatorenal Syndrome and Abdominal Compartment Syndrome with High Renal Congestion. 査読 国際誌

    Hiroteru Kamimura, Takayuki Watanabe, Tomoyuki Sugano, Nao Nakajima, Junji Yokoyama, Kenya Kamimura, Atsunori Tsuchiya, Masaaki Takamura, Hirokazu Kawai, Takashi Kato, Gen Watanabe, Satoshi Yamagiwa, Shuji Terai

    The American journal of case reports   18   1000 - 1004   2017年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND Hepatorenal syndrome (HRS) is a reversible renal impairment that occurs in patients with acute liver failure and advanced liver cirrhosis. HRS is due to a renal vasoconstriction that results from extreme vasodilatation. It is therefore a functional disorder, not associated with structural kidney damage. On the other hand, end-stage liver diseases are often complicated by massive ascites. Massive ascites may cause abdominal compartment syndrome (ACS), which includes impairment of renal blood flow, but there are no reports indicating that kidney lesions caused by ACS may pathologically contribute to end-stage liver diseases. CASE REPORT A 40-year-old man with acute liver failure was admitted to our hospital. He was diagnosed with type 1 HRS and showed ACS at the same time. He died 30 days after admission. There were signs of congestion in the kidneys upon dissection and advanced erythroid fullness in the renal tubules. CONCLUSIONS We report an autopsy case with HRS and ACS diagnosed with a clinical and histopathological consideration of liver and kidney. Further clinical studies are needed to improve management of renal failure in patients with acute liver failure and advanced liver cirrhosis.

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  • 当院におけるBordeline resectable膵癌の治療の現況

    林 和直, 五十嵐 聡, 水野 研一, 橋本 哲, 横山 純二, 山際 訓, 寺井 崇二

    日本消化器病学会雑誌   114 ( 臨増大会 )   A832 - A832   2017年9月

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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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  • Development and use of a non-biomaterial model for hands-on training of endoscopic procedures 査読

    Hiroki Sato, Ken-Ichi Mizuno, Yuichi Sato, Satoru Hashimoto, Kazunao Hayashi, Satoshi Ikarashi, Yutaka Honda, Junji Yokoyama, Shuji Terai

    Annals of Translational Medicine   5 ( 8 )   182   2017年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AME Publishing Company  

    Background: Endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM) are recently developed techniques that have the potential to significantly improve clinical outcomes. However, training opportunities on these techniques remain limited. To address this issue, we developed a novel ex-vivo ESD/POEM training model. Our aim in this paper is to describe the model and provide preliminary evidence of promising feasibility to improve access to ESD/POEM training. Methods: The model was developed using polyvinyl alcohol hydrogel, which can easily be modified to reproduce the stiffness of the different intestinal layers, namely the mucosa, submucosa, and muscle layer. Results: A training workshop, using our ex-vivo model, was held for 28 residents. Satisfaction and feasibility in using the ex-vivo model for endoscopic training were evaluated by using a self-report questionnaire. All participants were satisfied with their training experience (100% satisfaction rate), with 27 of the 28 participants reporting that the model was feasible in replicating all components of the ESD/POEM technique (96.4% feasibility rate). Conclusions: Based on this feedback, we propose that our non-biomaterial model has the feasibility to provide an effective endoscopy education tool and a satisfactory training experience.

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  • Long-term outcomes of colorectal endoscopic submucosal dissection in elderly patients 査読

    Yoshifumi Takahashi, Ken-ichi Mizuno, Kazuya Takahashi, Hiroki Sato, Satoru Hashimoto, Manabu Takeuchi, Masaaki Kobayashi, Junji Yokoyama, Yuichi Sato, Shuji Terai

    INTERNATIONAL JOURNAL OF COLORECTAL DISEASE   32 ( 4 )   567 - 573   2017年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Background and aims The safety and efficacy of endoscopic submucosal dissection (ESD) in elderly patients remain unclear. The aim of this study is to clarify the short- and long-term outcomes of colorectal ESD in elderly patients.
    Patients and methods A total of 482 consecutive patients with 501 colorectal lesions treated with ESD from February 2005 to December 2013 were retrospectively reviewed. Patients were divided into two groups: an elderly group (&gt;= 75 years of age) and a non-elderly group (&lt; 75 years of age). Shortterm outcomes of interest were procedure time, complication rate, hospital stay, en bloc resection rate, and non-curative resection rate. Long-term outcomes of interest were disease-specific survival, and overall survival rates in the elderly group (51 patients) and non-elderly group (92 patients) were also analyzed.
    Results No significant differences were observed between the groups with respect to short-term outcomes. Two patients in each group required emergency surgery. Of the patients who underwent non-curative resection, 7/12 (58%) in the elderly group and 15/23 (65%) in the non-elderly group underwent additional surgery. The 5-year disease-specific survival rates in the elderly and non-elderly groups were both 100%, and the corresponding 5-year overall survival rates were 86.3 and 93.5%, respectively (p = 0.026).
    Conclusions Short-term outcomes after colorectal ESD were equivalent in both groups, and all patients showed favorable long-term outcomes. Considering the benign prognosis of lesions resected with ESD, preoperative screening of comorbidities is essential to improve overall survival.

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  • Proposed criteria to differentiate heterogeneous eosinophilic gastrointestinal disorders of the esophagus, including eosinophilic esophageal myositis 査読

    Hiroki Sato, Nao Nakajima, Kazuya Takahashi, Go Hasegawa, Ken-ichi Mizuno, Satoru Hashimoto, Satoshi Ikarashi, Kazunao Hayashi, Yutaka Honda, Junji Yokoyama, Yuichi Sato, Shuji Terai

    WORLD JOURNAL OF GASTROENTEROLOGY   23 ( 13 )   2414 - 2423   2017年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BAISHIDENG PUBLISHING GROUP INC  

    AIM
    To define clinical criteria to differentiate eosinophilic gastrointestinal disorder (EoGD) in the esophagus.
    METHODS
    Our criteria were defined based on the analyses of the clinical presentation of eosinophilic esophagitis (EoE), subepithelial eosinophilic esophagitis (sEoE) and eosinophilic esophageal myositis (EoEM), identified by endoscopy, manometry and serum immunoglobulin E levels (s-IgE), in combination with histological and polymerase chain reaction analyses on esophageal tissue samples.
    RESULTS
    In five patients with EoE, endoscopy revealed longitudinal furrows and white plaques in all, and fixed rings in two. In one patient with sEoE and four with EoEM, endoscopy showed luminal compression only. Using manometry, failed peristalsis was observed in patients with EoE and sEoE with some variation, while EoEM was associated with hypercontractile or hypertensive peristalsis, with elevated s-IgE. Histology revealed the following eosinophils per high-power field values. EoE = 41.4 +/- 7.9 in the epithelium and 2.3 +/- 1.5 in the subepithelium; sEoE = 3 in the epithelium and 35 in the subepithelium (conventional biopsy); EoEM = none in the epithelium, 10.7 +/- 11.7 in the subepithelium (conventional biopsy or endoscopic mucosal resection) and 46.8 +/- 16.5 in the muscularis propria (peroral esophageal muscle biopsy). Presence of dilated epithelial intercellular space and downward papillae elongation were specific to EoE. Eotaxin-3, IL-5 and IL-13 were overexpressed in EoE.
    CONCLUSION
    Based on clinical and histological data, we identified criteria, which differentiated between EoE, sEoE and EoEM, and reflected a different pathogenesis between these esophageal EoGDs.

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  • 当科における術後再建腸管の胆管結石症に対する内視鏡治療の検討

    林 和直, 五十嵐 聡, 水野 研一, 本田 穣, 橋本 哲, 横山 純二, 佐藤 祐一, 山際 訓, 寺井 崇二

    Gastroenterological Endoscopy   59 ( Suppl.1 )   1036 - 1036   2017年4月

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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  

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  • 術後再建腸管例に対するERCP関連手技における偶発症の現状と対策

    五十嵐 聡, 林 和直, 水野 研一, 本田 穣, 橋本 哲, 横山 純二, 佐藤 祐一, 山際 訓, 寺井 崇二

    Gastroenterological Endoscopy   59 ( Suppl.1 )   1035 - 1035   2017年4月

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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  

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  • 他臓器癌合併IPMNの臨床像

    五十嵐 聡, 林 和直, 水野 研一, 本田 穣, 橋本 哲, 横山 純二, 佐藤 祐一, 山際 訓, 寺井 崇二

    日本消化器病学会雑誌   114 ( 臨増総会 )   A372 - A372   2017年3月

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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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  • 当科におけるCrohn病に合併した胆石症の検討

    林 和直, 五十嵐 聡, 水野 研一, 本田 穣, 橋本 哲, 横山 純二, 佐藤 祐一, 山際 訓, 寺井 崇二

    日本消化器病学会雑誌   114 ( 臨増総会 )   A335 - A335   2017年3月

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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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  • Phase 1 Clinical Study of siRNA Targeting Carbohydrate Sulphotransferase 15 in Crohn's Disease Patients with Active Mucosal Lesions 査読

    Kenji Suzuki, Junji Yokoyama, Yusuke Kawauchi, Yutaka Honda, Hiroki Sato, Yutaka Aoyagi, Shuji Terai, Kazuichi Okazaki, Yasuo Suzuki, Yukinori Sameshima, Tsuneo Fukushima, Kazuyuki Sugahara, Raja Atreya, Markus F. Neurath, Kenichi Watanabe, Hiroyuki Yoneyama, Hitoshi Asakura

    JOURNAL OF CROHNS & COLITIS   11 ( 2 )   221 - 228   2017年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:OXFORD UNIV PRESS  

    Background and Aims: Carbohydrate sulphotransferase 15 [CHST15] is a specific enzyme biosynthesizing chondroitin sulphate E that binds various pathogenic mediators and is known to create local fibrotic lesions. We evaluated the safety of STNM01, a synthetic double-stranded RNA oligonucleotide directed against CHST15, in Crohn's disease [CD] patients whose mucosal lesions were refractory to conventional therapy.
    Methods: This was a randomized, double-blind, placebo-controlled, concentration-escalation study of STNM01 by a single-dose endoscopic submucosal injection in 18 CD patients. Cohorts of increasing concentration of STNM01 were enrolled sequentially as 2.5 nM [n = 3], 25 nM [n = 3], and 250 nM [n = 3] were applied. A cohort of placebo [n = 3] was included in each concentration. Safety was monitored for 30 days. Pharmacokinetics was monitored for 24 h. The changes from baseline in the segmental Simple Endoscopic Score for CD [SES-CD] as well as the histological fibrosis score were evaluated.
    Results: STNM01 was well tolerated and showed no drug-related adverse effects in any cohort of treated patients. There were no detectable plasma concentrations of STNM01 at all measured time points in all treatment groups. Seven of nine subjects who received STNM01 showed reduction in segmental SES-CD at Day 30, when compared with those who received placebo. Histological analyses of biopsy specimens revealed that STNM01 reduced the extent of fibrosis.
    Conclusion: Local application of STNM01 is safe and well tolerated in CD patients with active mucosal lesions.

