研究者詳細 - 寺井　崇二

The factors influencing long-term outcomes of stenting for malignant colorectal obstruction in elderly group in community medicine 査読

Michitaka Imai, Kenya Kamimura, Yoshifumi Takahashi, Toshihiro Sato, Osamu Isokawa, Masaki Maruyama, Takamasa Kobayashi, Kazunao Hayashi, Shuji Terai

International Journal of Colorectal Disease 33 ( 2 ) 189 - 197 2018年2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：Springer Verlag

Purpose: Malignant bowel obstruction is a complication of colorectal carcinoma or metastasis from other carcinoma, and it causes significant damage on the condition of elderly patients
however, the self-expandable metallic stents (SEMSs) have been effectively used either for palliation or for bridging to the surgical procedure for this condition. The aim of this study was to investigate the factors influencing long-term outcomes of old-aged patients with SEMS for large bowel obstruction to develop the strategy for those patients in the community medicine. Methods: We performed a retrospective review of 42 patients with a median age of 83.0 years (range, 65–99 years), who underwent SEMS placement for malignant colorectal obstruction between 2006 and 2015 in our hospital. Univariate and multivariate logistic regressions were performed on data from the patients to assess the factors affecting 6-month survival without stent dysfunction. Results: The study population comprised 24 females (57.1%) and 18 males (42.9%). Of these, 38 patients (90.5%) received SEMS as palliation, whereas 4 patients (9.5%) underwent subsequent surgery. SEMSs were successfully inserted in 97.6% of patients. The median duration of follow-up was 205.0 days (range, 20–1377 days). On multivariate analysis, shorter stents (&lt
10 cm) yielded better outcomes than longer stents (≥ 10 cm) (P = 0.041), and the Cox proportional hazard model also indicated that shorter stents (P = 0.036) predicted longer event-free survival. Conclusions: Elderly patients with malignant bowel obstruction receiving shorter stents had longer event-free survival after stenting with better general condition.

DOI： 10.1007/s00384-017-2946-x

Possible involvement of chemokine C-C receptor 7−programmed cell death-1+ follicular helper T-cell subset in the pathogenesis of autoimmune hepatitis 査読

Naruhiro Kimura, Satoshi Yamagiwa, Tomoyuki Sugano, Toru Setsu, Kentaro Tominaga, Hiroteru Kamimura, Masaaki Takamura, Shuji Terai

Journal of Gastroenterology and Hepatology (Australia) 33 ( 1 ) 298 - 306 2018年1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：Blackwell Publishing

Background and Aim: Recent studies have demonstrated that B cells and follicular helper T (Tfh) cells, which are central regulators of humoral immune response, contribute to the development and progression of autoimmune diseases. Because Tfh cells can be divided into several subsets with distinct functional properties, this study aimed to examine the roles of different subsets of circulating Tfh cells in the immune pathogenesis of autoimmune hepatitis (AIH). Methods: Thirty-five patients with AIH, 28 patients with primary biliary cholangitis, 22 patients with chronic hepatitis B (CHB), and 44 health controls (HC) were enrolled. The frequencies of different Tfh subsets in the blood and liver were examined by flow cytometry and immunohistochemical staining. The function of circulating Tfh subsets was examined after in vitro stimulation. Results: In newly diagnosed AIH patients, the frequency of circulating chemokine C-C receptor 7−programmed cell death-1+ Tfh subset was significantly increased compared with that in CHB patients and HC, significantly correlated with clinical parameters, including serum IgG, prothrombin time and albumin levels, and significantly decreased after corticosteroid treatment. In the liver of AIH patients, the frequencies of activated Tfh subsets were significantly increased and positively correlated with those in the blood. Moreover, the ability to produce interleukin-21 and interleukin-17 from circulating Tfh cells was significantly increased in AIH patients compared with HC. Conclusions: These results significantly extend our understanding of Tfh subsets in AIH and suggest a potential role of dysregulated chemokine C-C receptor 7−programmed cell death-1+ Tfh subset in the pathogenesis and disease progression of AIH.

DOI： 10.1111/jgh.13844

Full-layer mucosal histology in achalasia: Histological epithelial wave is characteristic in "pinstripe pattern"-positive achalasia. 査読

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

Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society 30 ( 1 ) e13168 - e13168 2018年1月

臨床応用可能な肝臓選択的核酸医薬送達法の確立招待査読

上村顕也, 横尾健, 寺井崇二

BIO Clinica 33 ( 1 ) 34 - 38 2018年1月

Opinion

Terai, S.

