研究者詳細 - 寺井　崇二

Effect of Helicobacter pylori eradication on elder cases: Observational study in community-based medicine 査読

Masaki Maruyama, Kenya Kamimura, Ayako Hoshiyama, Koki Hoshiyama, Mari Hoshiyama, Yoshihiro Hoshiyama, Shuji Terai

WORLD JOURNAL OF CLINICAL CASES 5 ( 12 ) 412 - 418 2017年12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：BAISHIDENG PUBLISHING GROUP INC

AIM
To examine the effect of Helicobacter pylori (H. pylon) eradication therapy on the extra-gastrointestinal factors in elderly patients by a before-after observational study in community medicine.
METHODS
Medical records (1 May 2013-31 January 2014) of 130 patients who underwent H. pylori eradication therapy with 2-year after-eradication observation in our institute were reviewed. Data on sex; age; body weight; body mass index (BMI); mean corpuscular volume (MCV); total protein; low-density lipoprotein cholesterol, triglyceride, haemoglobin A1c and haemoglobin levels and gastric hyperplastic polyps (GHPs) at eradication was extracted. Two-year after-eradication change in data was analysed by paired-sample t-test; relationship between GHPs and subclinical iron deficiency anaemia (IDA) improvement was evaluated.
RESULTS
The mean patient age (median, interquartile range) at eradication was 69.6 (71.5, 64-77) years. Paired-sample t-tests showed that body weight, BMI and MCV increased by 0.52 kg (P = 0.018), 0.25 kg/m(2) (P = 0.006) and 0.83 fL (P < 0.001), respectively. The nonparametric Mann Whitney test showed no significant difference in the change rate of MCV after eradication between the groups with and without GHPs (P = 0.892).
CONCLUSION
H. pylori eradication therapy prevented weight loss and subclinical IDA in elderly individuals. GHPs were not associated with subclinical IDA.

DOI： 10.12998/wjcc.v5.i12.412

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

Efficacy and Safety of Pancreas-Targeted Hydrodynamic Gene Delivery in Rats 査読

Kohei Ogawa, Kenya Kamimura, Yuji Kobayashi, Hiroyuki Abe, Takeshi Yokoo, Norihiro Sakai, Takuro Nagoya, Akira Sakamaki, Satoshi Abe, Kazunao Hayashi, Satoshi Ikarashi, Junji Kohisa, Masanori Tsuchida, Yutaka Aoyagi, Guisheng Zhang, Dexi Liu, Shuji Terai

MOLECULAR THERAPY-NUCLEIC ACIDS 9 80 - 88 2017年12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：CELL PRESS

Development of an effective, safe, and convenient method for gene delivery to the pancreas is a critical step toward gene therapy for pancreatic diseases. Therefore, we tested the possibility of applying the principle of hydrodynamic gene delivery for successful gene transfer to pancreas using rats as a model. The established procedure involves the insertion of a catheter into the superior mesenteric vein with temporary blood flow occlusion at the portal vein and hydrodynamic injection of DNA solution. We demonstrated that our procedure achieved efficient pancreas-specific gene expression that was 2,000-fold higher than that seen in the pancreas after the systemic hydrodynamic gene delivery. In addition, the level of gene expression achieved in the pancreas by the pancreas-specific gene delivery was comparable to the level in the liver achieved by a liver-specific hydrodynamic gene delivery. The optimal level of reporter gene expression in the pancreas requires an injection volume equivalent to 2.0% body weight with flow rate of 1 mL/s and plasmid DNA concentration at 5 mu g/mL. With the exception of transient expansion of intercellular spaces and elevation of serum amylase levels, which recovered within 3 days, no permanent tissue damage was observed. These results suggest that pancreas-targeted hydrodynamic gene delivery is an effective and safe method for gene delivery to the pancreas and clinically applicable.

DOI： 10.1016/j.omtn.2017.08.009

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

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 < 0.01, standardized regression coefficient (r) = -0.65}, the number of stricture preventions (P < 0.01, r = -0.601), and the number of stricture resolutions (P < 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.