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  • Early Detection of Hepatocellular Carcinoma Recurrence Using the Highly Sensitive Fucosylated Fraction of Alpha-Fetoprotein 査読

    Toru Setsu, Atsunori Tsuchiya, Takayuki Watanabe, Takuro Nagoya, Satoshi Ikarashi, Kazunao Hayashi, Junji Yokoyama, Satoshi Yamagiwa, Shuji Terai

    Case Reports in Gastroenterology   11 ( 1 )   142 - 147   2017年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:S. Karger AG  

    Alpha-fetoprotein (AFP)-L3 was originally reported as a hepatocellular carcinoma (HCC)-specific tumor marker, and recent accumulation of evidence has revealed that AFP-L3 frequency predicts the biological malignancy potential of HCC. However, AFP-L3 elevation from undetectable levels after curative treatment could not be discussed due to the difficulties of calculating AFP-L3 concentrations when serum AFP levels were low. Here, as a novel method, we used highly sensitive AFP-L3 frequency to predict HCC recurrence after curative treatment. Our cases illustrate that recognizing elevation of AFP-L3 from undetectable levels led to the early detection of recurrent HCC due to more careful surveillance.

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  • Possible involvement of mucosal-associated invariant T cells in the progression of inflammatory bowel diseases 査読

    Kentaro Tominaga, Satoshi Yamagiwa, Toru Setsu, Naruhiro Kimura, Hiroki Honda, Hiroteru Kamimura, Yutaka Honda, Masaaki Takamura, Junji Yokoyama, Kenji Suzuki, Toshifumi Wakai, Shuji Terai

    BIOMEDICAL RESEARCH-TOKYO   38 ( 2 )   111 - 121   2017年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BIOMEDICAL RESEARCH PRESS LTD  

    munity. Recent studies have demonstrated that MAIT cells might be implicated in inflammatory bowel diseases (IBDs), but their precise function in IBD remains to be elucidated. We investigated the possible involvement of MAIT cells in the immunopathogenesis of IBDs. Heparinized peripheral blood and biopsy specimens of the colon were collected from 25 patients with ulcerative colitis (UC), 15 patients with Crohn's disease (CD), and 19 heathy individuals. Lymphocytes were isolated from the blood and colon, and then MAIT cells were analyzed by flow cytometry. The frequency of MAIT cells was significantly lower in the blood of IBD patients compared to healthy donors and significantly higher in the inflamed colons compared to healthy colons (P = 0.001). Among the IBD patients, the frequency of MAIT cells in the blood and colon was correlated with disease activities. In vitro activated MAIT cells from IBD patients secreted significantly more tumor necrosis factor-alpha and interleukin-17 than those from healthy donors. These findings indicate that MAIT cells are activated in IBD patients, and their accumulation in the inflamed mucosa is correlated with disease activities.

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  • [Series: Diagnosis at a Glance]. 査読

    Kobayashi T, Tsuchiya A, Kuraoka N, Yamamoto T, Honda Y, Yokoyama J, Kawai H, Yamagiwa S, Suda T, Terai S

    Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine   105 ( 11 )   2263 - 2267   2016年11月

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  • Pivotal Role of Carbohydrate Sulfotransferase 15 in Fibrosis and Mucosal Healing in Mouse Colitis 査読

    Kenji Suzuki, Somasundaram Arumugam, Junji Yokoyama, Yusuke Kawauchi, Yutaka Honda, Hiroki Sato, Yutaka Aoyagi, Shuji Terai, Kazuichi Okazaki, Yasuo Suzuki, Shuji Mizumoto, Kazuyuki Sugahara, Raja Atreya, Markus F. Neurath, Kenichi Watanabe, Taishi Hashiguchi, Hiroyuki Yoneyama, Hitoshi Asakura

    PLOS ONE   11 ( 7 )   e0158967   2016年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PUBLIC LIBRARY SCIENCE  

    Induction of mucosal healing (MH) is an important treatment goal in inflammatory bowel disease (IBD). Although the molecular mechanisms underlying MH in IBD is not fully explored, local fibrosis would contribute to interfere mucosal repair. Carbohydrate sulfotransferase 15 (CHST15), which catalyzes sulfation of chondroitin sulfate to produce rare E-disaccharide units, is a novel mediator to create local fibrosis. Here we have used siRNA-based approach of silencing CHST15 in dextran sulfate sodium (DSS) induced colitis in mice, human colon fibroblasts and cancer cell lines. In a DSS-induced acute colitis model, CHST15 siRNA reduced CHST15 mRNA in the colon, serum IL-6, disease activity index (DAI) and accumulation of F4/80(+) macrophages and ER-TR7(+) fibroblasts, while increased Ki-67(+) epithelial cells. In DSS-induced chronic colitis models, CHST15 siRNA reduced CHST15 mRNA in the colon, DAI, alpha-smooth muscle actin(+) fibroblasts and collagen deposition, while enhanced MH as evidenced by reduced histological and endoscopic scores. We also found that endoscopic submucosal injection achieved effective pancolonic delivery of CHST15 siRNA in mice. In human CCD-18 Co cells, CHST15 siRNA inhibited the expression of CHST15 mRNA and selectively reduced E-units, a specific product biosynthesized by CHST15, in the culture supernatant. CHST15 siRNA significantly suppressed vimentin in both TGF-beta-stimulated CCD18-Co cells and HCT116 cells while up-regulated BMP7 and Ecadherin in HCT116 cells. The present study demonstrated that blockade CHST15 represses colonic fibrosis and enhances MH partly though reversing EMT pathway, illustrating a novel therapeutic opportunity to refractory and fibrotic lesions in IBD.

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  • 当院における悪性胃十二指腸狭窄に対する内視鏡的ステント留置術の有用性の検討

    林 和直, 山本 幹, 水野 研一, 本田 穣, 橋本 哲, 横山 純二, 竹内 学, 佐藤 祐一, 寺井 崇二

    Gastroenterological Endoscopy   58 ( Suppl.1 )   790 - 790   2016年4月

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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  

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  • The Combination Therapy of Dissolution Using Carbonated Liquid and Endoscopic Procedure for Bezoars: Pragmatical and Clinical Review 査読

    Kohei Ogawa, Kenya Kamimura, Ken-ichi Mizuno, Yoko Shinagawa, Yuji Kobayashi, Hiroyuki Abe, Yukari Watanabe, Shunsaku Takahashi, Kazunao Hayashi, Junji Yokoyama, Manabu Takeuchi, Masaaki Kobayashi, Satoshi Yamagiwa, Yuichi Sato, Shuji Terai

    GASTROENTEROLOGY RESEARCH AND PRACTICE   2016   7456242   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:HINDAWI LTD  

    Bezoars are relatively rare foreign bodies of gastrointestinal tract and often cause ileus and ulcerative lesions in the stomach and subsequent bleeding and perforation due to their size and stiffness. Therefore, the removal of bezoars is essential and recent development of devices, the endoscopic removal procedure, is often applied. However, due to their stiffness, simple endoscopic removal failed in not a few cases, and surgical removal has also been used. Recently, the efficacy of a combination therapy of endoscopic procedure and dissolution using carbonated liquid has been reported. To develop the safe and effective removal procedure, we carefully reviewed a total of 55 reported cases in this study including our 3 additional cases, successfully treated with dissolution with endoscopic fragmentation. In summary, the data showed the efficiency in the combination therapy, treating the larger size of bezoar and reducing the length of hospital stay. To the best of our knowledge, this is the largest pragmatical and clinical review for the combination therapy of dissolution and endoscopic treatment for bezoars. This review should help physicians to manage bezoars more efficiently.

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  • Endoscopic Removal of Ingested Dentures and Dental Instruments: A Retrospective Analysis

    Ken-ichi Mizuno, Kazuya Takahashi, Kentaro Tominaga, Yuki Nishigaki, Hiroki Sato, Satoshi Ikarashi, Kazunao Hayashi, Takashi Yamamoto, Yutaka Honda, Satoru Hashimoto, Kenya Kamimura, Manabu Takeuchi, Junji Yokoyama, Yuichi Sato, Masaaki Kobayashi, Shuji Terai

    GASTROENTEROLOGY RESEARCH AND PRACTICE   2016   3537147   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:HINDAWI PUBLISHING CORP  

    Background. Dentures and dental instruments are frequently encountered ingested foreign bodies. The aim of the present study was to assess the safety and efficacy of endoscopically removing ingested dental objects. Methods. Twenty-nine consecutive patients with 29 dental objects who were treated at the Niigata University Medical and Dental Hospital from August 2009 to December 2015 were retrospectively reviewed. Characteristics of the patients and the ingested dental objects, the clinical features and findings of radiological imaging tests, and outcomes of endoscopic removal were analyzed. Results. Patients' mean age was 62.9 + 21.0 years. The ingested dental objects included 23 dentures (13 crowns, 4 bridges, 4 partial dentures, and 2 other dentures) and 6 dental instruments. Twenty-seven upper gastrointestinal endoscopies and 2 colonoscopies were performed, and their success rates were 92.6% and 100%, respectively. There were 2 cases of removal failure; one case involved an impacted partial denture in the cervical esophagus, and this case required surgical removal. Conclusions. Endoscopic removal of ingested dentures and dental instruments is associated with a favorable success rate and acceptable complications. The immediate intervention and appropriate selection of devices are essential for managing ingested dental objects.

