記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Linked color imaging (LCI) improves detection of colorectal neoplastic lesions during colonoscopy. However, polyps <5 mm in diameter often do not require resection, and the benefits of LCI are unclear for detection of colorectal polyps ≥5 mm that are indicated for endoscopic resection in clinical practice. This randomized controlled trial compared rates of detection of adenoma polyps, stratified by size, for LCI and white light imaging (WLI). METHODS: We compared ADR (5 mm-) and PDR (5 mm-), which were defined as the proportion of patients with at least one adenoma or polyp with a diameter of 5 mm or larger in the LCI and WLI groups. Moreover, we estimated ADR and PDR for diameters between 5 and 10 mm (ADR (5-9 mm), PDR (5-9 mm) ) and for diameters larger than 10 mm (ADR (10 mm-), PDR (10 mm-) ). RESULTS: Data from 594 patients (LCI, n=305; WLI, n=289) were analyzed. ADR (5 mm-) and PDR (5 mm-) were significantly higher in the LCI group than in the WLI group (ADR (5 mm-): P=0.016, PDR (5 mm-): P=0.020). In the assessment of adenoma and polyp size, ADR (5-9 mm) and PDR (5-9 mm) were significantly higher in the LCI group than in the WLI group, although no significant differences were seen in ADR (10 mm-) and PDR (10 mm-) between these groups. CONCLUSIONS: Polyps ≥5 mm, which are indicated for endoscopic treatment, were more easily visualized with LCI mode than with WLI mode. The improvement in detection rate was obvious for polyps <10 mm, which are easier to miss.

DOI： 10.1272/jnms.JNMS.2023_90-117

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本医科大学医学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The frequency of primary small intestinal adenocarcinoma is increasing but is still low. Its frequency is approximately 3% of that of colorectal adenocarcinoma. Considering that the small intestine occupies 90% of the surface area of the gastrointestinal tract, small intestinal adenocarcinoma is very rare. The main site of small intestinal adenocarcinoma is the proximal small intestine. Based on this characteristic, dietary animal proteins/lipids and bile concentrations are implicated and reported to be involved in carcinogenesis. Since most nutrients are absorbed in the proximal small intestine, the effect of absorbable intestinal content is a suitable explanation for why small intestinal adenocarcinoma is more common in the proximal small intestine. The proportion of aerobic bacteria is high in the proximal small intestine, but the absolute number of bacteria is low. In addition, the length and density of villi are greater in the proximal small intestine. However, the involvement of villi is considered to be low because the number of small intestinal adenocarcinomas is much smaller than that of colorectal adenocarcinomas. On the other hand, the reason for the low incidence of small intestinal adenocarcinoma in the distal small intestine may be that immune organs reside there. Genetic and disease factors increase the likelihood of small intestinal adenocarcinoma. In carcinogenesis experiments in which the positions of the small and large intestines were exchanged, tumors still occurred in the large intestinal mucosa more often. In other words, the influence of the intestinal contents is small, and there is a large difference in epithelial properties between the small intestine and the large intestine. In conclusion, small intestinal adenocarcinoma is rare compared to large intestinal adenocarcinoma due to the nature of the epithelium. It is reasonable to assume that diet is a trigger for small intestinal adenocarcinoma.

DOI： 10.3748/wjg.v28.i39.5658

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Small bowel adenocarcinomas (SBAs) are rare and there is little comprehensive data on SBA genomic alterations for Asian patients. This study aimed to profile genomic alterations of SBA in Japanese patients using targeted next-generation sequencing (NGS). METHODS: We examined 22 surgical resections from patients with primary SBA. SBA genomic alterations were analyzed by NGS. Mismatch repair (MMR) status was determined by immunohistochemical analysis. Mucin phenotypes were classified as gastric (G), intestinal (I), gastrointestinal (GI), and null (N) types on MUC2, MUC5AC, MUC6, and CD10 immunostaining. RESULTS: The most common genomic alterations found in SBA tumors were TP53 (n = 16), followed by KRAS (n = 6), APC (n = 5), PIK3CA (n = 4), CTNNB1 (n = 3), KIT (n = 2), BRAF (n = 2), CDKN2A (n = 2), and PTEN (n = 2). Deficient MMR tumors were observed in 6 out of 22 patients. Tumor mucin phenotypes included 2 in G-type, 12 in I-type, 3 in GI-type, and 5 in N-type. APC and CTNNB1 mutations were not found in G-type and GI-type tumors. KRAS mutations were found in all tumor types except for G-type tumors. TP53 mutations were found in all tumor types. Although no single gene mutation was associated with overall survival (OS), we found that KRAS mutations were associated with significant worse OS in patients with proficient MMR tumors. CONCLUSIONS: SBA genomic alterations in Japanese patients do not differ significantly from those reports in Western countries. Tumor localization, mucin phenotype, and MMR status all appear to impact SBA gene mutations.

DOI： 10.1186/s12885-022-09824-6

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Primary thyroid lymphoma (PTL) is a rare disease frequently arising against a background of autoimmune thyroiditis. It has recently been reported that the inactivation of the NF-κB negative regulator A20 by deletion and/or mutation could be involved in the pathogenesis of subsets of B-cell lymphomas. This study investigated the clinicopathologic characteristics and A20 mutation in PTL.We analyzed the characteristics of 45 PTL patients (14 men and 31 women), with a median age of 71 (range, 35-90) years. A20 mutations were analyzed in DNA extracted from 20 samples consisting of 19 tumor tissues and 1 sample from Hashimoto's thyroiditis.Thirty-five patients (82%) had a history of Hashimoto's thyroiditis and 29 (64%) had diffuse large B-cell lymphoma (DLBCL), presenting with larger tumors including bulky mass, elevated soluble interleukin-2 receptor levels, and longer history of Hashimoto's thyroiditis compared with mucosa-associated lymphoid tissue (MALT) lymphoma patients (n=16). A20 mutations were identified in 3 of 19 PTL patients (16%), 2 of 10 (20%) with DLBCL, and 1 of 9 (11%) with MALT lymphoma. Interestingly, all patients with A20 mutations had Hashimoto's thyroiditis. Furthe

DOI： 10.1272/jnms.JNMS.2022_89-305

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

早期胃癌ESD非治癒切除症例は「内視鏡的根治度(eCura)C-2症例」と呼ばれ、原則的に追加外科手術が推奨されている。一方、高齢で複数併存疾患を有するいわゆる手術ハイリスク症例では、無治療経過観察も選択肢となる。eCuraC-2症例かつ手術ハイリスクの場合、追加治療方針の決定には病変側因子(病理結果から推測されるリンパ節転移リスク)と患者側因子(年齢や併存疾患から予測される手術リスクおよび非胃癌死を含む生命予後)の両者を考慮する必要がある。現在、病変側因子についてはリンパ節転移リスクを予測するスコアリングシステムが提案され、また患者側因子に関してもさまざまな予後予測指標の有用性や侵襲性の低い術式が模索されている。近い将来、ESD非治癒切除症例における病変側因子と患者側因子の両者を包括的にとらえた、治療方針決定のアルゴリズムの登場が期待される。(著者抄録)

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Three-dimensional (3D) technology has been used in many fields, including flexible endoscopy. We evaluated the usefulness of 3D visualization for endoscopically diagnosing superficial gastric neoplasia. METHODS: Twelve participants (4 novices, 4 trainees and 4 experts) evaluated two-dimensional (2D) and 3D endoscopic still images of 28 gastric neoplasias, obtained before ESD with white-light imaging (WLI) and narrow-band imaging (NBI). Assessments of the delineation accuracy of tumor extent and tumor morphology under 2D and 3D visualization were based on the histopathological diagnosis of ESD specimens. Participants answered visual analog scale (VAS) questionnaires (0-10, worst to best) concerning the (a) ease of recognition of lesion morphology, (b) lesion extent and (c) comprehensive endoscopic cognition under 2D and 3D visualization. The endpoints were the accuracy of tumor extent and morphology type and the degree of confidence in assessing (a)-(c). RESULTS: The delineation accuracy of lesion extent [mean (95% confidence interval)] with WLI under 3D visualization [60.2% (56.1-64.3%)] was significantly higher than that under 2D visualization [52.3% (48.2-56.4%)] (P < 0.001). The accuracy with NBI under 3D visualization [70.3% (66.8-73.7%)] was also significantly higher than that under 2D visualization [64.2% (60.7-67.4%)] (P < 0.001). The accuracy of the morphology type with NBI under 3D visualization was significantly higher than that under 2D visualization (P = 0.004). The VAS for all aspects of endoscopic recognition under 3D visualization was significantly better than that under 2D visualization (P < 0.01). CONCLUSIONS: Three-dimensional visualization can enhance the diagnostic quality for superficial gastric tumors.

DOI： 10.1186/s12876-021-01829-y

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The relationship between gastroesophageal reflux disease (GERD) and constipation has not yet been examined in Japan. We herein analyzed the use of laxatives by GERD and non-GERD patients to clarify the relationship between GERD and constipation. METHODS: This was a retrospective observational study designed to examine the use of laxatives by GERD and non-GERD patients. A total of 118 patients (mean age 69.7 years, 50 males) with reflux esophagitis (RE) and non-erosive reflux disease (NERD) who received maintenance acid-suppressive therapy for more than 1 year were included in the GERD group (83 RE patients, 35NERD patients). Similarly, 61 patients (mean age 69.4 years, 28 males) who received regular acid-suppressive therapy for reasons other than GERD were included in the non-GERD group. We also investigated demographic factors associated with the onset of GERD, including body mass index (BMI), age, and sex. RESULTS: The frequency of laxative use was significantly higher in the GERD group (38.1%) than in the non-GERD group (21.3%). No significant differences were observed in dose frequencies between the groups. The type of laxative used also did not significantly differ between the groups. Furthermore, no significant differences were noted in sex, age, or BMI between the groups. CONCLUSIONS: The use of laxatives was significantly more common in GERD patients than in non-GERD patients. The present results suggest that a relationship exists between GERD and constipation.

DOI： 10.1007/s10388-020-00770-5

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Gastrointestinal muscular sampling is useful in the histological assessment of functional gastrointestinal disorders. We devised a new sampling method to obtain a large volume of muscle tissues and then investigated the feasibility and safety of endoscopic muscular resection with a ligation device in an in vivo porcine model. METHODS: After establishing a submucosal tunnel, a rubber band was placed on the muscle tissue by sucking the exposed muscle layer. Thereafter, the established pseudopolyp was removed using an electrocautery snare, and the entry site of the submucosal tunnel was closed endoscopically. This procedure was performed at three sites in the esophagus and stomach of two pigs. The technical success, histology, and survival rate on postoperative day 7 were examined postoperatively. RESULTS: We successfully completed the mentioned procedure in 11 of the 12 sites (92%), without the occurrence of severe adverse events. The median diameters of obtained tissues from the esophagus and stomach, respectively, were 5 mm and 10 mm. Histologically, both the inner and outer muscle layers were included in all specimens. The postprocedural course was found uneventful in both pigs during the observatory period. CONCLUSIONS: Endoscopic muscular resection using a ligation device enabled us to obtain large and thick muscle tissue samples. This approach may facilitate more precise histological assessments of functional gastrointestinal disorders.

DOI： 10.1272/jnms.JNMS.2021_88-602

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

症例は63歳男性で、肺扁平上皮癌に対しペムブロリズマブを計31コース施行し部分奏功を維持していたが、開始から23ヵ月後より下痢を認め、32コース目を中止し入院した。入院時検査所見で軽度炎症反応上昇を認め、下部消化管内視鏡検査および病理組織所見で潰瘍性大腸炎に類似する所見を認めたことから、ペムブロリズマブによる免疫関連副作用(irAE)大腸炎と診断した。プレドニゾロンにより症状は軽快したが、漸減中に誤嚥性肺炎を合併し抗菌薬加療を行った。第70病日に偽膜性腸炎とCMV腸炎を同時合併し、メトロニダゾールおよびガンシクロビルにより症状改善を認めた。第105病日にirAE大腸炎を再燃したが軽症であり、メサラジンによる維持治療で半年経過している。

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J04450&link_issn=&doc_id=20201225120035&doc_link_id=130007966563&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007966563&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

当院で入院加療された急性下部消化管出血364例のうち急性出血性直腸潰瘍(AHRU)38例の臨床的特徴について検討した。男性20例、女性18例、平均年齢77歳。Performance Status(PS)は3-4が61%。併存疾患として高血圧、糖尿病、悪性腫瘍を多く認めた。患者背景についてAHRU 38例、非AHRU 326例の2群にわけて単変量解析をしたところ、PS≧3以上の症例がAHRU群で有意に多かった。AHRU全38症例に対して大腸内視鏡検査が施行され、52.6%は内視鏡処置が施行され、44.7%は保存加療で経過観察となっていた。初回内視鏡止血処置の割合は、クリップ止血術のみが11例、凝固止血7例、クリップ+凝固止血術1例、クリップ+HSE1例であった。再出血は29%で認められ、再出血11例と非再出血27例について単変量解析を用いて比較検討したが、有意差はなかった。AHRU 38例のうち入院中に死亡した例は24%で、原疾患や併存疾患などの増悪が主な死因であった。死亡例9例と非死亡例29例について単変量解析による比較検討では有意差はなかった。AHRUを認める例では、非AHRUの例と比較してPS3以上の例が有意に多かったが、ADLの低い重症例が多いことが原因と考えられる。基礎疾患や併存疾患の増悪で死亡する例も多く、内視鏡処置だけでなく、全身状態の把握と偶発症の管理が大事と言える。(著者抄録)

researchmap

その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J04450&link_issn=&doc_id=20201225120004&doc_link_id=130007966569&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007966569&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Three-dimensional (3D) visualization offers better depth recognition than two-dimensional (2D) imaging, thus helping to provide more useful information. We compared 3D and 2D endoscopy with regard to endoscopic recognition and endoscopic submucosal dissection (ESD) marking for superficial gastric neoplasia. METHODS: ESD marking was performed on half of a neoplasia margin under 2D observation and the on other half under 3D observation for 28 gastric lesions (26 early gastric cancers and 2 adenomas). The accuracy of ESD marking was evaluated based on the distance between the pathological and endoscopic neoplasia margins measured on histology sections of ESD specimens. The technical ease of ESD marking and endoscopic lesion recognition (lesion morphology, lesion extent, and comprehensive endoscopic cognition) were assessed using visual analog scale (VAS) questionnaires. RESULTS: The mean distance between the pathological and endoscopic margins under 3D observation (1.03 ± 0.80 mm) was significantly (p = 0.002) shorter than that under 2D observation (1.94 ± 1.96 mm). The VAS for technical ease of ESD marking under 3D observation was significantly better (p < 0.01) than that under 2D observation. The VAS for all aspects of endoscopic recognition under 3D observation was significantly better (p < 0.01) than under 2D observation. CONCLUSIONS: 3D flexible endoscopy achieved more accurate endoscopic recognition and ESD marking for superficial gastric neoplasia than a 2D approach in a clinical setting of ESD.

DOI： 10.1007/s00464-020-08124-z

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：日本小腸学会  

researchmap

記述言語：日本語   出版者・発行元：日本小腸学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Proton pump inhibitor (PPI) therapy causes hypergastrinemia, which could promote the development and progression of neuroendocrine tumors (NETs). Concerns have been raised about the safety of long-term PPI use due to a possible increased risk of NETs. This study aimed to investigate the association between hypergastrinemia and the risk of NETs. Twenty outpatients presenting with serum gastrin levels greater than 400 pg/mL after long-term PPI treatment were registered in this study. Immunohistochemical analyses for chromogranin A (CgA), Ki67, gastrin and CCK/B gastrin receptor (CCKBR) were performed, and positive cell numbers were counted. There were no NET or gastric epithelial neoplasia cases observed among any of the 20 patients examined throughout the PPI treatment period. Histologically, ECL cell hyperplasia were shown in all patients. However, no relationship was found between serum gastrin levels and the number of CgA positive ECL cells. There was also no relationship between serum gastrin levels and the proportion of Ki67 positive cells or the density of CCKBR positive cells. The data indicate no relationship may exist between NETs and hypergastrinemia secondary to PPI treatment in patients having no, or mild, atrophic gastritis.

