研究者詳細 - 寺井　崇二

論文 - 寺井　崇二

分割表示 1,167 件中 341 - 360 件目／全件表示 >>

自己免疫性膵炎と膵癌との鑑別の現状と課題

小川光平, 林和直, 五十嵐聡, 寺井崇二

ENDOSCOPIC FORUM for digestive disease 37 ( 1 ) 32 - 32 2021年7月

Shrinkage of a Submucosal Tumor in the Rectum. 国際誌

Takamasa Kobayashi, Manabu Takeuchi, Shuji Terai

Journal of gastrointestinal and liver diseases : JGLD 30 ( 2 ) 183 - 184 2021年6月

Severe steatosis and mild colitis are important for the early occurrence of hepatocellular carcinoma. 国際誌

Takeki Sato, Atsunori Tsuchiya, Takashi Owaki, Masaru Kumagai, Satoko Motegi, Takahiro Iwasawa, Shunsuke Nojiri, Masahiro Ogawa, Suguru Takeuchi, Yusuke Watanabe, Yuzo Kawata, Hiroteru Kamimura, Shuji Terai

Biochemical and biophysical research communications 566 36 - 44 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

The number of patients with non-alcoholic steatohepatitis (NASH) and inflammatory bowel disease (IBD) is increasing. This study elucidates the effect of both NASH and IBD on hepatocellular carcinoma (HCC) using a mouse model combining NASH and IBD. The melanocortin 4 receptor-deficient (Mc4r-KO) mice were divided into four groups with or without a high-fat diet (HFD) and with or without dextran sulfate sodium (DSS) to induce colitis, and the differences in liver damage and occurrence of HCC were analyzed. In the HFD + DSS group, the body weight, liver weight/body weight ratio, and serum levels of albumin and alanine aminotransferase were significantly lower than those in the HFD group. We further found that steatosis was significantly lower and lobular inflammation was significantly higher in the HFD + DSS group than those in the HFD group, and that individual steatosis and lobular inflammation state in the HFD + DSS mice varied. We detected HCC only in the HFD + DSS group, and mice with severe steatosis and mild colitis were found to be at high risk of HCC. Presently, the prediction of HCC is very difficult. In some cases, severe colitis reverses the fat accumulation due to appetite loss. Our findings clearly showed that severe steatohepatitis and mild colitis are simultaneously essential for the occurrence of HCC in patients with NASH and IBD.

DOI： 10.1016/j.bbrc.2021.05.097

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Effect of Lenvatinib on a Hepatocellular Carcinoma with Fibroblast Growth Factor Receptor 4 Expression: A Case Report and Review of the Literature.

Osamu Shibata, Kenya Kamimura, Masayoshi Ko, Norihiro Sakai, Hiroyuki Abe, Shinichi Morita, Takeshi Mizusawa, Hiroki Sato, Akira Sakamaki, Shuji Terai

Internal medicine (Tokyo, Japan) 60 ( 11 ) 1709 - 1715 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Basic and clinical research have shown that the expression of molecules involved in the hepatocellular carcinoma (HCC) cell signaling pathway is related to the sensitivity to molecular-targeted agents. We herein report a case of HCC that was effectively treated with lenvatinib after a poor response to sorafenib. The tumor showed a high expression of fibroblast growth factor receptor 4, which is reportedly related to the sensitivity to lenvatinib in vitro. The information obtained from this case and from our literature review highlights the importance of assessing the expression of the molecules involved in tumors for effective precision medicine.

DOI： 10.2169/internalmedicine.6580-20

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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

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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Transoral surgery for superficial head and neck cancer: National Multi-Center Survey in Japan. 国際誌

Chikatoshi Katada, Manabu Muto, Satoshi Fujii, Tetsuji Yokoyama, Tomonori Yano, Akihito Watanabe, Toshiro Iizuka, Shigetaka Yoshinaga, Ichiro Tateya, Hiroki Mitani, Yuichi Shimizu, Akiko Takahashi, Tomoyuki Kamijo, Noboru Hanaoka, Makoto Abe, Akihiro Shiotani, Koichi Kano, Yukinori Asada, Tamotsu Matsuhashi, Hirohito Umeno, Kenji Okami, Kenichi Goda, Shinichiro Hori, Yoichiro Ono, Shuji Terai, Yasuaki Nagami, Kenichi Takemura, Kenro Kawada, Mizuo Ando, Naoto Shimeno, Akihito Arai, Yasutoshi Sakamoto, Masaaki Ichinoe, Tetsuo Nemoto, Masahiro Fujita, Hidenobu Watanabe, Tadakazu Shimoda, Atsushi Ochiai, Takakuni Kato, Ryuichi Hayashi