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  • 嚥下障害を契機に発見された前立腺癌縦隔転移の1例

    品川 陽子, 小川 光平, 水野 研一, 上村 顕也, 竹内 学, 林 和直, 山本 幹, 本田 穣, 橋本 哲, 横山 純二, 佐藤 祐一, 小林 正明, 野本 実, 梅津 哉

    新潟医学会雑誌   129 ( 5 )   291 - 291   2015年5月

  • 定圧炭酸ガス送気システムを用いた大腸内視鏡下腸管内送気圧と検査時の苦痛、最適な内視鏡視野との関連について

    高橋 祥史, 水野 研一, 小林 正明, 高橋 一也, 西垣 祐紀, 林 和直, 山本 幹, 本田 穣, 橋本 哲, 横山 純二, 竹内 学, 佐藤 祐一, 寺井 崇二

    Gastroenterological Endoscopy   57 ( Suppl.1 )   927 - 927   2015年4月

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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  

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  • The relationship between iron deficiency in patients with helicobacter pylori-infected nodular gastritis and the serum prohepcidin level 査読

    Yuichi Sato, Osamu Yoneyama, Masaki Azumaya, Manabu Takeuchi, Syun-ya Sasaki, Junji Yokoyama, Kazuhiko Shioji, Yusuke Kawauchi, Satoru Hashimoto, Yuuki Nishigaki, Masaaki Kobayashi, Kazuhito Sugimura, Terasu Honma, Rintaro Narisawa, Yutaka Aoyagi

    Helicobacter   20 ( 1 )   11 - 18   2015年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing Ltd  

    Helicobacter pylori (H. pylori) is recognized as a causative agent for unexplained iron-deficiency anemia (IDA). We evaluated many background factors influencing an iron-deficiency state in adult patients with various H. pylori-infected upper gastrointestinal tract diseases. Method: Study 1: H. pylori-infected 121 patients (nodular gastritis (NG) (n = 19), duodenal ulcer (DU) (n = 30), or gastric ulcer (GU) (n = 47), or gastric hyperplastic polyp (GHP) (n = 25)) were enrolled. The RBC count and hemoglobin, iron, ferritin, pepsinogen (PG) I, PG II, gastrin, and anti-H. pylori antibody (Ab) levels in the serum were measured. Study 2: H. pylori-infected 105 patients (NG, n = 19
    DU, n = 43
    GU, n = 32
    GHP, n = 11) and non-H. pylori-infected individuals (n = 35) were examined for the levels of prohepcidin, ferritin, and iron in the serum. In addition, we measured the data before and after the H. pylori eradication. Results: In the patients with GHP and NG, hypoferritinemia was observed in comparison with the GU and DU patients. In the GHP patients, low levels of PG I, a decreased PG I/II ratio, and hypergastrinemia were observed. The levels of serum prohepcidin in the patients with H. pylori-associated disease were higher than those in the uninfected adults. In the patients with NG, the serum prohepcidin levels were higher than those in the other H. pylori-infected patient groups and decreased after the eradication. Conclusion: H. pylori-related iron-deficiency state might be associated with several factors, such as hypochlorhydria and hepcidin, in patients with GHP or NG.

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  • The relationship between iron deficiency in patients with helicobacter pylori-infected nodular gastritis and the serum prohepcidin level 査読

    Yuichi Sato, Osamu Yoneyama, Masaki Azumaya, Manabu Takeuchi, Syun-ya Sasaki, Junji Yokoyama, Kazuhiko Shioji, Yusuke Kawauchi, Satoru Hashimoto, Yuuki Nishigaki, Masaaki Kobayashi, Kazuhito Sugimura, Terasu Honma, Rintaro Narisawa, Yutaka Aoyagi

    Helicobacter   20 ( 1 )   11 - 18   2015年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing Ltd  

    Helicobacter pylori (H. pylori) is recognized as a causative agent for unexplained iron-deficiency anemia (IDA). We evaluated many background factors influencing an iron-deficiency state in adult patients with various H. pylori-infected upper gastrointestinal tract diseases. Method: Study 1: H. pylori-infected 121 patients (nodular gastritis (NG) (n = 19), duodenal ulcer (DU) (n = 30), or gastric ulcer (GU) (n = 47), or gastric hyperplastic polyp (GHP) (n = 25)) were enrolled. The RBC count and hemoglobin, iron, ferritin, pepsinogen (PG) I, PG II, gastrin, and anti-H. pylori antibody (Ab) levels in the serum were measured. Study 2: H. pylori-infected 105 patients (NG, n = 19
    DU, n = 43
    GU, n = 32
    GHP, n = 11) and non-H. pylori-infected individuals (n = 35) were examined for the levels of prohepcidin, ferritin, and iron in the serum. In addition, we measured the data before and after the H. pylori eradication. Results: In the patients with GHP and NG, hypoferritinemia was observed in comparison with the GU and DU patients. In the GHP patients, low levels of PG I, a decreased PG I/II ratio, and hypergastrinemia were observed. The levels of serum prohepcidin in the patients with H. pylori-associated disease were higher than those in the uninfected adults. In the patients with NG, the serum prohepcidin levels were higher than those in the other H. pylori-infected patient groups and decreased after the eradication. Conclusion: H. pylori-related iron-deficiency state might be associated with several factors, such as hypochlorhydria and hepcidin, in patients with GHP or NG.

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  • Familial juvenile polyposis syndrome with a novel SMAD4 germline mutation

    Yutaka Honda, Yuichi Sato, Junji Yokoyama, Masaaki Kobayashi, Rintaro Narisawa, Yusuke Kawauchi, Takahiro Hoshi, Kazuhito Yajima, Tatsuo Kanda, Yoichi Ajioka, Katsuyoshi Hatakeyama, Yutaka Aoyagi

    Clinical Journal of Gastroenterology   6 ( 5 )   361 - 367   2013年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Juvenile polyposis syndrome (JPS) is a dominantly inherited disorder characterized by the development of numerous juvenile polyps (JPs) of the gastrointestinal tract, and associated with a mutation of the SMAD4 or BMPR1A gene. Here, we report a mother-daughter case of familial JPS. A 29-year-old female patient with severe iron deficiency anemia and hypoproteinemia had numerous polyps in the stomach and a few polyps in the ileum and colon that were detected endoscopically. Biopsy specimens from the gastric polyps were diagnosed as JPs. The patient underwent a laparoscopy-assisted total gastrectomy, and her anemia and hypoproteinemia improved. Her mother also had multiple JPs in the stomach, duodenum, jejunum, and colon. We then diagnosed them as having familial JPS. Moreover, germline mutation analysis of the 2 patients presented a novel pathogenic SMAD4 variant. © 2013 Springer Japan.

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  • Economic impact of combination therapy with infliximab plus azathioprine for drug-refractory Crohn's disease: A cost-effectiveness analysis 査読

    Shota Saito, Utako Shimizu, Zhang Nan, Nozomu Mandai, Junji Yokoyama, Kenshi Terajima, Kouhei Akazawa

    Journal of Crohn's and Colitis   7 ( 2 )   167 - 174   2013年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Combination therapy with infliximab (IFX) and azathioprine (AZA) is significantly more effective for treatment of active Crohn's disease (CD) than IFX monotherapy. However, AZA is associated with an increased risk of lymphoma in patients with inflammatory bowel disease. Aim: To evaluate the cost-effectiveness of combination therapy with IFX plus AZA for drug-refractory CD. Methods: A decision analysis model is constructed to compare, over a time horizon of 1. year, the cost-effectiveness of combination therapy with IFX plus AZA and that of IFX monotherapy for CD patients refractory to conventional non-anti-TNF-α therapy. The treatment efficacy, adverse effects, quality-of-life scores, and treatment costs are derived from published data. One-way and probabilistic sensitivity analyses are performed to estimate the uncertainty in the results. Results: The incremental cost-effectiveness ratio (ICER) of combination therapy with IFX plus AZA is 24,917 GBP/QALY when compared with IFX monotherapy. The sensitivity analyses reveal that the utility score of nonresponding active disease has the strongest influence on the cost-effectiveness, with ICERs ranging from 17,147 to 45,564 GBP/QALY. Assuming that policy makers are willing to pay 30,000 GBP/QALY, the probability that combination therapy with IFX plus AZA is cost-effective is 0.750. Conclusions: Combination therapy with IFX plus AZA appears to be a cost-effective treatment for drug-refractory CD when compared with IFX monotherapy. Furthermore, the additional lymphoma risk of combination therapy has little significance on its cost-effectiveness. © 2012 European Crohn's and Colitis Organisation.

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  • Economic impact of combination therapy with infliximab plus azathioprine for drug-refractory Crohn's disease: A cost-effectiveness analysis

    Shota Saito, Utako Shimizu, Zhang Nan, Nozomu Mandai, Junji Yokoyama, Kenshi Terajima, Kouhei Akazawa

    Journal of Crohn's and Colitis   7 ( 2 )   167 - 174   2013年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Combination therapy with infliximab (IFX) and azathioprine (AZA) is significantly more effective for treatment of active Crohn's disease (CD) than IFX monotherapy. However, AZA is associated with an increased risk of lymphoma in patients with inflammatory bowel disease. Aim: To evaluate the cost-effectiveness of combination therapy with IFX plus AZA for drug-refractory CD. Methods: A decision analysis model is constructed to compare, over a time horizon of 1. year, the cost-effectiveness of combination therapy with IFX plus AZA and that of IFX monotherapy for CD patients refractory to conventional non-anti-TNF-α therapy. The treatment efficacy, adverse effects, quality-of-life scores, and treatment costs are derived from published data. One-way and probabilistic sensitivity analyses are performed to estimate the uncertainty in the results. Results: The incremental cost-effectiveness ratio (ICER) of combination therapy with IFX plus AZA is 24,917 GBP/QALY when compared with IFX monotherapy. The sensitivity analyses reveal that the utility score of nonresponding active disease has the strongest influence on the cost-effectiveness, with ICERs ranging from 17,147 to 45,564 GBP/QALY. Assuming that policy makers are willing to pay 30,000 GBP/QALY, the probability that combination therapy with IFX plus AZA is cost-effective is 0.750. Conclusions: Combination therapy with IFX plus AZA appears to be a cost-effective treatment for drug-refractory CD when compared with IFX monotherapy. Furthermore, the additional lymphoma risk of combination therapy has little significance on its cost-effectiveness. © 2012 European Crohn's and Colitis Organisation.

