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Sagami R, Yamao K, Minami R, Nakahodo J, Akiyama H, Nishikiori H, Mizukami K, Yamao K, Bhatia V, Amano Y, Murakami K. Endoscopic Ultrasound Can Differentiate High-Grade Pancreatic Intraepithelial Neoplasia, Small Pancreatic Ductal Adenocarcinoma, and Benign Stenosis. Gut Liver 2024; 18:338-347. [PMID: 37165770 PMCID: PMC10938144 DOI: 10.5009/gnl220521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 05/12/2023] Open
Abstract
Background/Aims High-grade pancreatic intraepithelial neoplasia and invasive pancreatic ductal adenocarcinoma ≤10 mm are targets for early detection of pancreatic cancer. However, their imaging characteristics are unknown. We aimed to identify endoscopic ultrasound findings for the detection of these lesions. Methods Patients diagnosed with high-grade pancreatic intraepithelial neoplasia (n=29), pancreatic ductal adenocarcinoma ≤10 mm (n=11) (who underwent surgical resection), or benign main pancreatic duct stenosis (n=20) between January 2014 and January 2021 were retrospectively included. Six features differentiating these lesions were examined by endoscopic ultrasonography: main pancreatic duct stenosis, upstream main pancreatic duct dilation, hypoechoic areas surrounding the main pancreatic duct irregularities (mottled areas without demarcation or round areas with demarcation), branch duct dilation, prominent lobular segmentation, and atrophy. Interobserver agreement was assessed by two independent observers. Results Hypoechoic areas surrounding the main pancreatic duct irregularities were observed more frequently in high-grade pancreatic intraepithelial neoplasia (82.8%) and pancreatic ductal adenocarcinoma ≤10 mm (90.9%) than in benign stenosis (15.0%) (p<0.001). High-grade pancreatic intraepithelial neoplasia exhibited mottled hypoechoic areas more frequently (79.3% vs 18.9%, p<0.001), and round hypoechoic areas less frequently (3.4% vs 72.7%, p<0.001), than pancreatic ductal adenocarcinoma ≤10 mm. The sensitivity and specificity of hypoechoic areas for differentiating high-grade pancreatic intraepithelial neoplasia, pancreatic ductal adenocarcinoma ≤10 mm, and benign stenosis were both 85.0%, with moderate interobserver agreement. Conclusions The hypoechoic areas surrounding main pancreatic duct irregularities on endoscopic ultrasound may differentiate between high-grade pancreatic intraepithelial neoplasia, pancreatic ductal adenocarcinoma ≤10 mm, and benign stenosis (Trial Registration: UMIN Clinical Trials Registry (UMIN000044789).
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, Oita San-ai Medical Center, Oita, Japan
- Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Japan
| | - Kentaro Yamao
- Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Japan
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Ryuki Minami
- Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Japan
- Department of Gastroenterology, Tenri Hospital, Nara, Japan
| | - Jun Nakahodo
- Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Japan
- Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Hidetoshi Akiyama
- Department of Gastroenterology, Oita Red Cross Hospital, Oita, Japan
| | | | - Kazuhiro Mizukami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Kenji Yamao
- Department of Gastroenterology, Narita Memorial Hospital, Aichi, Japan
| | - Vikram Bhatia
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Yuji Amano
- Department of Endoscopy, Urawa Kyosai Hospital, Saitama, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
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Ikenoyama Y, Goda K, Fujisaki J, Ishihara R, Takeuchi M, Takahashi A, Takaki Y, Hirasawa D, Momma K, Amano Y, Yagi K, Furuhashi H, Hashimoto S, Kanesaka T, Shimizu T, Ono Y, Yamagata T, Fujiwara J, Azumi T, Watanabe G, Ohkura Y, Nishikawa M, Oyama T. A simpler diagnostic algorithm of the Japan Esophageal Society classification for Barrett's esophagus-related superficial neoplasia. Esophagus 2024; 21:22-30. [PMID: 38064022 DOI: 10.1007/s10388-023-01029-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 11/03/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND We previously developed a Japan Esophageal Society Barrett's Esophagus (JES-BE) magnifying endoscopic classification for superficial BE-related neoplasms (BERN) and validated it in a nationwide multicenter study that followed a diagnostic flow chart based on mucosal and vascular patterns (MP, VP) with nine diagnostic criteria. Our present post hoc analysis aims to further simplify the diagnostic criteria for superficial BERN. METHODS We used data from our previous study, including 10 reviewers' assessments for 156 images of high-magnifying narrow-band imaging (HM-NBI) (67 dysplastic and 89 non-dysplastic histology). We statistically analyzed the diagnostic performance of each diagnostic criterion of MP (form, size, arrangement, density, and white zone), VP (form, caliber change, location, and greenish thick vessels [GTV]), and all their combinations to achieve a simpler diagnostic algorithm to detect superficial BERN. RESULTS Diagnostic accuracy values based on the MP of each single criterion or combined criteria showed a marked trend of being higher than those based on VP. In reviewers' assessments of visible MPs, the combination of irregularity for form, size, or white zone had the highest diagnostic performance, with a sensitivity of 87% and a specificity of 91% for dysplastic histology; in the assessments of invisible MPs, GTV had the highest diagnostic performance among the VP of each single criterion and all combinations of two or more criteria (sensitivity, 93%; specificity, 92%). CONCLUSION The present post hoc analysis suggests the feasibility of further simplifying the diagnostic algorithm of the JES-BE classification. Further studies in a practical setting are required to validate these results.
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Affiliation(s)
- Yohei Ikenoyama
- Department of Gastroenterology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Tokyo, Japan
| | - Kenichi Goda
- Gastrointestinal Endoscopy Center, Dokkyo Medical University, Tochigi, Japan.
- Department of Gastroenterology, School of Medicine, Dokkyo Medical University, 880 Kitakobayashi Mibu, Tochigi, 321-0293, Japan.
| | - Junko Fujisaki
- Department of Gastroenterology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Tokyo, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Manabu Takeuchi
- Department of Gastroenterology, Nagaoka Red Cross Hospital, Niigata, Japan
| | - Akiko Takahashi
- Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan
| | - Yasuhiro Takaki
- Department of Gastroenterology, Medical Corporation Shin-Ai Station Clinic, Fukuoka, Japan
| | - Dai Hirasawa
- Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
| | - Kumiko Momma
- Department of Endoscopy, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
| | - Kazuyoshi Yagi
- Department of Gastroenterology and Hepatology, Institute of Community Medicine, Niigata University, Uonuma Kikan Hospital, Niigata, Japan
| | - Hiroto Furuhashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoru Hashimoto
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Tomoki Shimizu
- Department of Gastroenterology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Tokyo, Japan
| | - Yoichiro Ono
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Taku Yamagata
- Department of Gastroenterology, Sendai City Medical Center, Miyagi, Japan
| | - Junko Fujiwara
- Department of Endoscopy, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Takane Azumi
- Department of Gastroenterology, International University of Health and Welfare Ichikawa Hospital, Chiba, Japan
| | - Gen Watanabe
- Department of Pathology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yasuo Ohkura
- Pathology and Cytology Center, PCL Japan, Saitama, Japan
| | - Masako Nishikawa
- Clinical Research Support Center, The Jikei University School of Medicine, Tokyo, Japan
| | - Tsuneo Oyama
- Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan
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Matsumura T, Ebigbo A, Römmele C, Ikematsu H, Ishigami H, Suzuki T, Harada H, Yada T, Takatori Y, Takeuchi M, Okimoto K, Akizue N, Maruoka D, Kitagawa Y, Minamide T, Iwaki T, Amano Y, Matsusaka K, Nagashima K, Maehata T, Yahagi N, Messmann H, Kato N. Diagnostic Value of Adding Magnifying Chromoendoscopy to Magnifying Narrow-Band Imaging Endoscopy for Colorectal Polyps. Clin Gastroenterol Hepatol 2023; 21:2551-2559.e2. [PMID: 36739935 DOI: 10.1016/j.cgh.2023.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 12/28/2022] [Accepted: 01/21/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS This study examined the additional value of magnifying chromoendoscopy (MCE) on magnifying narrow-band imaging endoscopy (M-NBI) in the optical diagnosis of colorectal polyps. METHODS A multicenter prospective study was conducted at 9 facilities in Japan and Germany. Patients with colorectal polyps scheduled for resection were included. Optical diagnosis was performed by M-NBI first, followed by MCE. Both diagnoses were made in real time. MCE was performed on all type 2B lesions classified according to the Japan NBI Expert Team classification and other lesions at the discretion of endoscopists. The diagnostic accuracy and confidence of M-NBI and MCE for colorectal cancer (CRC) with deep invasion (≥T1b) were compared on the basis of histologic findings after resection. RESULTS In total, 1173 lesions were included between February 2018 and December 2020, with 654 (5 hyperplastic polyp/sessile serrated lesion, 162 low-grade dysplasia, 403 high-grade dysplasia, 97 T1 CRCs, and 32 ≥T2 CRCs) examined using MCE after M-NBI. In the diagnostic accuracy for predicting CRC with deep invasion, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for M-NBI were 63.1%, 94.2%, 61.6%, 94.5%, and 90.2%, respectively, and for MCE they were 77.4%, 93.2%, 62.5%, 96.5%, and 91.1%, respectively. The sensitivity was significantly higher in MCE (P < .001). However, these additional values were limited to lesions with low confidence in M-NBI or the ones diagnosed as ≥T1b CRC by M-NBI. CONCLUSIONS In this multicenter prospective study, we demonstrated the additional value of MCE on M-NBI. We suggest that additional MCE be recommended for lesions with low confidence or the ones diagnosed as ≥T1b CRC. Trials registry number: UMIN000031129.
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Affiliation(s)
- Tomoaki Matsumura
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.
| | - Alanna Ebigbo
- Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Christoph Römmele
- Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Hiroaki Ikematsu
- Division of Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Hideaki Ishigami
- Department of Gastroenterology, Chiba Rosai Hospital, Chiba, Japan
| | - Takuto Suzuki
- Endoscopy Division, Chiba Cancer Center, Chiba, Japan
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tomoyuki Yada
- Division of Gastroenterology and Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan
| | - Yusaku Takatori
- Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Manabu Takeuchi
- Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Kenichiro Okimoto
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Akizue
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Daisuke Maruoka
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | | | - Tatsunori Minamide
- Division of Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Tomoyuki Iwaki
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Kengo Nagashima
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Tadateru Maehata
- Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Naohisa Yahagi
- Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan
| | - Helmut Messmann
- Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany
| | - Naoya Kato
- Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Murakami D, Yamato M, Amano Y, Nishino T, Arai M. Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists. BMJ Open Gastroenterol 2023; 10:e001143. [PMID: 37407230 DOI: 10.1136/bmjgast-2023-001143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/18/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVE The documented variation in gastric cancer (GC) detection among endoscopists has often been dismissed as a coincidental artefact of the low incidence of gastric neoplasms; it is not considered associated with differences in physicians' performance of the esophagogastroduodenoscopy procedure. This study is to confirm whether significant variations among endoscopists in early GC detection suggest the individual performance of the upper endoscopy. DESIGN A retrospective observational study at a single centre in Japan assessed the results of 218 early GCs detected during 25 688 routine esophagogastroduodenoscopies by 12 endoscopists. The main outcome was the rate of early GC detection for each endoscopist under the same circumstances. Other measures included the major diameters and locations of the lesions, Helicobacter pylori infection status, and baseline patient characteristics that could affect the prevalence of GC. RESULTS The early GC detection rates exhibited wide variation among endoscopists (0.09%-2.87%) despite performing routine esophagogastroduodenoscopies in a population with a similar background. Endoscopists were assigned to a low-detection group (n=6; detection rate: 0.47% (range: 0.09%-0.55%)) and a high-detection group (n=5; detection rate: 0.83% (range: 0.63%-1.12%)), with the single highest detector analysed separately due to his distinct detection rate (2.87%). Endoscopists in the high-detection group had better detection rates for minute (major diameter ≤5 mm) and small (major diameter 6-10 mm) GCs than the low-detection group (0.19%/0.23% vs 0.085%/0.098%). These differences were significant (p<0.01), although there were no significant differences in detection of larger tumours (major diameter ≥11 mm; 0.40% vs 0.28%; p=0.13). The tumour location and H. pylori status were similar in the low-detection group, high-detection group and for the highest detector. CONCLUSION Significant variation in the detection of hard-to-find, smaller GCs may reflect individual performance of the examination.