DOI： 10.1016/j.prp.2020.153113

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：日本消化器病学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(有)科学評論社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

掲載種別：研究論文（学術雑誌）  

© 2020, Springer Science+Business Media, LLC, part of Springer Nature. Background: Three-dimensional (3D) visualization offers better depth recognition than two-dimensional (2D) imaging, thus helping to provide more useful information. We compared 3D and 2D endoscopy with regard to endoscopic recognition and endoscopic submucosal dissection (ESD) marking for superficial gastric neoplasia. Methods: ESD marking was performed on half of a neoplasia margin under 2D observation and the on other half under 3D observation for 28 gastric lesions (26 early gastric cancers and 2 adenomas). The accuracy of ESD marking was evaluated based on the distance between the pathological and endoscopic neoplasia margins measured on histology sections of ESD specimens. The technical ease of ESD marking and endoscopic lesion recognition (lesion morphology, lesion extent, and comprehensive endoscopic cognition) were assessed using visual analog scale (VAS) questionnaires. Results: The mean distance between the pathological and endoscopic margins under 3D observation (1.03 ± 0.80 mm) was significantly (p = 0.002) shorter than that under 2D observation (1.94 ± 1.96 mm). The VAS for technical ease of ESD marking under 3D observation was significantly better (p < 0.01) than that under 2D observation. The VAS for all aspects of endoscopic recognition under 3D observation was significantly better (p < 0.01) than under 2D observation. Conclusions: 3D flexible endoscopy achieved more accurate endoscopic recognition and ESD marking for superficial gastric neoplasia than a 2D approach in a clinical setting of ESD.

DOI： 10.1007/s00464-020-08124-z

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background and study aims  Endoscopic full-thickness resection (EFTR) involves several technical issues that need to be addressed. We devised a novel technique termed third-space EFTR and investigated its feasibility and safety in animal models. Methods  Third-space EFTR was performed in three isolated porcine stomachs (ex vivo) and four live pigs (in vivo, 1-week survival). The technique involved a circumferential mucosal incision, submucosal tunnelling on the proximal side, endoscopic suturing of the surrounding mucosa, a circumferential seromuscular incision in the submucosal tunnel, transoral retrieval and entry site closure of the tunnel. The technical outcomes were investigated. Results  In the ex vivo study, the procedure was successfully completed with R0 resection. In the in vivo study, the procedure was completed in all pigs; however, R0 resection failed in one pig owing to snaring resection. All pigs survived without severe adverse events. Conclusions  Our findings indicate that third-space EFTR is feasible and safe. This technique may be useful as a minimally invasive endoscopic option for reliable treatment of small gastric submucosal tumours.

DOI： 10.1055/a-0858-2210

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1371/journal.pone.0205165

PubMed

researchmap

記述言語：日本語   出版者・発行元：日本小腸学会  

【目的】

Peutz-Jeghers症候群（PJS) は大きな有茎性ポリープを切除することが腸重積の予防に非常に有効である．ダブバルーン小腸内視鏡（DBE）でのクロスドクリップ法によるポリープ切除は，ポリープ数の増加，偶発症の減少が見込める．一方で大きなポリープは癌化することがあるため，ポリペクトミー後の検体回収が必要になる．さらにPJSは開腹歴の既往のためDBE挿入困難例で長時間の検査が多い為，安全で確実なDBE処置が求められる．

【方法】

2006年6月より2018年9月までに，DBEを施行したPJS12例，全検査37件を分析し，クロスドクリップ併用群と非併用群に分けて後ろ向きに比較し，当科におけるPJSの小腸ポリープ切除の特徴を遡及的に検討した．

【結果】

男性4例，女性８例．初回検査時の平均年齢は34.7(16-64) 歳，12例中開腹歴があったのは11例で，そのうち10例で癒着高度のため挿入困難であった．DBEによる小腸ポリープ切除施行例が10例（クロスドクリップ併用4例），2例は観察のみであった．全小腸が観察可能であったのは，13例中9例で，全小腸の平均挿入時間（検査時間）は122分（207分）であった．ポリープ切除10例中クロスドクリップ併用群4例の平均ポリープ処置数は17.5個，非併用群6例の平均ポリープ切除数3.5個であった．合併症に関しては，6例で高度の出血が見られたが，いずれもクロスドクリップ非併用群であった．

【結論】

PJSに対する内視鏡的ポリープ切除では，クロスドクリップを併用することで，より多くのポリープ処置が安全に可能であった．

DOI： 10.32264/shocho.2.0_38

CiNii Research

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

Background/Aims: We aimed to clarify whether cyclooxygenase- 2 (COX-2) and microsomal prostaglandin E synthase- 1 (mPGES-1) genotypes were associated with certain histological findings and endoscopical appearances based on Kyoto classification. Methods: We enrolled 285 Helicobacter pylori -infected gastritis patients. Genotypes of COX-2 1195, COX-2 1290, mPGES-1, interleukin-1 beta (IL-1 beta) 511 and tumour necrosis factor-alpha (TNF-alpha) 308 were analyzed. Genotyping was performed by polymerase chain reaction. Endoscopic appearances and histological assessment were determined by using Kyoto classification, operative link on gastritic intestinal metaplasia assessment and the updated Sydney system. Results: There was a significant (p = 0.027) relationship between the IL-1 beta 511 C-carrier and histological gastric inflammation in H. pylori -infected gastritis patients. There was a significant (p = 0.009) correlation between the COX-2 1195 G-carrier genotype and histological intestinal metaplasia in the gastric antrum of H. pylori -infected gastritis patients and gastric xanthoma (p = 0.027). The COX-2 1195 G-carrier genotype was also significantly (p = 0.038) associated with the score of endoscopic intestinal metaplasia based on Kyoto classification. The mPGES-1 genotype was significantly (p = 0.002) associated with endoscopic swelling of area. Conclusion: Our results suggest that in Japan, there exists a significant correlation between the COX-2 1195 Gcarrier genotype and intestinal metaplasia in histological and endoscopic findings based on Kyoto classification in H. pylori -infected gastric mucosa. (C) 2017 S. Karger AG, Basel

DOI： 10.1159/000479864

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

In this study, we evaluated the clinical utility of detecting KRAS mutations in circulating cell-free (ccf) DNA of metastatic colorectal cancer patients. We prospectively recruited 94 metastatic colorectal cancer patients. Circulating cell-free DNA was extracted from plasma samples and analyzed for the presence of seven KRAS point mutations. Using the Invader Plus assay with peptide nucleic acid clamping method and digital PCR, KRAS mutations were detected in the ccfDNA in 35 of 39 patients previously determined to have primary tumors containing KRAS mutations using the Luminex method, and in 5 of 55 patients with tumors containing wild-type KRAS. Curative resection was undertaken in 7 of 34 patients with primary and ccfDNA KRAS mutations, resulting in the disappearance of the mutation from the cell-free DNA in five of seven patients. Three of these patients had tumor recurrence and KRAS mutations in their ccfDNA reappeared. Epidermal growth factor receptor blockade was administered to 24 of the KRAS tumor wildtype patients. Of the 24 patients with wild-type KRAS in their primary tumors, three patients had KRAS mutations in their ccfDNA and did not respond to treatment with epidermal growth factor receptor (EGFR) blockade. We also detected a new KRAS mutation in five patients during chemotherapy with EGFR blockade, before disease progression was detectable with imaging. The detection of KRAS mutations in ccfDNA is an attractive approach for predicting both treatment response and acquired resistance to EGFR blockade, and for detecting disease recurrence.

DOI： 10.1111/cas.12959

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Goals:
The aim is to elucidate the efficacy and safety of double-balloon endoscopy (DBE) for small bowel capsule endoscopy (SBCE) retrieval from small bowel stricture and to follow the outcome of the stricture where the SBCE was entrapped.
Background:
The retention of SBCE is a serious adverse event and most retained capsules are retrieved by surgery. There is still no report analyzing the follow-up of patients with stricture after retrieval of entrapped SBCEs by DBE.
Methods:
This study was designed a retrospective cohort study. Subjects were 12 consecutive patients with small bowel stricture where retrieval of entrapped SBCE was attempted using DBE. Success rate of the SBCE retrieval by DBE, surgical rate of the small bowel stricture, adverse events of DBE, and outcomes in the follow-up period were evaluated.
Results:
Diagnoses were Crohn's disease, nonsteroidal anti-inflammatory drugs-induced enteropathy, ischemic enteritis, and carcinoma in 8, 2, 1, and 1 patients, respectively. SBCE was successfully retrieved in 11 of the 12 patients (92%). No adverse events were encountered in all endoscopic procedures such as retrieval of SBCEs and dilation of the strictures. Nine of the 12 patients (75%) did not undergo surgical treatment for the stricture where SBCE was entrapped through the follow-up period (mean, 1675 +/- 847 d).
Conclusions:
Retrieval of SBCEs using DBE was safe, had a high success rate, and was useful to evaluate the need for surgery. Seventy-five percent of patients with small bowel stricture where the SBCE was entrapped did not require surgery through approximately 5 years.

DOI： 10.1097/MCG.0000000000000335

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BIOMED CENTRAL LTD  

Background: The ErbB family consists of four proteins including (EGFR)/ErbB1, ErbB2, ErbB3, and ErbB4, and plays a crucial role in the promotion of multiple tumorigenic processes. In addition to the traditional pathways of EGFR signaling, EGFR translocates to the nucleus and acts as a transcription factor in the proliferation of cancer cells. Heregulin is known as both an ErbB3 and an ErbB4 ligand. This study aimed to investigate the expression of heregulin and its relevant EGFR family members as well as their phosphorylated forms in human colorectal cancer (CRC) tissues and to determine the relationship between their expression and clinicopathological factors including patient prognosis.
Methods: We analyzed the effects of exogenous heregulin on ErbB2, ErbB3 and ErbB4 phosphorylation in Caco-2, DLD-1, and HCT 116 colon cancer cell lines by western blot analysis. We examined 155 surgical resections from colorectomy patients. Cellular localization of ErbB1-4, their phosphorylated forms and heregulin protein was analyzed in CRC surgical resections by immunohistochemical analysis. Immunohistochemical results were compared with clinicopathological factors and patient prognosis.
Results: Phosphorylated ErbB2 (pErbB2) and phosphorylated ErbB3 (pErbB3) were detected in both nuclear and cytosolic fractions of Caco-2 and DLD-1 cells stimulated by exogenous heregulin. Whereas, phosphorylated ErbB4 (pErbB4) was detected only in cytosolic fractions of HCT 116 cells stimulated by exogenous heregulin. Phosphorylated EGFR (pEGFR) immunoreactivity was observed in the cytoplasm and nuclei of cancer cells, whereas the pattern of EGFR staining was membranous and cytoplasmic. Subcellular localization of pErbB2, cytoplasmic, membranous, or nuclear, varied among cases. pErbB3 immunoreactivity was exclusively observed in the nuclei of cancer cells. pErbB4 immunoreactivity was observed in the cell membrane of cancer cells. Statistically, heregulin immunoreactivity correlated with pErbB2 and pErbB4 expression. In multivariate analysis for disease free survival, lymph node status, pErbB3 and pErbB4 expression retained independent prognostic significance. In multivariate analysis for overall survival, lymph node status, pEGFR and pErbB4 retained independent prognostic significance.
Conclusions: ErbB2 and ErbB3 phosphorylated by heregulin localized in the nucleus of CRC cells. Phosphorylated ErbB1-4 and heregulin contribute to poorer patient prognosis in CRC. This heregulin-ErbB family member autocrine loop may be a candidate for targeted treatment of CRC.

DOI： 10.1186/1471-2407-14-863

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

Recently, a report showed that proton-pump inhibitors (PPI) exacerbate non-steroidal anti-inflammatory drug-induced small intestinal injury in the rat. In the present report of two human cases, small intestinal injuries were probably induced and/or exacerbated after PPI treatment. Case 1 was a 30-year-old healthy man in whom no small intestinal mucosal break was detected at baseline capsule endoscopy. After 2 weeks of omeprazole given 20 mg once daily, he was found to have two small intestinal mucosal breaks. Case 2 was a 40-year-old healthy man in whom six small intestinal mucosal breaks were detected at baseline capsule endoscopy. After 2 weeks of omeprazole given 20 mg once daily, 12 small intestinal mucosal breaks were detected. Follow-up capsule endoscopy carried out 3 weeks after stopping omeprazole in case 2 showed seven small intestinal mucosal breaks were detected, showing restitution of the small intestinal mucosal injury. These two cases were obtained from a pilot study evaluating the effect of single administration of PPI on small intestinal mucosa in humans. In the pilot study, six healthy male volunteers were given omeprazole 20 mg for a period of 2 weeks. Small intestinal injury was evaluated before and after PPI treatment using capsule endoscopy. In four subjects other than the two above-mentioned cases, no small intestinal mucosal breaks were found at both baseline and post-treatment capsule endoscopy. Considering the two cases with increased or newly detected small intestinal mucosal breaks, omeprazole may exacerbate/induce small intestinal injury.

DOI： 10.1111/den.12188

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER PHYSIOLOGICAL SOC  

Apurinic/apyrimidinic endonuclease-1 (APE-1) is a key enzyme responsible for DNA base excision repair and is also a multifunctional protein such as redox effector for several transcriptional factors. Our study was designed to investigate APE-1 expression and to study its interaction with cyclo-oxygenase (COX)-2 expression and VEGF production in the esophageal cancer. The expression of APE-1, COX-2, monocyte chemoattractant protein (MCP)-1, CC-chemokine receptor (CCR) 2, and VEGF were evaluated by immunohistochemistry in 65 human esophageal squamous cell carcinoma (ESCC) tissues. Real-time PCR and Western blotting were performed to detect mRNA and protein expression of APE-1 and p-signal transducer and activator of transcription 3 (STAT3) expression in MCP-1-stimulated ESCC cell lines (KYSE 220 and EC-GI-10). siRNA for APE-1 was treated to determine the role of APE-1 in the regulation of COX-2 expression, VEGF production, and antiapoptotic effect against cisplatin. In human ESCC tissues, nuclear localization of APE-1 was observed in 92.3% (60/65) of all tissues. There was a significant relationship (P = 0.029, R = 0.49) between nuclear APE-1 and cytoplasmic COX-2 expression levels in the esophageal cancer tissues. In KYSE 220 and EC-GI-10 cells, MCP-1 stimulation significantly increased mRNA and protein expression of APE-1. Treatment with siRNA for APE-1 significantly inhibited p-STAT3 expression levels in MCP-1-stimulated cells. Furthermore, treatment of siRNA for APE-1 significantly reduced COX-2 expression and VEGF production in MCP-1-stimulated esophageal cancer cell lines. Treatment with APE-1 siRNA significantly increased apoptotic levels in cisplatin-incubated KYSE 220 and EC-GI-10 cells. We concluded that APE-1 is overexpressed and associated with COX-2 expression and VEGF production in esophageal cancer tissues.

DOI： 10.1152/ajpgi.00057.2013

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)先端医学社  

炎症性腸疾患(IBD)関連腫瘍の遺伝子異常、マイクロサテライト不安定性、遺伝子メチル化などに関する多くの報告がある。IBD関連大腸癌の癌化過程では、散発性大腸癌の発癌過程に密接に関与するAPC、K-ras、p53遺伝子異常の頻度やタイミングは異なる。p53免疫染色はその遺伝子自体の変異を反映しており、IBD関連大腸発癌過程の早期からp53過剰発現がみられるため、簡便で有用な早期病変検出法といえる。IBDの非腫瘍粘膜においても、高頻度にp16INK4a、p14ARF遺伝子のメチル化がみられることやIBD関連腫瘍非合併例にくらべ、腫瘍合併例における非腫瘍粘膜のエストロゲンレセプターのメチル化の頻度が高いことも示されており、IBD関連大腸発癌過程の早期病変の発見に役立つ可能性を示唆している。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3164/jcbn.12-95

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：HINDAWI PUBLISHING CORPORATION  

Unresectable colorectal carcinomas (CRCs) as considered incurable even if the primary tumors and the metastatic ones can undergo resection are correlated with poor prognosis. We evaluated the association between micropapillary pattern at the invasive front and unresectable CRCs. Thirty-four out of 264 (12.9%) CRC patients with stages III and IV were unresectable cases. The patients with unresectable CRCs had significantly worse survival than those with resectable CRCs (P &lt; 0.001). Micropapillary pattern was evident in 12 (4.5%) out of 264 cases. This pattern was observed in 6 of 34 (17.6%) unresectable CRCs and in 6 of 230 (2.6%) resectable cases (P = 0.002). Unresectable CRCs revealed more frequently deeper invasion (odds ratio (OR), 1.175; 95% confidence interval (CI), 1.113-1.241), lymph node metastasis (OR, 2.356; 95% CI, 1.132-4.905), and presence of micropapillary pattern at the invasive front (OR, 8.000; 95% CI, 2.415-26.504) as compared to resectable cases. By multivariable logistic regression analysis, only micropapillary pattern was shown to be an independent predictor of unresectable CRCs (OR, 9.451; 95% CI, 2.468-36.196; P &lt; 0.001). In conclusion, micropapillary pattern at the invasive front is associated with unresectable CRCs, and detection of it could help identify unresectable CRC cases.