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  • Irsogladine maleate ameliorates infl ammation and fi brosis in mice with chronic colitis induced by dextran sulfate sodium

    Hana Yamaguchi, Kenji Suzuki, Masaki Nagata, Tomoyuki Kawase, Vijayakumar Sukumaran, Rajarajan A. Thandavarayan, Yusuke Kawauchi, Junji Yokoyama, Masayuki Tomita, Hiroshi Kawachi, Kenichi Watanabe, Hiroyuki Yoneyama, Hitoshi Asakura, Ritsuo Takagi

    Medical Molecular Morphology   45 ( 3 )   140 - 151   2012年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Intestinal fi brosis is a common and severe complication of infl ammatory bowel disease (IBD), especially Crohn's disease (CD). To investigate the therapeutic approach to intestinal fi brosis, we have developed a mouse model of intestinal fi brosis by administering dextran sulfate sodium (DSS) and examining the effects of irsogladine maleate (IM) [2,4-diamino-6-(2,5- dichlorophenyl)-s-triazine maleate], which has been widely used as an antiulcer drug for gastric mucosa in Japan, on DDS-induced chronic colitis. In this experimental colitis lesion, several pathognomonic changes were found: increased deposition of collagen, increased number of profi brogenic mesenchymal cells such as fi broblasts (vimentin+, 〈-SMA) and myofi broblasts (vimentin+, 〈-SMA+) in both mucosa and submucosa of the colon with infi ltrating infl ammatory cells, and increased mRNA expressions of collagen type I, transforming growth factor (TGF)-®, matrix metalloproteinase (MMP)-2, and tissue inhibitor of matrix metalloproteinase (TIMP)-1. When IM was administered intrarectally to this colitis, all these pathological changes were signifi cantly decreased or suppressed, suggesting a potential adjunctive therapy for intestinal fi brosis. IM could consequently reduce fi brosis in DSS colitis by direct or indirect effect on profi brogenic factors or fi broblasts. Therefore, the precise effect of IM on intestinal fi brosis should be investigated further. © 2012 The Japanese Society for Clinical Molecular Morphology.

    DOI: 10.1007/s00795-011-0550-7

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  • Irsogladine maleate ameliorates infl ammation and fi brosis in mice with chronic colitis induced by dextran sulfate sodium 査読

    Hana Yamaguchi, Kenji Suzuki, Masaki Nagata, Tomoyuki Kawase, Vijayakumar Sukumaran, Rajarajan A. Thandavarayan, Yusuke Kawauchi, Junji Yokoyama, Masayuki Tomita, Hiroshi Kawachi, Kenichi Watanabe, Hiroyuki Yoneyama, Hitoshi Asakura, Ritsuo Takagi

    Medical Molecular Morphology   45 ( 3 )   140 - 151   2012年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Intestinal fi brosis is a common and severe complication of infl ammatory bowel disease (IBD), especially Crohn's disease (CD). To investigate the therapeutic approach to intestinal fi brosis, we have developed a mouse model of intestinal fi brosis by administering dextran sulfate sodium (DSS) and examining the effects of irsogladine maleate (IM) [2,4-diamino-6-(2,5- dichlorophenyl)-s-triazine maleate], which has been widely used as an antiulcer drug for gastric mucosa in Japan, on DDS-induced chronic colitis. In this experimental colitis lesion, several pathognomonic changes were found: increased deposition of collagen, increased number of profi brogenic mesenchymal cells such as fi broblasts (vimentin+, 〈-SMA) and myofi broblasts (vimentin+, 〈-SMA+) in both mucosa and submucosa of the colon with infi ltrating infl ammatory cells, and increased mRNA expressions of collagen type I, transforming growth factor (TGF)-®, matrix metalloproteinase (MMP)-2, and tissue inhibitor of matrix metalloproteinase (TIMP)-1. When IM was administered intrarectally to this colitis, all these pathological changes were signifi cantly decreased or suppressed, suggesting a potential adjunctive therapy for intestinal fi brosis. IM could consequently reduce fi brosis in DSS colitis by direct or indirect effect on profi brogenic factors or fi broblasts. Therefore, the precise effect of IM on intestinal fi brosis should be investigated further. © 2012 The Japanese Society for Clinical Molecular Morphology.

    DOI: 10.1007/s00795-011-0550-7

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  • [Immunomodulator: azathioprine and 6-mercaptopurine].

    Suzuki K, Honda Y, Kawauchi Y, Yokoyama J

    Nihon rinsho. Japanese journal of clinical medicine   70 Suppl 1   318 - 23   2012年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • 【潰瘍性大腸炎の初期病変とその進展・経過】潰瘍性大腸炎の初期病変 臨床的特徴と進展様式

    横山 純二, 渡辺 和彦, 味岡 洋一, 本間 照, 松沢 純, 小林 正明, 河内 裕介, 青柳 豊

    胃と腸   44 ( 10 )   1523 - 1533   2009年9月

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    記述言語:日本語   出版者・発行元:(株)医学書院  

    大腸アフタ様病変から典型的潰瘍性大腸炎へと進展した6症例(初期アフタ群)について,アフタの内視鏡像,進展様式,臨床経過を分析し,潰瘍性大腸炎の初期病変としてのアフタの意義について検討した.また,潰瘍性大腸炎診断後の経過中に,大腸にアフタ様病変を認めた9症例(経過中アフタ群)についても同様の検討を行った.各群に認めた大腸アフタ様病変は,Ia型(平坦型・発赤と白点),Ib型(平坦型・白苔と周囲の紅暈)とII型(隆起型)の3群に分けられた.初期アフタ群では,II型アフタが6例中4例を占め,4例とも直腸主体で,アフタから典型像への直接進展がみられたのに対し,I型アフタの2例は,アフタ消褪後,別部位に典型像が出現していた.一方,経過中アフタ群は9例ともI型アフタで,Ib型アフタ4例全例が典型像への進展が認められたのに対し,Ia型アフタは5例中1例のみしか進展が認められなかった.以上より,II型アフタは潰瘍性大腸炎の初期病変と考えられ,またIb型アフタについても初期病変である可能性が示唆された.しかし,Ia型アフタについては,大部分が潰瘍性大腸炎の活動期や寛解期に出現する一部分症であると考えられた.(著者抄録)

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  • 腸管リンパ管拡張症、蛋白漏出性胃腸症をきたした空腸潰瘍性病変

    渡辺 和彦, 杉村 一仁, 丹羽 恵子, 田村 康, 横山 純二, 佐藤 祐一, 小林 正明, 成澤 林太郎, 青柳 豊, 味岡 洋一, 中嶋 孝司, 関根 厚雄

    新潟医学会雑誌   122 ( 7 )   382 - 382   2008年7月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • 内視鏡的切除術を行った直腸マラコプラキアの1例

    丹羽 恵子, 渡辺 和彦, 田村 康, 横山 純二, 小林 正明, 杉村 一仁, 成澤 林太郎, 青柳 豊, 西倉 健, 味岡 洋一

    ENDOSCOPIC FORUM for digestive disease   22 ( 1 )   91 - 91   2006年6月

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  • A primary follicular lymphoma of the duodenum treated successfully with radiation therapy

    Masaaki Takamura, Rintaro Narisawa, Yudzuru Maruyama, Junji Yokoyama, Yasuo Fukuhara, Hirokazu Kawai, Satoshi Yamagiwa, Yuichi Sato, Yasunobu Matsuda, Kazuhito Sugimura, Takafumi Ichida, Yutaka Aoyagi

    Internal Medicine   45 ( 5 )   309 - 311   2006年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A 48-year-old man was admitted to our hospital because of repeated episodes of epigastralgia. Endoscopy showed multiple whitish granules extending from the 2nd to 3rd portion of the duodenum. Biopsy specimens showed well circumscribed follicles with a monotonous population of predominantly small cleaved cells that were positive for CD20, CD10 and BCL-2, but negative for CD5. A full staging study showed no abnormalities. The tumor was finally diagnosed according to the WHO classification as a stage I follicular lymphoma (FL), grade 1, of the duodenum and subsequently received irradiation to the involved area. After 3 years of follow-up, he is still in complete remission. Because FL arising in the duodenum has recently reported with increasing frequency, patients with multiple granules in the duodenum should be examined carefully. © 2006 The Japanese Society of Internal Medicine.

    DOI: 10.2169/internalmedicine.45.1464

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  • A primary follicular lymphoma of the duodenum treated successfully with radiation therapy 査読

    Masaaki Takamura, Rintaro Narisawa, Yudzuru Maruyama, Junji Yokoyama, Yasuo Fukuhara, Hirokazu Kawai, Satoshi Yamagiwa, Yuichi Sato, Yasunobu Matsuda, Kazuhito Sugimura, Takafumi Ichida, Yutaka Aoyagi

    INTERNAL MEDICINE   45 ( 5 )   309 - 311   2006年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    A 48-year-old man was admitted to our hospital because of repeated episodes of epigastralgia. Endoscopy showed multiple whitish granules extending from the 2nd to 3rd portion of the duodenum. Biopsy specimens showed well circumscribed follicles with a monotonous population of predominantly small cleaved cells that were positive for CD20, CD10 and BCL-2, but negative for CD5. A full staging study showed no abnormalities. The tumor was finally diagnosed according to the WHO classification as a stage I follicular lymphoma (FL), grade 1, of the duodenum and subsequently received irradiation to the involved area. After 3 years of follow-up, he is still in complete remission. Because FL arising in the duodenum has recently reported with increasing frequency, patients with multiple granules in the duodenum should be examined carefully.

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  • Complete disappearance of pulmonary metastases in a case of hepatocellular carcinoma treated with docetaxel-based systemic chemotherapy

    T Ishikawa, T Ichida, J Yokoyama, Y Matsuda, T Watanabe, H Asakura

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   19 ( 12 )   1423 - 1426   2004年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BLACKWELL PUBLISHING ASIA  

    A case of the complete shrinkage of pulmonary metastases from multiple hepatocellular carcinomas (HCC) after administration of docetaxel, cisplatin and enteric-coated tegafur/uracil is reported. A 54-year-old Japanese man was diagnosed with recurrent multiple HCC associated with pulmonary metastases and compensated liver cirrhosis. Docetaxel, cisplatin and enteric-coated tegafur/uracil were given to this patient. After 2 months of treatment, there was a decrease in tumor markers and a shrinkage of the pulmonary metastases. Image analyses such as chest X-rays and chest computed tomography scans showed a disappearance of the pulmonary metastases, although the multiple HCC did not disappear completely. This was evaluated as a complete remission of metastatic lesions or a partial remission of primary lesions according to the World Health Organization criteria. No recurrence of pulmonary metastasis was seen for 10 months. This combination therapy was well-tolerated for lung cancer and could represent an effective treatment for pulmonary metastases from HCC. (C) 2004 Blackwell Publishing Asia Pty Ltd.