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Affiliation(s)
- Daisuke Murakami
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Centre, Yachiyo, Chiba, Japan
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
- Department of Gastroenterology and Endoscopy, New Tokyo Hospital, Mtsudo, Chiba, Japan
| | - Masayuki Yamato
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
| | - Yuji Amano
- Department of Gastroenterology and Endoscopy, New Tokyo Hospital, Mtsudo, Chiba, Japan
| | - Takayoshi Nishino
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Centre, Yachiyo, Chiba, Japan
| | - Makoto Arai
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Centre, Yachiyo, Chiba, Japan
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Sagami R, Hayasaka K, Ujihara T, Iwaki T, Katsuyama Y, Harada H, Ome Y, Honda G, Horiguchi SI, Murakami K, Amano Y. Role of EUS combined with a newly modified scoring system to detect pancreatic high-grade precancerous lesions. Endosc Ultrasound 2023; 12:111-119. [PMID: 36861510 PMCID: PMC10134925 DOI: 10.4103/eus-d-21-00187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 08/01/2022] [Indexed: 03/03/2023] Open
Abstract
Backgrounds and Objectives Although pancreatic cancer (PC) has an extremely poor prognosis, the 5-year survival rate of patients with pancreatic high-grade precancerous lesion without invasive carcinoma (PHP) is favorable. PHP diagnosis and identification of patients requiring intervention are needed. We aimed to validate a modified PC detection scoring system regarding its detection ability for PHP and PC in the general population. Subjects and Methods We modified an existing PC detection scoring system that incorporates low-grade risk (LGR) factors (family history, presence of diabetes mellitus [DM] or worsening DM, heavy drinking, smoking, stomach symptoms, weight loss, and pancreatic enzyme) and high-grade risk (HGR) factors (new-onset DM, familial PC, jaundice, tumor biomarkers, chronic pancreatitis, intraductal papillary mucinous neoplasm, cysts, hereditary PC syndrome, and hereditary pancreatitis). Each factor was scored as one point; LGR score ≥3 points and/or HGR score ≥1 point (positive scores) were indicative of PC. The newly modified scoring system incorporated main pancreatic duct dilation as an HGR factor. The PHP diagnosis rate using this scoring system combined with EUS was prospectively analyzed. Results Among 544 patients with positive scores, 10 had PHP. The diagnosis rates were 1.8% for PHP and 4.2% for invasive PC. Although the number of LGR and HGR factors tended to increase with PC progression, none of the individual factors were significantly different between patients with PHP and those without lesions. Conclusion The newly modified scoring system evaluating multiple factors associated with PC could potentially identify patients with higher risk of PHP or PC.
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, Oita San-ai Medical Center, Oita, Japan
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Tomoyuki Iwaki
- Department of Gastroenterology, Urawa Kyosai Hospital, Saitama, Japan
| | - Yasushi Katsuyama
- Department of Gastroenterology, Urawa Kyosai Hospital, Saitama, Japan
| | - Hideaki Harada
- Department of Gastroenterology, Urawa Kyosai Hospital, Saitama, Japan
| | - Yusuke Ome
- Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, Shinjuku-Ku, Tokyo, Japan
| | - Goro Honda
- Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, Shinjuku-Ku, Tokyo, Japan
| | - Shin-ichiro Horiguchi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo, Tokyo, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Yufu, Oita, Japan
| | - Yuji Amano
- Department of Gastroenterology, Urawa Kyosai Hospital, Saitama, Japan
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Sagami R, Hayasaka K, Ujihara T, Iwaki T, Katsuyama Y, Harada H, Tsuji H, Sato T, Nishikiori H, Murakami K, Amano Y. Accurate Evaluation of Residual Common Bile Duct Stones by Endoscopic Ultrasound: A Two-Step Check Method for Residual Stone Clearance. Digestion 2022; 103:224-231. [PMID: 35124676 DOI: 10.1159/000521925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 01/08/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS Residual common bile duct (CBD) stones occasionally become symptomatic after stone removal with endoscopic retrograde cholangiopancreatography (ERCP) upon removal of the endoscopic biliary stent (EBS). An accurate evaluation of residual stones before stent removal is necessary. This study evaluated a new two-step check method using endoscopic ultrasound (EUS) for the detection of residual stones after ERCP stone removal. METHODS Fifty-six patients who underwent CBD stone removal and EBS placement were prospectively enrolled. Residual stones were evaluated by the check method. EBS was removed at the time of the check method or at a later time of residual stone removal. The primary outcome was to evaluate the efficacy of this check method. RESULTS Residual CBD stone/sludge was detected in 20 of 56 patients (35.7%; stones: 28.6%, sludge: 7.1%) by the check method and removed by the ERCP procedure at a later time. After stent and final stone removal, patients were followed for an average of 211 days; cholangitis recurred in only 1.8% of patients. There were no adverse events associated with the check method. Temporary EBS prevented the recurrence of cholangitis by residual stone and caused no adverse events in the pancreatobiliary tract until the two-step check method (median, 113 days; range, 17-232 days). CONCLUSION The new check method may be ideal and feasible for EBS removal because recurrences are very rare when a clear CBD has been verified, and an additional ERCP procedure is also possibly avoided.
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, Oita San-ai Medical Center, Oita, Japan
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Japan
| | - Tomoyuki Iwaki
- Department of Gastroenterology, Urawa Kyosai Hospital, Saitama, Japan
| | - Yasushi Katsuyama
- Department of Gastroenterology, Urawa Kyosai Hospital, Saitama, Japan
| | - Hideaki Harada
- Department of Gastroenterology, Urawa Kyosai Hospital, Saitama, Japan
| | - Hiroaki Tsuji
- Department of Gastroenterology, Oita San-ai Medical Center, Oita, Japan
| | - Takao Sato
- Department of Gastroenterology, Oita San-ai Medical Center, Oita, Japan
| | | | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yuji Amano
- Department of Gastroenterology, Urawa Kyosai Hospital, Saitama, Japan
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Sagami R, Sato T, Mizukami K, Motomura M, Okamoto K, Fukuchi S, Otsuka Y, Abe T, Ono H, Mori K, Wada K, Iwaki T, Nishikiori H, Honda K, Amano Y, Murakami K. Diagnostic Strategy of Early Stage Pancreatic Cancer via Clinical Predictor Assessment: Clinical Indicators, Risk Factors and Imaging Findings. Diagnostics (Basel) 2022; 12:diagnostics12020377. [PMID: 35204468 PMCID: PMC8871200 DOI: 10.3390/diagnostics12020377] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/27/2022] [Accepted: 01/27/2022] [Indexed: 01/27/2023] Open
Abstract
Early detection of pancreatic ductal adenocarcinoma (PDAC) in the general population is difficult due to unknown clinical characteristics. This study was conducted to clarify the factors associated with early stage PDAC. Well-known symptoms and factors associated with PDAC were classified into clinical indicators, risk factors, and imaging findings concomitant with early stage PDAC. To analyze these factors for the detection of patients with early stage PDAC compared to patients without PDAC, we constructed new diagnostic strategies. The factors of 35 patients with early stage PDAC (stage 0 and IA) and 801 patients without PDAC were compared retrospectively. Clinical indicators; presence and number of indicators, elevated pancreatic enzyme level, tumor biomarker level, acute pancreatitis history, risk factors; familial pancreatic cancer, diabetes mellitus, smoking history, imaging findings; presence and number of findings, and main pancreatic duct dilation were significant factors for early stage PDAC detection. A new screening strategy to select patients who should be examined by imaging modalities from evaluating clinical indicators and risk factors and approaching a definitive diagnosis by evaluating imaging findings had a relatively high sensitivity, specificity, and areas under the curve of 80.0%, 80.8%, and 0.80, respectively. Diagnosis based on the new category and strategy may be reasonable for early stage PDAC detection.
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, Oita San-ai Medical Center, 1213 Oaza Ichi, Oita 870-1151, Japan; (R.S.); (T.S.); (H.N.)
| | - Takao Sato
- Department of Gastroenterology, Oita San-ai Medical Center, 1213 Oaza Ichi, Oita 870-1151, Japan; (R.S.); (T.S.); (H.N.)
| | - Kazuhiro Mizukami
- Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamacho, Yufu 879-5593, Japan; (K.O.); (K.M.); (K.H.); (K.M.)
- Correspondence: ; Tel.: +81-97-586-6193
| | - Mitsuteru Motomura
- Department of Gastroenterology, Oita Red Cross Hospital, 3-2-37 Chiyo-Machi, Oita 870-0033, Japan;
| | - Kazuhisa Okamoto
- Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamacho, Yufu 879-5593, Japan; (K.O.); (K.M.); (K.H.); (K.M.)
| | - Satoshi Fukuchi
- Department of Gastroenterology, Oita City Medical Association Almeida Memorial Hospital, 1509-2 Miyazaki, Oita 870-1195, Japan; (S.F.); (K.W.)
| | - Yuichiro Otsuka
- Department of Gastroenterology, Oita Medical Center, 2-11-45 Yokota, Oita 870-0263, Japan;
| | - Takashi Abe
- Department of Gastroenterology, Oita Kouseiren Tsurumi Hospital, 4333 Tsurumi, Beppu 874-8585, Japan;
| | - Hideki Ono
- Department of Gastroenterology, Oita Prefectural Hospital, 2-8-1 Bunyo, Oita 870-8511, Japan;
| | - Kei Mori
- Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamacho, Yufu 879-5593, Japan; (K.O.); (K.M.); (K.H.); (K.M.)
| | - Kurato Wada
- Department of Gastroenterology, Oita City Medical Association Almeida Memorial Hospital, 1509-2 Miyazaki, Oita 870-1195, Japan; (S.F.); (K.W.)
| | - Tomoyuki Iwaki
- Department of Endoscopy, Urawa Kyosai Hospital, 3-15-31 Harayama, Saitama 336-0931, Japan; (T.I.); (Y.A.)
| | - Hidefumi Nishikiori
- Department of Gastroenterology, Oita San-ai Medical Center, 1213 Oaza Ichi, Oita 870-1151, Japan; (R.S.); (T.S.); (H.N.)
| | - Koichi Honda
- Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamacho, Yufu 879-5593, Japan; (K.O.); (K.M.); (K.H.); (K.M.)
| | - Yuji Amano
- Department of Endoscopy, Urawa Kyosai Hospital, 3-15-31 Harayama, Saitama 336-0931, Japan; (T.I.); (Y.A.)
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamacho, Yufu 879-5593, Japan; (K.O.); (K.M.); (K.H.); (K.M.)
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8
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Murakami D, Harada H, Amano Y. Auriculate Ulcers in Gastrointestinal Tract. Clin Gastroenterol Hepatol 2022; 20:A19. [PMID: 32911065 DOI: 10.1016/j.cgh.2020.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 08/30/2020] [Accepted: 09/03/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
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9
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Kobayashi M, Kojima K, Murayama K, Amano Y, Koyama T, Ogama N, Takeshita T, Fukuhara T, Tanaka N. MK-6, a novel not-α IL-2, elicits a potent antitumor activity by improving the effector to regulatory T cell balance. Cancer Sci 2021; 112:4478-4489. [PMID: 34545658 PMCID: PMC8586658 DOI: 10.1111/cas.15127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 12/11/2022] Open
Abstract
IL-2 is a pleiotropic cytokine that regulates immune cell homeostasis. Its immunomodulatory function has been used clinically as an active immunotherapy agent for metastatic cancers. However, severe adverse effects, including the vascular leak syndrome and the preferential stimulation of anti-immunogenic Treg rather than effector T cells, have been obstacles. We newly designed a mutein IL-2, Mutakine-6 (MK-6), with reduced IL-2Rα-binding capability. MK-6 induced comparable cell growth potential toward IL-2Rβγ-positive T cells but was far less efficient in in vitro Treg proliferation and STAT5 activation. Unlike IL-2, in vivo administration of MK-6 produced minimal adverse effects. Using CT26 and B16F10-syngeneic tumor models, we found MK-6 was highly efficacious on tumor regression. Serum albumin conjugation to MK-6 prolonged in vivo half-life and accumulated in CT26 tumors, showing enhanced antitumor effect. Tumor-infiltrating leukocytes analysis revealed that albumin-fused MK-6 increased the ratio of effector CD8+ T cells to CD4+ Treg cells. These results demonstrated that MK-6 is an efficient immunomodulator potentially used for improved immunotherapy with decreased adverse effects and attenuated Treg stimulation.