DOI： 10.1155/2013/851623

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CHURCHILL LIVINGSTONE  

Background & aims: There are no data regarding basal folate levels in patients without colorectal adenoma. This study aimed to determine the minimum serum folate concentration that associates with reduced risk of colorectal adenoma.
Methods: 1510 consecutive patients underwent total colonoscopy for suspected colorectal lesions after barium enema examination. Prior to colonoscopy, history of alcohol consumption was noted and blood serum analyzed for folate and vitamin B12 levels. Polypoid lesions were evaluated histologically. We excluded patients with anemia, history of colonoscopy, overconsumption of alcohol, or malignancies. In all, 458/1510 patients (male/female; 258/200, 40-75 years) were determined eligible. Variables were compared between patients with adenoma and those without adenoma.
Results: Serum folate concentration was the variable with the most significant statistical variation between males with adenoma (8.0 ng/ml) and males without adenoma (9.2) (p = 0.001). Serum folate concentrations in females with adenoma did not differ significantly from those in females without adenoma (10.7 versus 10.9). When subjects were stratified into groups according to serum folate, we found no significant difference in the prevalence of adenoma in patients with folate levels greater than 8.0 ng/ml.
Conclusion: Patients with serum folate concentrations above 8.0 ng/ml had the lowest risk of developing colorectal adenoma. (C) 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

DOI： 10.1016/j.clnu.2011.04.007

Web of Science

PubMed

researchmap

記述言語：英語   出版者・発行元：MOSBY-ELSEVIER  

DOI： 10.1016/j.gie.2010.08.033

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：The Japanese Society of Internal Medicine  

原因不明消化管出血（OGIB）は，原因検索追求の程度・再発性の有無により多種の消化管病変を含む．本邦では上下部消化管内視鏡を施行して原因が不明な消化管出血をここに含むことができるが，出血源が上下部内視鏡で検索が困難な小腸に存在するとは限らない．小腸内視鏡の進歩により50％近いOGIBの出血源を発見・診断・治療可能になった．同時に非ステロイド性抗炎症薬服用OGIB患者の出血源が高率に小腸潰瘍性病変であることが明らかとなり対策が求められている．<br>

DOI： 10.2169/naika.100.50

CiNii Books

researchmap

その他リンク： https://jlc.jst.go.jp/DN/JALC/00362959565?from=CiNii

記述言語：日本語   出版者・発行元：(有)科学評論社  

著者らは75歳以上の切除不能胃癌20例(高齢者群)を対象にS-1ベース化学療法を施行し、治療成績を75歳未満の非高齢者群20例と比較検討した。化学療法のレジメンはS-1単独療法、S-1+低用量CDDP療法、S-1+CDDP療法のいずれが施行された。その結果、BSCとなった症例は高齢者群で7例(35%)、非高齢者群で2例(10%)であった。推定50%生存期間中央値は非高齢者群18例で11.3ヵ月、高齢者群13例で14.5ヵ月と有意差はなかった。grade 3/4の有害事象は非高齢者群では白血球減少、貧血が3例(16.5%)、好中球減少が2例(11%)、食欲不振、吐気、口内炎、疲労、皮疹がそれぞれ1例(5.5%)で、高齢者群では好中球減少と血小板減少が2例(15%)、白血球減少、貧血、Cre上昇、食欲不振、下痢がそれぞれ1例(7.5%)と、両群間で有意差はなく、いずれの群も治療関連死はなかった。尚、在宅期間率は、非高齢者群で60.4%、高齢者群で78.8%と有意差はみられなかった。

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER JAPAN KK  

Background A study reported that rebamipide was effective at reducing short-term nonsteroidal anti-inflammatory drug (NSAID)-induced enteropathy. The purpose of this study was to re-evaluate the effect of the co-administration of rebamipide on small intestinal injuries induced by short-term NSAID treatment.
Methods Eighty healthy male volunteers were randomly assigned to two study groups: a control group (N = 40), which received NSAID (diclofenac sodium, 75 mg/day) and omeprazole (20 mg/day) treatment along with a placebo; and a rebamipide group, which received NSAID, omeprazole and rebamipide (300 mg/day). Small intestinal injuries (mucosal breaks plus denuded areas) were evaluated by capsule endoscopy before and after 14 days of treatment.
Results A total of 38 control subjects and 34 rebamipide subjects completed the treatment and were evaluated by capsule endoscopy. NSAID therapy increased the mean number of mucosal injuries per subject from a basal level of 0.1 +/- 0.3 to 16 +/- 71 and 4.2 +/- 7.8 in the control and rebamipide groups, respectively, but the difference was not significant. The difference in the percentage of subjects with at least one mucosal injury post-treatment was also not significant (control 63%; rebamipide 47%). Limiting our analysis to subjects with mucosal injuries, rebamipide co-treatment had the tendency to reduce the mean number of mucosal injuries per subject from 25 in the control group to 8.9 in the rebamipide group (multiple comparisons test; p = 0.088, Mann-Whitney U test; p = 0.038).
Conclusions Rebamipide co-therapy had the potential to reduce the intensity of small intestinal injury induced by 2-week administration of diclofenac.

DOI： 10.1007/s00535-010-0332-3

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Japanese Journal of Cancer and Chemotherapy Publishers Inc.  

There are no specific symptoms of patients with carcinoma of the small intestine. Therefore, it is difficult to diagnose in the early stage by imaging modalities such as radiological enteroclysis, computed tomography, and classical endoscopy. However, double balloon endoscopy makes it possible to diagnose the carcinoma of the entire small bowel by taking tissue samples for pathological assessment. The characteristic of endoscopic findings is irregular ulcerated tumor with malignant stricture. It is still difficult to find carcinoma of small intestine in patients without symptoms and most cases are advanced when diagnosis is achieved. We should try to diagnose in early stage by combining images modalities, capsule endoscopy and double balloon endoscopy safely and efficiently, resulting in improving the patients' prognosis.

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本高齢消化器病学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

P&gt;Background
Nonsteroidal anti-inflammatory drugs (NSAIDs) induce small intestinal mucosal injuries. The concentrations of NSAIDs, bile acids and intestinal flora may differ in the proximal and distal parts of the small intestine. This study aimed to analyse types and distributions of NSAID-induced small intestinal injuries.
Subjects and methods
In total 55 healthy male volunteers were examined using baseline capsule endoscopy (CE). Subjects then undertook a 14-day regimen of NSAID medication (diclofenac sodium, 75 mg day-1) with proton-pump inhibitors (omeprazole 20 mg day-1) as gastroprotection. After 14 days, subjects underwent post-treatment CE and were assessed for three types of small intestinal injuries: denuded areas, erosions and ulcers. The proximal and distal parts of the small intestine were arbitrarily classified according to CE transit time from the duodenal bulb.
Results
Baseline CE revealed six mucosal lesions in 6 of 55 subjects (11%), consisting of three denuded areas and three erosions. Post-treatment CE identified 636 lesions in 32 of 53 subjects (60%); including 115 denuded areas in 16 subjects, 498 erosions in 22 subjects and 23 ulcers in 8 subjects. The distribution of small intestinal injuries differed according to type; denuded areas (90%: 103/115) were predominantly located in the proximal part, erosions throughout the small intestine and all ulcers in the distal part. The location of ulcers and denuded areas differed statistically (P &lt; 0 center dot 0001).
Conclusions
The impact of short-term NSAID medication on the small intestine differed according to intestinal site, with most denuded areas identified in the proximal part and all ulcers in the distal part.

DOI： 10.1111/j.1365-2362.2010.02290.x

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本高齢消化器病学会  

切除不能胃癌症例において、75歳以下のPS良好例に対してはS-1ベース化学療法が生存期間延長に有効であると報告されている。今回、我々は75歳以上の切除不能胃がん症例を対象にS-1ベース化学療法の有効性を検討した。75歳以上の患者12例と75歳未満の患者12例を対象としレトロスペクティブに解析した。S-1ベース化学療法の生存期間中央値は非高齢者(75歳未満)群で9.7ヵ月、高齢者(75歳以上)群で9.5ヵ月であった。各群の有害事象は容認できる範囲であった。75歳以上の切除不能胃癌症例であってもPS良好例ではS-1ベース化学療法は生存期間延長に有用である可能性が示唆された。(著者抄録)

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL PUBLISHING, INC  

Pyogenic granuloma is a lobular capillary hemangioma that occurs mostly on the skin, and occasionally on the mucosal surface of the oral cavity, but very rarely in the gastrointestinal tract. We report the case of a 63-year-old woman who suffered from palpitations, and iron deficiency anemia for 5 years. Esophagogastroduodenoscopy and colonoscopy could not reveal significant bleeding focus. She had not received medical treatment except for oral iron. Capsule endoscopy revealed a bleeding focus in the small intestine. Afterwards, we carried out double balloon endoscopy to treat the lesion. We found a subpedunculated polyp in the small intestine at 100 cm away from ileocecal valve by double balloon endoscopy and resected it endoscopically. The histological features of the polyp were consistent with pyogenic granuloma. Anemia had improved gradually without giving oral iron after polypectomy.

DOI： 10.1111/j.1443-1661.2009.00928.x

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

Capsule endoscopy and balloon endoscopy, advanced modalities that now allow for full investigation of the entire small intestine, have revealed that non-steroidal anti-inflammatory drugs (NSAIDs) can cause a variety of abnormalities in the small intestine. Traditional NSAIDs can induce small intestinal injuries in over 50% of patients. Several studies have shown that the preventive effect of proton pump inhibitors does not extend to the small intestine, suggesting that concomitant therapy may be required to prevent small intestinal side effects associated with traditional NSAIDs use. Recently, several randomized controlled trials used capsule endoscopy to evaluate the preventive effect of certain drugs on NSAID-induced small intestinal injuries. These studies show that misoprostol and rebamipide have a preventive effect for NSAID-induced small intestinal mucosal injuries. However, these studies included only a small series of healthy volunteers and tested short-term NSAID treatment. Therefore, further extensive studies are clearly required to ascertain the beneficial effect of these drugs. Copyright (C) 2010 S. Karger AG, Basel

DOI： 10.1159/000308361

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：GEORG THIEME VERLAG KG  

Background and study aims: Endoscopic submucosal dissection (ESD) may cause excessive duodenogastric reflux (DGR) in a similar manner to distal gastrectomy, particularly after antral resections. We aimed to examine the occurrence of DGR after ESD.
Patients and methods: Patients with gastric neoplasm for whom ESD was indicated were categorized according to lesion site: the antral group (lower [L] stomach, n=46) and the nonantral group (upper or middle [U or M] stomach, n=49). Endoscopy was performed before ESD, the day after ESD, and 3 months after ESI), and the fasting bile acid concentration (BAC) in the gastric juice was analyzed.
Results: BAC values showed significant interaction between time point and group, although this association differed in the antral and nonantral groups. BACs on the day after ESD were higher in the antral group than in the nonantral group, but not the pre-ESD and 3 months post-ESD levels. In the antral group only, fasting BACs increased significantly the day after ESD and decreased to baseline levels 3 months post-ESD. There was also a correlation between BAC and lesion location in the antral subgroups, with significantly higher BACs found the day after ESD in patients with lesser curvature lesions.
Conclusions: ESD of lesions in the antral lesser curvature may lead to a transient early increase in DGR. However, ESD does not result in long-term DGR, a factor that is known to increase the risk of carcinogenesis following gastrectomy.

DOI： 10.1055/s-0029-1215221

Web of Science

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY-ELSEVIER  

Background: There is no known preventive agent against nonsteroidal anti-inflammatory drug (NSAID) induced small-intestinal injury.
Objective: To evaluate by capsule endoscopy whether coadministration of prostaglandin (PG) can prevent small-intestinal damage induced by short-term NSAID treatment.
Design: Single-blind, randomized, controlled trial.
Setting: All procedures were performed at Nippon Medical School.
Subjects: Thirty-four healthy male Volunteers.
Methods: All subjects were randomly assigned to 2 groups: an NSAID-control group, who underwent NSAID (diclofenac sodium, 25 mg 3 times daily) and omeprazole (20 mg once daily) treatment, and an NSAID-PG group, who received PG (misoprostol, 200 mu g 3 times daily) in addition to the same NSAID-omeprazole treatment. Eligible Subjects, 15 per group, underwent capsule endoscopy before and 14 days after treatment.
Main Outcome Measurements: The number of mucosal breaks at capsule endoscopy.
Results: NSAID treatment significantly increased the mean (SD) number of mucosal breaks per subject, from a basal level of 0.1 +/- 0.3 up to 2.9 +/- 6.3 lesions in the NSAID-control group (P = .012). In contrast, there was no significant change in the mean number of mucosal breaks before and after PG cotreatment (P = 0.42). Thus, the mean number of posttreatment mucosal breaks per subject was significantly higher in the NSAID-control group than in the NSAID-PG group (P = .028). There was a significant increase in the percentage of subjects in the NSAID-control group, with at least I mucosal break after treatment (from 6.7% to 53.3%), whereas there was no change in the incidence of mucosal breaks in the NSAID-PG group, which remained at 13.3%. (P = .002).
Limitations: Single-center, open-label study.
Conclusions: PG cotherapy reduced the incidence of small-intestinal lesions induced by a 2-week administration of diclofenac sodium. (Gastrointest Endosc 2009;69:1339-46.)

DOI： 10.1016/j.gie.2008.08.017

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The aim of this study is to investigate the expression of three prostaglandin E synthase (PGES) isomers in colorectal cancer (CRC) tissue and to evaluate their relationship to clinicopathological factors and patient prognosis. Microsomal PGES (mPGES)-1, mPGES-2, cytosolic PGES (cPGES) and cyclooxygenase (COX)-2 protein expression were analyzed by real-time polymerase chain reaction and Western blot. The localization of each PGES and COX-2 protein was examined by immunohistochemistry in 155 surgical resections and correlated to clinicopathological factors and patient prognosis. mPGES-1 mRNA and protein levels were significantly higher in CRC than in paired normal tissues. mPGES-1 immunoreactivity localized in cancer cells in 43% of cases. mPGES-2 immunoreactivity was significantly more pronounced in cancer cells than in adjacent normal epithelium in 36% of cases. cPGES immunoreactivity was homogeneous in cancer cells and thus determined constitutive. mPGES-1 and mPGES-2 correlated with significantly worse prognosis in stage I-III patients. These results indicate that mPGES-1 and mPGES-2 may each play a role in CRC progression.

DOI： 10.1007/s00428-009-0777-z

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Objective: Studies suggest that synbiotic therapy could prove more effective in the treatment of ulcerative colitis (UC) than therapies limited to probiotics or prebiotics. This study compared the effect of each of these therapies in the treatment of UC.
Methods: One hundred twenty outpatients with UC were randomly sorted into three groups of 40 patients each for probiotic, prebiotic, or synbiotic therapy. The probiotic group ingested one daily capsule consisting of Bifidobacterium longum 2 X 10(9) colony-forming units and the prebiotic group ingested daily 8.0-g doses of psyllium. The synbiotic group underwent both treatments. All patients completed Inflammatory Bowel Disease Questionnaires (IBDQs) at the onset of the trial, at the 2-wk midpoint, and at the 4-wk end of the trial. Blood variables were also evaluated in a subset of 32 patients randomly selected from all groups and values were compared with IBDQ scores.
Results: Thirty-one patients in the probiotic group, 31 in the prebiotic group, and 32 in the synbiotic group qualified for analyses. The remaining 26 patients had incomplete questionnaires. Total IBDQ scores improved within groups by the end of the trial (probiotics 162 to 169, NS; prebiotics 174 to 182, NS; synbiotics 168 to 176, P = 0.03). Individual scores improved as follows: probiotics, emotional function (P = 0.03); prebiotics, bowel function (P = 0.04); and synbiotics, systemic and social functions (P = 0.008 and P = 0.02). C-reactive protein decreased significantly only with synbiotic therapy (from 0.59 to 0.14 mg/dL, P = 0.04). There were no adverse events.
Conclusion: Patients with UC on synbiotic therapy experienced greater quality-of-life changes than patients on probiotic or prebiotic treatment. These data suggest that synbiotic therapy may have a synergistic effect in the treatment of UC. (C) 2009 Published by Elsevier Inc.