Drug Delivery System 33 ( 5 ) 2018年

Gastrointestinal: A rare case of concomitant type III achalasia and chronic idiopathic intestinal pseudo-obstruction

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

Journal of Gastroenterology and Hepatology (Australia) 33 ( 3 ) 559 - 559 2018年

Exploration for cell sources for liver regenerative medicine: “CLiP” as a dawn of cell transplantation therapy

Hosaka, K., Katsuda, T., Terai, S., Ochiya, T.

Stem Cells and Cancer in Hepatology: From the Essentials to Application 2018年

Successful closure with over-the-scope clip of an iatrogenic duodenal perforation due to endoscopic ultrasonography

Morita, S., Suda, T., Oda, C., Hoshi, T., Kanefuji, T., Yagi, K., Terai, S.

Endoscopic Forum for Digestive Disease 34 ( 1 ) 2018年

Effective prevention of sorafenib-induced hand-foot syndrome by dried-bonito broth. 査読国際誌

Kenya Kamimura, Yoko Shinagawa-Kobayashi, Ryo Goto, Kohei Ogawa, Takeshi Yokoo, Akira Sakamaki, Satoshi Abe, Hiroteru Kamimura, Takeshi Suda, Hiroshi Baba, Takayuki Tanaka, Yoshizu Nozawa, Naoto Koyama, Masaaki Takamura, Hirokazu Kawai, Satoshi Yamagiwa, Yutaka Aoyagi, Shuji Terai

Cancer management and research 10 805 - 813 2018年

記述言語：英語掲載種別：研究論文（学術雑誌）

Background: Sorafenib (SOR) is a molecular medicine that prolongs the survival of patients with hepatocellular carcinoma (HCC). Therefore, the management of side effects is essential for the longer period of continuous medication. Among the various side effects, hand-foot syndrome (HFS) is the most common, occurring in 30%-50% of patients, and often results in discontinuation of the SOR medication. However, its mechanism has not been clarified, and no effective prevention method has been reported for the symptoms. Therefore, this study aimed to analyze its mechanism and to develop an effective prevention regimen for the symptoms. Materials and methods: To assess the mechanism of SOR-induced HFS, the peripheral blood flow in the hand and foot was carefully monitored by Doppler ultrasound, thermography, and laser speckle flowgraphy in the cases treated with SOR and its contribution was assessed. Then, the effect of dried-bonito broth (DBB), which was reported to improve peripheral blood flow, on the prevention of the symptom was examined by monitoring its occurrence and the peripheral blood flow. Results: A total of 25 patients were enrolled in this study. In all, eight patients developed HFS, and all cases showed a significant decrease in the peripheral blood flow. DBB contributed to an increase in the flow (p = 0.009) and significantly decreased occurrence of HFS (p = 0.005) than control. Multivariable analysis showed that the ingestion of DBB is a significant independent contributor to HFS-free survival period (p = 0.035). Conclusion: The mechanism of SOR-induced HFS involves a decrease in the peripheral blood flow, and the ingestion of DBB effectively prevents the development of the syndrome by maintaining the flow.

DOI： 10.2147/CMAR.S159370

Antireflux Metal Stent for Initial Treatment of Malignant Distal Biliary Obstruction 査読

Shinichi Morita, Yasuaki Arai, Shunsuke Sugawara, Miyuki Sone, Yasunari Sakamoto, Takuji Okusaka, Shigetaka Yoshinaga, Yutaka Saito, Shuji Terai

Gastroenterology Research and Practice 2018 3805173 2018年

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 Limited

Objectives. To compare the use of an antireflux metal stent (ARMS) with that of a conventional covered self-expandable metal stent (c-CSEMS) for initial stenting of malignant distal biliary obstruction (MDBO). Materials and Methods. We retrospectively investigated 59 consecutive patients with unresectable MDBO undergoing initial endoscopic biliary drainage. ARMS was used in 32 patients and c-CSEMS in 27. Technical success, functional success, complications, causes of recurrent biliary obstruction (RBO), time to RBO (TRBO), and reintervention were compared between the groups. Results. Stent placement was technically successful in all patients. There were no significant intergroup differences in functional success (ARMS [96.9%] versus c-CSEMS [96.2%]), complications (6.2 versus 7.4%), and RBO (48.4 versus 42.3%). Food impaction was significantly less frequent for ARMS than for c-CSEMS (P=0.037), but TRBO did not differ significantly between the groups (log-rank test, P=0.967). The median TRBO was 180.0 [interquartile range (IQR), 114.0-349.0] days for ARMS and 137.0 [IQR, 87.0-442.0] days for c-CSEMS. In both groups, reintervention for RBO was successfully completed in all patients thus treated. Conclusion. ARMS offers no advantage for initial stent placement, but food impaction is significantly prevented by the antireflux valve.