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Affiliation(s)
- Maki Kobayashi
- Division of Tumor Immunobiology, Miyagi Cancer Center Research Institute, Natori, Japan.,Division of Tumor Immunobiology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Division of Respiratory Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Respiratory Medicine, Miyagi Cancer Center Hospital, Natori, Japan
| | - Katsuhiko Kojima
- Department of Microbiology and Immunology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazutaka Murayama
- Division of Biomedical Measurements and Diagnostics, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Yuji Amano
- Department of Microbiology and Immunology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takashi Koyama
- Division of Tumor Immunobiology, Miyagi Cancer Center Research Institute, Natori, Japan.,Division of Tumor Immunobiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naoko Ogama
- Division of Tumor Immunobiology, Miyagi Cancer Center Research Institute, Natori, Japan
| | - Toshikazu Takeshita
- Department of Microbiology and Immunology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tatsuro Fukuhara
- Division of Respiratory Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Respiratory Medicine, Miyagi Cancer Center Hospital, Natori, Japan
| | - Nobuyuki Tanaka
- Division of Tumor Immunobiology, Miyagi Cancer Center Research Institute, Natori, Japan.,Division of Tumor Immunobiology, Tohoku University Graduate School of Medicine, Sendai, Japan
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10
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Murakami D, Yamato M, Amano Y, Tada T. Challenging detection of hard-to-find gastric cancers with artificial intelligence-assisted endoscopy. Gut 2021; 70:1196-1198. [PMID: 32816967 PMCID: PMC8108284 DOI: 10.1136/gutjnl-2020-322453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan .,Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
| | - Masayuki Yamato
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
| | - Tomohiro Tada
- Tada Tomohiro Institute of Gastroenterology and Proctology, Saitama, Japan,Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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11
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Murakami D, Harada H, Yamato M, Amano Y. Cytomegalovirus-associated esophagitis on early esophageal cancer in immunocompetent host: a case report. Gut Pathog 2021; 13:24. [PMID: 33863376 PMCID: PMC8051061 DOI: 10.1186/s13099-021-00418-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 04/01/2021] [Indexed: 11/28/2022] Open
Abstract
Background Cytomegalovirus (CMV)-associated gastrointestinal diseases usually occur in immunocompromised patients; however, few cases has also been described in healthy hosts despite still unclear pathological mechanisms. CMV esophagitis causes various lesions, such as erythematous mucosa, erosions, and ulcers, although such inflammatory changes can appear in superficial esophageal cancers or in surrounding areas. CMV-associated esophagitis has been also reported in cancer patients, but typically in those with advanced and/or terminal stage cancers secondary to chemoradiotherapy-induced immunosuppression or the physiologic demands of the malignancy itself. To our best knowledge, we firstly report on an immunocompetent patient subject to endoscopic submucosal dissection (ESD) for early esophageal cancer complicated with CMV infection. Case presentation A 77-year-old man underwent esophagogastroduodenoscopy (EGD) at a local clinic. EGD revealed a lugol-unstained reddish lesion with whitish exudates in the middle-distal esophagus. Histological evaluation of lesion biopsy revealed atypical squamous epithelium with CMV-positive granulation tissue and aggregates of macrophages, prompting referral for further examination and treatment. Magnifying endoscopy with narrow-band imaging showed an erosive lesion with white moss in a well-demarcated brownish area with irregular mesh-like microvessels. ESD was performed for diagnosis and treatment. Histopathological examination of the resected specimen revealed superficial, moderately differentiated squamous cell carcinoma (SCC) with multiple lymphatic infiltration, and few CMV-positive cells were found in the erosive part of the SCC. Interestingly, he had no underlying conditions to predispose to CMV infection and no risk factors for esophageal cancer, other than gender and age. He received neither steroids for stricture prevention nor antiviral agents post-EGD and 4-month follow-up was negative for esophagitis. Conclusions This is the first report of a case of CMV esophagitis superimposed on early esophageal cancer in an immunocompetent host and might provide valuable information for possible adverse effects of steroid administration during ESD procedures, despite their common use for prevention of post-ESD stricture.
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Affiliation(s)
- Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan. .,Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. .,Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, 477-96 Owadashinden, Yachiyo, Chiba, 276-8524, Japan.
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Masayuki Yamato
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
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12
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Harada H, Miyaoka Y, Yuki T, Iwaki T, Maeda G, Nakahara R, Murakami D, Ujihara T, Katsuyama Y, Hayasaka K, Kushiyama Y, Fujishiro H, Amano Y. Postpolypectomy bleeding of colorectal polyps in patients with continuous warfarin and short-term interruption of direct oral anticoagulants. Gastrointest Endosc 2021; 93:691-698. [PMID: 33022270 DOI: 10.1016/j.gie.2020.09.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/26/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Postpolypectomy bleeding (PPB) is the most common adverse event after colorectal polypectomy. Use of anticoagulants is an important risk factor for PPB. This study aimed to evaluate PPB in patients receiving treatment with warfarin and direct oral anticoagulants (DOACs). METHODS Between August 2017 and July 2019, 5449 patients with 12,601 polyps who underwent endoscopic snare resection of colorectal polyps were enrolled. Endoscopic snare resection was performed in patients receiving continuous warfarin (C-warfarin) and in patients who experienced 1 day cessation of (O-) of DOACs in accordance with the Japanese Gastroenterological Endoscopy Society guidelines. RESULTS The PPB rate in the group receiving anticoagulants was statistically higher than that in the group without anticoagulants (8.5% [33/387] vs 1.2% [63/5,062], respectively; P < .001). By multivariate logistic regression analysis, male gender (odds ratio [OR], 2.17; P = .007), warfarin (OR, 4.64; P < .001), DOACs (OR, 6.59; P < .001), and multipolyp removal (OR, 1.77; P = .007) were significant risk factors for PPB. PPB was observed in 9 and 21 patients in the C-warfarin and O-DOACs groups, respectively: C-warfarin (8.0% [9/113]), O-dabigatran (6.1% [2/33]), O-rivaroxaban (14.8% [9/61]), O-apixaban (9.8% [9/92]), and O-edoxaban (1.8% [1/56]). The PPB rate with the O-edoxaban group was significantly lower than that with the O-rivaroxaban group (P < .05). CONCLUSIONS Use of anticoagulant therapy was an independent risk factor for PPB. The rates of PPB in patients receiving C-warfarin and O-DOACs were also higher than those in patients not receiving anticoagulants. Edoxaban may be safe through short-term withdrawal in patients undergoing endoscopic snare resection of colorectal polyps.
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Affiliation(s)
- Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Youichi Miyaoka
- Department of Endoscopy, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Takafumi Yuki
- Department of Gastroenterology, Matsue Red Cross Hospital, Matsue, Japan
| | - Tomoyuki Iwaki
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Gen Maeda
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Ryotaro Nakahara
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Hirofumi Fujishiro
- Department of Gastroenterology, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
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13
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Nakahara R, Amano Y, Murakami D, Ogawa S, Ujihara T, Iwaki T, Katsuyama Y, Hayasaka K, Harada H, Tada Y, Yuki T, Miyaoka Y, Kushiyama Y, Fujishiro H, Ishihara S. Relationship between colonic diverticulosis and colon neoplasms in Japanese patients. Dig Endosc 2021; 33:418-424. [PMID: 32438477 DOI: 10.1111/den.13745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/11/2020] [Accepted: 05/15/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM Colonic diverticulosis (CD) has been reported to be associated with presence of colon neoplasms (CNs) in Western patients, since most of the associated risk factors are common between them. However, such correlation has not been fully investigated in Asian patients. In this study, the association of CNs with CD was evaluated in a multicenter investigation. METHODS We enrolled 5633 patients who underwent both colonoscopy and esophagogastroduodenoscopy due to annual follow-up, screening for positive occult blood testing and abdominal symptoms between January 2016 and December 2017 at three institutions. The relationship between the presence of CNs and CD was investigated, and predictors for presence of CNs were determined by multivariate logistic analysis. RESULTS The enrolled patients consisted of 1799 (31.9%) with CD (average age 70.0 years, male 64.0%) and 3834 without CD (66.0 years, male 52.9%), with the prevalence of CNs in those groups 46.6% and 44.2%, respectively (P = 0.090). Predictors for early colon cancer were shown to be age (OR 1.02, 95% CI 1.01-1.04, P = 0.010), laxatives use (OR 1.76, 95% CI 1.17-2.64, P = 0.007), gastric neoplasms (OR 2.16, 95% CI 1.23-3.81, P = 0.008), and CD (OR 1.64, 95% CI 1.16-2.31, P = 0.005). Early colon cancer in the distal colon was most frequently detected in patients with right-sided CD (RR 2.50, P = 0.001). CONCLUSION In Japanese patients, early colon cancer was more frequently found in those with as compared to those without CD. The presence of CD may be an important indicator for an index colonoscopy examination to detect colon cancer. (Clinical-trial-registry: UMIN000038985).
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Affiliation(s)
- Ryotaro Nakahara
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
| | - Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Sayaka Ogawa
- Department of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tomoyuki Iwaki
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yasumasa Tada
- Department of Gastroenterology, Matsue Red Cross Hospital, Shimane, Japan
| | - Takafumi Yuki
- Department of Gastroenterology, Matsue Red Cross Hospital, Shimane, Japan
| | - Youichi Miyaoka
- Department of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan
| | | | - Hirofumi Fujishiro
- Department of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Shunji Ishihara
- Department of Internal Medicine II, Faculty of Medicine, Shimane University, Shimane, Japan
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14
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Sagami R, Yamao K, Nakahodo J, Minami R, Tsurusaki M, Murakami K, Amano Y. Pre-Operative Imaging and Pathological Diagnosis of Localized High-Grade Pancreatic Intra-Epithelial Neoplasia without Invasive Carcinoma. Cancers (Basel) 2021; 13:cancers13050945. [PMID: 33668239 PMCID: PMC7956417 DOI: 10.3390/cancers13050945] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 12/11/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) arises from precursor lesions, such as pancreatic intra-epithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasm (IPMN). The prognosis of high-grade precancerous lesions, including high-grade PanIN and high-grade IPMN, without invasive carcinoma is good, despite the overall poor prognosis of PDAC. High-grade PanIN, as a lesion preceding invasive PDAC, is therefore a primary target for intervention. However, detection of localized high-grade PanIN is difficult when using standard radiological approaches. Therefore, most studies of high-grade PanIN have been conducted using specimens that harbor invasive PDAC. Recently, imaging characteristics of high-grade PanIN have been revealed. Obstruction of the pancreatic duct due to high-grade PanIN may induce a loss of acinar cells replaced by fibrosis and lobular parenchymal atrophy. These changes and additional inflammation around the branch pancreatic ducts (BPDs) result in main pancreatic duct (MPD) stenosis, dilation, retention cysts (BPD dilation), focal pancreatic parenchymal atrophy, and/or hypoechoic changes around the MPD. These indirect imaging findings have become important clues for localized, high-grade PanIN detection. To obtain pre-operative histopathological confirmation of suspected cases, serial pancreatic-juice aspiration cytologic examination is effective. In this review, we outline current knowledge on imaging characteristics of high-grade PanIN.
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, Oita San-ai Medical Center, 1213 Oaza Ichi, Oita, Oita 870-1151, Japan
- Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Osaka 589-8511, Japan; (K.Y.); (J.N.); (R.M.)
- Correspondence: ; Tel.: +81-97-541-1311; Fax: +81-97-541-5218
| | - Kentaro Yamao
- Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Osaka 589-8511, Japan; (K.Y.); (J.N.); (R.M.)
- Department of Gastroenterology and Hepatology, Kindai University, Osaka-Sayama, Osaka 589-8511, Japan
| | - Jun Nakahodo
- Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Osaka 589-8511, Japan; (K.Y.); (J.N.); (R.M.)
- Department of Gastroenterology Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
| | - Ryuki Minami
- Pancreatic Cancer Research for Secure Salvage Young Investigators (PASSYON), Osaka-Sayama, Osaka 589-8511, Japan; (K.Y.); (J.N.); (R.M.)
- Department of Gastroenterology, Tenri Hospital, 200 Mishimacho, Tenri, Nara 632-0015, Japan
| | - Masakatsu Tsurusaki
- Department of Diagnostic Radiology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka 589-8511, Japan;
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasamacho, Yufu, Oita 879-5593, Japan;
| | - Yuji Amano
- Department of Endoscopy, Urawa Kyosai Hospital, 3-15-31 Harayama, Midoriku, Saitama 336-0931, Japan;
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15
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Murakami D, Harada H, Amano Y. An unexpected cause of lower gastrointestinal bleeding. Clin Case Rep 2021; 9:586-587. [PMID: 33489223 PMCID: PMC7813000 DOI: 10.1002/ccr3.3549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/06/2020] [Accepted: 10/19/2020] [Indexed: 11/25/2022] Open
Abstract
Although appendiceal bleeding is rare, physicians should keep this finding in mind as a possible cause of bleeding from the right colon because the colonoscopic diagnosis may be essential in determining the need for surgical intervention.