DOI： 10.1016/j.nut.2008.11.017

Web of Science

researchmap

記述言語：日本語   出版者・発行元：Japan Gastroenterological Endoscopy Society Kanto Chapter  

ダブルバルーン内視鏡を用いてPeutz-Jeghers症候群の40mm大の有茎性小腸ポリープ2個を，茎を留置スネアで絞扼して放置した。4日後に絞扼したポリープの脱落を確認した。1年後にカプセル内視鏡を施行し，切除すべきポリープを指摘できなかった。茎を留置スネアで絞扼して放置する方法は組織回収が出来ないが，同時に多数のポリープが処置できるので多発ポリープに対して有効な治療法と考えられる。

DOI： 10.11641/pde.75.2_88

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2010068095

記述言語：日本語   出版者・発行元：The Medical Association of Nippon Medical School  

The capsule endoscope (CE) and the double-balloon endoscope (DBE), were developed to visualize the entire small intestine, have substantially altered diagnostic options in patients with small intestinal diseases. The CE provides clear, natural images of the entire small intestine and allows for the visualization of even minute lesions, such as solitary red spots and minor erosions. However, the major disadvantages of the CE are that it sometimes fails to reach the cecum, can become trapped in the intestine, and does not allow biopsy or treatment. The DBE can reach beyond the ligament of Treitz when inserted orally, and can reach beyond the ileocecal valve when inserted anally; therefore, real-time visualization of the entire small intestine is possible when the oral and anal approaches are combined. The DBE provides sharp endoscopic images, but its main advantage lies in its four-directional angle of operation and special instrument channel that allow both directed biopsies and treatments, such as the resection of polyps and the dilation of strictures. However, the major disadvantages of examination with the DBE when compared with the CE are that it requires sedation, often requires fluoroscopy, and cannot be performed without additional support staff. Therefore, the CE can be used to screen for small intestinal pathologies, and the DBE can be used for the optimal diagnosis and treatment of these diseases. Both the CE and DBE should be established as gold standards in the diagnosis and treatment of small intestinal lesions.<br>

DOI： 10.1272/manms.5.130

CiNii Books

researchmap

その他リンク： https://jlc.jst.go.jp/DN/JALC/00330853321?from=CiNii

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

Background/Aims: Heregulin (HRG/NRG) ligation to erbB3/4 promotes their respective heterodimerization with erbB2, and consequent erbB2 tyrosine phosphorylation. Although HRG has been shown to be expressed in a variety of cancer tissues, its expression and role in colon cancer have yet to be clarified. We therefore examined the link between the expression of these erbB receptors, and the relationship between HRG and vascular endothelial growth factor (VEGF) expression in colon cancer. Methods: We analyzed the effects of HRG on VEGF secretion in 6 colorectal cancer cell lines by enzyme-linked immunosorbent assay, and HRG-induced p85 subunit of phosphatidylinositol 3-kinase (p85 PI-3K), Akt, extracellular signal-regulated kinase 1/2 (ERK1/2), and p38 mitogen-activated protein kinase (p38 MAPK) activation in Caco-2 colon cancer cell lines by Western blot. We also examined HRG and VEGF mRNA expression in 16 colon cancer biopsy samples by real-time PCR. The localization of HRG and VEGF protein expression in colon cancer tissue was detected by immunohistochemistry. Results: Exogenous HRG stimulated VEGF secretion in all cell lines examined, and VEGF mRNA expression in Caco-2 cells. HRG also activated p85 PI-3K, Akt, ERK1/2, and p38 MAPK. VEGF secretion was inhibited by both specific p38 MAPK inhibitor and proteasome inhibitor that inhibit nuclear factor kappa B (NF-kappa B) activation. In colon cancer biopsy samples, HRG mRNA expression correlated with VEGF mRNA expression. HRG immunoreactivity was observed both in cancer cells and in mesenchymal cells in colon cancer tissues. Conclusion: These data suggest that HRG might affect colon cancer growth by regulating VEGF secretion via the erbB3 signaling pathway through autocrine and paracrine mechanisms. Copyright (C) 2009 S. Karger AG, Basel

DOI： 10.1159/000229775

Web of Science

researchmap

記述言語：日本語   出版者・発行元：The Medical Association of Nippon Medical School  

We report on a 70-year-old man with recurrent bloody bowel discharge. We detected angiectasia at the distal ileum at initial capsule endoscopy. The angioectasia was treated with double balloon endoscopy. After treatment, bloody bowel discharge recurred. At a second capsule endoscopy after treatment of the distal ileum with double balloon endoscopy, another angiectasia and a bleeding ulcer were detected on the proximal jejunum. The bleeding ulcer was re-treated with double balloon endoscopy. After re-treatment, bloody bowel discharge again recurred. At a third capsule endoscopy, active bleeding was detected at the proximal jejunum. We were then able to diagnose the angiectasia on the proximal jejunum detected at the second capsule endoscopy and to determine that it was the source of bleeding. The angiectasia was detected and was treated with double balloon endoscopy. After treatment, the bloody bowel discharge has not recurred. We should carefully treat patients with multiple angiectasias, because most angiectasias can be sources of bleeding.<br>

DOI： 10.1272/manms.5.221

CiNii Books

researchmap

その他リンク： https://jlc.jst.go.jp/DN/JALC/00340357659?from=CiNii

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Purpose: Prostaglandin E-2 is related to wound healing. Three different prostaglandin E synthases have been identified: microsomal prostaglandin E synthase (mPGES)-1, mPGES-2, and cytosolic prostaglandin E synthase. This study examined mPGES-1 expression in the cornea during the reparative process that occurs after an alkali burn.
Methods: mPGES-1 messenger RNA (mRNA) and protein expression levels were examined by reverse transcription-polymerase chain reaction and Western blot analysis. Localization of mPGES-1 mRNA was examined by in situ hybridization. Using immunostaining, the localization of mPGES-1, cyclooxygenase (COX)-2, and alpha-smooth muscle actin (alpha-SMA) protein was studied.
Results: Although mPGES-1 mRNA is expressed in normal cornea, after a corneal injury, a progressive increase of mPGES-1 mRNA occurs. In this study, 2-6 weeks after injury, mPGES-1 mRNA was detected in the stromal spindle cells. Western blot analysis also showed that mPGES-1 protein expression was observed in normal cornea, with an increase noted from 2 to 4 weeks after corneal injury. mPGES-1 immunoreactivity was negative in normal cornea; however, starting at 2 weeks after injury, positive staining of the stromal spindle cells was noted. Although COX-2 and alpha-SMA immunoreactivities were negative in the stroma of normal cornea, after injury, staining was observed in the stromal spindle cells.
Conclusions: alpha-SMA-positive cells and myofibroblasts express mPGES-1 mRNA and protein, and in addition, mPGES-1 colocalized with COX-2, suggesting that myofibroblasts synthesize prostaglandin E, and may act on and accelerate corneal wound healing.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY-ELSEVIER  

Background: Double-balloon endoscopy (DBE) is a new method that allows visualization, tissue sampling, and therapeutic intervention of pathologies throughout the small-intestinal tract.
Objective. In the present study, we evaluated the diagnostic yield of DBE and its impact on the final diagnosis, treatment, and clinical outcome of patients with obscure GI bleeding (OGIB).
Design and setting: A hospital-based cross-sectional, follow-up study.
Patients: We studied 108 consecutive patients (66 men and 42 women) referred to our hospital from July 2003 to February 2007 for the evaluation of OGIB: 13 patients with overt-ongoing bleeding, 76 with overt-previous bleeding, and 19 with occult OGIB.
Main Outcome Measurements: Diagnostic yield, a final diagnosis, treatment, and clinical outcome were all analyzed in each group.
Results: DBE diagnostic rates for patients with overt-ongoing, overt-previous, and occult bleeding were 100.0%, 48.4% ancl 42.1%, respectively. The difference in diagnostic yields between the overt-ongoing group and the 2 other groups was statistically significant (P &lt;.005). The most common sources of bleeding were ulcers and tumor lesions. Small-intestinal lesions were identified in 52 of 1.08 patients; of which 36 patients (69.2%) were biopsied and 49 patients (94.2%) received treatment. Eight patients (7.4%) had recurrent bleeding during the mean follow-up period of 28.5 months. Sensitivity, specificity, and positive and negative predictive values of DBE in the diagnoses of small-intestinal lesions in patients with OGIB were 92.7%, 96.4%, 98.1% ancl 87.1% respectively. No serious complications were encountered.
Conclusions: DBE was proven to be a very useful diagnostic tool and had a therapeutic impact in the majority of patients with OGIB. The best candidates for the procedure were patients with overt-ongoing bleeding.

DOI： 10.1016/j.gie.2008.03.1062

Web of Science

researchmap

記述言語：日本語   出版者・発行元：日本臨床社  

PubMed

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2008240510

記述言語：英語   出版者・発行元：MOSBY-ELSEVIER  

DOI： 10.1016/j.gie.2008.03.753

Web of Science

researchmap

記述言語：英語   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

記述言語：英語   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

記述言語：英語   出版者・発行元：MOSBY-ELSEVIER  

DOI： 10.1016/j.gie.2008.03.761

Web of Science

researchmap

記述言語：英語   出版者・発行元：MOSBY-ELSEVIER  

DOI： 10.1016/j.gie.2008.03.757

Web of Science

researchmap

記述言語：英語   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

記述言語：英語   出版者・発行元：MOSBY-ELSEVIER  

DOI： 10.1016/j.gie.2008.03.756

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER TOKYO  

Background. Recent studies have reported that expression of monocyte chemoattractant protein 1 (MCP-1) and its receptor (CCR2) and CD40 ligation on mesenchymal cells play important roles in tumor development. Cyclooxygenase 2 (COX-2) has also been shown to contribute to tumor angiogenesis. We examined the interaction between MCP-1 and CD40 ligation in mesenchymal cells in gastric cancer to determine the effect of these factors on vascular endothelial growth factor (VEGF) production via upregulation of COX-2 expression. Methods. COX-2, prostaglandin E(2) (PGE(2)), and VEGF production were evaluated in CD40 ligand (CD40L)-stimulated macrophages. CD40L and MCP-1 mRNA levels in gastric cancer tissues were evaluated by real-time polymerase chain reaction (PCR). Localizations of MCP-1, CD40L, CD34, CD40, and CCR2 in 34 gastric cancer tissue specimens were evaluated by single-or double-label immunohistochemistry. Results. COX-2 expression levels were significantly higher in CD40L-stimulated macrophages and correlated with increased PGE(2) and VEGF production. Addition of MCP-1 to CD40L-stimulated macrophages had a synergistic effect on COX-2 expression and subsequent PGE(2) and VEGF production. CD40L and MCP-1 mRNA levels were significantly higher in poorly differentiated gastric cancers than in H. pylori-infected gastritis patients. High microvessel density was significantly associated with MCP-1 and CCR2 scores and lymph node metastasis. Conclusions. MCP-1 and CD40L had a synergistic effect on COX-2 expression and subsequent VEGF production in gastric cancer.

DOI： 10.1007/s00535-007-2151-8

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CHURCHILL LIVINGSTONE  

Recent studies have reported that expression of MCP-1 and its receptor, CCR2; and CD40-CD40 ligand (CD40L) interaction on mesenchymal cells play important roles in tumor development. Studies have also connected MCP-1, CCR2, and CD40L to COX-2 expression. The aim of this study was to examine the effect of MCP-1/CCR2 and CD40-CD40L interaction on COX-2 and VEGF expression in endothelial cells. We also investigated the localization of these proteins in gastric cancer tissue. COX-2 and CCR2 levels were evaluated in CD40L-stimulated HUVECs by Western blot and real-time PCR. VEGF secreted in the culture media was quantified by EliSA. Localizations of MCP-1, CD40L, CD34, CD40 and CCR2 in 34 gastric cancer tissue specimens were evaluated by immunohistochemistry. CD40-CD40L interaction-induced COX-2 production and subsequently, upregulated COX-2 production contributed to elevated VEGF and CCR2 levels in CD40L-stimulated HUVECs. CD40L-stimulated VEGF production was COX-2 but not COX-1 dependent. RS-102895, a CCR2-specific antagonist, significantly reduced VEGF production in CD40L- and MCP-1-stimulated HUVECs. MCP-1 had a synergistic effect on COX-2, CCR2 and VEGF levels in Cd40L-stimulated HUVECs. In gastric cancer tissue, there was significant correlation between microvessel density and scores for CD40L, MCP-1 and CCR2 protein expression. Thus, MCP-1 had a synergistic effect on COX-2 and CCR2 protein expression in CD40L-stimulated HUVECs and thereby stimulated VEGF production in these cells. (c) 2007 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.plefa.2007.10.030

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：GEORG THIEME VERLAG KG  

Background and study aims: Several studies have shown the value of capsule endoscopy and double balloon endoscopy (DBE) in small-intestinal bleeding. The purpose of this study was to evaluate the impact of capsule endoscopy results on subsequent DBE examination, and the 1-year clinical outcome of this combined approach in patients with obscure gastrointestinal bleeding (OGIB).
Patients and methods: A total of 45 consecutive patients with OGIB underwent capsule endoscopy. Patients with positive capsule endoscopy results underwent DBE for biopsy or therapy, and those with negative results underwent further assessment for possible diagnostic misses on capsule endoscopy. Tumors, ulcerations, and vascular lesions were considered as sources of bleeding. Diagnoses of OGIB lesions and clinical outcome were assessed 1 year after these examinations.
Results: Responsible lesions were found in 22 patients (49%): 19 lesions in 18/45 patients (40%) undergoing capsule endoscopy, and 18/36 patients (50%) undergoing subsequent DBE. In all, 10 tumors, nine vascular lesions, and four ulcerations were found. In two patients, vascular lesions were only later diagnosed by conventional methods (4%). Capsule endoscopy results guided our choice of the proper DBE model for successful therapeutic intervention in five patients. Re-bleeding rates were low during 1-year follow-up of the entire group (mean follow-up, 18.8 months): 5 % in cases with positive diagnoses on capsule endoscopy and/or DBE, and 12 % in negative cases.
Conclusions: A combined approach using capsule endoscopy followed by DBE proves valuable in the diagnosis and treatment of patients with OGIB, leaves a low rate of undiagnosed bleeding sources, and has a good long-term outcome.