    DOI: 10.1111/j.1400-1746.2004.03737.x

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  • Recurrence of hepatocellular carcinoma 102 months after successful eradication and removal of membranous obstruction of the inferior vena cava

    M Takamura, T Ichida, J Yokoyama, Y Matsuda, M Nomoto, Y Aoyagi

    JOURNAL OF GASTROENTEROLOGY   39 ( 7 )   681 - 684   2004年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER TOKYO  

    We report a 54-year-old Japanese woman who developed liver tumors 102 months after hepatic resection for hepatocellular carcinoma (HCC) and percutaneous transluminal angioplasty (PTA) for membranous obstruction of the inferior vena cava (MOVC), which is one form of Budd-Chiari syndrome. In the present admission workup showed no evidence of co-infection with hepatitis B and C viruses. Dynamic computed tomography (CT) and magnetic resonance imaging showed an enhanced lesion, 1.5 cm in diameter, in segment 3 of the liver, and no obstruction of the inferior vena cava after PTA. CT during both arterial portography and hepatic arteriography revealed another lesion, showing different hemodynamics, in segment 2. The patient therefore underwent hepatic resection, and the tumors were diagnosed histologically as HCC. The two tumors differed in their morphological features, one containing abundant fibrous stroma, whereas the other did not. The nontumorous liver tissue showed central zonal fibrosis, i.e., reversed lobulation, and partial expansion of nodule-like formations, indicating lack of progression since the situation seen at the initial hepatectomy. The presence of nontumorous liver tissue showing the above features suggests that, even after successful treatment for relief of congestion, patients who have had MOVC should be followed closely for as long as possible because of the risk of HCC recurrence. This is the first reported case of HCC recurrence after successful treatment of MOVC.

    DOI: 10.1007/s535-004-1365-2

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  • 腸管狭窄のため内視鏡診断が困難であった直腸低分化充実型腺癌の1例

    保屋野 真, 小林 正明, 上村 顕也, 横山 純二, 本間 照, 青柳 豊, 飯合 恒夫, 岡本 春彦, 畠山 勝義, 塩路 和彦, 味岡 洋一

    ENDOSCOPIC FORUM for digestive disease   19 ( 2 )   225,234 - 229,234   2003年11月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

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  • Lymph node metastasis and micrometastasis of submucosal invasive colorectal carcinoma: An indicator of the curative potential of endoscopic treatment 査読

    Yokoyama J, Ajioka Y, Watanabe H, Asakura H

    Acta Medica et Biologica   50 ( 1 )   1 - 8   2002年3月

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    記述言語:英語   掲載種別:学位論文(博士)  

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  • Mutations of p53 in morphologically non-neoplastic mucosa of long-standing ulcerative colitis

    H Takaku, Y Ajioka, H Watanabe, H Hashidate, S Yamada, J Yokoyama, S Kazama, T Suda, K Hatakeyama

    JAPANESE JOURNAL OF CANCER RESEARCH   92 ( 2 )   119 - 126   2001年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BUSINESS CENTER ACADEMIC SOCIETIES JAPAN  

    Two cases of ulcerative colitis (UC)-associated carcinoma or dysplasia and morphologically non-neoplastic mucosa with p53 protein overexpression ((MNNM-p53OE) were selected. DNA was extracted from the paraffin blocks of these lesions and exons 5-8 of the p53 gene were analyzed by PCR and direct sequencing, In addition, mutations in K-ras codon 12 were analyzed by PCR-RFLP methods, MNNM-p53OE was located surrounding and adjoining a coexisting carcinoma and/or dysplasia. A p53 mutation was detected in 12/22 (54.5%) MNNM-p53OE samples, 4/8 (50%) dysplasia samples and 8/8 (100%) carcinoma samples. The p53 mutations detected in MNNM-p53OE were identical to those demonstrated in the adjoining carcinoma and/or dysplasia. No K-ras codon 12 mutation was detected in ang of the samples. These results indicate that MNNM-p53OE mag share an identical clonal linkage with a coexisting carcinoma and/or dysplasia, and may be an initial and submorphological form of UC-associated neoplasia, Recognition of MNNM-p53OE in biopsy specimens may help to identify patients with UC at risk of developing colorectal carcinoma.

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  • Heterogeneity of p53 mutational status in intramucosal carcinoma of the colorectum

    S Yamada, Y Ajioka, H Watanabe, H Hashidate, H Takaku, S Kazama, J Yokoyama, K Nishikura, T Fujiwara, K Asakura

    JAPANESE JOURNAL OF CANCER RESEARCH   92 ( 2 )   161 - 166   2001年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:BUSINESS CENTER ACADEMIC SOCIETIES JAPAN  

    The aim of this study was to elucidate whether or not p53 genetic heterogeneity would occur while colorectal carcinoma was limited to the mucosa, Eight eases of endoscopically resected colorectal intramucosal carcinomas were analyzed to determine the p53 gene sequence (exons 5 to 8). Six out of 8 cases showed p53 gene mutations, and in all of them, the mutational status was heterogeneous. In 4 cases, mutated codons were heterogeneous as well. These data indicate that p53 gene alterations in colorectal carcinomas occur and diverge at the stage of intramucosal carcinoma, supporting our previously proposed hypothesis that colorectal carcinomas can be composed of various subclones as regards p53 gene mutation, while the carcinoma is limited to the mucosa, and one of these subclones commences invasion to the submucosa after clonal selection, thus generating a monoclonal invasive carcinoma.

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  • Improved survival with oral administration of enteric-coated tegafur/uracil for advanced stage IV-A hepatocellular carcinoma 査読

    Toru Ishikawa, Takafumi Ichida, Soichi Sugitani, Yasunori Tsuboi, Takuya Genda, Satoshi Sugahara, Kazuhiro Uehara, Jun Inayoshi, Junji Yokoyama, Yuiko Ishimoto, Hitoshi Asakura

    Journal of Gastroenterology and Hepatology (Australia)   16 ( 4 )   452 - 459   2001年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing  

    Background and Aims: There is currently no proven chemotherapy regimen for hepatocellular carcinoma (HCC). The principal chemotherapeutic approach in most cases is infusion therapy into the hepatic arteries feeding the tumors. However, the clinical effects of chemotherapy are extremely poor. Therefore, in the present study, we conducted a prospective randomized trial of the efficacy of oral administration of enteric-coated tegafur/uracil for advanced HCC. Methods: From 1994 to 1999, a total of 56 consecutive patients with unresectable stage IV-A HCC were studied prospectively to examine the efficacy of enteric-coated tegafur/uracil in HCC and to determine the significant prognostic factors. Twenty-eight patients were treated only with enteric-coated tegafur/uracil without other anticancer treatment. Another 20 patients were given conservative management only. The remaining eight patients withdrew from the study. Results: In the group treated only with enteric-coated tegafur/uracil, the median survival time and 1 and 2 year survival rates were 12.13 months and 55.3 and 36.9%, respectively. In the control group, the median survival time and 1 year survival rate were 6.20 months and 5.5%, respectively. By both univariate analysis and multivariate analysis using Cox's proportional hazards model, treatment with enteric-coated tegafur/uracil was shown to be the factor most significantly favoring a better prognosis. Conclusions: Although the prognosis of most patients with stage IV-A HCC is poor, administration of enteric-coated tegafur/uracil induces long-term survival and is an effective treatment for stage IV-A HCC. © 2001 Blackwell Science Asia Pty Ltd.

    DOI: 10.1046/j.1440-1746.2001.02352.x

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  • Early colorectal cancer with special reference to the superficial nonpolypoid type from a histopathologic point of view

    Y Ajioka, H Watanabe, S Kazama, H Hashidate, J Yokoyama, S Yamada, H Takaku, K Nishikura

    WORLD JOURNAL OF SURGERY   24 ( 9 )   1075 - 1080   2000年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER-VERLAG  

    The incidence and histopathologic characteristics of nonpolypoid (superficial type) early colorectal carcinomas were studied and compared with those of the polypoid type. The superficial type was subclassified as elevated (type IIa), type IIa with central depression (type IIa+IIc), plain (type IIb), depressed (type IIc), and IIc with marginal elevation (type IIc+IIa). The superficial type comprised 22%, and 27% of intramucosal and submucosal carcinomas, respectively. Pure type IIb was not found, and there were only three pure type IIc lesions. Type IIa+IIc and IIc+IIa (and IIc) showed a significantly higher rate of submucosal invasion among the small tumors (59% and 71% less than 20 mm, respectively) compared to the polypoid type; type IIa showed no significant difference. The incidence of lymph node metastasis among submucosal carcinomas showed no significant difference between the superficial type and the polypoid type. About 64% and 52% of type IIa and IIa+IIc tumors accompanied residual adenoma, suggesting that they originated from small, flat adenomas through the adenoma-carcinoma sequence, whereas type IIc+IIa (and IIc) did not have an adenomatous component, implying that they arose de novo or originated through an adenoma-carcinoma sequence at a smaller size than the type IIa and IIa+IIc lesions. Superficial-type early colorectal carcinomas are not rare, and they are not uniform in nature. Rapid growth and invasion to the submucosa is characteristic of superficial-type lesions with a central depression, and only superficial depressed (type IIc+IIa, IIc) lesions fan arise de novo. Although they grow rapidly to invade the submucosa, it cannot be said that they show more aggressive behavior than the polypoid type.

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  • Complete remission of multiple hepatocellular carcinomas associated with hepatitis C virus-related, decompensated liver cirrhosis by oral administration of enteric-coated tegafur/uracil 査読

    Toru Ishikawa, Takafumi Ichida, Yuiko Ishimoto, Junji Yokoyama, Minoru Nomoto, Yusuke Ebe, Hiroyuki Usuda, Makoto Naito, Hitoshi Asakura

    American Journal of Gastroenterology   94 ( 6 )   1682 - 1685   1999年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier Inc.  

    We report a case of complete remission of multiple hepatocellular carcinomas after oral administration of enteric-coated tegafur/uracil. A 77- yr-old woman was diagnosed as having recurrent hepatocellular carcinoma associated with decompensated liver cirrhosis. We administered enteric- coated tegafur/uracil to this patient. After 1 month of oral administration, there was a decrease in tumor markers. An image analysis showed disappearance of hepatocellular carcinoma. No recurrence of the hepatocellular carcinoma was recognized for 18 months up to the time of the patient's death, which was due to massive bleeding from a hemorragic rectal ulcer. At autopsy, the tumor lesion had necrotized. Oral administration of enteric-coated granules containing tegafur/uracil may provide an effective treatment for hepatocellular carcinoma.