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Affiliation(s)
| | - Hideaki Harada
- Department of GastroenterologyNew Tokyo HospitalChibaJapan
| | - Yuji Amano
- Department of EndoscopyNew Tokyo HospitalChibaJapan
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16
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Affiliation(s)
- Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan.
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
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17
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Sagami R, Hayasaka K, Ujihara T, Nakahara R, Murakami D, Iwaki T, Suehiro S, Katsuyama Y, Harada H, Nishikiori H, Murakami K, Amano Y. Endoscopic transpapillary gallbladder drainage for acute cholecystitis is feasible for patients receiving antithrombotic therapy. Dig Endosc 2020; 32:1092-1099. [PMID: 32052507 DOI: 10.1111/den.13650] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 02/06/2020] [Accepted: 02/09/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Patients with acute cholecystitis receiving antithrombotic therapy (ATT) have an increased risk of bleeding complications during surgery and percutaneous drainage. Endoscopic transpapillary gallbladder drainage (ETGBD) is recommended for such cases; however, evidence is limited. To investigate this issue further, we performed a retrospective multicenter study. METHODS One hundred thirty patients with acute cholecystitis who underwent ETGBD were enrolled. They were divided into an ATT group (continuation of ATT on the day of the procedure and/or heparin substitution) and a Non-ATT group (discontinuation or no use of ATT). The primary outcome was bleeding complication rate, and the secondary outcomes were technical success rate, clinical success rate and total complication rate. RESULTS Eighty-three patients were enrolled in the ATT group, and 47 were enrolled in the Non-ATT group. In the ATT group, 42.2% continued multi-agent ATT. No bleeding complications occurred in either group. There were no significant differences between the ATT and Non-ATT groups in the technical success rate (84.3% vs 89.4%, P = 0.426 respectively) or the clinical success rate (97.1% vs 100%, P = 0.259, respectively). The overall early complication rate was 3.1% (4/130): mild pancreatitis (n = 3) and cholangitis (n = 1). Stent dysfunction was found in 10.9% of patients (at 196 days on average), and the 12-month stent patency rate was 69.0%. CONCLUSIONS No significant difference was found in the bleeding complication rate between ETGBD with and without ATT. ETGBD may be an ideal drainage method for patients with acute cholecystitis receiving ATT.
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Affiliation(s)
- Ryota Sagami
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Kenji Hayasaka
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tetsuro Ujihara
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Ryotaro Nakahara
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Daisuke Murakami
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tomoyuki Iwaki
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Satoshi Suehiro
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yasushi Katsuyama
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Hideaki Harada
- Departments of, Department of, Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
| | - Yuji Amano
- Department of, Endoscopy, New Tokyo Hospital, Chiba, Japan
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18
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Amano Y, Ishimura N, Ishihara S. Is Malignant Potential of Barrett’s Esophagus Predictable by Endoscopy Findings? Life (Basel) 2020; 10:life10100244. [PMID: 33081277 PMCID: PMC7602941 DOI: 10.3390/life10100244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/01/2020] [Accepted: 10/14/2020] [Indexed: 12/17/2022] Open
Abstract
Given that endoscopic findings can be used to predict the potential of neoplastic progression in Barrett’s esophagus (BE) cases, the detection rate of dysplastic Barrett’s lesions may become higher even in laborious endoscopic surveillance because a special attention is consequently paid. However, endoscopic findings for effective detection of the risk of neoplastic progression to esophageal adenocarcinoma (EAC) have not been confirmed, though some typical appearances are suggestive. In the present review, endoscopic findings that can be used predict malignant potential to EAC in BE cases are discussed. Conventional results obtained with white light endoscopy, such as length of BE, presence of esophagitis, ulceration, hiatal hernia, and nodularity, are used as indicators of a higher risk of neoplastic progression. However, there are controversies in some of those findings. Absence of palisade vessels may be also a new candidate predictor, as that reveals degree of intense inflammation and of cyclooxygenase-2 protein expression with accelerated cellular proliferation. Furthermore, an open type of mucosal pattern and enriched stromal blood vessels, which can be observed by image-enhanced endoscopy, including narrow band imaging, have been confirmed as factors useful for prediction of neoplastic progression of BE because they indicate more frequent cyclooxygenase-2 protein expression along with accelerated cellular proliferation. Should the malignant potential of BE be shown predictable by these endoscopic findings, that would simplify methods used for an effective surveillance, because patients requiring careful monitoring would be more easily identified. Development in the near future of a comprehensive scoring system for BE based on clinical factors, biomarkers and endoscopic predictors is required.
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Affiliation(s)
- Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan
- Correspondence: ; Tel.: +81-047-711-8700; Fax: +81-047-392-8718
| | - Norihisa Ishimura
- Department of Internal Medicine II, Faculty of Medicine, Shimane University, Shimane 693-8501, Japan; (N.I.); (S.I.)
| | - Shunji Ishihara
- Department of Internal Medicine II, Faculty of Medicine, Shimane University, Shimane 693-8501, Japan; (N.I.); (S.I.)
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Sagami R, Hayasaka K, Ujihara T, Nakahara R, Murakami D, Iwaki T, Katsuyama Y, Harada H, Tsuji H, Sato T, Nishikiori H, Murakami K, Amano Y. Feasibility of endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis patients receiving antithrombotic therapy. Ann Gastroenterol 2020; 33:391-397. [PMID: 32624660 PMCID: PMC7315717 DOI: 10.20524/aog.2020.0496] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/28/2020] [Indexed: 12/16/2022] Open
Abstract
Background Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) as a treatment for patients with acute cholecystitis has been shown to obtain high technical and clinical success rates and a low recurrence rate. However, the safety of EUS-GBD for patients receiving antithrombotic therapy (ATT) has not been proven. The aim was to evaluate the safety and efficacy of EUS-GBD in patients receiving ATT. Methods Twelve patients with acute cholecystitis associated with gallstones who were receiving antithrombotic therapy and underwent EUS-GBD were enrolled in this retrospective study. Patients with grade II or III cholecystitis who had failed endoscopic transpapillary GBD (ETGBD) or developed recurrence after multiple ETGBD procedures underwent urgent drainage by EUS-GBD. The primary outcome was the rate of bleeding complications after the procedure and the secondary outcomes were the technical and clinical success rates, complications, and recurrence. Results Eleven (91.6%) patients underwent EUS-GBD with continuation of ATT (at least 1 agent). Five of 12 patients (41.7%) were receiving more than 1 agent for ATT. The rate of bleeding complications was 0% and the technical success rate was 100%, even though some patients had high-grade (severe) cholecystitis and/or several underlying diseases. Early complications were found in 2 (16.7%) patients. The clinical success rate was 91.7% (11/12). There were no recurrences of cholecystitis during the follow-up period (mean 261 [range 5-650] days). Conclusions EUS-GBD yielded high technical and clinical success rates and a low recurrence rate. No patients receiving ATT developed bleeding complications. EUS-GBD might be a good option for patients on ATT.
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, Oita San-ai Medical Center, Oita (Ryota Sagami Hiroaki Tsuji, Takao Sato, Hidefumi Nishikiori)
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Ryotaro Nakahara
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Tomoyuki Iwaki
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Yasushi Katsuyama
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba (Kenji Hayasaka, Tetsuro Ujihara, Ryotaro Nakahara, Daisuke Murakami, Tomoyuki Iwaki, Yasushi Katsuyama, Hideaki Harada)
| | - Hiroaki Tsuji
- Department of Gastroenterology, Oita San-ai Medical Center, Oita (Ryota Sagami Hiroaki Tsuji, Takao Sato, Hidefumi Nishikiori)
| | - Takao Sato
- Department of Gastroenterology, Oita San-ai Medical Center, Oita (Ryota Sagami Hiroaki Tsuji, Takao Sato, Hidefumi Nishikiori)
| | - Hidefumi Nishikiori
- Department of Gastroenterology, Oita San-ai Medical Center, Oita (Ryota Sagami Hiroaki Tsuji, Takao Sato, Hidefumi Nishikiori)
| | - Kazunari Murakami
- Department of Gastroenterology, Faculty of Medicine, Oita University (Kazunari Murakami)
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba (Yuji Amano), Japan
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Yotsumoto T, Matsumoto Y, Zokumasu K, Ando T, Maemura K, Amano Y, Watanabe K, Kage H, Kakimi K, Nakajima J, Takai D. B19 New Potential Targets of Antibody-Drug Conjugates for Small-Cell Lung Carcinoma. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Sagami R, Hayasaka K, Nishikiori H, Harada H, Amano Y. Current Status in the Treatment of Acute Cholecystitis Patients Receiving Antithrombotic Therapy: Is Endoscopic Drainage Feasible?- A Systematic Review. Clin Endosc 2020; 53:176-188. [PMID: 31914723 PMCID: PMC7137572 DOI: 10.5946/ce.2019.177] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/12/2019] [Indexed: 12/15/2022] Open
Abstract
The bleeding complication risk of surgery or percutaneous transhepatic gallbladder drainage (PTGBD) may increase in patients with acute cholecystitis receiving antithrombotic therapy (ATT). Endoscopic gallbladder drainage (EGBD) may be recommended for such patients. English articles published between 1991 and 2018 in peer-reviewed journals that discuss cholecystectomy, PTGBD, and EGBD in patients with ATT or coagulopathy were reviewed to assess the safety of the procedures, especially in terms of the bleeding complication. There were 8 studies on cholecystectomy, 3 on PTGBD, and 1 on endoscopic transpapillary gallbladder drainage (ETGBD) in patients receiving ATT. With respect to EGBD, 28 studies on ETGBD (including 1 study already mentioned above) and 26 studies on endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) were also analyzed. The overall bleeding complication rate in patients with ATT who underwent cholecystectomy was significantly higher than that in patients without ATT (6.5% [23/354] vs. 1.2% [26/2,224], p<0.001). However, the bleeding risk of cholecystectomy and PTGBD in patients receiving ATT was controversial. The overall technical success, clinical success, and bleeding complication rates of ETGBD vs. EUS-GBD were 84% vs. 96% (p<0.001), 92% vs. 97% (p<0.001), and 0.65% vs. 2.1% (p=0.005), respectively. One patient treated with ETGBD experienced bleeding complication among 191 patients with bleeding tendency. ETGBD may be an ideal drainage procedure for patients receiving ATT from the viewpoint of bleeding, although EUS-GBD is also efficacious.
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
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Murakami D, Harada H, Amano Y, Yamato M. Do polyglycolic acid sheets really prevent bleeding after endoscopic submucosal dissection? An opinion from physiological viewpoints. Endoscopy 2020; 52:76. [PMID: 31853930 DOI: 10.1055/a-1021-8624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan.,Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
| | - Masayuki Yamato
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
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23
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Affiliation(s)
- Daisuke Murakami
- Department of Gastroenterology (Daisuke Murakami, Hideaki Harada)
- Correspondence to: Daisuke Murakami, MD, MSc, Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan, 1271 Wanagaya, Matsudo, Chiba, Japan, e-mail:
| | - Hideaki Harada
- Department of Gastroenterology (Daisuke Murakami, Hideaki Harada)
| | - Yuji Amano
- Department of Endoscopy (Yuji Amano), New Tokyo Hospital, Chiba, Japan
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24
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Thanh Nha Uyen L, Amano Y, Al-Kzayer LFY, Kubota N, Kobayashi J, Nakazawa Y, Koike K, Sakashita K. PCDH17 functions as a common tumor suppressor gene in acute leukemia and its transcriptional downregulation is mediated primarily by aberrant histone acetylation, not DNA methylation. Int J Hematol 2019; 111:451-462. [PMID: 31865541 DOI: 10.1007/s12185-019-02799-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 12/16/2022]
Abstract
We recently reported that methylation of PCDH17 gene is found in 30% of children with B-cell precursor acute lymphoblastic leukemia (ALL), and is significantly correlated to event-free or overall survival. We here evaluated PCDH17 mRNA expression in pediatric acute myeloid leukemia (AML) and ALL. PCDH17 mRNA expression levels in children with ALL/AML were lower than those in healthy counterparts. We next elucidated the mechanism underlying down-regulation of PCDH17 mRNA, using myeloid and lymphoid leukemic cell lines. Treatment with the histone deacetylase inhibitor trichostatin A (TSA) resulted in restoration of PCDH17 mRNA expression and growth inhibition in K562, HL60, REH, and RCH-ACV cell lines. Upregulation of PCDH17 mRNA expression resulted from histone H3 acetylation. Knockdown of the PCDH17 gene, caused by transduction of PCDH17-targeted shRNA, significantly enhanced the proliferation of KU812 cells. Meanwhile, overexpression of PCDH17 via retroviral-particle transfection substantially inhibited the growth of Kasumi1 cells. The fold-increase in PCDH17 mRNA expression mediated by 5-azacytidine, an inhibitor of DNA methyltransferase, was fundamentally lower than that produced by TSA. In conclusion, our results suggest that PCDH17 gene functions as a common tumor suppressor gene in leukemic cells, and that histone deacetylase inhibitors re-express PCDH17 mRNA to a greater extent than demethylation reagents.