DOI： 10.1055/s-2007-967014

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Studies have linked microsomal prostaglandin E synthase (mPGES)-1 with gastric cancer. The purpose of this study was to determine mPGES-1, mPGES-2, and cytosolic PGES (cPGES) expression in gastric cancer and to evaluate the correlation between mPGES-1 and mPGES-2 expression and clinicopathological factors and cyclooxygenase-2 expression. PGES protein expression was examined by Western blot in gastric cancer cell lines and in biopsy samples from patients with gastric cancer. mPGES-1, mPGES-2, and cPGES protein localizations were examined immunohistochemically in 129 archival gastric cancer surgical resections. mPGES-1 protein expression was found in gastric cancer biopsies and cancer cell lines with differentiated or undifferentiated adenocarcinoma. There was no mPGES-1 expression in nonneoplastic biopsies. All cell lines and tissue samples expressed mPGES-2 and cPGES. Immunohistochemical analysis showed cancer cells expressed mPGES-1 in 47% of cases. mPGES-2 immunoreactivity was seen both in nonneoplastic glandular epithelium and cancer cells; however, cancer cell immunoreactivity was significantly more pronounced in 29% of cases. cPGES expression was constitutive both in nonneoplastic and neoplastic tissues, with no significant variation among cases. mPGES-1 and mPGES-2 expression correlated with cyclooxygenase-2 expression. mPGES-1 and mPGES-2 expression, and tumor-node-metastasis stage had independent prognostic significance under multivariate analysis in patients with gastric cancer overall and in patients with differentiated cancers. However, only tumor-node-metastasis stage and mPGES-2 expression retained independent prognostic significance in patients with poorly differentiated cancers. mPGES-1 and mPGES-2 correlate with clinicopathological factors and may be valuable prognostic factors in gastric cancer. (c) 2007 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.humpath.2007.04.020

Web of Science

PubMed

researchmap

記述言語：英語   出版者・発行元：BLACKWELL PUBLISHING  

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：MOSBY-ELSEVIER  

Background: The recent development of double balloon endoscopy (DBE) has revolutionized enteroscopy This system allows for endoscopic scrutiny and treatment of the entire small bowel, but general consensus has riot vet been reached regarding procedural guidelines.
Methods: We have been using the DBE system since June 2003, at Nippon Medical School Hospital, Tokyo, japan, where 163 patients have undergone 265 DBE examinations. This study presents a detailed analysis of the current status of DBE examination at our institution, with particular focus on indications, contraindications, sedation, choice of insertion route, complications, and relevant technical points.
Observations: The most common indication for DBE was obscure GI bleeding. Patients were placed under conscious or deep sedation and their vital signs were monitored throughout the examination. The choice of either an oral or anal insertion route was determined on the basis of clinical symptoms or any previous examination data. When analyzing the entire small bowel, we began via the anal route and marked the intestine with India ink at the furthest insertion point lying closest to the oral route. We then switched our approach to the oral route, and confirmed total enteroscopy when the enteroscope reached the India-ink mark. With regard to complications, we encountered I case of acute pancreatitis and 2 cases of aspiration pneumonia after examination.
Conclusions: The DBE system allows for full investigation of the pathology of the small intestine and timely, endoscopic treatment. However, for the DBE system to achieve more widespread acceptance, it is critical that we establish a universal method for its safe and efficient use.

DOI： 10.1016/j.gie.2007.01.026

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING  

Background: Clinical trials of probiotic treatment for Crohn's disease (CD) have yielded conflicting results. This study assessed the clinical usefulness of combined probiotic and prebiotic therapy in the treatment of active CD.
Method: Ten active CD outpatients without history of operation for CD were enrolled. Their mean (SD) age was 27 7 years and the main symptoms presented were diarrhea and abdominal pain. Patients' initial therapeutic regimen of aminosalicylates and prednisolone failed to achieve remission. Patients were thus initiated on a synbiotic therapy, consisting of both probiotics (75 billion colony forming units [CFU] daily) and prebiotics (psyllium 9.9 g daily). Probiotics mainly comprised B fidobacteriuln and Lactobacillus. Patients were free to adjust their intake of probiotics or prebiotics throughout the trial. Crohn's disease activity index (CDAI), International Organization for the Study of Inflammatory Bowel Disease (IOIBD) score and blood sample variables were evaluated and compared before and after the trial.
Results: The duration of the trial was 13.0 +/- 4.5 months. By the end of therapy, each patient had taken a 45 24 billion CFU daily probiotic dose, with six patients taking an additional 7.9 +/- 3.6 g daily psylliurn dose. Seven patients had improved clinical symptoms following combined probiotic and prebiotic therapy. Both CDAI and IOIBD scores were significantly reduced after therapy (255-136, P = 0.009; 3.5-2. 1, P = 0.03, respectively). Six patients had a complete response, one had a partial response, and three were non-responders. Two patients were able to discontinue their prednisolone therapy, while four patients decreased their intake. There were no adverse events.
Conclusion: High-dose probiotic and prebiotic cotherapy can be safely and effectively used for the treatment of active CD.

DOI： 10.1111/j.1440-1746.2006.04535.x

Web of Science

researchmap

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CARDEN JENNINGS PUBL CO LTD  

Pure white cell aplasia (PWCA) is a rare hematologic disorder characterized by agranulocytosis, a lack of virtually all neutrophil-lineage cells (from neutrophils to myeloblasts) in the bone marrow, and normal erythropoiesis and megakaryocytopoiesis. We report the first case of PWCA that developed in a patient with primary biliary cirrhosis (PBC). An 83-year-old woman, who had had an elevated serum alkaline phosphatase level and shown positivity for serum antimitochondrial antibodies for 10 years, was referred to us because of a perianal abscess. She had severe neutropenia, and her bone marrow showed typical findings of PWCA. Although methylprednisolone pulse therapy induced complete neutrophil recovery, this effect was transient. She died of infection, and the autopsy confirmed the diagnosis of PBC. In vitro investigations showed that factors inhibitory to normal CD34 cell-derived granulopoiesis were present in the patient's serum.

DOI： 10.1532/IJH97.06018

Web of Science

PubMed

researchmap

記述言語：日本語   出版者・発行元：The Medical Association of Nippon Medical School  

DOI： 10.1272/manms.3.164

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2008098346

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Editrice Kurtis s.r.l.  

Cases of acromegaly due to GHRH-producing pancreatic endocrine tumors have been reported. Here we present a case of a 31-yr-old non-acromegalic man with hyperparathyroidism and elevated serum IGF-I with normal serum GH levels. Serum GH was not suppressed below 1 ng/ml by the glucose tolerance test and increased in response to TRH and GHRH administration. Magnetic resonance imaging (MRI) revealed pituitary hyperplasia and an abdominal computed tomography (CT) scan showed a tumor in the pancreatic tail. Plasma concentration of GHRH was elevated. Based on these clinical data, multiple endocrine neoplasia (MEN) type 1 was suspected. Three enlarged parathyroid glands were removed and a distal pancreatectomy was performed. Pathological examination of the parathyroid glands and pancreatic tumor showed nodular hyperplasia and a well-differentiated endocrine tumor, respectively, both compatible with MEN features. Immunohistochemistry revealed positive immunoreactivity for GHRH, SS, insulin, glucagon, chromogranin A, and pancreatic polypeptide in the pancreatic tumor. After pancreatic surgery, elevated levels of GHRH and IGF-I were normalized and pituitary hyperplasia definitely decreased in size. In cases of pituitary hyperplasia with elevated IGF-I, ectopic GHRH syndrome must be considered even if physical features of acromegaly are absent. It is also important to measure plasma GHRH concentrations in order to give a diagnosis. © 2007, Editrice Kurtis.

DOI： 10.1007/BF03346321

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(株)南江堂  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Elevated expression of cyclooxygenase-2 has been found in colorectal cancer. One of the mechanisms through which cyclooxygenase-2 affects tumorigenesis is through its overexpression, which leads to increased invasiveness of cancer cells. A crucial step in this pathway is thought to be the induction of membrane-type-1 matrix metalloproteinase, which activates matrix metalloproteinase-2. However, to date there have been few clinicopathologic studies concerning cyclooxygenase-2-mediated invasiveness in human colorectal cancer tissues. METHODS: We performed immunohistochemical analysis of the respective antigens on colorectal cancer specimens obtained by surgical resections from 96 patients with colorectal cancer. RESULTS: Cyclooxygenase-2 and membrane-type-1 matrix metalloproteinase expression was positive exclusively in cancer cells in 88 cases (92 percent) and 23 cases (24 percent), respectively. All 23 cases expressing membrane-type-1 matrix metalloproteinase also expressed cyclooxygenase-2. Matrix metalloproteinase-2 expression was positive in cancer cells in 20 cases (21 percent) and stromal cells in 52 cases (54 percent). Expression of matrix metalloproteinase-2 in cancer cells correlated with lymphatic invasion and local recurrence. Statistically, a significant correlation was found between cyclooxygenase-2 and membrane-type-1 matrix metalloproteinase expression, and membrane-type-1 matrix metalloproteinase and matrix metalloproteinase-2 expression in cancer cells. There was no association between cyclooxygenase-2 expression and matrix metalloproteinase-2 expression. However, immunostaining of serial sections revealed that in the majority of cases examined, nearly 100 percent of cancer cells expressing matrix metalloproteinase-2 also coexpressed cyclooxygenase-2. CONCLUSIONS: This study indicates strong association between both cyclooxygenase-2 and membrane-type-1 matrix metalloproteinase expression, and membrane-type-1 matrix metalloproteinase and matrix metalloproteinase-2 in colorectal cancer. These results support our thesis of a direct correlation between cyclooxygenase-2 and membrane-type-1 matrix metalloproteinase expression--with consequent association between cyclooxygenase-2 and matrix metalloproteinase-2 activation, and tumor invasiveness andrecurrence in certain cases of colorectal cancer.

DOI： 10.1007/s10350-006-0588-0

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER PHYSIOLOGICAL SOC  

We have previously shown heregulin (HRG)-alpha expression in human gastric fibroblasts and its stimulation of gastric epithelial cell growth. Although cyclooxygenase (COX)-2 has also been shown to stimulate growth factor production in these cells, the interaction between COX-2 and HRG remains unknown. Conditioned media (CM) from gastric fibroblasts incubated with PGE(2) or interleukin (IL)-1 beta, a well known COX-2 inducer, were analyzed for their effect on erbB3 tyrosine phosphorylation in MKN28 gastric epithelial cells. HRG protein expression in fibroblast lysates and CM was also examined by western blot. HRG-alpha and HRG-beta mRNA expression in gastric fibroblasts and human gastric tissue was examined by real-time quantitative PCR. HRG and COX-2 expressions in surgical resections of human gastric ulcer tissue were examined immunohistochemically. CM from fibroblasts incubated with PGE(2), or IL-1 beta, stimulated erbB3 phosphorylation in MKN28 cells. Preincubation of the fibroblasts with celecoxib, a selective COX-2 inhibitor, suppressed CM-induced erbB3 phosphorylation. This inhibition was reversed by exogenous PGE(2). As with erbB3 phophorylation, IL-1 beta stimulated both HRG-alpha and HRG-alpha mRNA expression, as well as HRG release into gastric fibroblast CM. IL-1 beta-stimulated HRG expression and release were also inhibited by celecoxib, and exogenous PGE(2) restored this inhibitory effect, suggesting the activation of an IL-1 beta-COX-2-PGE(2) pathway that culminates in the release of HRG from fibroblasts. HRG-alpha and HRG-beta mRNA levels were significantly higher in gastric ulcer tissue than in normal gastric mucosa. HRG immunoreactivity was found in interstitial cells of the gastric ulcer bed and coexpressed with COX-2. These results suggest that HRG might be a new member of the growth factor family involved in the COX-2-dependent ulcer repair process.

DOI： 10.1152/ajpgi.00253.2005

Web of Science

PubMed

researchmap

記述言語：英語   出版者・発行元：BLACKWELL PUBLISHING  

DOI： 10.1111/j.1440-1746.2006.04120.x

Web of Science

PubMed

researchmap

記述言語：英語   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：B M J PUBLISHING GROUP  

Background and aims: Cyclooxygenase 2 (COX-2) expression in subepithelial macrophages of colorectal adenoma has been suggested as the first in a series of steps leading to colorectal tumorigenesis. We tested the hypothesis that chemokines released from human colorectal adenoma epithelium might be involved in COX-2 expression in macrophages of the lamina propria.
Methods: Endoscopic samples of sporadic colorectal adenomas were tested by enzyme linked immunosorbent assay for chemokines involved in macrophage chemotaxis. Localisation of adenoma macrophage chemoattractant protein 1 (MCP-1) and COX-2 were determined by immunohistochemistry. The effects of MCP-1, in the presence or absence of celecoxib, on COX-2 expression, and prostaglandin (PG) E-2 and vascular endothelial growth factor (VEGF) release, were examined in human macrophages isolated from peripheral blood.
Results: MCP-1 levels were markedly higher in adenoma with mild-moderate dysplasia (129.7 ( 19.9) pg/ mg protein) and severe dysplasia (227.9 (35.4) pg/ mg protein) than in normal colonic mucosa (55.8 (4.2)pg/mg protein). Other chemokine levels, macrophage inflammatory proteins (MIP)-1 alpha and MIP-1 beta, and the chemokine regulated on activation of normal T cell expressed and secreted (RANTES) did not vary significantly between adenoma and normal mucosa. MCP-1 levels in both adenoma and normal colonic mucosa increased significantly three hours after tissue cultivation in vitro. MCP- 1 immunoreactivity was restricted to the adenoma epithelium, with no reactivity seen in adjacent normal epithelial cells. MCP- 1 stimulated COX-2 expression and PGE(2) and VEGF release in human macrophages. Celecoxib, a selective COX-(2) inhibitor, inhibited MCP-1- induced PGE(2) and VEGF release in macrophages. Addition of exogenous PGE(2) reversed this inhibitory effect on VEGF release, suggesting that MCP- 1 in adenoma epithelial cells might be involved in COX-2 expression and subsequent macrophage activation.
Conclusions: MCP-1 in colorectal adenoma epithelial cells might be involved in macrophage migration and COX-2 expression, leading to the subsequent development of colonic adenoma.

DOI： 10.1136/gut.2004.059824

Web of Science

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：KARGER  

Background/Aim: The aim of this study was to see whether administration of celecoxib, a selective COX-2 inhibitor, prior to the appearance of intestinal metaplasia could prevent the development of gastric cancer in Helicobacter pylori-infected Mongolian gerbils. Methods: Fifty-two Mongolian gerbils were divided into 3 groups and given 5 biweekly doses of N-methyl-N-nitrosourea (MNU; 30 ppm). At week 12, group 2 (n = 20) and group 3 ( n = 22) gerbils were then given an injection of H. pylori, while group 1 controls ( n = 10) received Brucella broth alone. In addition, 7 weeks after H. pylori inoculation, at week 19, group 3 gerbils also received a 36-week administration course of celecoxib ( 1,500 ppm) in their diet. The incidence of gastric adenocarcinoma was determined at week 54 by histological analysis. COX-2 and Cdx2 protein expression and COX activity were evaluated for each group. The extent of intestinal metaplasia, Cdx2 and MUC2 expression, and the apoptotic index were evaluated semi-quantitatively by immunohistochemistry. Results: The incidence of gastric adenocarcinoma was: group 1, 0% (0/10); group 2, 65% (13/20), and group 3, 23% (5/22; p &lt; 0.05). Continuous celecoxib administration significantly reduced COX activity and COX-2 protein expression, Cdx2 and MUC2 protein immunoreactivity, and the extent of Alcian blue periodic acid-Schiff-positive intestinal metaplasia in H. pylori-infected gerbils. Celecoxib also induced apoptosis in these gerbils. Significant inhibition of Cdx2 expression in group 3 gerbils was also shown by Western blot analysis. Conclusions: Prior to the first appearance of intestinal metaplasia, timely administration of celecoxib prevents gastric cancer occurrence by disrupting the progression of intestinal metaplasia into gastric carcinoma through its inhibition of Cdx2 expression in MNU-pretreated H. pylori-infected Mongolian gerbils. Copyright (c) 2006 S. Karger AG, Basel.

DOI： 10.1159/000100503

Web of Science

PubMed

researchmap

記述言語：英語   出版者・発行元：The Medical Association of Nippon Medical School  

DOI： 10.1272/jnms.73.38

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER TOKYO  

Background. Recent reports suggest that Helicobacter pylori infection can potentially increase the risk of colorectal cancer. The purpose of this study was to assess the association between H. pylori infection and the risk of colorectal adenoma and adenocarcinoma, and to evaluate any differences on the basis of sex. Methods. The subjects were 669 (40- to 80-year-old) patients who underwent both barium enema examination and total colonoscopy, and who were evaluated for H. pylori infection by C-13-urea breath test, urease test, or histological diagnosis of biopsied gastric specimens. There were 142 H. pylori-negative and 527-positive patients. The odds ratios (ORs) for H. pylori-positive patients with colorectal adenoma and adenocarcinoma, and for tumor patients with either adenoma or adenocarcinoma were calculated. Results. Among the H. pylori-negative patients, there were 52 patients without tumor, 63 with adenoma, 27 with adenocarcinoma, and 90 with tumor. Among the H. pylori-positive patients, there were 136, 264, 127, and 391 patients respectively. Pooling all subjects, those infected with H. pylori had a significantly increased OR for adenoma, adenocarcinoma, or tumor, compared to H. pylori-free patients (OR, 1.60, 1.80, and 1.66, respectively). For female H. pylori-positive subjects, the risk of having adenocarcinoma or tumor was significantly higher than that for their H. pylori-free counterparts, while for male H. pylori-positive and -negative subjects, there was no such significant difference. Conclusions. The results therefore suggest that, in patients aged 40-80 years, H. pylori infection increased the risk of colorectal adenoma and adenocarcinoma, with significantly higher risks for female patients.