Cancer medicine 10 ( 12 ) 3848 - 3861 2021年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Head and neck cancers, especially in hypopharynx and oropharynx, are often detected at advanced stage with poor prognosis. Narrow band imaging enables detection of superficial cancers and transoral surgery is performed with curative intent. However, pathological evaluation and real-world safety and clinical outcomes have not been clearly understood. The aim of this nationwide multicenter study was to investigate the safety and efficacy of transoral surgery for superficial head and neck cancer. We collected the patients with superficial head and neck squamous cell carcinoma who were treated by transoral surgery from 27 hospitals in Japan. Central pathology review was undertaken on all of the resected specimens. The primary objective was effectiveness of transoral surgery, and the secondary objective was safety including incidence and severity of adverse events. Among the 568 patients, a total of 662 lesions were primarily treated by 575 sessions of transoral surgery. The median tumor diameter was 12 mm (range 1-75) endoscopically. Among the lesions, 57.4% were diagnosed as squamous cell carcinoma in situ. The median procedure time was 48 minutes (range 2-357). Adverse events occurred in 12.7%. Life-threatening complications occurred in 0.5%, but there were no treatment-related deaths. During a median follow-up period of 46.1 months (range 1-113), the 3-year overall survival rate, relapse-free survival rate, cause-specific survival rate, and larynx-preservation survival rate were 88.1%, 84.4%, 99.6%, and 87.5%, respectively. Transoral surgery for superficial head and neck cancer offers effective minimally invasive treatment. Clinical trials registry number: UMIN000008276.

DOI： 10.1002/cam4.3927

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併存する疾患のあることが多い高齢者における上部消化管疾患のマネージメント地域病院における消化器サルコペニア疾患診療の有用性

上村博輝, 小島雄一, 高橋一也, 高綱将史, 平野正明, 政二文明, 藤田一, 辻村恭憲, 小林太一, 寺井崇二

日本消化器病学会甲信越支部例会抄録集 68回 52 - 52 2021年6月

感染性被包化と壊死門脈瘻を伴う膵仮性嚢胞の一例(A case of pancreatic pseudocyst-portal vein fistula with infected walled off necrosis)

前田悠一郎, 林和直, 戸田遼, 若林拓哉, 木村究, 水戸將貴, 小島雄一, 小川光平, 荒生祥尚, 木村成宏, 五十嵐聡, 土屋淳紀, 徳永麻美, 佐藤知巳, 寺井崇二

日本消化器病学会甲信越支部例会抄録集 68回 35 - 35 2021年6月

Effectiveness of EUS-Guided Fine-Needle Biopsy versus EUS-Guided Fine-Needle Aspiration: A Retrospective Analysis. 国際誌

Naosuke Kuraoka, Satoru Hashimoto, Shigeru Matsui, Shuji Terai

Diagnostics (Basel, Switzerland) 11 ( 6 ) 2021年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic tumors and subepithelial lesions (SEL) of the gastrointestinal tract are effective for histological diagnosis. There are also reports that tissue sampling is possible with a smaller number of punctures by EUS-guided fine-needle biopsy (EUS-FNB). In this study, we retrospectively compared the diagnostic abilities of EUS-FNA and EUS-FNB. We examined 130 patients who underwent EUS-FNA/EUS-FNB for pancreatic tumors and SEL from July 2018 to January 2021. None of the cases underwent rapid on-site evaluation. There were 94 and 36 cases in the EUS-FNA and EUS-FNB groups, respectively. The median tumor size in the EUS-FNB group was 30 mm, which was significantly larger than the EUS-FNA group (p = 0.02). In addition, transgastric puncture was significantly more common in the EUS-FNB group (p = 0.01). The EUS-FNA and EUS-FNB groups had a sensitivity of 82.9% and 91.7% and an accuracy rate of 85.1% and 91.7%, respectively. However, both procedures had a comparable diagnostic ability.

DOI： 10.3390/diagnostics11060965

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Long-term survival of 11 years with multidisciplinary therapy for hepatocellular carcinoma metastasis to the ovary and peritoneum: a case report.