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Affiliation(s)
- Le Thanh Nha Uyen
- Department of Medical Genetics, Hue University of Medicine and Pharmacy, Hue, Vietnam.,Department of Pediatrics, Shinshu University School of Medicine, Matsumoto,, Nagano, Japan
| | - Yuji Amano
- Department of Microbiology and Immunology, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | | | - Noriko Kubota
- Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
| | - Jun Kobayashi
- Department of Laboratory Medicine, Nagano Children's Hospital, Azumino, Japan
| | - Yozo Nakazawa
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto,, Nagano, Japan
| | - Kenichi Koike
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto,, Nagano, Japan.,Shinonoi General Hospital, Minami Nagano Center, Nagano, Japan
| | - Kazuo Sakashita
- Department of Pediatrics, Shinshu University School of Medicine, Matsumoto,, Nagano, Japan. .,Department of Hematology and Oncology, Nagano Children's Hospital, 3100 Toyoshina, Azumino, Nagano, Japan.
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25
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Murakami D, Harada H, Amano Y. Foreign body in the ileum after eating shabu-shabu. Postgrad Med J 2019; 96:301. [PMID: 31757872 DOI: 10.1136/postgradmedj-2019-137200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/08/2019] [Accepted: 11/10/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Japan
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Matsudo, Japan
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26
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Sagami R, Hayasaka K, Ujihara T, Nakahara R, Murakami D, Iwaki T, Suehiro S, Katsuyama Y, Harada H, Amano Y. A New Technique of Endoscopic Transpapillary Gallbladder Drainage Combined with Intraductal Ultrasonography for the Treatment of Acute Cholecystitis. Clin Endosc 2019; 53:221-229. [PMID: 31684701 PMCID: PMC7137567 DOI: 10.5946/ce.2019.099] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/24/2019] [Indexed: 12/24/2022] Open
Abstract
Background/Aims: Endoscopic transpapillary gallbladder drainage (ETGBD) is useful for the treatment of acute cholecystitis; however, the technique is difficult to perform. When intraductal ultrasonography (IDUS) is combined with ETGBD, the orifice of the cystic duct in the common bile duct may be more easily detected in the cannulation procedure. The aim of this study was to evaluate the efficacy of ETGBD with IDUS compared with that of ETGBD alone.
Methods: A total of 100 consecutive patients with acute cholecystitis requiring ETGBD were retrospectively recruited. The first 50 consecutive patients were treated using ETGBD without IDUS, and the next 50 patients were treated using ETGBD with IDUS. Through propensity score matching analysis, we compared the clinical outcomes between the groups. The primary outcome was the technical success rate.
Results: The technical success rate of ETGBD with IDUS was significantly higher than that of ETGBD without IDUS (92.0% vs. 76.0%, p=0.044). There was no significant difference in procedure length between the two groups (74.0 min vs. 66.7 min, p=0.310). The complication rate of ETGBD with IDUS was significantly higher than that of ETGBD without IDUS (6.0% vs. 0%, p<0.001); however, only one case showed an IDUS technique-related complication (pancreatitis).
Conclusions: The assistance of IDUS may be useful in ETGBD.
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Affiliation(s)
- Ryota Sagami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Ryotaro Nakahara
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tomoyuki Iwaki
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Satoshi Suehiro
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
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27
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Amano Y, Nakahara R, Yuki T, Murakami D, Ujihara T, Tomoyuki I, Sagami R, Suehiro S, Katsuyama Y, Hayasaka K, Harada H, Tada Y, Miyaoka Y, Fujishiro H. Relationship between Barrett's esophagus and colonic diseases: a role for colonoscopy in Barrett's surveillance. J Gastroenterol 2019; 54:984-993. [PMID: 31240437 DOI: 10.1007/s00535-019-01600-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/18/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Given that risk factors for Barrett's carcinogenesis are predictive, appropriate management and surveillance of Barrett's esophagus (BE) may be provided. The presence of colorectal neoplasms (CRNs) is a possible predictor of the development of BE and the progression to esophageal adenocarcinoma (EAC). We evaluated the relationship between BE or EAC and colonic diseases, including neoplasms and diverticulosis. METHODS Patients (N = 5606) who underwent both colonoscopy and esophagogastroduodenoscopy between January 2016 and December 2017 at three institutions were enrolled. The relationships between the presence of colonic diseases and BE or EAC and other clinical or endoscopic predictors of the presence of BE were investigated retrospectively. RESULTS The prevalence of BE ≥ 1 cm and ≥ 3 cm in length was 13.0% and 0.52%, respectively. BE was closely related with the presence of colorectal adenoma (48.4% vs. 37.2% in non-BE; P < 0.001), adenocarcinoma (16.6% vs. 8.4%, P < 0.001) and colonic diverticulosis (CD) (34.1% vs. 29.3%, P < 0.001). In patients with long-segment BE, CRNs (79.3%, P < 0.001) and CD (48.2%, P = 0.038) were more common. EAC patients also had a statistically significantly higher incidence of CRNs than non-BE patients (87.5% vs. 45.6%, P = 0.027). Diverticulosis at the distal colon correlated significantly with EAC and BE (50.0%, P = 0.010 and 15.4%, P = 0.024, vs. 12.0% in non-BE). Multivariate analysis showed that CRNs (t = 8.55, P < 0.001), reflux esophagitis (t = 5.26, P < 0.001) and hiatal hernia (t = 11.68, P < 0.001) were predictors of BE. CONCLUSIONS The presence of CRNs was strongly associated with BE and EAC. Therefore, colonoscopy may be useful for establishing a strategy for the surveillance of BE.
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Affiliation(s)
- Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, 1271 Wanagaya, Matsudo, 270-2232, Chiba, Japan.
| | - Ryotaro Nakahara
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Takafumi Yuki
- Department of Gastroenterology, Matsue Red Cross Hospital, Matsue, Japan
| | - Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Iwaki Tomoyuki
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Ryota Sagami
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Satoshi Suehiro
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Yasushi Katsuyama
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba, Japan
| | - Yasumasa Tada
- Department of Gastroenterology, Matsue Red Cross Hospital, Matsue, Japan
| | - Youichi Miyaoka
- Department of Endoscopy, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Hirofumi Fujishiro
- Department of Gastroenterology, Shimane Prefectural Central Hospital, Izumo, Japan
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Harada H, Nakahara R, Murakami D, Suehiro S, Nagasaka T, Ujihara T, Sagami R, Katsuyama Y, Hayasaka K, Tounou S, Amano Y. The effect of anticoagulants on delayed bleeding after colorectal endoscopic submucosal dissection. Surg Endosc 2019; 34:3330-3337. [PMID: 31482349 DOI: 10.1007/s00464-019-07101-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 08/21/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS The withdrawal of antithrombotic therapy from patients at high risk of thromboembolism is controversial. Previously, treatment with anticoagulants, such as warfarin and dabigatran, was recommended for heparin bridge therapy (HBT) during endoscopic submucosal dissection (ESD). However, HBT is associated with a high risk of bleeding during and after ESD. This study aimed to investigate the clinical outcomes of colorectal ESD in patients treated with warfarin and direct oral anticoagulants (DOAC). METHODS This study included 412 patients with superficial colorectal neoplasms that were resected by ESD between June 2010 and June 2018. The patients were classified into two groups: without antithrombotics (n = 286) and with anticoagulants (n = 51). The anticoagulants group was further divided into two groups: warfarin (n = 26) and DOAC (n = 25). RESULTS Among all patients, delayed bleeding occurred in 35 (8.5% [35/412]) patients. The bleeding rate in the anticoagulants group (11.8% [6/51]) was higher than that in the group without antithrombotics (6.6% [19/286]), but the difference was not statistically significant (P = 0.240). The bleeding rate in the DOAC group (16.0% [4/25]) was higher than that in the warfarin group (7.7% [2/26]), but the difference was not statistically significant (P = 0.419). All delayed bleeding was successfully managed with endoscopic hemostasis. Thromboembolic events were not observed in any patients. CONCLUSIONS The bleeding rate with anticoagulants was relatively high. However, all bleeding events with anticoagulants were minor and clinically controllable. Colorectal ESD with DOAC and warfarin may be feasible and acceptable.
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Affiliation(s)
- Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan.
| | - Ryotaro Nakahara
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Satoshi Suehiro
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Takuya Nagasaka
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Ryota Sagami
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Yasushi Katsuyama
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 270-2232, Japan
| | - Shigetaka Tounou
- Department of Gastroenterology, Secomedic Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
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Takata Y, Nakajima S, Kobayashi J, Ono K, Amano Y, Takahashi Y. Current-feedback-stabilized laser system for quantum simulation experiments using Yb clock transition at 578 nm. Rev Sci Instrum 2019; 90:083002. [PMID: 31472606 DOI: 10.1063/1.5110037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/28/2019] [Indexed: 06/10/2023]
Abstract
We developed a laser system for the spectroscopy of the clock transition in ytterbium (Yb) atoms at 578 nm based on an interference-filter stabilized external-cavity diode laser (IFDL) emitting at 1156 nm. Owing to the improved frequency-to-current response of the laser-diode chip and the less sensitivity of the IFDL to mechanical perturbations, we succeeded in stabilizing the frequency to a high-finesse ultra-low-expansion glass cavity with a simple current feedback system. Using this laser system, we performed high-resolution clock spectroscopy of Yb and found that the linewidth of the stabilized laser was less than 320 Hz.
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Affiliation(s)
- Y Takata
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - S Nakajima
- The Hakubi Center for Advanced Research, Kyoto University, Kyoto 606-8501, Japan
| | - J Kobayashi
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - K Ono
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - Y Amano
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - Y Takahashi
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
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Harada H, Nakahara R, Murakami D, Suehiro S, Ujihara T, Sagami R, Katsuyama Y, Hayasaka K, Amano Y. Saline-pocket endoscopic submucosal dissection for superficial colorectal neoplasms: a randomized controlled trial (with video). Gastrointest Endosc 2019; 90:278-287. [PMID: 30930074 DOI: 10.1016/j.gie.2019.03.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 03/15/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Colorectal endoscopic submucosal dissection (ESD) is a time-consuming procedure because of the technical difficulty. The newly developed saline-pocket ESD (SP-ESD) provides a clearer view and better traction of the submucosal layer compared with the standard ESD with gas insufflation (S-ESD). This study aimed to prospectively compare the efficacy and safety between S-ESD and SP-ESD in patients with superficial colorectal neoplasms (SCNs). METHODS From April 2017 to November 2018, 95 patients with SCNs ≥20 mm in diameter were prospectively and randomly enrolled. Four patients were excluded because of an incomplete ESD procedure. Patients were finally allocated to 2 groups, S-ESD with 45 patients and SP-ESD with 46 patients. The primary outcome was dissection speed. Secondary outcomes were ESD procedure time, en bloc and complete resection rates, perforation rate, and adverse effects. RESULTS Median dissection speed was significantly faster in the SP-ESD than the S-ESD group (20.1 mm2/min [range, 17.3-28.1] vs 16.3 mm2/min [range, 11.4-19.8]; P < .001). Median procedure time was significantly shorter in the SP-ESD than the S-ESD group (29.5 minutes [range, 22.3-44] vs 41 minutes [range, 31-55]; P < .001). The en bloc and complete resection rates were 100% in both groups. No perforations occurred among patients. The volume of saline solution used in the SP-ESD group was significantly greater than that in the S-ESD group (200 mL [range, 120-250] vs 150 mL [range, 100-200]; P = .016). CONCLUSIONS SP-ESD improved dissection speed and procedure time compared with S-ESD. SP-ESD may be an alternative method for resection of SCNs. (Clinical trial registration number: UMIN 000026317.).