    DOI: 10.1111/j.1572-0241.1999.01163.x

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▶ 全件表示

MISC

  • 非ウイルス性肝硬変時代の門亢症〜ウイルス性との共通点・相違点を中心に〜 原発性胆汁性胆管炎における食道・胃静脈瘤の検討

    薛 徹, 横山 純二, 高綱 将史, 荒生 祥尚, 上村 輝博, 坂牧 僚, 横尾 健, 上村 顕也, 土屋 淳紀, 高村 昌昭, 寺井 崇二

    日本門脈圧亢進症学会雑誌   25 ( 3 )   110 - 110   2019年9月

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  • CONSIDERATION OF SERUM IGA IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

    Kentaro Tominaga, Yuzo Kawata, Naruhiro Kimura, Takeshi Mizusawa, Hiroki Sato, Satoshi Ikarashi, Kazunao Hayashi, Kenichi Mizuno, Satoru Hashimoto, Atsunori Tsuchiya, Junji Yokoyama, Shuji Terai

    GASTROENTEROLOGY   156 ( 6 )   S847 - S847   2019年5月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

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  • サルコペニア研究の最前線 (特集 肝疾患におけるサルコペニア)

    吉田 智彰, 横山 純二, 冨永 顕太郎, 上村 博輝, 坂牧 僚, 高村 昌昭, 寺井 崇二

    消化器・肝臓内科 = Gastroenterology & hepatology   5 ( 1 )   120 - 126   2019年1月

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    記述言語:日本語   出版者・発行元:科学評論社  

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  • 膵癌術前胆道ドレナージにおける大口径プラスチックステントの役割

    五十嵐聡, 林和直, 寺井崇二, 水澤健, 川田雄三, 冨永顕太郎, 佐藤裕樹, 水野研一, 橋本哲, 横山純二, 高村昌昭

    Gastroenterological Endoscopy (Web)   61 ( Supplement1 )   2019年

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  • 慢性膵炎による膵管狭窄に対するステント治療の現状と課題

    林和直, 五十嵐聡, 寺井崇二, 水澤健, 冨永顕太郎, 佐藤裕樹, 水野研一, 橋本哲, 横山純二

    Gastroenterological Endoscopy (Web)   61 ( Supplement1 )   2019年

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    Endoscopic Forum for Digestive Disease   34 ( 2 )   195   2018年12月

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    小川光平, 上村顕也, 阿部聡司, 高昌良, 冨永顕太郎, 河久順志, 五十嵐聡, 林和直, 坂牧僚, 水野研一, 横山純二, 寺井崇二

    肝臓   59 ( Supplement 3 )   A990   2018年11月

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    記述言語:日本語  

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  • 炎症性腸疾患患者における血清IgAの検討

    冨永 顕太郎, 横山 純二, 寺井 崇二

    Gastroenterological Endoscopy   60 ( Suppl.2 )   2121 - 2121   2018年10月

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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  

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  • 術後胆汁中膵酵素値とERCP後膵炎の関連

    河久 順志, 五十嵐 聡, 林 和直, 荒生 祥尚, 阿部 寛幸, 高橋 一也, 渡邉 順, 横山 純二, 寺井 崇二

    Gastroenterological Endoscopy   60 ( Suppl.2 )   2156 - 2156   2018年10月

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    林 和直, 五十嵐 聡, 河久 順志, 高橋 一也, 冨永 顕太郎, 水野 研一, 橋本 哲, 横山 純二, 山際 訓, 寺井 崇二

    Gastroenterological Endoscopy   60 ( Suppl.2 )   2110 - 2110   2018年10月

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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  

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    五十嵐 聡, 林 和直, 河久 順志, 冨永 顕太郎, 高橋 一也, 水野 研一, 橋本 哲, 横山 純二, 山際 訓, 寺井 崇二

    Gastroenterological Endoscopy   60 ( Suppl.2 )   2086 - 2086   2018年10月

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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  

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  • 9年間の経過観察を行った、全大腸に潰瘍性大腸炎類似のびまん性発赤粘膜を呈したCrohn病の1例

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    ENDOSCOPIC FORUM for digestive disease   34 ( 1 )   82 - 82   2018年6月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

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    河久 順志, 五十嵐 聡, 林 和直, 高橋 一也, 冨永 顕太郎, 水野 研一, 橋本 哲, 横山 純二, 寺井 崇二

    Gastroenterological Endoscopy   60 ( Suppl.1 )   762 - 762   2018年4月

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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  

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  • 内臓脂肪面積と生活習慣病、胆膵疾患、膵脂肪変性に関する検討

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    日本消化器病学会雑誌   115 ( 臨増総会 )   A393 - A393   2018年4月

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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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  • IPMNの悪性診断における膵液細胞診の役割

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    Gastroenterological Endoscopy   60 ( Suppl.1 )   671 - 671   2018年4月

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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  

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  • 内臓脂肪面積と生活習慣病、胆膵疾患、膵脂肪変性に関する検討

    河久 順志, 五十嵐 聡, 林 和直, 高橋 一也, 冨永 顕太郎, 水野 研一, 橋本 哲, 上村 博輝, 高村 昌昭, 横山 純二, 川合 弘一, 寺井 崇二

    日本消化器病学会雑誌   115 ( 臨増総会 )   A393 - A393   2018年4月

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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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  • 当院における1型自己免疫性膵炎診療の現状と課題

    林 和直, 五十嵐 聡, 木村 成宏, 河久 順志, 高橋 一也, 冨永 顕太郎, 水野 研一, 橋本 哲, 横山 純二, 山際 訓, 寺井 崇二

    日本消化器病学会雑誌   115 ( 臨増総会 )   A299 - A299   2018年4月

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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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  • 消化管機能検査 最新技術とその応用 消化管運動機能検査としての小腸カプセル内視鏡の有用性の検討

    冨永 顕太郎, 横山 純二, 寺井 崇二

    日本消化器病学会雑誌   115 ( 臨増総会 )   A136 - A136   2018年4月

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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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  • 食道アカラシアの診断と治療戦略 経口内視鏡的筋層切開術(POEM)後に生じる逆流性食道炎の検討

    高橋 一也, 佐藤 裕樹, 冨永 顕太郎, 河久 順志, 五十嵐 聡, 林 和直, 水野 研一, 橋本 哲, 横山 純二, 寺井 崇二

    日本消化管学会雑誌   2 ( Suppl. )   135 - 135   2018年2月

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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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  • IPMNの悪性診断における膵液細胞診の役割

    五十嵐聡, 林和直, 河久順志, 冨永顕太郎, 高橋一也, 水野研一, 橋本哲, 横山純二, 山際訓, 寺井崇二

    Gastroenterological Endoscopy (Web)   60 ( Supplement1 )   671(J‐STAGE)   2018年

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  • プロポフォールを用いた鎮静によるバルーン内視鏡下ERCPの現況

    河久順志, 五十嵐聡, 林和直, 高橋一也, 冨永顕太郎, 水野研一, 橋本哲, 横山純二, 寺井崇二

    Gastroenterological Endoscopy (Web)   60 ( Supplement1 )   762(J‐STAGE)   2018年

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  • 多職種連携チーム医療が著効した食道慢性GVHDの一例

    難波亜矢子, 上村駿, 諏訪部達也, 笠見卓哉, 河本啓介, 河本啓介, 田中智之, 小林弘典, 布施香子, 小師優子, 真柄仁, 高昌良, 冨永顕太郎, 橋本哲, 横山純二, 柴崎康彦, 柴崎康彦, 瀧澤淳, 曽根博仁, 増子正義

    日本造血細胞移植学会総会プログラム・抄録集   40th   305   2017年12月

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  • 直接胆道鏡下での三脚鉗子を用いた結石除去術が有効であった胆管空腸吻合術後の肝内結石の1例

    渡邉 貴之, 五十嵐 聡, 林 和直, 名古屋 拓郎, 薜 徹, 土屋 淳紀, 横山 純二, 寺井 崇二

    ENDOSCOPIC FORUM for digestive disease   33 ( 2 )   131 - 131   2017年11月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

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  • 当科における超高齢者の術後再建腸管に対するERCPの検討

    河久順志, 五十嵐聡, 林和直, 高村昌昭, 横山純二, 寺井崇二

    日本高齢消化器病学会誌   20 ( 1 )   63   2017年7月

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  • 消化器疾患における再生医療

    土屋 淳紀, 小島 雄一, 清野 智, 渡邉 雄介, 川田 雄三, 五十嵐 俊三, 中島 尚, 橋本 哲, 横山 純二, 寺井 崇二

    腎臓内科・泌尿器科   5 ( 6 )   587 - 593   2017年6月

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    記述言語:日本語   出版者・発行元:(有)科学評論社  

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  • Long-Term Outcome of Endoscopic Submucosal Dissection in Esophageal Squamous Cell Carcinoma Invading Into the Muscularis Mucosa or Submucosa Up to 200 mu m

    Kazuya Takahashi, Satoru Hashimoto, Kenichi Mizuno, Hiroki Sato, Satoshi Ikarashi, Kazunao Hayashi, Yutaka Honda, Junji Yokoyama, Yuichi Sato, Shuji Terai

    GASTROINTESTINAL ENDOSCOPY   85 ( 5 )   AB108 - AB108   2017年5月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:MOSBY-ELSEVIER  

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  • SUBMUCOSAL INJECTION OF THE OLIGONUCLEOTIDE STNM01 IS ABLE TO INDUCE CLINICAL REMISSION, MUCOSAL HEALING AND HISTOLOGICAL RESPONSE IN LEFT-SIDED ULCERATIVE COLITIS PATIENTS WITH MODERATE-TO-SEVERE DISEASE

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    GASTROENTEROLOGY   152 ( 5 )   S186 - S186   2017年4月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:W B SAUNDERS CO-ELSEVIER INC  

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    本田 穣, 横山 純二, 冨永 顕太郎, 高橋 一也, 西垣 佑紀, 五十嵐 聡, 林 和直, 水野 研一, 橋本 哲, 佐藤 祐一, 寺井 崇二

    日本消化器病学会雑誌   114 ( 臨増総会 )   A275 - A275   2017年3月

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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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  • 粘膜,粘膜下層,さらに筋層の時代へ~Minimally Invasive Treatmentの新たな潮流~〔粘膜下層に対するアプローチ〕Submucosal endoscopyによる筋層生検—経口内視鏡的食道筋層生検術(POEM‐b)による新しい知見—

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    消化器内視鏡   29 ( 2 )   273‐277   2017年2月

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  • Submucosal injection of the oligonucleotide STNM01 is able to induce clinical remission, mucosal healing and histological response in left-sided ulcerative colitis patients with moderate-to-severe disease