Satoko Motegi, Takeshi Yokoo, Ryosuke Nozawa, Rie Azumi, Yuzo Kawata, Kohei Ogawa, Toru Setsu, Ken-Ichi Mizuno, Koji Nishino, Hajime Umezu, Hirokazu Kawai, Takeshi Suda, Shuji Terai

Clinical journal of gastroenterology 14 ( 4 ) 1211 - 1220 2021年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

We herein report a rare case of HCC metastases to the ovary and peritoneum in a 61-year-old female patient who has achieved 11-year survival with multidisciplinary therapy. The patient was diagnosed with HCC during balloon angioplasty performed for Budd-Chiari syndrome in 1994 and underwent partial hepatectomy twice. Five years after the second hepatectomy, allochronic recurrence of a single nodule detected in S8 was treated by radiofrequency ablation, followed by percutaneous ethanol injection therapy and stereotactic body radiotherapy. However, her α-fetoprotein level rose to 1862 ng/mL within one year and computed tomography revealed a large pelvic tumor suggesting HCC metastasis to the ovary. The subsequent laparotomy revealed one 11-cm left ovarian tumor, one small right ovarian nodule, and numerous peritoneal nodules. Bilateral salpingo-oophorectomy and peritoneal resection of as many nodules as possible were performed. Combination therapy with intravenous 5-fluorouracil plus cisplatin and ramucirumab monotherapy effectively suppressed tumor progression with maintenance of hepatic functional reserve, and she has achieved long-term survival of 11 years, illustrating that multidisciplinary therapy with favorable hepatic functional reserve maintenance can contribute to long-term survival in HCC with extrahepatic spread.

DOI： 10.1007/s12328-021-01434-2

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Endoscopic retrieval of multiple sewing needles by using the tip of a magnetic tube. 国際誌

Shinichi Morita, Kazuyoshi Yagi, Takahiro Hoshi, Satoshi Abe, Shuji Terai

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 6 ( 5 ) 228 - 230 2021年5月

Paris II and Rotterdam criteria are the best predictors of outcomes in patients with primary biliary cholangitis in Japan. 国際誌

Naruhiro Kimura, Masaaki Takamura, Nobutaka Takeda, Yusuke Watanabe, Yoshihisa Arao, Masahumi Takatsuna, Suguru Takeuchi, Hiroyuki Abe, Toru Setsu, Hiroteru Kamimura, Akira Sakamaki, Kenya Kamimura, Atsunori Tsuchiya, Shuji Terai

Hepatology international 15 ( 2 ) 437 - 443 2021年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Biochemical response to treatment in patients with primary biliary cholangitis (PBC) reflects prognosis. However, the best predictive criteria to detect biochemical response remain undetermined. In addition, because these criteria need > 6 months until definition, parameters that can estimate its results before initiating treatment are needed. METHODS: We conducted a single-center retrospective study on 196 patients with PBC, followed up for at least 12 months after initiating treatment. RESULTS: Kaplan-Meier analysis showed that Paris II (p = 0.002) and Rotterdam criteria (p = 0.001) could estimate the overall survival of PBC patients, whereas Paris II (p = 0.001), Rotterdam (p = 0.001), and Rochester criteria (p= 0.025) could estimate liver-related deaths. Cox hazard analysis revealed Paris II and Rotterdam criteria as significantly independent predictors of overall survival (hazard ratio (HR) 3.948, 95% CI 1.293-12.054, p = 0.016 and HR 6.040, 95% CI 1.969-18.527, p = 0.002, respectively) and liver-related deaths (HR 10.461, 95% CI 1.231-88.936, p = 0.032 and HR 10.824, 95% CI 1.252-93.572, p = 0.032, respectively). The results of Paris II criteria could be estimated by serum prothrombin time (Odds ratio (OR) 1.052, 95% CI 1.008-1.098, p = 0.021) and alanine transaminase level (OR 0.954, 95% CI 0.919-0.991, p = 0.014) whereas, those of Rotterdam criteria could be estimated by serum albumin level (OR 3.649, 95% CI 1.098-12.128, p = 0.035) at the time of diagnosis. CONCLUSIONS: This study highlights the best prediction criteria and pre-treatment parameters that facilitate the prognosis of PBC patients.

DOI： 10.1007/s12072-021-10163-0

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Analysis of the safety of pretransplant corticosteroid therapy in patients with acute liver failure and late-onset hepatic failure in Japan. 国際誌

Takuro Hisanaga, Isao Hidaka, Isao Sakaida, Nobuaki Nakayama, Akio Ido, Naoya Kato, Yasuhiro Takikawa, Kazuaki Inoue, Masahito Shimizu, Takuya Genda, Shuji Terai, Hirohito Tsubouchi, Hajime Takikawa, Satoshi Mochida, Intractable Hepato-Biliary Disease Study Group Of Japan

JGH open : an open access journal of gastroenterology and hepatology 5 ( 4 ) 428 - 433 2021年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