DOI： 10.1007/s00535-005-1649-1

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective. Neutrophil activation followed by free radical production is a feature that is common to the various forms of gastric injury. However, the roles of cyclooxygenase (COX)-1 and -2 in neutrophil activation have yet to be clarified in the gastric mucosa. We examined the roles of both COX-1 and COX-2 in neutrophil activation and free radical production in ischemia-reperfusion (IR) injury in the gastric mucosa of mice. Material and methods. Ischemia was induced by clamping the celiac artery for 30 min, then removing the clamp for 90 min. SC-560, a selective COX-1 inhibitor
NS-398, a selective COX-2 inhibitor
or rebamipide, a mucoprotective agent, was administered to mice 60 min before ischemia. Gastric damage was evaluated histologically and by measuring myeloperoxidase (MPO) activity. Expressions of COX protein and intercellular adhesion molecule (ICAM)-1 were evaluated by Western blot analysis and ELISA, respectively. Effects of these drugs on thiobarbituric acid reactive substances (TEARS) and gastric blood flow were also evaluated. Results. COX-2 expression was induced in gastric mucosa 60 min after reperfusion, whereas COX-1 expression remained unaltered. Localization of COX-1 and ICAM-1 in IR-injured mucosa was observed mainly in endothelial cells, while COX-2 expression was detected in mesenchymal cells such as mononuclear cells, spindle-like cells and endothelial cells. SC-560 significantly decreased gastric blood flow at the reperfusion point and reduced gastric mucosal injury in IR mice. Furthermore, SC-560 pretreatment significantly reduced MPO activity, TBARS levels and ICAM-1 expression. In contrast, NS-398 significantly increased ICAM-1 expression, MPO activity and TEARS levels, and aggravated gastric damage in IR mice. Rebamipide pretreatment reduced both COX-2 expression and IR injury. Conclusions. In IR mice, COX-2 protects the gastric mucosa by down-regulating ICAM-1 expression, whereas COX-1 is involved in up-regulating reperfusion flow, thereby aggravating the mucosa. © 2005 Taylor &amp
Francis.

DOI： 10.1080/00365520510015827

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: There is a lack of evidence for the efficacy of preventive medications for peptic ulcers (PUs) among long-term users of non-steroidal anti-inflammatory drugs (NSAIDs) in Japan. Aim: To estimate the preventive effect by normal dose, not high-dose histamine-H2 receptor antagonists (H2RA) for NSAID-induced ulcers. Methods: We designed two different studies to assess the efficacy of anti-ulcer agents in rheumatoid arthritis (RA) in patients treated over a long term with NSAIDs. An investigative survey divided patients into those not taking anti-ulcer agents (non-medication group)
those taking mucosal protective agents (mucosal protectant group), H2RA (H2RA group), proton pump inhibitors (PPI group), or a prostaglandin E1 analog (PG) (PG group). The second study compared prospectively the preventive effects of either famotidine 20 mg bd (famotidine group) or lansoprazole 15 mg daily (lansoprazole group) in patients with PU scars. Results: The prevalence of PU in the H2RA group was significantly lower compared to the mucosal protectant group (P &lt
0.05), and the mucosal protectant group was not significantly different to the non-medication group. The prospective study revealed that the PU onset rate of the famotidine group was 8% (1/13), and lansoprazole group was 15% (2/13), indicating no significant differences between the two. Conclusions: In Japan, normal-dose H2RA is expected to be a new PU preventive treatment strategy in patients requiring long-term NSADD therapy. © 2005 Blackwell Publishing Ltd.

Scopus

PubMed

researchmap

DOI： 10.1111/j.1365-2036.2005.02477.x

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background.: Helicobacter pylori eradication decreases recurrence of peptic ulcers with marked improvement in histological inflammation, but gastric mucosal injuries may be developed even after eradication. Purpose.: To investigate the mechanisms responsible for the development of gastric erosions after eradication, we analysed the relationship between clinicopathological risk factors and the occurrence of gastric erosion after curing H. pylori infection. Patients.: Sixty patients underwent endoscopy before, and 3, 6 and 12 months after the completion of H. pylori eradication. Methods.: Risk factors associated with the development of gastric erosions after eradication were assessed by multivariate analysis, and cyclooxygenase-1 and -2 immunoreactivity was histologically examined in the gastric mucosa before and after eradication. Results.: The cumulative prevalence of gastric erosions after H. pylori eradication was 38.3% within 1 year. Using multivariate analysis, corpus gastritis scores (inflammation score + activity score), corpus atrophy scores and an age of more than 50 years were found to be independent factors associated with the development of gastric erosion after eradication with odds ratios of 7.39, 0.13 and 5.00, respectively. Cyclooxygenase-2 immunoreactivity of the corpus was decreased for the non-erosion group after eradication, but not for the erosion group. Conclusions.: Severe gastritis or less severe atrophy in oxyntic glands but not in pyloric glands before eradication may be involved in the development of gastric erosions after curing H. pylori infection. © 2005 Editrice Gastroenterologica Italiana S.r.l.

DOI： 10.1016/j.dld.2004.12.012

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We examined the effect of oxidized low-density lipoprotein (oxLDL) on the insulin secretion in the culture of HIT-T15 cell line, an islet beta-cell line derived from a hamster pancreatic tumor. In order to check the uptake of modified LDL by HIT-T15 cells, we prepared DiI-labeled native LDL (nLDL), acetylated LDL (AcLDL), and oxLDL. After the addition of each LDL into the cultures of HIT-T15 cells, fluorescence microscopic study was done. It was suggested that AcLDL and oxLDL were taken up by HIT-T15 cells, as well as nLDL. mRNA expression of the LDL receptor, CD36, and SR-B1 was detected in HIT-T15 by RT-PCR. The medium insulin level was measured in the culture of HIT-T15 cells with each LDL. oxLDL significantly reduced the insulin secretion stimulated by various concentrations of glucose, the intracellular content of insulin, and the expression of preproinsulin mRNA compared to the control cultures without LDL addition. In contrast, nLDL and AcLDL had no effect on the insulin secretion, the intracellular insulin level, or the expression of preproinsulin mRNA. MTT assay findings (reflecting cell numbers) were not different between cultures with and without LDLs. These results indicated that oxLDL disturbed the insulin metabolism of HIT-T15 cells.

DOI： 10.1016/j.bbalip.2004.11.018

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier  

We examined the effect of oxidized low-density lipoprotein (oxLDL) on the insulin secretion in the culture of HIT-T15 cell line, an islet β-cell line derived from a hamster pancreatic tumor. In order to check the uptake of modified LDL by HIT-T15 cells, we prepared DiI-labeled native LDL (nLDL), acetylated LDL (AcLDL), and oxLDL. After the addition of each LDL into the cultures of HIT-T15 cells, fluorescence microscopic study was done. It was suggested that AcLDL and oxLDL were taken up by HIT-T15 cells, as well as nLDL. mRNA expression of the LDL receptor, CD36, and SR-B1 was detected in HIT-T15 by RT-PCR. The medium insulin level was measured in the culture of HIT-T15 cells with each LDL. oxLDL significantly reduced the insulin secretion stimulated by various concentrations of glucose, the intracellular content of insulin, and the expression of preproinsulin mRNA compared to the control cultures without LDL addition. In contrast, nLDL and AcLDL had no effect on the insulin secretion, the intracellular insulin level, or the expression of preproinsulin mRNA. MTT assay findings (reflecting cell numbers) were not different between cultures with and without LDLs. These results indicated that oxLDL disturbed the insulin metabolism of HIT-T15 cells. © 2004 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.bbalip.2004.11.018

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

We have previously shown that the cyclooxygenase (COX)-2/PGE2 pathway plays a key role in VEGF production in gastric fibroblasts. Recent studies have identified three PGE synthase (PGES) isozymes: cytosolic PGES (cPGES) and microsomal PGES (mPGES)-1 and -2, but little is known regarding the expression and roles of these enzymes in gastric fibroblasts. Thus we examined IL-1β-stimulated mPGES-1 and cPGES mRNA and protein expression in gastric fibroblasts by quantitative PCR and Western blot analysis, respectively, and studied both their relationship to COX-1 and -2 and their roles in PGE2 and VEGF production in vitro. IL-1β stimulated increases in both COX-2 and mPGES-1 mRNA and protein expression levels. However, COX-2 mRNA and protein expression were more rapidly induced than mPGES-1 mRNA and protein expression. Furthermore, MK-886, a nonselective mPGES-1 inhibitor, failed to inhibit IL-1β-induced PGE2 release at the 8-h time point, while totally inhibiting PGE2 at the later stage. However, MK-886 did inhibit IL-1β-stimulated PGES activity in vitro by 86.8%. N-(2-cyclohexyloxy-4-nitrophenyl)-methanesulfonamide (NS-398), a selective COX-2 inhibitor, totally inhibited PGE2 production at both the 8-h and 24-h time points, suggesting that COX-2-dependent PGE2 generation does not depend on mPGES-1 activity at the early stage. In contrast, NS-398 did not inhibit VEGF production at 8 h, and only partially at 24 h, whereas MK-886 totally inhibited VEGF production at each time point. These results suggest that IL-1β-induced mPGES-1 protein expression preferentially coupled with COX-2 protein at late stages of PGE2 production and that IL-1β-stimulated VEGF production was totally dependent on membrane-associated proteins involved in eicosanoid and glutathione metabolism (MAPEG) superfamily proteins, which includes mPGES-1, but was partially dependent on the COX-2/PGE2 pathway.

DOI： 10.1152/ajpgi.00313.2004

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Recently, three different prostaglandin E2 synthases have been identified: microsomal prostaglandin E synthase (mPGES)-1, cytosolic PGES (cPGES), and mPGES-2
however, their role and connection to cyclooxygenase (COX)-2 in the gastric ulcer repair process remain unknown. Therefore, we examined mPGES-1, cPGES, and mPGES-2 expression and localization in the stomach in vitro and in vivo. Tissues were obtained from Helicobacter pylori (H. pylori)-infected patients and consisted of surgical resections of gastric ulcers, or biopsies of gastric ulcers or gastritis. mPGES-1 mRNA and protein expression levels were examined by real-time polymerase chain reaction (PCR) and Western blot analysis, respectively. mPGES-1, cPGES, and mPGES-2 localization were analyzed immunohistochemically. Induction of PGES expression in response to interleukin (IL)-1β was examined in vitro in the cultured human gastric fibroblast line Hs262.St. Real-time PCR analysis of mPGES-1 mRNA expression in biopsy samples showed significantly higher expression levels in open than in closed gastric ulcer tissue. Western blot analysis showed mPGES-1 protein expression limited to open ulcer tissue, while mPGES-2 and cPGES immunoreactivities were seen in both open and closed ulcer tissue. Immunohistochemical analysis showed strong mPGES-1 expression in fibroblasts and macrophages of the ulcer bed, paralleling COX-2 expression. cPGES and mPGES-2 expression levels were seen in both fibroblasts of the ulcer bed and in epithelial cells. Furthermore, stronger cPGES and mPGES-2 immunoreactivities were seen in scattered mast cell-like cells and neuroendocrine-like cells, respectively. Induction of mPGES-1 expression in response to IL-1β was seen in cultured gastric fibroblasts in vitro, and double immunostaining showed mPGES-1 coexpression with COX-2 in fibroblasts of the ulcer bed in vivo. In conclusion, mPGES-1, cPGES, and mPGES-2 are all expressed in gastric ulcer tissue, but only mPGES-1 parallels COX-2 expression in mesenchymal and inflammatory cells of the ulcer bed, suggesting a key role for this enzyme in the ulcer repair process.

DOI： 10.1038/labinvest.3700200

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: One of the counter-effects of Helicobacter pylori eradication therapy is subsequent obesity. Ghrelin is a recently discovered growth hormone releasing peptide. This endogenous secretagogue increases appetite and facilitates fat storage. The majority of circulating ghrelin is produced in the gastric mucosa. Therefore, we aimed at investigating changes in ghrelin immunoreactivity in gastric mucosa tissues of patients infected with H. pylori. METHODS: Sixty-one patients with H. pylori infection (25 cases each of duodenal and gastric ulcer, and 11 cases of gastritis) and 22 healthy controls without H. pylori infection were included in the study. H. pylori-infected patients received standard proton pump-based triple therapy followed by histological examination and 13C-urea breath test to confirm H. pylori eradication. H. pylori was eradicated in 50 out of 61 patients. Biopsy specimens were obtained from antrum and corpus before and 3 months following eradication, Ghrelin expression was evaluated immunohistochemically with an anti-ghrelin antibody, and the number of ghrelin-positive cells determined per 1 mm 2 of the lamina propria mucosa. RESULTS: There was no relationship between ghrelin immunoreactivity and body weight or body mass index for healthy controls. The number of ghrelin-positive cells was significantly lower for H. pylori-infected patients than for healthy controls. However, the ghrelin-positive cell number increased significantly following H. pylori eradication without significant change in severity of atrophy. CONCLUSIONS: These data indicated that H. pylori infection affected ghrelin expression. After H. pylori eradication, gastric tissue ghrelin concentration increased significantly. This could lead to the increased appetite and weight gain seen following H. pylori eradication.

DOI： 10.1111/j.1572-0241.2004.30291.x

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ENDOCRINE SOC  

Ghrelin is a GH-releasing peptide originally purified from the rat stomach. It has been demonstrated that ghrelin expression, within the gastroenteric system, is regulated by both the metabolic and GH milieu. Our laboratory and others have previously reported that ghrelin is also produced in the pituitary. Given that the receptor for ghrelin [GH secretagogue receptor (GHS-R)] is also expressed by the pituitary, the possibility exists that locally produced ghrelin plays an autocrine/paracrine role in regulating GH release. Because we have previously reported that GHRH infusion increases pituitary levels of ghrelin mRNA, we hypothesized that GHRH could be a key regulator of pituitary ghrelin expression. In this report, we demonstrate that 4-hGHRH infusion increased pituitary ghrelin peptide content. Interestingly, under experimental conditions in which hypothalamic GHRH expression is increased, e.g. GH deficiency due to GH gene mutation, glucocorticoid deficiency, and hypothyroidism, we observed that pituitary ghrelin expression (mRNA levels and peptide content) was also increased. Consistent with this positive correlation between GHRH and ghrelin, pituitary ghrelin expression (mRNA levels and peptide content) was found to be decreased in conditions in which hypothalamic GHRH expression is decreased, e.g. GH treatment, glucocorticoid excess, hyperthyroid state, and food deprivation. Collectively, these results suggest that pituitary ghrelin expression is GHRH dependent. We also conducted functional studies to examine whether the pituitary ghrelin/GHS-R system contributes to GH release after GHRH stimulation, by challenging pituitary cell cultures with GHRH in the presence of a GHS-R-specific inhibitor ([D-Lys-3]-GHRP-6). The GHS-R inhibitor did not affect GH release in the absence of GHRH, but significantly reduced GHRH-mediated GH release. This is the first report demonstrating that endogenous pituitary ghrelin can play a physiological role in GH release, by optimizing somatotroph responsiveness to GHRH.

DOI： 10.1210/en.2003-1424

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

VEGF is a highly specific stimulator of endothelial cells and may play an important role in angiogenesis in the process of tissue regeneration. We previously showed that cyclooxygenase-2 (COX-2) expressed in mesenchymal cells of the ulcer bed is involved in the ulcer repair process. To clarify the role of COX-2 in angiogenesis during gastric ulcer healing, we investigated the relation between COX-2 expression and VEGF production in human gastric fibroblasts in vivo and in vitro. Gastric fibroblasts were cultured in RPMI 1640 with and without IL-1α or IL-1β in the presence or absence of NS-398, a selective COX-2 inhibitor. Supernatant VEGF and PGE2 concentrations were measured by enzyme-linked immunosorbent assay. COX-2 expression in fibroblasts was determined by Western blot analysis. VEGF and COX-2 expression in surgical resections of human gastric ulcer tissue was examined immunohistochemically. IL-1 dose dependently enhanced VEGF release in cultured gastric fibroblasts after a 24-h stimulation. IL-1 also stimulated PGE2 production in gastric fibroblasts via COX-2 induction. NS-398 significantly suppressed VEGF and PGE2 release from IL-1-stimulated gastric fibroblasts
concurrent addition of PGE2 restored NS-398-inhibited VEGF release. COX-2 and VEGF immunoreactivity were colocalized in fibroblast-like cells in the ulcer bed of gastric tissues. These results suggest that COX-2 plays a key role in VEGF production in gastric fibroblasts stimulated by IL-1 in vitro and that angiogenesis induced by the COX-2-VEGF pathway might be involved in gastric ulcer healing.