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Affiliation(s)
- Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Ryotaro Nakahara
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Satoshi Suehiro
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Ryota Sagami
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | | | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Chiba, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
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Amano Y, Akazawa Y, Yasuda J, Yoshino K, Kojima K, Kobayashi N, Matsuzaki S, Nagasaki M, Kawai Y, Minegishi N, Ishida N, Motoki N, Hachiya A, Nakazawa Y, Yamamoto M, Koike K, Takeshita T. A low-frequency IL4R locus variant in Japanese patients with intravenous immunoglobulin therapy-unresponsive Kawasaki disease. Pediatr Rheumatol Online J 2019; 17:34. [PMID: 31269967 PMCID: PMC6610867 DOI: 10.1186/s12969-019-0337-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/07/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Kawasaki disease (KD) is a systemic vasculitis which may be associated with coronary artery aneurysms. A notable risk factor for the development of coronary artery aneurysms is resistance to intravenous immunoglobulin (IVIG) therapy, which comprises standard treatment for the acute phase of KD. The cause of IVIG resistance in KD is largely unknown; however, the contribution of genetic factors, especially variants in immune-related genes, has been suspected. METHODS To explore genetic variants related to IVIG-unresponsiveness, we designated KD patients who did not respond to both first and second courses of IVIG therapy as IVIG-unresponsive patients. Using genomic DNA from 30 IVIG-unresponsive KD patients, we performed pooled genome sequencing targeting 39 immune-related cytokine receptor genes. RESULTS The single nucleotide variant (SNV), rs563535954 (located in the IL4R locus), was concentrated in IVIG-unresponsive KD patients. Individual genotyping showed that the minor allele of rs563535954 was present in 4/33 patients with IVIG-unresponsive KD, compared with 20/1063 individuals in the Japanese genome variation database (odds ratio = 7.19, 95% confidence interval 2.43-21.47). Furthermore, the minor allele of rs563535954 was absent in 42 KD patients who responded to IVIG treatment (P = 0.0337), indicating that a low-frequency variant, rs563535954, is associated with IVIG-unresponsiveness in KD patients. Although rs563535954 is located in the 3'-untranslated region of IL4R, there was no alternation in IL4R expression associated with the mior allele of rs563535954. However, IVIG-unresponsive patients that exhibited the minor allele of rs563535954 tended to be classified into the low-risk group (based on previously reported risk scores) for prediction of IVIG-resistance. Therefore, IVIG-unresponsiveness associated with the minor allele of rs563535954 might differ from IVIG-unresponsiveness associated with previous risk factors used to evaluate IVIG-unresponsiveness in KD. CONCLUSION These findings suggest that the SNV rs563535954 could serve as a predictive indicator of IVIG-unresponsiveness, thereby improving the sensitivity of risk scoring systems, and may aid in prevention of coronary artery lesions in KD patients.
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Affiliation(s)
- Yuji Amano
- 0000 0001 1507 4692grid.263518.bDepartment of Microbiology and Immunology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan
| | - Yohei Akazawa
- 0000 0001 1507 4692grid.263518.bDepartment of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan
| | - Jun Yasuda
- 0000 0001 2248 6943grid.69566.3aTohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan ,0000 0001 2248 6943grid.69566.3aGraduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Kazuhisa Yoshino
- 0000 0001 1507 4692grid.263518.bDepartment of Microbiology and Immunology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan
| | - Katsuhiko Kojima
- 0000 0001 1507 4692grid.263518.bDepartment of Microbiology and Immunology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan
| | - Norimoto Kobayashi
- 0000 0001 1507 4692grid.263518.bDepartment of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan
| | - Satoshi Matsuzaki
- 0000 0001 1507 4692grid.263518.bDepartment of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan
| | - Masao Nagasaki
- 0000 0001 2248 6943grid.69566.3aTohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan ,0000 0001 2248 6943grid.69566.3aGraduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan ,0000 0001 2248 6943grid.69566.3aGraduate School of Information Science, Tohoku University, 6-3-09, Aramaki Aza-Aoba, Aoba-ku, Sendai, Miyagi 980-8579 Japan
| | - Yosuke Kawai
- 0000 0001 2248 6943grid.69566.3aTohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan ,0000 0001 2248 6943grid.69566.3aGraduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Naoko Minegishi
- 0000 0001 2248 6943grid.69566.3aTohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan ,0000 0001 2248 6943grid.69566.3aGraduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Noriko Ishida
- 0000 0001 2248 6943grid.69566.3aTohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan ,0000 0001 2248 6943grid.69566.3aGraduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Noriko Motoki
- 0000 0001 1507 4692grid.263518.bDepartment of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan
| | - Akira Hachiya
- 0000 0001 1507 4692grid.263518.bDepartment of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan
| | - Yozo Nakazawa
- 0000 0001 1507 4692grid.263518.bDepartment of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan
| | - Masayuki Yamamoto
- 0000 0001 2248 6943grid.69566.3aTohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan ,0000 0001 2248 6943grid.69566.3aGraduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575 Japan
| | - Kenichi Koike
- 0000 0001 1507 4692grid.263518.bDepartment of Pediatrics, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 Japan ,Shinonoi General Hospital, Minami Nagano Center, 666-1 Shinonoi, Nagano City, Nagano 388-8004 Japan
| | - Toshikazu Takeshita
- Department of Microbiology and Immunology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
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Murakami D, Harada H, Amano Y. A gastric submucosal tumor showing unique morphological changes. Frontline Gastroenterol 2019; 11:417-418. [PMID: 32879724 PMCID: PMC7447274 DOI: 10.1136/flgastro-2019-101185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Matsudo-shi, Japan
| | - Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Matsudo-shi, Japan
| | - Yuji Amano
- Department of Gastroenterology, New Tokyo Hospital, Matsudo-shi, Japan
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33
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Harada H, Suehiro S, Murakami D, Nakahara R, Nagasaka T, Ujihara T, Sagami R, Katsuyama Y, Hayasaka K, Amano Y. Feasibility of gastric endoscopic submucosal dissection with continuous low-dose aspirin for patients receiving dual antiplatelet therapy. World J Gastroenterol 2019; 25:457-468. [PMID: 30700942 PMCID: PMC6350173 DOI: 10.3748/wjg.v25.i4.457] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/19/2018] [Accepted: 01/10/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) for gastric neoplasms during continuous low-dose aspirin (LDA) administration is generally acceptable according to recent guidelines. This retrospective study aimed to investigate the effect of continuous LDA on the postoperative bleeding after gastric ESD in patients receiving dual antiplatelet therapy (DAPT).
AIM To investigate the feasibility of gastric ESD with continuous LDA in patients with DAPT.
METHODS A total of 597 patients with gastric neoplasms treated with ESD between January 2010 and June 2017 were enrolled. The patients were categorized according to type of antiplatelet therapy (APT).
RESULTS The postoperative bleeding rate was 6.9% (41/597) in all patients. Patients were divided into the following two groups: no APT (n = 443) and APT (n = 154). APT included single-LDA (n = 95) and DAPT (LDA plus clopidogrel, n = 59) subgroups. In the single-LDA and DAPT subgroups, 56 and 39 patients were received continuous LDA, respectively. The bleeding rate with continuous single-LDA (10.7%) was similar to that with discontinuous single-LDA (10.3%) (P > 0.99). Although the bleeding rate with continuous LDA in patients receiving DAPT (23.1%) was higher than that with discontinuous LDA in patients receiving DAPT (5.0%), no significant difference was observed (P = 0.141).
CONCLUSION The bleeding rate with continuous LDA in patients receiving DAPT was not statistically different from that with discontinuous LDA in patients receiving DAPT. Therefore, continuous LDA administration may be acceptable for ESD in patients receiving DAPT, although patients should be carefully monitored for possible bleeding.
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Affiliation(s)
- Hideaki Harada
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
| | - Satoshi Suehiro
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
| | - Daisuke Murakami
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
| | - Ryotaro Nakahara
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
| | - Takuya Nagasaka
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
| | - Tetsuro Ujihara
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
| | - Ryota Sagami
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
| | - Yasushi Katsuyama
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
| | - Kenji Hayasaka
- Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
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Goda K, Fujisaki J, Ishihara R, Takeuchi M, Takahashi A, Takaki Y, Hirasawa D, Momma K, Amano Y, Yagi K, Furuhashi H, Shimizu T, Kanesaka T, Hashimoto S, Ono Y, Yamagata T, Fujiwara J, Azumi T, Nishikawa M, Watanabe G, Ohkura Y, Oyama T. Newly developed magnifying endoscopic classification of the Japan Esophageal Society to identify superficial Barrett's esophagus-related neoplasms. Esophagus 2018; 15:10.1007/s10388-018-0623-y. [PMID: 29923024 PMCID: PMC6021472 DOI: 10.1007/s10388-018-0623-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/31/2018] [Indexed: 02/03/2023]
Abstract
AIM AND METHODS The Japan Esophageal Society created a working committee group consisting of 11 expert endoscopists and 2 pathologists with expertise in Barrett's esophagus (BE) and esophageal adenocarcinoma. The group developed a consensus-based classification for the diagnosis of superficial BE-related neoplasms using magnifying endoscopy. RESULTS The classification has three characteristics: simplified, an easily understood classification by incorporating the diagnostic criteria for the early gastric cancer, including the white zone and demarcation line, and the presence of a modified flat pattern corresponding to non-dysplastic histology by adding novel diagnostic criteria. Magnifying endoscopic findings are composed of mucosal and vascular patterns, and are initially classified as "visible" or "invisible." Morphologic features were evaluated for "visible" patterns, and were subsequently rated as "regular" or "irregular," and the histology, non-dysplastic or dysplastic, was predicted. CONCLUSION We introduce the process and outline of the magnifying endoscopic classification.
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Affiliation(s)
- Kenichi Goda
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, Tokyo, 135-8577, Japan.
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
| | - Junko Fujisaki
- Department of Gastroenterology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Tokyo, Japan
| | - Ryu Ishihara
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Manabu Takeuchi
- Department of Gastroenterology, Nagaoka Red Cross Hospital, Niigata, Japan
| | - Akiko Takahashi
- Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan
| | - Yasuhiro Takaki
- Department of Gastroenterology, Ashiya Central Hospital, Fukuoka, Japan
| | - Dai Hirasawa
- Department of Gastroenterology, Sendai Kousei Hospital, Miyagi, Japan
| | - Kumiko Momma
- Department of Endoscopy, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Yuji Amano
- Department of Endoscopy, New Tokyo Hospital, Chiba, Japan
| | - Kazuyoshi Yagi
- Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hiroto Furuhashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Tomoki Shimizu
- Department of Gastroenterology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Tokyo, Japan
| | - Takashi Kanesaka
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Satoru Hashimoto
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Yoichiro Ono
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Taku Yamagata
- Department of Gastroenterology, Sendai City Medical Center, Miyagi, Japan
| | - Junko Fujiwara
- Department of Endoscopy, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Takane Azumi
- Department of Gastroenterology, International University of Health and Welfare Ichikawa Hospital, Chiba, Japan
| | - Masako Nishikawa
- Clinical Research Support Center, The Jikei University School of Medicine, Tokyo, Japan
| | - Gen Watanabe
- Department of Pathology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yasuo Ohkura
- Pathology and Cytology Center, PCL Japan, Saitama, Japan
| | - Tsuneo Oyama
- Department of Endoscopy, Saku Central Hospital Advanced Care Center, Nagano, Japan
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Miyaoka Y, Suemitsu S, Fujiwara A, Kotani S, Tsukano K, Yamanouchi S, Kusunoki R, Miyake T, Fujishiro H, Kohge N, Yamamoto T, Amano Y. Endoscopic submucosal dissection of early gastric cancer via inverted overtube in a patient with situs inversus totalis: a case report. Endosc Int Open 2018; 6:E625-E629. [PMID: 29756022 PMCID: PMC5943690 DOI: 10.1055/a-0581-7101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/17/2018] [Indexed: 12/11/2022] Open
Abstract
Background and study aims A 72-year-old man with complete situs inversus presented with early gastric cancer on the lesser curvature wall of the antrum of the stomach. Endoscopic submucosal dissection (ESD) was selected as a treatment. When the patient was positioned in the left decubitus position, the lesion was hidden by blood and gastric fluid because it was located on the gravitational side. Therefore, we decided to perform ESD with the patient in the right lateral decubitus position and use an inverted overtube, which provided a good endoscopic view without the need to rearrange the endoscopist, assistants, or endoscopic system. ESD was safe and feasible using the inverted overtube.
