研究者詳細 - 寺井　崇二

論文 - 寺井　崇二

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肝性脳症〜わが国における現状と課題〜潜在性肝性脳症患者における呼気中水素・メタン分析の有用性の検討

坂牧僚, 横山邦彦, 小山究太郎, 森田真一, 阿部寛幸, 上村顕也, 高村昌昭, 横山純二, 寺井崇二

日本門脈圧亢進症学会雑誌 26 ( 3 ) 76 - 76 2020年10月

急性膵炎およびその合併症治療の最前線新潟県における重症急性膵炎の予後改善を目指して Niigata SAP network

林和直, 五十嵐聡, 寺井崇二

日本消化器病学会雑誌 117 ( 臨増大会 ) A624 - A624 2020年10月

Synchronous Double Bile Duct Cancers with Distinct Genetic Features.

Shinichi Morita, Takeshi Suda, Yoji Kishi, Toshimitsu Iwasaki, Nobuyoshi Hiraoka, Itsuo Nagayama, Takahiro Hoshi, Satoshi Abe, Kazuyoshi Yagi, Go Hasegawa, Toshihiko Ikarashi, Shuji Terai

Internal medicine (Tokyo, Japan) 59 ( 17 ) 2129 - 2134 2020年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 69-year-old man was referred to our hospital because of appetite loss. Imaging showed a nodular tumor in the perihilar bile duct and a second flat lesion in the distal bile duct. Right hepatopancreaticoduodenectomy was performed, and the histopathological findings demonstrated that the perihilar and distal lesions were moderately and poorly differentiated adenocarcinoma, respectively, and anatomically separated. Furthermore, the resected specimens showed no pancreaticobiliary maljunction. Histological and TP53 gene analyses in a rare case of synchronous double bile duct cancers suggest that there are various genetic pathways through which bile duct cancer develops, highlighting the complexity of its pathogenesis.

DOI： 10.2169/internalmedicine.4613-20

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Transcriptomic Dissection of Hepatocyte Heterogeneity: Linking Ploidy, Zonation, and Stem/Progenitor Cell Characteristics 査読

Takeshi Katsuda, Kazunori Hosaka, Juntaro Matsuzaki, Wataru Usuba, Marta Prieto-Vila, Tomoko Yamaguchi, Atsunori Tsuchiya, Shuji Terai, Takahiro Ochiya

Cellular and Molecular Gastroenterology and Hepatology 9 ( 1 ) 161 - 183 2020年9月

2D-Shear Wave ElastographyとTransient Elastographyの乖離症例の特徴

杉田萌乃, 横尾健, 荒生祥尚, 薛徹, 上村博輝, 坂牧僚, 上村顕也, 土屋淳紀, 高村昌昭, 寺井崇二

肝臓 61 ( Suppl.2 ) A695 - A695 2020年9月

健診受検者における年齢層別NAFLDの解析と高齢者の意識変化

横尾健, 佐藤公俊, 丹羽佑輔, 荒生祥尚, 薛徹, 上村博輝, 坂牧僚, 上村顕也, 土屋淳紀, 高村昌昭, 寺井崇二

肝臓 61 ( Suppl.2 ) A671 - A671 2020年9月

mALBI score/gradeからみたNASH薬物治療に対する肝予備能への影響

高村昌昭, 横尾健, 荒生祥尚, 薛徹, 上村博輝, 坂牧僚, 上村顕也, 土屋淳紀, 寺井崇二

肝臓 61 ( Suppl.2 ) A691 - A691 2020年9月

2D-Shear Wave ElastographyとTransient Elastographyの乖離症例の特徴

杉田萌乃, 横尾健, 荒生祥尚, 薛徹, 上村博輝, 坂牧僚, 上村顕也, 土屋淳紀, 高村昌昭, 寺井崇二

肝臓 61 ( Suppl.2 ) A695 - A695 2020年9月

mALBI score/gradeからみたNASH薬物治療に対する肝予備能への影響

高村昌昭, 横尾健, 荒生祥尚, 薛徹, 上村博輝, 坂牧僚, 上村顕也, 土屋淳紀, 寺井崇二

肝臓 61 ( Suppl.2 ) A691 - A691 2020年9月

健診受検者における年齢層別NAFLDの解析と高齢者の意識変化

横尾健, 佐藤公俊, 丹羽佑輔, 荒生祥尚, 薛徹, 上村博輝, 坂牧僚, 上村顕也, 土屋淳紀, 高村昌昭, 寺井崇二

肝臓 61 ( Suppl.2 ) A671 - A671 2020年9月

消化器疾患に対する再生医療の応用間葉系幹細胞の治療効果メカニズム検証に基づく肝硬変に対するより効果的な治療法開発

土屋淳紀, 高村昌昭, 寺井崇二

肝臓 61 ( Suppl.2 ) A583 - A583 2020年9月

Effectiveness of Endoscopic Pancreatic Stenting for Pancreatic Pseudocyst-Portal Vein Fistula

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

CASE REPORTS IN GASTROENTEROLOGY 14 ( 3 ) 570 - 576 2020年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：KARGER

Pancreatic pseudocyst-portal vein (PP-PV) fistula, mostly occurring after pseudocyst formation following acute/chronic pancreatitis, is a rare but life-threatening condition. The majority of treatments are based on conservative or surgical interventions. We report the case of a 70-year-old man with a PP-PV fistula and PV thrombosis. We adopted conservative treatment at first due to his mild symptoms. However, after resuming food intake, the patient had severe abdominal pain. Following endoscopic retrograde cholangiopancreatography, we found that the pseudocyst was connected with the PV through the fistula. Subsequently, an endoscopic nasopancreatic drainage (ENPD) catheter was inserted into the main pancreatic duct to establish pancreatic drainage, which resulted in a decrease in the abdominal pain. After the ENPD tube had been exchanged for endoscopic pancreatic stenting, his abdominal pain did not recur. Therefore, this case demonstrated endoscopic treatment as an effective treatment option for PP-PV fistula.