DOI： 10.1152/ajpgi.00537.2003

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

A 52-year-old Japanese woman who presented with gastrointestinal (GI) bleeding underwent a proximal gastrectomy for a gastrointestinal stromal tumor (GIST) with a foveolar hyperplasia at the apex of the tumor, 4.5 cm in size, located in the upper body of the stomach. Although GIST are often asymptomatic and are found only incidentally, clinical symptoms such as bleeding, abdominal pain, or obstruction, occasionally lead to a premorbid diagnosis. When submucosal tumors present GI bleeding, the source of the bleeding usually is an ulceration of the mucosa over the tumor. However, in the present study, it was thought that the bleeding originated from the region of foveolar hyperplasia.

DOI： 10.1111/j.1443-1661.2003.00335.x

Scopus

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background/Aims: ErbB2 expression in esophageal adenocarcinoma has been shown to correlate with its clinicopathological features. However, expression levels for EGF receptor, erbB2 and erbB3 in specialized columnar epithelium (SCE) of Barrett's esophagus have yet to be determined. To investigate the relationship between EGF family receptors and Barrett's esophagus, we examined expression levels for EGF receptor, erbB2 and erbB3 in SCE of Barrett's esophagus. Methods: 10 consecutive patients with short- and long-segment Barrett's esophagus, and 10 control subjects without organic esophagogastric diseases were enrolled. Biopsy samples of Barrett's mucosa stained or not stained with methylene blue applied endoscopically were used for histological evaluation and Western blot analysis of EGF receptor, erbB2 and erbB3 proteins. Results: Mean length of Barrett's esophagus was 2.6 cm (range 1-8 cm) and all tissue samples from methylene blue stained Barrett's mucosa consisted of non-dysplastic SCE. In the Barrett's group, Western blot analysis showed that EGF receptor and erbB2 were equally and strongly expressed in SCE and squamous epithelium
in contrast, erbB3 expression in SCE was considerably weaker. In control subjects, all proteins showed strong expression for all samples. Immunohistochemical analysis of SCE in Barrett's esophagus showed positive EGF receptor and erbB2 expression, and no erbB3 expression. Conclusions: ErbB2 is strongly expressed in both non-dysplastic SCE and squamous epithelium, whereas erbB3 expression is essentially limited to the squamous epithelium. Copyright © 2004 S. Karger AG, Basel.

DOI： 10.1159/000080928

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background and aims: To clarify the interaction between gastric epithelial and mucosal T cells, we examined the role of cytokines released from epithelial cells in response to Helicobacter pylori water extract protein (HPWEP) in regulating T cell cyclooxygenase 2 (COX-2) expression and activation. Methods: Media from MKN-28 cells incubated with HPWEP for 48 hours were added to Jurkat T cells and human peripheral T cells. C-C and CXC chemokine concentrations in MKN-28 cell media, and COX-2 expression, interferon γ (IFN-γ), and interleukin (IL)-4 secretions in T cells were determined by western blot analysis and ELISA methods. Distributions of COX-2 positive T cells and monocyte chemoattractant protein 1 (MCP-1) in tissue specimens with H pylori associated gastritis were determined as single or double labelling by immunohistochemistry. Results: MCP-1, IL-7, IL-8, and RANTES were detected in media from MKN- 28 cells incubated with HPWEP. Media as a whole, and MCP-1 alone, stimulated COX-2 expression and peripheral T cell proliferation. Anti-MCP-1 antibody inhibited media stimulated COX-2 mRNA expression in Jurkat T cells. Media stimulated IFN-γ but not IL-4 secretion from peripheral T cells, while MCP-1 stimulated IL-4 but not IFN-γ secretion. Both stimulated cytokine release, and peripheral T cell proliferation was partially inhibited by NS-398, a specific COX-2 inhibitor. In mucosa with gastritis, COX-2 was expressed in T cells and MCP-1 was localised mainly in epithelial and mononuclear cells. MCP-1 levels and the intensity of COX-2 expression in tissue samples were closely related. Conclusions: Cytokines such as MCP-1, released from gastric epithelial cells in response to HPWEP, seem to modulate T cell immune responses, at least in part via COX-2 expression.

DOI： 10.1136/gut.52.9.1257

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：H G E UPDATE MEDICAL PUBLISHING S A  

Background/Aims: It has been reported that alcohol intake and folate deficiency are associated with an increased risk of colorectal adenomas and carcinomas. Mean corpuscular volume is increased under these conditions. We have reported that the mean corpuscular volume was higher in patients with adenoma. than without, adenoma in middle-aged men. The aim of this study was to assess the association between mean corpuscular volume and risk of colorectal. adenoma in menopausal women.
Methodology: The subjects were 415 menopausal women who underwent both barium enema examination and total colonoscopy, and their blood samples were analyzed. The subjects were divided into two groups with or without adenoma, and were divided into four groups according to the mean corpuscular volume value. Various, variables were compared among the groups, and the odds ratios of adenoma were calculated.
Results: The mean corpuscular volume was higher in patients with adenoma than without adenoma (P=0.002). As for the mean corpuscular volume value, the odds ratio (95% CI) of patients,with adenoma was 1.00 (referent); (mean corpuscular volume (fl) &lt;90), 1.50 (6.93-2.07); (greater than or equal to90 but &lt;92.5), 1.52 (0.97-2.07); (greater than or equal to92.5 but &lt;95) and 2.87 (2.25-3.45); (greater than or equal to95).
Conclusions: Mean corpuscular volume greater than or equal to95 may be used as an index of the risk for colorectal adenomas in menopausal women.

Web of Science

researchmap

Nonsteroidal anti-inflammatory drugs (NSAIDs) are known to cause gastric mucosal injury by upregulating ICAM-1 expression, and thus activating neutrophils in the gastric mucosa in vivo. However, studies differ on just how NSAIDs affect ICAM-1 expression in vitro. We therefore examined the effects of the NSAIDs indomethacin and NS-398, a non-selective and a selective cycloxygenase-2 (COX-2) inhibitor, respectively, on ICAM-1 expression in human umbilical vein endothelial cells (HUVEC) and gastric fibroblasts in vitro. IL-1β at 10 ng/ml strongly stimulated increases in ICAM-1 expression in HUVEC and gastric fibroblasts. Indomethacin and NS-398 did not affect ICAM-1 expression in endothelial cells, while both indomethacin and NS-398 significantly inhibited IL-1β-stimulated ICAM-1 expression in gastric fibroblasts without any influence on COX-2 expression. To our interest, the addition of prostaglandin E2 not only reversed the suppression, but synergistically down-regulated ICAM-1 expression with indomethacin in gastric fibroblasts. MG-132 pretreatment strongly suppressed IL-β-stimulated ICAM-1 expression in both cell types. The results suggest that NSAIDs-stimulated ICAM-1 expression is not likely to directly affect the endothelial cells in the gastric mucosa, and that COX-2 plays no role in NSAID-stimulated increases in ICAM-1 expression in endothelial cells and gastric fibroblasts.

Scopus

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：TAYLOR & FRANCIS AS  

Background: There have been no reports that low serum cholesterol levels increase the risk of colorectal adenoma, although many studies have shown that they do increase the risk of colorectal cancer. Alcohol intake, which is associated with a risk of colorectal adenomas, and serum cholesterol levels are closely related. The purpose of this study was to evaluate the influence of alcohol consumption on the association between serum cholesterol levels and colorectal adenoma. Methods: The subjects were 1,349 male patients who underwent both barium enema examination and, total colonoscopy. They answered a questionnaire regarding their alcohol consumption history, and their blood samples were analysed. The subjects were divided into three groups: those with no tumour (with neither adenoma nor adenocarcinoma), those with adenoma and those with adenocarcinoma. Among the groups, the serum total cholesterol and triglyceride levels were compared in all the patients, in the patients who did not drink daily and in the patients who did. Results: In all the patients, the serum cholesterol and triglyceride levels did not differ between the patients with and those without adenoma. In the daily drinkers, the serum cholesterol and triglyceride levels were significantly lower in patients with adenoma than in those without. Conclusions: Significantly lower levels of serum cholesterol and triglycerides were found in daily drinkers with adenoma than in those without.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL PUBLISHING LTD  

Background: Helicobacter pylori eradication markedly improves histological inflammation and decreases peptic ulcer recurrence, but little is known about the subsequent development of gastric mucosal injury.
Aim: To investigate whether acid suppression treatment after eradication influences the development of gastric erosions.
Methods: Eighty-one patients (gastritis or peptic ulcer) after successful H. pylori eradication were divided into two groups: 40 received an H2-blocker for 6 months (H2-blocker-positive) and 41 received no treatment (H2-blocker-negative). Endoscopy was performed before, and at 3 and 6 months after completion of eradication.
Results: Cumulative prevalence of gastric erosions in the H2-blocker-positive group was significantly lower than in the H2-blocker-negative group, 25% vs. 42%, respectively. In the H2-blocker-negative group but not the H2-blocker-positive group, the cumulative prevalence of gastric erosions after eradication was higher in patients with less severe corpus atrophy or more severe corpus gastritis.
Conclusions: Development of gastric erosions after H. pylori eradication may be controlled by acid suppression treatment. Less severe atrophy or more severe gastritis in oxyntic glands before eradication may be involved in the development of gastric erosions. These results support the idea that recovery of acid secretion may be one of factors for development of gastric mucosal erosions after successful eradication.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background: Helicobacter pylori eradication markedly improves histological inflammation and decreases peptic ulcer recurrence, but little is known about the subsequent development of gastric mucosal injury. Aim: To investigate whether acid suppression treatment after eradication influences the development of gastric erosions. Methods: Eighty-one patients (gastritis or peptic ulcer) after successful H. pylori eradication were divided into two groups: 40 received an H2-blocker for 6 months (H2-bIocker-positive) and 41 received no treatment (H2-blocker-negative). Endoscopy was performed before, and at 3 and 6 months after completion of eradication. Results: Cumulative prevalence of gastric erosions in the H2-blocker-positive group was significantly lower than in the H2-blocker-negative group, 25% vs. 42%, respectively. In the H2-blocker-negative group but not the H2-blocker-positive group, the cumulative prevalence of gastric erosions after eradication was higher in patients with less severe corpus atrophy or more severe corpus gastritis. Conclusions: Development of gastric erosions after H. pylori eradication may be controlled by acid suppression treatment. Less severe atrophy or more severe gastritis in oxyntic glands before eradication may be involved in the development of gastric erosions. These results support the idea that recovery of acid secretion may be one of factors for development of gastric mucosal erosions after successful eradication. © 2002 Blackwell Science Ltd.

Scopus

PubMed

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

CiNii Books

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background. Endogenous and exogenous prostaglandins (PGs) have been shown to contribute to reducing the gastric injury caused by irritants given subsequently. The aim of this study was to clarify whether cyclooxygenase-2 (COX-2) protein induced by pretreatment was involved in the prevention of subsequent ethanol-caused gastric injury in mice. Methods. Mice were pretreated with acidified ethanol or saline and then COX-2 protein expression in the stomach was immunohistochemically determined every 8h. Mice were administered 95% ethanol 24h after the acidified ethanol pretreatment, and gastric mucosal damage was evaluated macroscopically and histologically. The effects of NS-398 or indomethacin on the 95% ethanol-caused damage were also examined. Results. Acidified ethanol pretreatment induced COX-2 protein expression in lamina propria macrophages of the gastric mucosa, with a peak level 24h after the pretreatment. The 95% ethanol treatment caused gastric mucosal damage. The degree of the damage was not different between mice pretreated with acidified ethanol and those pretreated with saline. However, NS-398 aggravated the ethanol-caused damage only in mice pretreated with acidified ethanol, while indomethacin aggravated the damage, evaluated histologically, irrespective of the pretreatment. Conclusions. Pretreatment-induced COX-2, in addition to COX-1, seemed to be involved in the defense mechanism through minimizing the damage caused by a subsequent irritant.

DOI： 10.1007/s005350200016

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

The effect of Helicobacter pylori infection on non-steroidal anti-inflammatory drug-induced gastric mucosal injury is controversial. Aim: To examine the effect of the interaction between H. pylori and non-steroidal anti-inflammatory drugs on gastric mucosal injury. Methods: Mongolian gerbils infected with H. pylori were treated with indometacin at 8 mg/kg for 2 days or 7 days. Mucosal damage was assessed by macroscopic and histological examination, and myeloperoxidase activity was measured as an index of neutrophil infiltration. The expression levels of cyclo-oxygenase proteins were determined by Western blot analysis and cyclo-oxygenase activity. Results: A 2-day course of indometacin did not cause an increase in gastric damage in H. pylori infected Mongolian gerbils compared to uninfected gerbils, while a 7-day course of indometacin caused additive gastric damage in H. pylori-infected animals. H. pylori infection induced cyclo-oxygenase-2 expression in the stomach. Treatment with indometacin for 2 days did not significantly affect cyclo-oxygenase activity in H. pylori infected animals, while treatment for 7 days inhibited both cyclo-oxygenase-1 and cyclo-oxygenase-2 activities. Pre-treatment with a selective cyclo-oxygenase-2 inhibitor aggravated mucosal injury in H. pylori-infected animals treated or not treated with indometacin for 2 days. Conclusions: Our results suggest that cyclo-oxygenase2 protein induced by H. pylori infection may be involved in the defence of the gastric mucosa against damage caused by non-steroidal anti-inflammatory drugs. Therefore, inhibition of cyclo-oxygenase-2 activity may enhance non-steroidal anti-inflammatory drug-caused gastric damage in H. pylori-infected animals.

DOI： 10.1046/j.1365-2036.2002.01211.x

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）   出版者・発行元：SPRINGER-VERLAG TOKYO  

Because 50% of elderly patients in Japan have Helicobacter pylori infection, many NSAID-induced peptic ulcers, by chance, occur in patients who happen to be H. pylori-positive. Many previous studies have reported the relation between H. pylori and NSAIDs. Chan et al. and Bianchi et al. described increased risk for ulcers in H. pylori-positive NSAID users. In contrast, recent prospective studies show that the presence of H. pylori does not increase the risk of gastric or duodenal ulcers in arthritis patients or healthy subjects taking NSAIDs. Because many H. pylori-positive patients are administered NSAIDs in Japan, it is important to determine whether these offensive factors affected the gastric mucosa additively or independently. Regarding cyclooxygenase-2 (COX-2) protein, which is the target enzyme against NSAIDs, COX-2 expressed at inflammatory sites in the gastrointestinal tract presumably plays a role in the repair process of gastric damage. H. pylori infection elevated COX-2 protein in gastric epithelium and decreased the levels of COX mRNA in the stomachs of mice with experimentally induced gastric erosions or ulcers, although COX-2 mRNA levels were undetectable in controls. Therefore, it seems to be important to determine the role of COX-2 protein in the gastric tissues to clarify the relation between H. pylori infection and NSAIDs.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL SCIENCE ASIA  

Background and Aims: A relatively large number of patients with multiple myeloma have been reported to develop a secondary malignancy such as cancer of the breast, biliary system or bower.
Methods:A retrospective study was performed in 734 patients with hematologic disease diagnosed at Nippon Medical School Hospital between May 1984 and September 1994 to determine the incidence of colorectal cancer in these patients based on a history review, colonoscopic findings, and surgical or autopsy data.
Results: Of the 734 patients, 14 (1.9%) had colorectal cancer; two of 11 patients (18.2%) had pure red cell aplasia; two of 25 patients (8%) had multiple myeloma; and three of 46 patients (6.5%) had aplastic anemia. Patients with:pure red cell aplasia, multiple myeloma or aplastic anemia had colorectal cancer at a significantly higher rate compared to those with leukemia (P &lt; 0.005, P &lt; 0.02, P &lt; 0.01, respectively).
Conclusions: It is possible that a relatively large number of patients with pure red cell aplasia, multiple myeloma or aplastic anemia will develop a colorectal cancer. (C) 2000 Blackwell Science Asia Pty Ltd.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BRITISH MED JOURNAL PUBL GROUP  

Background-Prostaglandin endoperoxide synthase/cyclooxygenase (COX) is the key enzyme in gastric mucosal protection and repair but its cellular localisation in the human stomach is still unclear.
Aims-To investigate immunohistochemically the cellular distribution of COX-1 and COX-2 proteins in the human stomach with or without gastritis or ulceration.
Patients and Methods-Tissues were obtained by surgical resection of gastric ulcers associated with perforation (n=9) or by biopsy from Helicobacter pylori positive patients with gastric ulcers (n=45) and H pylori negative healthy subjects (n=15). COX expression was detected by semiquantitative reverse transcription-polymerase chain reaction (RT-PCR), western blotting, and light and electron microscopic immunohistochemistry.
Results-COX-2 mRNA and protein were detected in gastric ulcer tissues but not in intact gastric mucosa. COX-1 mRNA and protein were detected in the intact mucosa. COX-2 immunostaining was exclusively localised in macrophages and fibroblasts between necrotic and granulation tissues of the ulcer bed. The percentage of COX-2 expressing cells was significantly higher in open than in closed ulcers, and in gastritis than in gastric mucosa without H pylori infection. COX-I immunoreactivity localised in lamina propria mesenchymal cells was similar in various stages of ulcer disease and in intact gastric mucosa. Electron microscopic immunohistochemistry revealed both COX-1 and COX-2 on the luminal surfaces of the endoplasmic reticulum and nuclear envelope of macrophages and fibroblasts.
Conclusions-Our results showed that COX-2 protein was induced in macrophages and fibroblasts in gastric ulcers and H pylori related gastritis, suggesting its involvement in the tissue repair process.