    R. Atreya, T. Kuehbacher, M. J. Waldner, S. Hirschmann, O. Drvarov, R. Abu Hashem, C. Maaser, T. Kucharzik, J. Dinter, C. Schramm, J. Mertens, B. Holler, J. Moessner, K. Suzuki, J. Yokoyama, S. Terai, H. Yoneyama, H. Asakura, T. Hibi, M. F. Neurath

    JOURNAL OF CROHNS & COLITIS   11   S69 - S69   2017年2月

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  • 術後再建腸管例に対するERCP関連手技における偶発症の現状と対策

    五十嵐聡, 林和直, 水野研一, 本田穣, 橋本哲, 横山純二, 佐藤祐一, 山際訓, 寺井崇二

    Gastroenterological Endoscopy (Web)   59 ( Supplement1 )   1035(J‐STAGE)   2017年

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  • 薬剤過敏症症候群後に潰瘍性大腸炎を発症した一例

    吉田智彰, 横山純二, 高橋一也, 竹内卓, 林和直, 橋本哲, 本田譲, 藤本篤, 渡邊玄, 梅津哉, 佐藤祐一, 寺井崇二

    日本消化管学会総会学術集会プログラム・抄録集   13th   2017年

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  • A novel training model made of polyvinyl alcohol hydrogel for endoscopic submucosal dissection

    Ken-Chi Mizuno, Hiroki Sato, Satoshi Ikarashi, Kazunao Hayashi, Yutaka Honda, Satoru Hashimoto, Junji Yokoyama, Yuichi Sato, Shuji Terai

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   31   277 - 278   2016年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

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  • 一目瞭然!目で診る症例

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    日本内科学会雑誌   105 ( 11 )   2263 - 2267   2016年11月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

    DOI: 10.2169/naika.105.2263

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  • 自然経過で縮小した多臓器(肝、肺、腎)炎症性偽腫瘍の1例

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    肝臓   57 ( 6 )   287 - 294   2016年7月

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    記述言語:日本語   出版者・発行元:(一社)日本肝臓学会  

    症例は関節リウマチの診断で外来加療中の76歳女性。当科受診2ヵ月前から全身倦怠感、1ヵ月前から軽度右季肋部痛を自覚していた。近医を受診し、腹部超音波検査で肝右葉に35mm大の腫瘤を指摘された。造影CTでは肝右葉から右腎に及ぶ造影効果の乏しい腫瘤に加え、両側腎、左肺に腫瘤を認めた。悪性腫瘍を疑い、肝生検目的で当科に入院した。腹部超音波検査では約2週間で肝腫瘤が16mmに縮小していたが、診断目的で経皮的肝針生検を施行した。検体内には軽度炎症細胞浸潤を伴う高度線維化領域を認めたが、腫瘍性病変は指摘できなかった。組織像に加え画像検査で肝、腎、肺いずれの病変も縮小したことから、炎症性偽腫瘍と診断し経過観察の方針とした。本疾患はあらゆる臓器を原発とする可能性があり、しばしば悪性腫瘍との鑑別が困難で切除に至る症例もある。多発症例も報告されているが、検索し得た限りでは3臓器にわたる多発症例はなく貴重な症例と考え報告する。(著者抄録)

    DOI: 10.2957/kanzo.57.287

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  • 重複癌に合併した多血性肝腫瘍の1例

    渡邉 貴之, 菅野 智之, 中島 尚, 上村 博輝, 横山 純二, 山際 訓, 野本 実, 寺井 崇二, 梅津 哉, 佐藤 聡史, 岩崎 友洋, 小方 則夫

    新潟医学会雑誌   129 ( 10 )   613 - 613   2015年10月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • クームス陰性自己免疫性溶血性貧血(AIHA)を合併した急性肝不全の1例

    中島 尚, 菅野 智之, 上村 博輝, 横山 純二, 山際 訓, 野本 実, 寺井 崇二, 梅津 哉, 佐藤 聡史, 岩崎 友洋, 小方 則夫

    新潟医学会雑誌   129 ( 10 )   630 - 630   2015年10月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • 【生検を極める】 胃の内視鏡生検に必要な知識と技術

    小林 正明, 水野 研一, 橋本 哲, 竹内 学, 林 和直, 山本 幹, 本田 穣, 横山 純二, 佐藤 祐一, 兼藤 務, 須田 剛士, 寺井 崇二

    消化器内視鏡   27 ( 6 )   966 - 971   2015年6月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    生検を極めるには、スコープ操作や採取手技だけでなく、実際の内視鏡所見を踏まえて、どの場所から生検を採取すると、どのような組織像が得られるのかを予測しながら検査を行うトレーニングが必要である。内視鏡観察を疎かにして、診断を安易に生検に頼っていては、内視鏡検査をいくら行っても実力は身につかない。内視鏡診断力の向上のためには、生検を含めた病理組織診断に関する知識や理解も必要となる。生検後に動脈性出血をきたした経験もあり、緊急止血を含めた偶発症対策も欠かすことはできない。これらは、内視鏡を用いた各種治療手技を目指すための第一歩でもあり確実に習得したい。(著者抄録)

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  • 【Helicobacter pylori陰性胃癌研究の最前線】 Helicobacter pylori除菌後発生する胃癌の形態変化

    佐藤 祐一, 小林 正明, 水野 研一, 橋本 哲, 竹内 学, 林 和直, 山本 幹, 本田 穣, 横山 純二

    Helicobacter Research   19 ( 1 )   40,8 - 44,8   2015年2月

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    記述言語:日本語   出版者・発行元:(株)先端医学社  

    ヘリコバクター・ピロリ感染胃炎に対して、除菌療法の保険診療が承認され、除菌治療を受ける患者は増加している。その一方、Helicobacter pylori除菌後の長期経過観察例も増加することになり、H.pylori除菌後胃癌が発見される症例が今後増加することが予想される。今回われわれは、除菌後に発見される胃癌は慢性胃炎像に類似した表面模様を呈することを示し、その発見および範囲決定が困難になっていることを提示した。除菌後胃癌の発見には、背景胃粘膜の萎縮の評価とともに、NBI拡大内視鏡を用いるなどして、通常より注意深い観察が必要となろう。(著者抄録)

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  • Long-term outcomes of endoscopic submucosal dissection for colorectal neoplasms

    Yoshifumi Takahashi, Ken Ichi Mizuno, Masaaki Kobayashi, Kazuya Takahashi, Yu Ki Nishigaki, Satoru Hashimoto, Manabu Takeuchi, Takashi Yamamoto, Honda Yutaka, Junji Yokoyama, Yu Ichi Sato

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   29   63 - 63   2014年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • Endoscopic submucosal dissection for correct diagnosis of dysplasia in ulcerative colitis

    Ken Ichi Mizuno, Junji Yokoyama, Masaaki Kobayashi, Yoshifumi Takahashi, Kazuya Takahashi, Yuki Nishigaki, Takashi Yamamoto, Yutaka Honda, Satoru Hashimoto, Manabu Takeuchi, Yuichi Sato, Yoichi Ajioka

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   29   59 - 59   2014年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • 【胃癌ESD適応拡大病変の経過と予後】 胃癌ESD後の異時性多発胃癌例の臨床病理学的特徴と経過・予後

    小林 正明, 橋本 哲, 竹内 学, 水野 研一, 林 和直, 山本 幹, 本田 穣, 横山 純二, 佐藤 祐一

    胃と腸   49 ( 11 )   1609 - 1619   2014年10月

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    記述言語:日本語   出版者・発行元:(株)医学書院  

    胃癌ESDを受けた500例を経過観察(中央値5.2年)し,119例(24%)に同時性多発癌,61例(12%)に異時性多発癌が発見された.異時性例に原病死はないが,3例はSM2であった.また,EMR/ESDを受けた524例においてH.pylori感染,時代背景(1990年代vs.2000年代),背景粘膜萎縮,同時多発,性別などの因子別に異時性多発癌累積発見率を検討した.同時多発例と男性から高率に異時多発癌が発見され,H.pylori陰性例からの発見は陽性例と同等であった.発癌を認めた胃炎粘膜からは,同時・異時合わせて30%以上の多発癌が発生することを念頭に置き,ESDの前後には慎重な内視鏡観察が必要である.(著者抄録)

    DOI: 10.11477/mf.1403200031

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  • 42 当科におけるsorafenib治療の検討(Ⅰ.一般演題, 第37回リバーカンファレンス)

    長島 藍子, 須田 剛士, 倉岡 直亮, 罇 陽介, 山本 幹, 横山 純二, 五十嵐 正人, 川合 弘一, 山際 訓, 青柳 豊, 松田 康伸, 大越 省吾, 小林 真

    新潟医学会雑誌   127 ( 10 )   580 - 580   2013年10月

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    記述言語:日本語   出版者・発行元:新潟医学会  

    CiNii Article

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  • The clinical outcomes of endoscopic submucosal dissection for superficial esophageal carcinoma with esophageal varices

    Manabu Takeuchi, Masaaki Kobayashi, Satoru Hashimoto, Junji Yokoyama, Yuichi Sato, Yutaka Aoyagi

    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   27   112 - 112   2012年12月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • 診断に苦慮し急速な肝不全の進行を来たした肝アミロイドーシスの1例

    星隆洋, 田村康, 佐藤裕樹, 横山純二, 山際訓, 青柳豊, 丸山弦, 大矢洋, 森山雅人, 後藤眞

    新潟医学会雑誌   126 ( 11 )   628   2012年11月

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    記述言語:日本語  

    J-GLOBAL

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  • 急性DSS腸炎におけるマレイン酸イルソグラジン(ガスロンN)注腸治療効果の検討

    山口 花, 鈴木 健司, 孫 曉梅, 本田 穣, 河内 裕介, 横山 純二, 永田 昌毅, 富田 雅之, 河内 裕, 渡辺 賢一, 高木 律男, 朝倉 均

    消化器と免疫   ( 48 )   124 - 129   2012年3月

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    記述言語:日本語   出版者・発行元:日本消化器免疫学会  

    マレイン酸イルソグラジン(IM;商品名 ガスロンN)は広く臨床で使用されている胃炎・胃潰瘍治療剤であり、ギャップ結合細胞間コミュニケーション活性化作用や抗炎症作用などが明らかにされている。我々はC57BL/6Jマウスに3%Dextran sulfate sodium(DSS)を自由飲水させて腸炎を惹起し、IMを注腸投与し、その効果を検討した。病態コントロール群に比べ、IM治療群ではDSS腸炎の臨床所見・病理組織学的所見が改善した。このメカニズムとして、IMは、DSSによる粘液分泌減少を抑制し、タイトジャンクションやギャップ結合の機能を改善させている可能性が示唆された。(著者抄録)