DOI： 10.1159/000510331

Web of Science

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脂肪性肝疾患における自律神経系ネットワークを介したセロトニンの関与

大脇崇史, 上村顕也, 高昌良, 名古屋拓郎, 永山逸夫, 大越麻理奈, 薛徹, 寺井崇二

肝臓 61 ( Suppl.2 ) A670 - A670 2020年9月

肝臓を基軸とした臓器連関肝臓を基軸とし自律神経系経路を介する多臓器連関の肝病態への関与の解明

上村顕也, 大脇崇史, 寺井崇二

肝臓 61 ( Suppl.2 ) A613 - A613 2020年9月

Portal Vein Thrombosis Associated with Trousseau Syndrome due to Urinary Bladder Squamous Cell Carcinoma in a Liver Cirrhosis Patient. 査読

Naruhiro Kimura, Atsunori Tsuchiya, Chiyumi Oda, Atsushi Kimura, Kazunori Hosaka, Kentaro Tominaga, Kazunao Hayashi, Tatsuya Abé, Hajime Umezu, Shuji Terai

Internal medicine (Tokyo, Japan) 59 ( 16 ) 1971 - 1975 2020年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 75-year-old woman with liver cirrhosis was admitted for treatment of portal vein thrombosis (PVT). Computed tomography (CT) showed PVT, massive ascites, and multiple abdominal organ embolism. Blood tests revealed a decreased liver function (Child-Pugh grade C). Language impairment followed by progressive left hemi-paralysis was subsequently detected. Magnetic resonance imaging revealed multiple small acute cerebral infarctions and, on CT, a 30-mm bladder tumour; a biopsy specimen examination showed squamous cell carcinoma. Her general condition worsened rapidly, and the best supportive care was chosen. Our findings suggest that, in patients with PVT, Trousseau syndrome should be considered, even in cases of liver cirrhosis.

DOI： 10.2169/internalmedicine.4112-19

PubMed

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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

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

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

PubMed

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Real-world effectiveness and safety of tolvaptan in liver cirrhosis patients with hepatic edema: results from a post-marketing surveillance study (START study).

Isao Sakaida, Shuji Terai, Masayuki Kurosaki, Mitsuru Okada, Takahiro Hirano, Yasuhiko Fukuta

Journal of gastroenterology 55 ( 8 ) 800 - 810 2020年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: This large-scale post-marketing surveillance study (START study) evaluated the effectiveness and safety of tolvaptan in Japanese liver cirrhosis patients with hepatic edema in real-world clinical settings. Here, we present the final analysis outcomes. METHODS: A prospective, multicenter, non-interventional study involving patients who received tolvaptan for the treatment of liver cirrhosis with hepatic edema with an insufficient response to conventional diuretics. The observation period was up to 6 months. Effectiveness evaluation included changes in body weight and clinical symptoms. Safety analysis included evaluation of adverse drug reactions (ADRs). RESULTS: Case reports of 1111 patients were collected. Of these, 1109 were included in the safety analysis and 1098 in the effectiveness analysis. The mean age was 69.4 ± 11.5 years and 695 (62.7%) patients were male. After tolvaptan treatment, a decrease in body weight from baseline was - 2.6 ± 2.7 kg on day 7 and - 3.8 ± 4.1 kg on day 14. Moreover, clinical symptoms significantly improved over the 14-day treatment. Frequently reported ADRs were thirst (6.6%), hepatic encephalopathy (2.3%), dehydration (1.5%), and hypernatremia (1.2%). A serum sodium level of ≥ 150 mEq/L was reported in five patients (0.5%). Multivariate analyses showed that the baseline blood urea nitrogen (BUN) level (cut-off value: 22.4 mg/dL) was the predictive factor for tolvaptan treatment response. CONCLUSIONS: The results suggest that tolvaptan was effective and well-tolerated in liver cirrhosis patients with hepatic edema. In the real-world clinical setting, tolvaptan provides a useful option for the treatment of hepatic edema.

DOI： 10.1007/s00535-020-01691-x

PubMed

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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

【線維化慢性疾患のキープロセス多彩な間質細胞が織りなす組織リモデリング"fibrosis"の理解】(第3章)各臓器疾患における線維化間葉系幹細胞投与による肝線維化改善、再生誘導効果

寺井崇二, 土屋淳紀

実験医学 38 ( 12 ) 2059 - 2062 2020年8月

記述言語：日本語出版者・発行元：(株)羊土社

われわれは2003年より、肝硬変症に対する自己骨髄細胞の臨床研究を開始、その後局所麻酔で少量の骨髄液を回収し間葉系幹細胞に培養し投与する方法を開発した。さらに、より多くの患者に対し治療を実行するため"他家脂肪組織由来間葉系幹細胞投与療法"の治験を行ってきた。一方で、なぜ骨髄細胞は肝硬変に効果があるか?についての基礎研究は、現在の二光子励起顕微鏡等を用いた解析では、投与した間葉系幹細胞は主に肺に遊走され、そこで"指揮細胞"としてエクソソームを出すことで、硬変部に、実働細胞としてマクロファージ等の細胞を遊走させ、マクロファージがM2表現型になることで線維化改善、さらにオンコスタチンMあるいはVEGF等を出すことで、肝線維化改善、再生誘導することが明らかになった。今になってあらためて過去のデータを見直すと、肝臓に定着していた細胞は主にマクロファージであった。基礎、臨床研究・治験を推進してきた現在までの結果について総括する。(著者抄録)

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