Background and Aim: In Japan, corticosteroids have been commonly used as a part of multidisciplinary therapy for patients with acute liver failure and late-onset hepatic failure. However, there is controversy regarding the development of infections and other complications. In this study, the influence of corticosteroids on patient outcomes after liver transplantation was investigated. Methods: This study included 167 patients with acute liver failure and late-onset hepatic failure who underwent liver transplantation between 2010 and 2015. The effects of pretransplant corticosteroid therapy on patient outcomes were evaluated using a database constructed by the subcommittee for fulminant hepatitis in the Intractable Hepato-Biliary Diseases Study Group of Japan. Results: The subacute type and the median total bilirubin levels were higher in those receiving corticosteroids than in those not receiving corticosteroids. Although infections tended to be higher in patients receiving corticosteroids, pretransplant corticosteroid administration did not affect the survival rates. The duration from corticosteroid initiation to liver transplantation was longer in patients who developed infections. The survival rates, however, did not differ between patients with and without infections. Conclusions: Corticosteroids were administered to patients with poor prognoses. Otherwise, the overall outcome in those administered corticosteroids was not significantly different from that in those administered without corticosteroids. Although infectious complications tended to occur, they were generally controllable and nonfatal. Pretransplant corticosteroid therapy may be permissible, with regarding for infections and performed within the minimum duration.

DOI： 10.1002/jgh3.12508

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Achalasia and esophageal cancer: a large database analysis in Japan.

Hiroki Sato, Shuji Terai, Yuto Shimamura, Shinwa Tanaka, Hironari Shiwaku, Hitomi Minami, Chiaki Sato, Ryo Ogawa, Hiroshi Yokomichi, Haruhiro Inoue

Journal of gastroenterology 56 ( 4 ) 360 - 370 2021年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Achalasia has been reported to be associated with esophageal cancers (ECs). However, owing to the rarity of achalasia, details of achalasia-related ECs are not well investigated. METHOD: The incidence of ECs in Japanese patients with achalasia and achalasia-related esophageal motility disorders (EMDs) was estimated, and risk factors for achalasia-related ECs were determined. Characteristics of ECs and treatment courses were also analyzed. RESULTS: Between 2010 and 2019, 2714 Japanese patients with achalasia and achalasia-related EMDs were recorded in 7 high-volume centers; 24 patients (21 men, 3 women) developed ECs. The incidence of ECs was estimated at 0.078 and 0.28 per 100 person-years from the onset and the diagnosis of disease, respectively. Kaplan-Meier estimate suggested that, in addition to a long history of achalasia, advanced age, male sex, and regular alcohol consumption were statistically significant risk factors for EC development. A prevalence of 40 ECs (12.5% multiple lesions, and 22.7% metachronal lesions) was also noted, predominantly distributed over the thoracic esophagus. All were histologically diagnosed as squamous cell carcinoma. Superficial ECs were successfully treated with endoscopic treatment in all cases, except one. Achalasia-related Barret esophagus was extremely rare, and Barret adenocarcinoma was not detected in our cohort. CONCLUSION: The high relative risk of ECs was clarified in Japanese achalasia patients, although the absolute risk remained low. Therefore, surveillance endoscopy may be recommended in limited patients with several aforementioned risk factors determined. Superficial cancer can be treated with endoscopic treatment. Multiple and metachronal ECs should be screened.

DOI： 10.1007/s00535-021-01763-6

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The first case of balloon-occluded retrograde transvenous obliteration and partial splenic embolization for gastric varices in situs inversus abdominus.

Yusuke Watanabe, Akihiko Osaki, Nobuo Waguri, Shuji Terai

Clinical journal of gastroenterology 14 ( 2 ) 656 - 661 2021年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

Situs inversus abdominus is a congenital abnormality characterized by the mirror image positioning of the abdominal organs, making it difficult to diagnosis and treatment of many diseases. Here, we report a rare case of gastric varices in situs inversus abdominus patient. A 55-year-old man was diagnosed with F2-shaped gastric varices associated with alcoholic cirrhosis. Abdominal dynamic computed tomography showed situs inversus abdominus, and gastric varices with a gastrorenal shunt. Due to the complex anatomy, emergency interventional radiology during bleeding was extremely difficult. Therefore, after thorough consultation, we decided to treat gastric varices prophylactically by balloon-occluded retrograde transvenous obliteration. After treatment, the patient's clinical course was generally good, with no adverse events, and the gastric varices disappeared. It is important to assess anatomical positioning using three-dimensional reconstruction computed tomography images before treatment, to adequately prepare, including selecting appropriate devices (i.e., catheters and sheath). Although preventive treatment of gastric varices is controversial, in cases with anatomical complexity, preventive treatment with sufficient preparation would be recommended. To the best of our knowledge, there are no reports of treatment for gastric varices in situs inversus abdominus patient. This case will serve as a reference for successful treatment in future cases.

DOI： 10.1007/s12328-020-01332-z

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当センターでの肝炎医療コーディネーター養成の現状と院内非専門医対策について

薛徹, 荒生祥尚, 廣川光, 寺井崇二

肝臓 62 ( Suppl.1 ) A242 - A242 2021年4月