DOI： 10.1155/2018/3805173

A Case of Enteritis Induced by Nivolumab 査読

Takamasa Kobayashi, Kazuya Takahashi, Shuji Terai

Clinical Gastroenterology and Hepatology 2018年

Specific gastric blood vessels in sinistral portal hypertension 査読

Hiroteru Kamimura, Toru Ishikawa, Noriko Ishihara, Shuji Terai

Internal Medicine 57 ( 7 ) 1053 - 1054 2018年

Prognostic value of subcutaneous adipose tissue volume in hepatocellular carcinoma treated with transcatheter intra-arterial therapy. 査読国際誌

Takamasa Kobayashi, Hirokazu Kawai, Oki Nakano, Satoshi Abe, Hiroteru Kamimura, Akira Sakamaki, Kenya Kamimura, Atsunori Tsuchiya, Masaaki Takamura, Satoshi Yamagiwa, Shuji Terai

Cancer management and research 10 2231 - 2239 2018年

記述言語：英語掲載種別：研究論文（学術雑誌）

Background: Prognosis of patients with hepatocellular carcinoma (HCC) who undergo transcatheter intra-arterial therapies, including transcatheter arterial chemoembolization and transcatheter arterial infusion chemotherapy, is affected by many clinical factors including liver function and tumor progression. However, the effect of body composition such as skeletal muscle and visceral and subcutaneous adipose tissues (VAT and SAT, respectively) on the prognosis of these patients remains unclear. We investigated the prognostic value of body composition in HCC patients treated with transcatheter intra-arterial therapies. Patients and methods: This study retrospectively evaluated 100 HCC patients treated with transcatheter intra-arterial therapies between 2005 and 2015. Areas of skeletal muscle, VAT, and SAT were measured on computed tomography images at third lumbar vertebra level and normalized by the height squared to calculate the skeletal muscle index, VAT index, and SAT index (SATI). The visceral to subcutaneous adipose tissue area ratio was also calculated. Overall survival (OS) was compared between high- and low-index groups for each body composition. Furthermore, prognostic significance was assessed by univariate and multivariate analyses using Cox proportional hazards models. Results: Among the body composition indexes, only SATI could significantly differentiate OS (p=0.012). Multivariate analysis showed that SATI (low- vs. high-SATI: HR, 2.065; 95% CI, 1.187-3.593; p=0.010), serum albumin (<3.5 vs. ≥3.5 g/dL; HR, 2.007; 95% CI, 1.037-3.886; p=0.039), serum alpha-fetoprotein (<20 vs. ≥20 ng/mL; HR, 0.311; 95% CI, 0.179-0.540; p<0.001), and Modified Response Evaluation Criteria in Solid Tumors assessment (complete response+partial response+stable disease vs. progressive disease; HR, 0.392; 95% CI, 0.221-0.696; p=0.001) were indicated as independent prognostic factors for OS. Conclusion: High SAT volume is associated with better survival outcomes in HCC patients treated with transcatheter intra-arterial therapies. Elucidation of the mechanisms regulating SAT volume may offer a new therapeutic strategy for these patients.

DOI： 10.2147/CMAR.S167417

Dynamics of basal lamina fenestrations in the rat intestinal villous epithelium in response to dietary conditions 査読

Rie Azumi, Keisuke Morita, Yusuke Mizutani, Manabu Hayatsu, Shuji Terai, Tatsuo Ushiki

Biomedical Research (Japan) 39 ( 2 ) 65 - 74 2018年

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 Foundation

The epithelial basal lamina of the small intestine forms a felt-like sheet at the base of the epithelium. Previous studies have shown that the basal lamina has numerous fenestrations, which are produced by leukocytes penetrating through the basal lamina. In this study, we aimed to directly visualize fenestrations of the rat basal lamina in intestinal villi by scanning electron microscopy (SEM) after removal of the villous epithelium by osmium maceration and ultrasonic treatment. Structural changes in fenestrations were then investigated in relation to dietary conditions. SEM of these tissues revealed the presence of fenestrations in the villous epithelial basal lamina in all segments of the small intestine, although the number was the highest in the jejunum. The present study also showed that the number and size of fenestrations increased after feeding in the jejunum, whereas changes were unclear in the ileum. These findings suggested that the basal lamina fenestrations were changed through the dynamics of migrating leukocytes in dietary conditions and may also be related to the regulation of nutrient absorption, particularly as lipids are transported from the intercellular space of the epithelium to the lamina propria.

DOI： 10.2220/biomedres.39.65