DOI： 10.1093/dote/dox057

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

【臓器間ネットワークからみた肝胆膵の恒常性とその破綻】臓器間ネットワークの破綻による疾患自律神経線維が肝再生に与えるインパクト

上村顕也, 井上良介, 名古屋拓郎, 酒井規裕, 寺井崇二

肝・胆・膵 75 ( 5 ) 967 - 972 2017年11月

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

Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus 30 ( 11 ) 1 - 8 2017年11月

Overexpression of a disintegrin and metalloproteinase 21 is associated with motility, metastasis, and poor prognosis in hepatocellular carcinoma 査読

Hiroki Honda, Masaaki Takamura, Satoshi Yamagiwa, Takuya Genda, Ryoko Horigome, Naruhiro Kimura, Toru Setsu, Kentaro Tominaga, Hiroteru Kamimura, Yasunobu Matsuda, Toshifumi Wakai, Yutaka Aoyagi, Shuji Terai

SCIENTIFIC REPORTS 7 ( 1 ) 15485 2017年11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：NATURE PUBLISHING GROUP

Cell motility plays an important role in intrahepatic metastasis of hepatocellular carcinoma (HCC), and predicts poor prognosis in patients. The present study investigated the role of a disintegrin and metalloproteinases (ADAMs) in HCC, since these proteins are known to be associated with cell motility. We confirmed the expression of 12 ADAMs with putative metalloproteinase activity in HCC cells, and established a KYN-2 HCC cell line stably expressing short interfering RNA against ADAM21 to investigate the effect of ADAM21 deficiency on HCC cell motility and metastasis in vitro and in vivo. We also examined ADAM21 expression in a cohort of 119 HCC patients by immunohistochemistry. ADAM21 was overexpressed in KYN-2 cells, and its knockdown reduced invasion, migration, proliferation, and metastasis relative to controls. In clinical specimens, ADAM21 positivity was associated with vascular invasion, large tumor size, high histological grade, and lower overall and recurrence-free survival as compared to cases that were negative for ADAM21 expression. A multivariate analysis revealed that ADAM21 positivity was an independent risk factor for overall (P = 0.003) and recurrence-free (P = 0.001) survival. These results suggest that ADAM21 plays a role in HCC metastasis and can serve as a prognostic marker for disease progression.

DOI： 10.1038/s41598-017-15800-z

Intraductal Papillary Neoplasm of the Bile Duct: A Rare Liver Tumor Complicated by Malignancy 査読

Kentaro Tominaga, Kenya Kamimura, Akira Sakamaki, Shuji Terai

HEPATOLOGY 66 ( 5 ) 1695 - 1697 2017年11月

Magnifying image-enhanced endoscopy for collagenous colitis. 査読

Kobayashi M, Hoshi T, Morita SI, Kanefuji T, Suda T, Hasegawa G, Terai S

Endoscopy international open 5 ( 11 ) E1069 - E1073 2017年11月

Live image and mechanistic analysis of Mesenchymal stem cells (MSCs) and induced bone marrow derived macrophages (id-BMMs) combination therapy for liver cirrhosis in mice 査読

Yusuke Watanabe, Atsunori Tsuchiya, Satoshi Seino, Syunzou Ikarashi, Suguru Takeuchi, Takayuki Watanabe, Kenya Kamimura, Masaaki Takamura, Satoshi Yamagiwa, Shuji Terai

HEPATOLOGY 66 76A - 76A 2017年10月

Usefulness of follicular helper T cell subset frequencies in the diagnosis of autoimmune hepatitis 査読

Naruhiro Kimura, Satoshi Yamagiwa, Ryoko Horigome, Hiroteru Kamimura, Kenya Kamimura, Atsunori Tsuchiya, Masaaki Takamura, Hirokazu Kawai, Shuji Terai

HEPATOLOGY 66 687A - 688A 2017年10月

Persistent reduction of mucosal-associated invariant T cells in primary biliary cholangitis 査読