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Affiliation(s)
- Youichi Miyaoka
- Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan,Corresponding author Youichi Miyaoka, MD, PhD Division of EndoscopyShimane Prefectural Central Hospital4-1-1 Himebara, Izumo 693-8555Shimane, Japan+81-0853-21-2197
| | - Shinsuke Suemitsu
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Aya Fujiwara
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Satoshi Kotani
- Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Kosuke Tsukano
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Satoshi Yamanouchi
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Ryusaku Kusunoki
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Tatsuya Miyake
- Division of Liver, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Hirofumi Fujishiro
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Naruaki Kohge
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Tomohiko Yamamoto
- Division of Pathology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Yuji Amano
- Division of Endoscopy, Kaken Hospital, International University of Health and Welfare, Chiba, Japan
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Nakano T, Kanai Y, Amano Y, Yoshimoto T, Matsubara D, Shibano T, Endo S, Niki T. P3.02-089 Establishment of Highly Metastatic Lung Cancer Cell Sublines in Long-term Three-dimensional Low Attachment Cultures. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Aso Y, Arita Y, Miura Y, Iwao S, Sumi K, Nakamichi A, Fujioka H, Sasaki Y, Hori D, Amano Y, Ishibashi M, Yabuuchi K, Abe Y, Jikumaru M, Kimura N, Matsubara E. Relationship between white matter lesions and cognitive function in subjects with mild cognitive impairment. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Matsuhashi N, Sakai E, Ohata K, Ishimura N, Fujisaki J, Shimizu T, Iijima K, Koike T, Endo T, Kikuchi T, Inayoshi T, Amano Y, Furuta T, Haruma K, Kinoshita Y. Surveillance of patients with long-segment Barrett's esophagus: A multicenter prospective cohort study in Japan. J Gastroenterol Hepatol 2017; 32:409-414. [PMID: 27416773 DOI: 10.1111/jgh.13491] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND AIM The incidence of esophageal adenocarcinoma (EAC) in cases with long-segment Barrett's esophagus (BE) has not been investigated in Japan. The aim of this study is to investigate the incidence of EAC in Japanese cases with long-segment BE prospectively. METHODS This is a multicenter prospective cohort study investigating the incidence rate of EAC in patients with BE with a length of at least 3 cm. Study subjects received index esophagogastroduodenoscopy at the time of enrollment, and they were instructed to undergo yearly follow-up esophagogastroduodenoscopy. Patients in whom EAC was diagnosed in the endoscopic examinations underwent subsequent treatment, and their prognosis was observed. RESULTS Of 215 enrolled patients, six (2.8%) were initially diagnosed with EAC at the enrollment. Among the remaining 209 patients, 132 received at least one follow-up esophagogastroduodenoscopy. In this follow-up, three EACs developed in 251 observed patient-years (incidence rate: 1.2% per year). Most of the EACs detected at the initial endoscopic examination (5/6, 83%) were already at advanced stages. Meanwhile, all the three lesions detected in the follow-up esophagogastroduodenoscopies were identified as early cancers and subjected to curative resection. CONCLUSIONS The incidence rate of EAC in Japanese cases with long-segment BE was calculated to be 1.2% in a year.
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Affiliation(s)
| | - Eiji Sakai
- Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Ken Ohata
- Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Norihisa Ishimura
- Second Department of Internal Medicine, Shimane University School of Medicine, Shimane, Japan
| | - Junko Fujisaki
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Tomoki Shimizu
- Department of Gastroenterology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoyuki Koike
- Department of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takao Endo
- Department of Gastroenterology, Sapporo Shirakaba-dai Hospital, Sapporo, Japan
| | - Takefumi Kikuchi
- Department of Gastroenterology, Sapporo Shirakaba-dai Hospital, Sapporo, Japan
| | | | - Yuji Amano
- Department of Endoscopy, Kaken Hospital, International University of Health and Welfare, Ichikawa, Japan
| | - Takahisa Furuta
- Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Ken Haruma
- Department of Gastroenterology, Department of Internal Medicine, Kawasaki Medical School, Okayama, Japan
| | - Yoshikazu Kinoshita
- Second Department of Internal Medicine, Shimane University School of Medicine, Shimane, Japan
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Harada M, Amano Y, Matsuzaki K, Hayashi Y, Nishitani H, Yoshizumi M, Yoshida O, Katoh I. Quantitative Evaluation of Intraarterial Lymphocyte Injection Therapy for Lymph Edema Using MR Imaging. Acta Radiol 2016. [DOI: 10.1177/028418519403500501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Five patients with unilateral leg lymph edema had intraarterial injections of lymphocytes in the affected leg with consequent improvement in 3. To assess the degree of lymph edema, T2 and intensity ratio between the 2 legs in STIR images were used. Mean and SD of T2 values in the subcutaneous tissue were measured using a triple echo sequence and found larger on the edematous side than in the opposite extremity. The mean T2 shortening obtained after the lymphocyte therapy correlated well with the reduction of limb circumference. Mean T2 reflects the fluid content, and SD of T2 the fluid distribution in the subcutaneous tissue. The degree of lymph edema and the effect of therapy can be evaluated quantitatively by measuring the value of the T2 relaxation time.
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Affiliation(s)
- M. Harada
- From the Departments of Radiology and Cardiovascular Surgery, School of Medicine, University of Tokushima, Tokushima, Japan
| | - Y. Amano
- From the Departments of Radiology and Cardiovascular Surgery, School of Medicine, University of Tokushima, Tokushima, Japan
| | - K. Matsuzaki
- From the Departments of Radiology and Cardiovascular Surgery, School of Medicine, University of Tokushima, Tokushima, Japan
| | - Y. Hayashi
- From the Departments of Radiology and Cardiovascular Surgery, School of Medicine, University of Tokushima, Tokushima, Japan
| | - H. Nishitani
- From the Departments of Radiology and Cardiovascular Surgery, School of Medicine, University of Tokushima, Tokushima, Japan
| | - M. Yoshizumi
- From the Departments of Radiology and Cardiovascular Surgery, School of Medicine, University of Tokushima, Tokushima, Japan
| | - O. Yoshida
- From the Departments of Radiology and Cardiovascular Surgery, School of Medicine, University of Tokushima, Tokushima, Japan
| | - I. Katoh
- From the Departments of Radiology and Cardiovascular Surgery, School of Medicine, University of Tokushima, Tokushima, Japan
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Amano Y, Takagi R, Takahama K, Kumazaki T. Contrast-enhanced T1-weighted black-blood fast spin-echo MR imaging of the brain: Technique for suppression of enhancing venous signal. Acta Radiol 2016. [DOI: 10.1080/028418501127346422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Contrast-enhanced T1-weighted black-blood fast spin-echo MR imaging (BB-FSE) was performed to suppress enhancing venous signal and flow artifacts in the brain without sacrificing the T1-weighted imaging contrast. Material and Methods: Twenty-five MR imaging sections (17 transverse and 8 coronal images) in 15 patients with various brain diseases were obtained by contrast-enhanced T1-weighted SE and BB-FSE images. Results: In contrast-enhanced T1-weighted BB-FSE images, venous signal was significantly less and T1-weighted contrast of the brain was more evident. No differences in flow artifacts were found between the two imaging techniques. The interobserver agreements were good for the venous signal and flow artifacts using both techniques. Conclusion: Contrast-enhanced T1-weighted BB-FSE imaging reduced the venous signal in the brain with maintaining T1-weighted contrast. This novel MR technique can be used when the suppression of enhancing venous signal is expected to improve the depiction of enhancing lesions in the brain.
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Affiliation(s)
- Y. Amano
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - R. Takagi
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - K. Takahama
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - T. Kumazaki
- Department of Radiology, Nippon Medical School, Tokyo, Japan
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Miyaoka Y, Fujiwara A, Kotani S, Tsukano K, Ogawa S, Yamanouchi S, Kusunoki R, Fujishiro H, Kohge N, Yamamoto T, Amano Y. Primary micropapillary carcinoma of the colon with submucosal invasion: A case report. Endosc Int Open 2016; 4:E744-7. [PMID: 27556088 PMCID: PMC4993887 DOI: 10.1055/s-0042-106721] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/11/2016] [Indexed: 12/27/2022] Open
Abstract
We present a case of invasive micropapillary carcinoma (IMPC) of the colon treated by endoscopic resection following magnifying endoscopy. A 47-year-old woman visited our hospital for follow-up of a positive fecal occult blood test. Colonoscopy revealed a semi-pedunculated reddish polyp, the surface of which showed gentle irregularity, and mild tension in the sigmoid colon. Magnifying colonoscopy with narrow band imaging revealed an irregular surface pattern with heterogeneity in vascular diameter and distribution. Magnifying endoscopic findings using crystal violet staining showed an irregular pit pattern with an expansion of stromal areas. Endoscopic resection of the sigmoid colon tumor was performed, and the histology of the resected specimen primarily revealed a micropapillary component with a small moderately differentiated adenocarcinoma component that massively invaded into the submucosal layer, accompanied by lymphatic invasion, although the tumor was very small (7 mm in diameter, smaller than any in previous reports). Laparoscopy-assisted sigmoidectomy and regional lymph node resection were performed; neither cancer nor lymph node metastases were present. This is the first report of a case with early-stage colonic IMPC observed with magnifying colonoscopy.
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Affiliation(s)
- Youichi Miyaoka
- Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan ,Corresponding author Yoichi Miyaoka, MD, PhD Division of Endoscopy, Shimane Prefectural Central Hospital4-1-1 Himebara, Izumo 693-8555, ShimaneJapan+81-0853-22-5111+81-0853-21-2197
| | - Aya Fujiwara
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Satoshi Kotani
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Kosuke Tsukano
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Sayaka Ogawa
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Satoshi Yamanouchi
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Ryusaku Kusunoki
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Hirofumi Fujishiro
- Division of Endoscopy, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Naruaki Kohge
- Division of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Tomohiko Yamamoto
- Division of Pathology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Yuji Amano
- Division of Endoscopy, Kaken Hospital, International University of Health and Welfare, Chiba, Japan
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Shibagaki K, Amano Y, Ishimura N, Taniguchi H, Fujita H, Adachi S, Kakehi E, Fujita R, Kobayashi K, Kinoshita Y. Diagnostic accuracy of magnification endoscopy with acetic acid enhancement and narrow-band imaging in gastric mucosal neoplasms. Endoscopy 2016; 48:16-25. [PMID: 26158242 DOI: 10.1055/s-0034-1392542] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIMS Magnification endoscopy with narrow-band imaging (NBIME) and NBIME with acetic acid enhancement (A-NBIME) visualize the capillary and microstructure patterns of the gastric mucosal surface, respectively. This study aimed to compare the diagnostic accuracy and interobserver agreement for white-light endoscopy (WLE), NBIME, and A-NBIME in the different histologic types of gastric mucosal neoplasm. PATIENTS AND METHODS Consecutive gastric neoplasms (n = 220; 49 adenomas, 144 differentiated adenocarcinomas, and 27 undifferentiated adenocarcinomas) were photographed with WLE, NBIME, and A-NBIME. Macroscopic patterns using WLE, capillary patterns using NBIME, and microstructure patterns using A-NBIME were respectively classified into type M1/M2/M3, type C1/C2/C3/C4, and type S1/S2/S3, as the indicators of adenoma, differentiated adenocarcinoma, and undifferentiated adenocarcinoma (Type C4, unevaluable because of capillary invisibility), according to the previously reported classifications. Endoscopic images were independently reviewed by three experts and three non-experts. Diagnostic accuracy and interobserver diagnostic agreement were compared among the modalities. RESULTS Kappa values (95 % confidence interval [CI]) for WLE, NBIME, and A-NBIME diagnosis were 0.36 (0.33 - 0.39), 0.58 (0.54 - 0.61), and 0.62 (0.55 - 0.68) for experts and 0.31 (0.29 - 0.33), 0.36 (0.34 - 0.38), and 0.52 (0.48 - 0.56) for non-experts, showing good reproducibility of A-NBIME diagnosis regardless of proficiency. All experts and non-experts diagnosed the histologic types statistically more accurately with A-NBIME than with WLE and NBIME (P < 0.05). Overall the "experts-agreed" diagnostic accuracy (95 %CI) was 75.5 % (70.0 - 81.0) for WLE vs. 74.1 % (67.6 - 80.6) for NBIME vs. 90.5 % (86.7 - 94.1) for A-NBIME (P < 0.05). WLE and NBIME were insufficient to predict the diagnosis of adenomas and undifferentiated adenocarcinomas. CONCLUSION A-NBIME showed statistically significantly higher diagnostic accuracy for gastric mucosal neoplasms, with good reproducibility, compared with WLE and NBIME, which provided similar lower accuracy.