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  • 【変わったぞ「消化管出血のマネジメント」】 上部消化管 腫瘍出血の対処法

    小林 正明, 橋本 哲, 河内 裕介, 本田 穣, 野澤 優次郎, 山田 一樹, 土屋 淳紀, 塩路 和彦, 竹内 学, 横山 純二, 佐藤 祐一, 須田 剛士, 青柳 豊

    消化器内視鏡   23 ( 11 )   1904 - 1909   2011年11月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    腫瘍出血は、緊急内視鏡が必要な上部消化管出血の約5%を占め、進行胃癌の頻度が高い。腫瘍出血の多くは慢性的な少量出血であるが、腫瘍表面の潰瘍形成に伴う大量出血に対しては、緊急内視鏡が必要である。検査前には腫瘍の存在が確認できていないことも多く、出血源同定と止血処置を優先しつつ、消化性潰瘍との鑑別を行う。緊急内視鏡における止血の手順や止血法の選択は、消化性潰瘍に対する場合と大きく異なるものではないが、一般に腫瘍出血では観察や治療の条件が不良であり、より簡便で確実な止血法が望まれる。近年、ESDや消化性潰瘍出血で頻用されている止血鉗子を用いた高周波凝固法は、腫瘍出血に対しても有用であり、露出血管を正確に把時するか、出血ポイントに、鉗子を閉じた状態で軽く押し当て、soft凝固で処置する。止血困難な場合や出血を繰り返す症例では、内視鏡治療に固執せずIVRや手術による止血を考慮する。(著者抄録)

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  • 小腸出血性ポリープの2例

    本田 穣, 青柳 智也, 土屋 淳紀, 冨樫 忠之, 須田 剛士, 青柳 豊, 河内 祐介, 横山 純二, 成澤 林太郎, 西倉 健, 梅津 哉, 高橋 元子, 岡本 春彦

    ENDOSCOPIC FORUM for digestive disease   26 ( 2 )   197 - 197   2010年10月

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    記述言語:日本語   出版者・発行元:(株)癌と化学療法社  

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  • 慢性DSS腸炎に対するPlasmid-IL-10注腸治療効果の検討

    野々村 頼子, 孫 暁梅, 鈴木 健司, 大坪 亜矢, 遠藤 悠, 河内 裕介, 横山 純二, 串田 良裕, 大根田 輝, 細野 正道, 丸山 弘樹, 渡辺 賢一, 松田 康伸, 青柳 豊

    消化器と免疫   ( 46 )   140 - 144   2010年3月

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    記述言語:日本語   出版者・発行元:日本消化器免疫学会  

    炎症性腸疾患(IBD)は炎症の再発、寛解を繰り返し、腸管の線維化に伴う腸管の狭窄をもたらす。われわれは、B6マウスに3% Dextran Sulfate Sodium(DSS)を自由飲水させ慢性DSS腸炎を惹起しIL-10遺伝子発現プラスミドの注腸治療を検討した。治療群では、無治療群に比べ、腸炎は臨床的、組織学的に改善し、腸管線維化の抑制が見られた。治療群において慢性DSS腸炎が改善したことより、IL-10遺伝子発現プラスミド注腸は、IBDの慢性腸管炎症と線維化に対する新たな治療法になり得ると考えた。(著者抄録)

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  • 慢性DSS腸炎におけるリザベン注腸治療効果の検討

    孫 暁梅, 鈴木 健司, 河内 裕介, 横山 純二, 斉藤 翼, 熊谷 さやか, 串田 良裕, 大根田 輝, 細野 正道, 渡辺 賢一, 松田 康伸, 永田 昌毅, 青柳 豊

    消化器と免疫   ( 45 )   139 - 143   2009年3月

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    記述言語:日本語   出版者・発行元:日本消化器免疫学会  

    腸管狭窄の原因である腸管線維化は炎症性腸疾患(IBD)の重篤な合併症であり、いまだ有効な治療法を欠いている。我々はB6マウスに3% Dextran sulfate sodium(DSS)を自由飲水させ慢性DSS腸炎を惹起し、肥満細胞膜安定剤トラニラストの注腸治療を検討した。無治療群に比べ、治療群において腸炎は臨床的、組織学的に改善し、腸管線維化の抑制効果もみられた。治療群で腸炎が有意に改善したことより、トラニラスト注腸がIBDの慢性腸管炎症と線維化の有効な治療戦略となりうると示唆された。(著者抄録)

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  • DSS腸炎におけるplasmid-IL-10注腸治療効果の検討

    河合 裕子, 孫 暁梅, 鈴木 健司, 河内 裕介, 横山 純二, 北澤 侑恵, 斉藤 翼, 大根田 輝, 熊谷 さやか, 串田 良裕, 細野 正道, 丸山 弘樹, 渡辺 賢一, 松田 康伸, 青柳 豊

    消化器と免疫   ( 45 )   144 - 148   2009年3月

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    記述言語:日本語   出版者・発行元:日本消化器免疫学会  

    IL-10遺伝子治療は炎症性腸疾患(IBD)の有力な治療法として注目されてきたが、IL-10の全身投与による副作用が問題となっている。我々はB6マウスに3% Dextran sulfate sodium(DSS)を自由飲水させ腸炎を惹起し、IL-10遺伝子発現プラスミドの注腸投与による治療効果を検討した。無治療群に比し、治療群では腸炎は臨床的、組織学的に改善がみられた。IL-10遺伝子発現プラスミド注腸により、DSS腸炎を改善できた。IL-10遺伝子注腸治療はIBD治療法になり得ると考えられた。(著者抄録)

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  • 31 アルコール性肝硬変に合併し, マロリー体の集簇を認めた結節性病変の1例(I.一般演題,第29回リバーカンファレンス)

    大崎 暁彦, 津端 俊介, 佐藤 俊大, 福原 康夫, 矢野 雅彦, 石本 結子, 横山 純二, 川合 弘一, 山際 訓, 松田 康伸, 杉村 一仁, 野本 実, 青柳 豊

    新潟医学会雑誌   122 ( 10 )   599 - 600   2008年10月

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    記述言語:日本語   出版者・発行元:新潟医学会  

    CiNii Article

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▶ 全件表示

共同研究・競争的資金等の研究

  • 炎症性腸疾患に合併する大腸癌における遺伝子変異に基づいた新しい診断・治療法の確立

    研究課題/領域番号:20K09003  2020年4月 - 2023年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    中野 麻恵, 島田 能史, 横山 純二, 中野 雅人, 小柳 英人, 田中 花菜, 市川 寛, 凌 一葦, 竹内 志穂

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

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  • 口腔ピロリ菌の闇に迫るー分離・同定,感染機序,持続感染制御因子の探索的研究

    研究課題/領域番号:19K22704  2019年6月 - 2021年3月

    日本学術振興会  科学研究費助成事業 挑戦的研究(萌芽)  挑戦的研究(萌芽)

    野杁 由一郎, 大墨 竜也, 竹中 彰治, 三室 仁美, 寺井 崇二, 横山 純二, 佐藤 裕樹

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    配分額:6370000円 ( 直接経費:4900000円 、 間接経費:1470000円 )

    申請書の計画に則り研究を遂行した。胃がんの原因であるピロリ菌(Helicobacter pylori)の口腔からの信頼性の高い同定法の開発を目指した。
    2018年1月~2019年7月に新潟大学医歯学総合病院に来院し、本研究の趣旨を説明し同意の得られた男女61名(平均年齢57歳)を対象とし、デンタルバイオフィルムを採取した。(承認番号2017-0150)。各サンプルから細菌DNAを抽出し、Single PCRおよびNested PCRを行った。Single PCRは、16S rRNA, およびvacAを標的遺伝子とするプライマー(EHC、Vac-A)を用いた。Nested PCRは、EHEHCの内部領域に位置するプライマー(ET-5)を用いた。コントロールは、H. pylori IID3023株を使用し、Single PCRとNested PCR法の検出限界も検討した。
    PCR法での陽性率はそれぞれ、EHC 3.2%(2/61)、Vac-A 3.2%(2/61)であった。Nested PCR法での陽性率はET-5 29.5%(18/61)であった。そのうち、ピロリ菌除菌療法後の患者のサンプル数は18で、陽性率はPCR法で各々EHC 0%(0/18)、Vac-A 5.6%(1/18)、Nested PCR法でET-5 38.9%(7/18)であった。Single PCRにおける検出限界は、1000分の1で、Nested PCR法では、100万分の1であった。
    今回61名中21名(34%)がピロリ菌陽性であり、口腔がピロリ菌のリザーバーとして機能していることが示唆され、抗菌療法に偏重したピロリ菌の制御戦略を再考する可能性が示された。現在、消化器内科の分担者が採集したヒトの胃からのH. pylorの検索を行っており、感染メカニズムの一端も解明が待たれるところである。

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  • 小腸絨毛基底膜における「窓」の脂肪吸収に対する調節機能の解明

    研究課題/領域番号:19K08462  2019年4月 - 2022年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    横山 純二, 寺井 崇二, 牛木 辰男, 高村 昌昭, 八木 一芳, 冨永 顕太郎

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

    ヒトでの小腸絨毛基底膜の窓の検討を行っている。小腸内視鏡下にヒト十二指腸、空腸、回腸各部位から生検材料を採取し、SEMによる基底膜の窓の観察を引き続き行った。これまでの検討で、ヒト小腸においてもラット同様に、小腸絨毛基底膜に窓が存在し、窓を通過する自由細胞の存在も明らかになった。しかし、絨毛の形態は、ラットとは異なり、同じ部位でも絨毛の形態にバリエーションがあることが分かり、その意義と、機能の違いの有無について、また、肥満者と非肥満者との違いについて解析をすすめている。
    呼気水素・メタン分析装置を用いての小腸内細菌増殖症(SIBO)の検討を行っている。肝硬変における肝性脳症や、過敏性腸症候群、炎症性腸疾患におけるSIBOの有無とその意義について解析をすすめており、今後は、脂肪吸収の効率、窓との相関を含め、総合的に検討していく予定である。

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  • 小腸絨毛基底膜の「窓」の解析と小腸吸収評価システムの開発

    2016年4月 - 2019年3月

    日本学術振興会  科学研究費助成事業  基盤研究(C)

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    資金種別:競争的資金

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