Toru Setsu, Satoshi Yamagiwa, Naruhiro Kimura, Hiroteru Kamimura, Atsunori Tsuchiya, Masaaki Takamura, Shuji Terai

HEPATOLOGY 66 166A - 166A 2017年10月

Effectiveness and safety of tolvaptan in liver cirrhosis patients with edema: Interim results of post-marketing surveillance of tolvaptan in liver cirrhosis (START study) 査読

Isao Sakaida, Shuji Terai, Masayuki Kurosaki, Moriyoshi Yasuda, Mitsuru Okada, Kosuke Bando, Yasuhiko Fukuta

HEPATOLOGY RESEARCH 47 ( 11 ) 1137 - 1146 2017年10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：WILEY

Aim: Loop diuretics and spironolactone are used in patients with hepatic edema, but they are sometimes associated with insufficient responses as well as adverse events. Tolvaptan, a vasopressin type 2 receptor antagonist, was approved for hepatic edema in 2013. A large-scale post-marketing surveillance study has been carried out to evaluate the effectiveness and safety of tolvaptan in real-world clinical settings.
Methods: Patients with hepatic cirrhosis with insufficient response to conventional diuretics were enrolled. The observational period was up to 6months. Changes in body weight and clinical symptoms were measured to evaluate effectiveness. The incidence of adverse drug reactions was summarized as a safety measure.
Results: Of 970 patients enrolled, 463 were included in the safety analysis. Of this group, 340 were included in the effectiveness analysis. Decreases in body weight from baseline were -2.38kg on day 7 and -3.52kg on day 14. Ascites and bloated feeling was significantly improved within 14days. The mean change in body weight depended on estimated glomerular filtration rate levels. The most frequently reported adverse drug reaction was thirst (6.9% of patients). Serum sodium level of 146mEq/L was observed in 12 patients (2.7%).
Conclusions: In the real-world clinical setting, tolvaptan showed aquaretic effectiveness in patients with cirrhosis. The mean change in body weight depended on renal function. We recommend tolvaptan use for hepatic cirrhosis at a stage in which the renal function is maintained.

DOI： 10.1111/hepr.12852

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

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.

A canine liver fibrosis model to develop a therapy for liver cirrhosis using cultured bone marrow-derived cells. 査読国際誌

Takashi Matsuda, Taro Takami, Ryo Sasaki, Tatsuro Nishimura, Yuki Aibe, Bruno Diaz Paredes, Luiz Fernando Quintanilha, Toshihiko Matsumoto, Tsuyoshi Ishikawa, Naoki Yamamoto, Kenji Tani, Shuji Terai, Yasuho Taura, Isao Sakaida

Hepatology communications 1 ( 7 ) 691 - 703 2017年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

We have been developing a therapy for liver cirrhosis using cultured autologous bone marrow-derived mesenchymal stem cells (BMSCs). Before human clinical trials can be considered, the safety and efficacy of BMSC infusion in medium to large animals must be confirmed; thus, we developed a canine liver fibrosis model. A small amount of bone marrow fluid was aspirated from the canine humerus to assess the characteristics of BMSCs. We implanted a venous catheter in the stomach and a subcutaneous infusion port in the back of the neck of each canine. Repeated injection of CCl4 through the catheter was performed to induce liver cirrhosis. After 10 weeks of CCl4 injection, eight canines were equally divided into two groups: no cell infusion (control group) and autologous BMSC infusion through the peripheral vein (BMSC group). A variety of assays were carried out before and 4 weeks after the infusion. The area of liver fibrosis stained with sirius red was significantly reduced in the BMSC group 4 weeks after BMSC infusion, consistent with a significantly shortened half-life of indocyanine green and improved liver function. Conclusion: We established a useful canine liver fibrosis model and confirmed that cultured autologous BMSC infusion improved liver fibrosis without adverse effects. (Hepatology Communications 2017;1:691-703).

DOI： 10.1002/hep4.1071