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Affiliation(s)
- Kotaro Shibagaki
- Department of Gastroenterology, Tottori Municipal Hospital, Tottori, Japan
| | - Yuji Amano
- Division of Endoscopy, Kaken Hospital, International University of Health and Welfare, Ichikawa, Japan
| | - Norihisa Ishimura
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Hideaki Taniguchi
- Department of Gastroenterology, Tottori Municipal Hospital, Tottori, Japan
| | - Hiraku Fujita
- Department of Gastroenterology, Tottori Municipal Hospital, Tottori, Japan
| | - Seiji Adachi
- Department of General Internal Medicine, Tottori Municipal Hospital, Tottori, Japan
| | - Eichi Kakehi
- Department of General Internal Medicine, Tottori Municipal Hospital, Tottori, Japan
| | - Ryosuke Fujita
- Department of General Internal Medicine, Tottori Municipal Hospital, Tottori, Japan
| | - Keita Kobayashi
- Department of Pathology, Tottori Municipal Hospital, Tottori, Japan
| | - Yoshikazu Kinoshita
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Izumo, Japan
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Amano Y, Azumi T. [Barrett's esophagus: its diagnosis and management in Japan]. Nihon Rinsho 2015; 73:1129-1135. [PMID: 26165069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The incidence of adenocarcinoma derived from Barrett's esophagus has been steadily increasing during the past some decades in Western countries. The development of better diagnostic and therapeutic strategies for Barrett's esophagus and Barrett's adenocarcinoma have become an important objective. In Japan, Barrett's adenocarcinoma has been gradually increasing as the results of a high incidence of reflux esophagitis, a decreasing of Helicobacter pylori infection and an increasing of obesity, etc. Subsequently, in recent, the management of Barrett's esophagus has come to be of interest as well as in the Western countries. Many issues found in the pathophysiology and epidemiology of Barrett's esophagus in Japanese patients are required to be clarified and the Japanese maneuvers regarding the diagnostic procedure and clinical management including the surveillance for patients with Barrett's esophagus should be established as soon as possible.
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Kojima K, Amano Y, Yoshino K, Tanaka N, Sugamura K, Takeshita T. ESCRT-0 protein hepatocyte growth factor-regulated tyrosine kinase substrate (Hrs) is targeted to endosomes independently of signal-transducing adaptor molecule (STAM) and the complex formation with STAM promotes its endosomal dissociation. J Biol Chem 2015; 290:8065-6. [PMID: 25819836 DOI: 10.1074/jbc.a114.578245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Tashiro S, Uchiyama G, Amano Y, Abe H, Yamane Y, Yoshida K. Release of Radioactive Materials from Simulated High-Level Liquid Waste at Boiling Accident in Reprocessing Plant. NUCL TECHNOL 2015. [DOI: 10.13182/nt14-57] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Tashiro
- Japan Atomic Energy Agency, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun Ibaraki, 319-1195, Japan
| | - G. Uchiyama
- Japan Atomic Energy Agency, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun Ibaraki, 319-1195, Japan
| | - Y. Amano
- Japan Atomic Energy Agency, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun Ibaraki, 319-1195, Japan
| | - H. Abe
- Japan Atomic Energy Agency, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun Ibaraki, 319-1195, Japan
| | - Y. Yamane
- Japan Atomic Energy Agency, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun Ibaraki, 319-1195, Japan
| | - K. Yoshida
- Japan Atomic Energy Agency, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun Ibaraki, 319-1195, Japan
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Amano Y, Azumi T, Tsuboi M, Motoori S, Ishimura N. [Epidemiology of Barrett's cancer in Japan: presents and perspectives]. Nihon Shokakibyo Gakkai Zasshi 2015; 112:219-31. [PMID: 25748148 DOI: 10.11405/nisshoshi.112.219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Yuji Amano
- Division of Endoscopy, Kaken Hospital, International University of Health and Welfare
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Shigemura T, Nakazawa Y, Amano Y, Sudo A, Watanabe M, Kobayashi M, Kobayashi N, Koike K, Agematsu K, Nishimura K. Subcutaneous abscess due to the basidiomycete Phellinus mori in a patient with chronic granulomatous disease. Infection 2015; 43:371-5. [DOI: 10.1007/s15010-015-0724-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 01/07/2015] [Indexed: 11/27/2022]
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48
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Uno G, Ishimura N, Tada Y, Tamagawa Y, Yuki T, Matsushita T, Ishihara S, Amano Y, Maruyama R, Kinoshita Y. Simplified classification of capillary pattern in Barrett esophagus using magnifying endoscopy with narrow band imaging: implications for malignant potential and interobserver agreement. Medicine (Baltimore) 2015; 94:e405. [PMID: 25621687 PMCID: PMC4602634 DOI: 10.1097/md.0000000000000405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The classification of Barrett esophagus (BE) using magnifying endoscopy with narrow band imaging (ME-NBI) is not widely used in clinical settings because of its complexity. To establish a new simplified available classification using ME-NBI.We conducted a cross-sectional study in a single-referral center. One hundred eight consecutive patients with BE using ME-NBI and crystal violet (CV) chromoendoscopy, and histological findings were enrolled. BE areas observed by ME-NBI were classified as type I or II on the basis of capillary pattern (CP), and as closed or open type on the basis of a mucosal pit pattern using CV chromoendoscopy; then, biopsy samples were obtained. We evaluated the relation between CP and pit pattern, expression of the factors with malignant potential, percentage of microvascular density, and interobserver agreement.One hundred thirty lesions from 91 patients were analyzed. Type II CP had more open type pit pattern areas and significantly greater microvascular density than type I. The presence of dysplasia, specialized intestinal metaplasia, expressions of COX-2, CDX2, and CD34, and PCNA index were significantly higher in type II, whereas the multivariate analysis showed that type II was the best predictor for the presence of dysplasia (OR 11.14), CD34 expression (OR 3.60), and PCNA (OR 3.29). Interobserver agreement for this classification was substantial (κ = 0.66).A simplified CP classification based on observation with ME-NBI is presented. Our results indicate that the classification may be useful for surveillance of BE with high malignant potential.
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Affiliation(s)
- Goichi Uno
- From the Department of Gastroenterology and Hepatology (GU, NI, Y. Tada, Y. Tamagawa, SI, YK), Shimane University School of Medicine; Division of Endoscopy (TY), Shimane University Hospital; Department of Pathology (TM, RM), Shimane University School of Medicine, Izumo; Division of Endoscopy (YA), Kaken Hospital, International University of Health and Welfare, Ichikawa, Japan; and Department of Internal Medicine (Y. Tamagawa), University of Texas Southwestern Medical Center, Dallas, TX
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Kojima K, Amano Y, Yoshino K, Tanaka N, Sugamura K, Takeshita T. ESCRT-0 protein hepatocyte growth factor-regulated tyrosine kinase substrate (Hrs) is targeted to endosomes independently of signal-transducing adaptor molecule (STAM) and the complex formation with STAM promotes its endosomal dissociation. J Biol Chem 2014; 289:33296-310. [PMID: 25296754 DOI: 10.1074/jbc.m114.578245] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The ESCRT-0 complex, consisting of the hepatocyte growth factor-regulated tyrosine kinase substrate (Hrs) and the signal-transducing adaptor molecule (STAM) proteins, recognizes ubiquitylated cargo during the initial step of endosomal sorting. The endosomal accumulation of overexpressed Hrs has been reported previously to be associated with endosome enlargement. In this study, we have found that co-expressing exogenous STAM1 in Hrs-overexpressing cells leads to a diffuse localization for a large part of the Hrs accumulated on endosomes and a recovery of the impaired cargo protein degradation process, thus suggesting that exogenous STAM abrogates the abnormalities of the Hrs-positive endosomes. A fluorescently labeled Hrs, introduced into the cells by membrane permeabilization, exhibited endosomal localization in the absence of STAM1 and gradually dissociated from the endosomes upon the sequential addition of recombinant STAM1. Furthermore, when microinjected into cells, the fluorescently labeled Hrs also showed endosomal accumulation; however, ESCRT-0 complexes formed prior to the microinjection did not. Analysis of the state of the complex in HeLa cells using blue-native PAGE revealed that the membrane-associated Hrs exists partly as a monomer and not only in the STAM1-bound form. Thus, our data suggest that the membrane binding and dissociation cycle of the ESCRT-0 proteins on the endosomal membrane is a critical step during the cargo sorting process.
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Affiliation(s)
- Katsuhiko Kojima
- From the Department of Microbiology and Immunology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 and
| | - Yuji Amano
- From the Department of Microbiology and Immunology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 and
| | - Kazuhisa Yoshino
- From the Department of Microbiology and Immunology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 and
| | | | - Kazuo Sugamura
- Molecular and Cellular Oncology, Miyagi Cancer Center Research Institute, 47-1 Nodayama, Medeshima-Shiode, Natori 981-1293, Japan
| | - Toshikazu Takeshita
- From the Department of Microbiology and Immunology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 and
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Adachi K, Hashimoto T, Ishihara S, Fujishiro H, Sato S, Sato H, Amano Y, Hattori S, Kinoshita Y. Comparison of five-day Helicobacter pylori eradication regimens: rabeprazole-based and omeprazole-based regimens with and without omeprazole pretreatment. Curr Ther Res Clin Exp 2014; 64:412-21. [PMID: 24944392 DOI: 10.1016/s0011-393x(03)00120-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2003] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The onset of antisecretory activity of rabeprazole is faster than that of omeprazole. OBJECTIVE This study was performed to compare the efficacy of short-term rabeprazole-based triple therapy with that of omeprazole-based triple therapy and to determine the influence of omeprazole pretreatment in omeprazole-based short-term triple therapy. METHODS This was a 2-center, open-label, prospective, randomized study. Patients who tested positive for Helicobacter (formerly Campylobacter) pylori were randomized to one of three 5-day regimens: (1) rabeprazole 20 mg BID, amoxicillin 500 mg TID, and clarithromycin 400 mg BID (RAC group); (2) omeprazole 20 mg BID, amoxicillin 500 mg TID, and clarithromycin 400 mg BID without omeprazole pretreatment (OAC1 group); and (3) omeprazole 20 mg BID, amoxicillin 500 mg TID, and clarithromycin 400 mg BID with 5 days of omeprazole pretreatment 20 mg BID (OAC2 group). Eradication was assessed by (13)C-urea breath test and rapid urease test ∼1 month after completion of treatment. All patients who entered this study were included in the intent-to-treat (ITT) analysis, patients who completed the study were included in the per-protocol (PP) analysis, and patients who did not undergo the (13)C-urea breath test and rapid urease test were included in the all-patients-treated (APT) analysis. RESULTS A total of 120 patients (86 men, 34 women; mean [SD] age, 55.8 [14.3] years; range, 19-86 years) were assigned to the RAC, OAC1, or OAC2 group (40 patients in each group). ITT, PP, and APT eradication rates in the RAC group were 90%, 92%, and 90%, respectively; in the OAC1 group, 75%, 83%, and 75%; and in the OAC2 group, 85%, 90%, and 87%. These eradication rates were not significantly different between groups. CONCLUSIONS Eradication rates did not differ significantly between the three 5-day proton pump inhibitor-based triple therapies in this study population. However, 5-day rabeprazole-based triple therapy tends to be more effective than 5-day omeprazole-based triple therapy in the eradication of H pylori, and treatment with omeprazole before eradication therapy may improve the eradication rates of 5-day omeprazole-based therapy.
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Affiliation(s)
- Kyoichi Adachi
- Second Department of Internal Medicine, Shimane Medical University, Shimane, Japan
| | | | - Shunji Ishihara
- Second Department of Internal Medicine, Shimane Medical University, Shimane, Japan
| | - Hirofumi Fujishiro
- Second Department of Internal Medicine, Shimane Medical University, Shimane, Japan
| | - Shuichi Sato
- Second Department of Internal Medicine, Shimane Medical University, Shimane, Japan
| | - Hiroshi Sato
- Second Department of Internal Medicine, Shimane Medical University, Shimane, Japan
| | - Yuji Amano
- Department of Gastrointestinal Endoscopy, Shimane Medical University, Shimane, Japan
| | - Shuzo Hattori
- Department of Internal Medicine, Unnan General Hospital, Shimane, Japan
| | - Yoshikazu Kinoshita
- Second Department of Internal Medicine, Shimane Medical University, Shimane, Japan
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