DOI： 10.1136/gut.46.6.782

Web of Science

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL SCIENCE LTD  

Background: Increasing evidence mesothelial cells contribute to the control of inflammation in the peritoneal cavity by secreting prostaglandins. A study has shown that cyclooxygenase (COX)-2 knockout mice die partly as a result of peritonitis.
Aim: To investigate the expression and location of COX in peritonitis associated with peptic ulcer perforation.
Methods: Gastric and duodenal tissues were collected intraoperatively from nine and four patients, respectively, and immunohistochemical staining for COX-1 and COX-2 was performed.
Results: Histologically, all patients had severe peritonitis around the perforation sites, into which many inflammatory cells and fibroblasts had infiltrated, and reactive mesothelial cells exhibited hyperplastic change. The COX-1 protein was not detected, whereas COX-2 was abundant in reactive mesothelial cells near the perforation site and disappeared away from the site. Macrophages and fibroblasts around the perforation site also revealed immunostaining for COX-2.
Conclusions: Our results showed that COX-2 protein is induced in mesothelial cells, as well as in macrophages and fibroblasts, in inflamed peritoneal tissues associated with peptic ulcer perforation suggesting involvement of COX-2 in tissue repair.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

OBJECTIVE: It has been reported that alcohol intake and folate deficiency are associated with an increased risk of colorectal adenomas and carcinomas. Mean corpuscular volume (MCV) of red blood cells has been reported to be increased in these conditions. The purpose of this study was to assess the association between MCV and risk of colorectal adenoma.
METHODS: The subjects were 497 middle-aged (45-65 yr old) men who underwent both barium enema examination and total colonoscopy. The subjects answered a questionnaire regarding their alcohol consumption history, and their blood samples were analyzed. The subjects were divided into four groups three times: with or without alcoholism, and with or without adenoma according to alcohol intake, and according to the MCV value. Various variables were compared among the groups, and the odds ratios of adenoma were calculated.
RESULTS: The MCV was higher in the alcoholic group than in the nonalcoholic group (p &lt;0.01) and in patients with adenoma than in those without adenoma (p &lt; 0.0001). When the subjects were stratified by alcohol intake, the MCV value had a higher significant difference than alcohol intake, between patients with adenoma and those without adenoma. As for the MCV value, the odds ratio (95% confidence interval) of adenoma was 1.00 (referent); (&lt;92), 1.20 (0.71-1.69); (greater than or equal to 92 but &lt;95), 2.61 (2.07-3.15); (greater than or equal to 95 but &lt;98); and 3.62 (2.99-4.25); (greater than or equal to 98).
CONCLUSION: A high MCV value may be used as a simple index of the risk of colorectal adenomas, regardless of alcohol consumption. (Am J Gastroenterol 2000;95: 793-797. (C) 2000 by Am. Coll. of Gastroenterology).

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

Background: Increasing evidence suggests that mesothelial cells contribute to the control of inflammation in the peritoneal cavity by secreting prostaglandins. A study has shown that cyclooxygenase (COX)-2 knockout mice die partly as a result of peritonitis. Aim: To investigate the expression and location of COX in peritonitis associated with peptic ulcer perforation. Methods: Gastric and duodenal tissues were collected intraoperatively from nine and four patients, respectively, and immunohistochemical staining for COX-1 and COX-2 was performed. Results: Histologically, all patients had severe peritonitis around the perforation sites, into which many inflammatory cells and fibroblasts had infiltrated, and reactive mesothelial cells exhibited hyperplastic change. The COX-1 protein was not detected, whereas COX-2 was abundant in reactive mesothelial cells near the perforation site and disappeared away from the site. Macrophages and fibroblasts around the perforation site also revealed immunostaining for COX-2. Conclusions: Our results showed that COX-2 protein is induced in mesothelial cells, as well as in macrophages and fibroblasts, in inflamed peritoneal tissues associated with peptic ulcer perforation, suggesting involvement of COX-2 in tissue repair.

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：W B SAUNDERS CO  

Background & Aims: Heregulins (HRGs) regulate the proliferation and differentiation of various cell types. However, very little is known about their function in the gastrointestinal tract. The aim of this study was to investigate the role of HRGs on gastrointestinal cells. Methods: We examined the expression of erbB receptors and HRG-alpha in human gastric cancer cell lines, rat gastrointestinal epithelial cells, and human gastric fibroblasts by Western blot analysis or reverse-transcription polymerase chain reaction. Receptor phosphorylation and heterodimerization induced by HRG-alpha were detected by Western blot analysis. We also evaluated the in vitro effects of HRG-alpha on cell proliferation and restitution. Results: Cancer cell lines and rat epithelial cells expressed erbB2 and erbB3, but protein expression of erbB4 was not detected. HRG-alpha was detected only in gastric fibroblasts. HRG-alpha activated tyrosine phosphorylation of epidermal growth factor receptor (EGFR), erbB2, and erbB3 and induced not only erbB3/erbB2 but also erbB3/EGFR and erbB2/EGFR heterodimer formation in MKN-28 cancer cells. Simultaneous cultivation of MKN-28 cells with gastric fibroblasts resulted in tyrosine phosphorylation of erbB3 in MKN-28 cells. HRG-alpha also stimulated proliferation of MKN-28 cells and gastric epithelial cells. Conclusions: The data suggest that HRG-alpha may affect epithelial cell proliferation through mesenchymal-epithelial interaction in the gastric mucosa.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：一般社団法人 日本消化器内視鏡学会 関東支部  

A 62-year-old man was admitted to our hospital because of dyspnea. He was proved to have HIV antibody. After admission, a large amount of anal bleeding appeared. Colonoscopy performed on the next day showed a large amount of blood, multiple erosions and ulcers in the entire colon and rectum.<br> The varioliform erosions that were characteristic in amoebic colitis and punched out ulcers were also observed. Biopsy was performed from the ulcer bottom, and its specimen revealed Entamoeba Histolytica (trophozoites) in the necrotic tissue. Soon after the tretment with metronidazole, anal bleeding disappered. On colonoscopy performed one month after the treatment ended, erosions and ulcers improved.<br> Because of the underlying disease and the various endoscopic findings of this case, a differential diagnosis was needed, especially with regard to cytomegarovirus colitis. A further comparative study of endoscopic findings of colitis seen in AIDS patients is needed.

DOI： 10.11641/pdensks.53.0_184

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：BLACKWELL SCIENCE  

There have been only a few endoscopic studies with respect to lower intestinal lesions of leukaemia and malignant lymphoma, although there have been many autopsy studies of these lesions. The aim of this study was to clarify these lesions using endoscopy. Colonoscopy was performed on 11 of 341 patients with leukaemia and on 32 of 105 patients with malignant lymphoma for frequent diarrhoea, anal bleeding or abnormal findings on barium enema examination, between April 1984 and September 1994. In eight of the 11 patients with leukaemia on whom endoscopy was performed, nine lesions were found; aphthoid ulcers, small ulcers or large tumours due to leukaemic infiltration were found in five, and colorectal adenoma was found in only one patient. Antibiotic-associated haemorrhagic colitis or pseudomembranous colitis was found in one patient each. In 10 of the 32 patients with malignant lymphoma, 11 lesions were found. The following were found in one patient each: large lymphomatous tumours, a large lymphomatous ulcer, multiple small polypoid lesions, multiple lymphomatous polyposis; and colorectal cancer or adenoma in six patients. However, the autopsy findings in patients with both diseases were mostly pseudomembrane formation or ulcers due to fungal and/or bacterial infection. It is concluded that accurate endoscopic diagnosis of lower intestinal lesions in patients with leukaemia or malignant lymphoma is essential for staging and treatment of these diseases and for determining their prognosis. Most lesions in leukaemia are aphthoid and small ulcers are due to leukaemic infiltration or antibiotics; most lesions in malignant lymphoma are elevated lesions such as cancer, adenoma or lymphomatous lesions as determined by endoscopy. This is in contrast to pseudomembrane formation or ulcers due to fungal and/or bacterial infection which are detected at autopsy.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：一般社団法人 日本消化器内視鏡学会 関東支部  

A 55-year-old male visited our department for further examination with positive fecal occul blood test results in the mass screening for colorectal cancer. He complained of abdominal pain and diarrhea which had started about 2 months before. Small ulcers and erosions were observed in the ascending colon and cecum at colonoscopy. Biopsied specimen at the erosions showed numerous trophozoites in the mucosa. Many Lamblias were observed under a microscope in residual liquid collected in the ascending colon or cecum. Thus, this patient was diagnosed as amoebic colitis complicated with Giardiasis.<br> At colonoscopy performed 3 weeks after Metronidazole therapy (1000mg/day) , erosions and ulcers in the ascending colon and cecum disappeared. This patient was thought to be infected with both parasites by taking contaminated foods because he was not homosexual and had no HIV antibody.

DOI： 10.11641/pdensks.52.0_150

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/1999101903

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER VERLAG  

Bile acids are believed to play a role in the etiology of colorectal cancer. To examine the relationship between bile acids and colorectal neoplasia, bile acids in colon residual liquid or fecal material were analyzed in 18 patients with colorectal adenoma, 12 patients with colorectal cancer, and 18 healthy control subjects. High-performance liquid chromatography combined with immobilized 3 alpha-hydroxysteroid dehydrogenase in column form showed a significant elevation in the proportion of deoxycholic acid (P &lt; 0.05), lithocholic acid (P &lt; 0.05), secondary bile acids (deoxycholic acid plus lithocholic acid) (P &lt; 0.02), and the chenodeoxycholic acid-lithocholic acid family (chenodeoxycholic acid plus lithocholic acid) (P &lt; 0.05) in the colon residual liquid or fecal material of the patients with colorectal adenoma compared with proportions in the control subjects. A similar trend was noted in the patients with colorectal cancer compared to the control subjects. These findings suggested that an increase in the proportion of secondary bile acids, in particular, of lithocholic acid, was closely related to the pathogenesis of colorectal neoplasia.

Web of Science

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SCANDINAVIAN UNIVERSITY PRESS  

Background: Colorectal adenomas are often detected on mass screening, although detection rates with fecal occult blood tests are low. The relationship between colorectal adenomas and the resulting blood loss was examined indirectly, using serum iron and ferritin levels. Methods: Serum iron and ferritin concentrations were measured in 184 men with colorectal adenomas (greater than or equal to 1 cm in 92; &lt;1 cm in 92) and in 92 healthy male controls. Values in the three groups were compared. In the patients with adenomas greater than or equal to 1 cm, serum iron and ferritin levels were compared on the basis of the site, number, histology, and degree of dysplasia of the adenoma. Results: The mean serum iron level was significantly lower in patients with adenomas greater than or equal to 1 cm than in controls (P&lt;0.05), although this level did not differ significantly between those with adenomas &lt;1 cm and controls. The mean serum ferritin level also was significantly lower in patients with adenomas greater than or equal to 1 cm than in those with adenomas &lt;1 cm and controls (P&lt;0.05, P&lt;0.01, respectively), although this level did not differ between those with adenomas &lt;1 cm and controls. There was no difference in mean serum iron or ferritin levels on the basis of the site, number, histology, or degree of dysplasia of the adenoma. Conclusions: We conclude that decreased serum iron and ferritin levels are related only to adenoma size and that adenomas greater than or equal to 1 cm may bleed steadily, resulting in iron deficiency. However, low dietary intake of iron and fiber may be one of the causes of low serum iron and ferritin.

Web of Science

researchmap

記述言語：日本語   出版者・発行元：一般社団法人 日本消化器内視鏡学会 関東支部  

症例は73歳男性。主訴は食欲不振と体重減少。消化管X線検査，内視鏡検査で胃から大腸の消化管に多数のポリープ様隆起性病変を認めた。また，表在リンパ節とCT検査で縦隔内，腹腔内，骨盤内のリンパ節腫脹を認めた。腋窩のリンパ節生検ではmalignant lymphoma，diffuse，small cleaved，B cell typeであった。胃，十二指腸，大腸より採取された組織からも同様の結果が得られた。以上の結果よりmultiple lymphomatous polyposisと診断した。化学療法（THP-COP）施行後，表在リンパ節はほぼ消失し，消化管病変では上行結腸からS状結腸ではpolyposisの完全な消失を認めたが，胃，十二指腸，直腸では著明な変化は認められなかった。

DOI： 10.11641/pdensks.48.0_111

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Altered colonic mucosal blood flow (CMBF) is thought to be involved in the onset mechanism of ischemic colitis (IC). This study was designed to clarify the features of CMBF in six patients with IC (average age, 61 yr) and 10 control subjects (44.6yr). In the IC patients, CMBF was measured at both the affected site (ulcer margin and surrounding mucosa) and at a normal appearing site, during the active, healing, or recovery phase, by the laser doppler method. In the control group, CMBF was measured in various segments of the colon. The CMBF around the ulcer site during the active phase was significantly lower than that at the homologous segment in normal controls, while CMBF at normal sites in IC patients did not differ markedly from that of normal controls. CMBF in reddened portions of the ulcer margin in IC patients was significantly higher than that of the surrounding mucosa. A significant increase in CMBF was also observed during PGEi administration as compared to that before administration. This evidence clearly indicates that decreased CMBF is involved in the pathogenic mechanism of IC. The CMBF at sites of active mucosal restoration was somewhat increased. Continuous intravenous administration of PGEi was found to increase CMBF in IC patients. Copyright © 1995, Wiley Blackwell. All rights reserved

DOI： 10.1111/j.1443-1661.1995.tb00168.x

Scopus

researchmap

記述言語：日本語   出版者・発行元：一般社団法人 日本消化器内視鏡学会 関東支部  

A 73-year-old man who complained of bloody stool was pointed out to have two polyps of sigmoid colon and admitted to our hospital for further examination and treatment.<br> On admission, mild anemia (Hb 10.5ｇ/dl) and hypergam maglobulinemia (36.1%) were observed. Serum immunoglobulin G (IgG) value was high (3,872 mg/dl) . In immunological electrophoresis, monoclonal gammopathy of IgG_κ type was observed and Bence-Jones protein in urine was positive. The bone marrow was occupied by atypical plasma cells. After all he was diagnosed multiple myeloma of IgG_κ type.<br> He had two plypes at the sigmoid colon, one polype was polypectomized under colonoscopy and proved to be a cancer in adenoma ; the other polyp was a cancer invading in proper muscle layer and surgically resected. The upper GI series and endoscopic examination revealed a gastric cancer of Borrman 3 type, about 5 cm in size, in the lesser curvature of gastric cardia.<br> We reported a rare case of multiple myeloma complicated with both gastric and sigmoid colon cancers.

DOI： 10.11641/pdensks.45.0_200

researchmap

記述言語：日本語   出版者・発行元：一般社団法人 日本消化器内視鏡学会 関東支部  

Endoscopic and clinicopathological findings in our consecutive 26 patients (19 males and 7 females, average age : 54.7 y.o.) with colorectal submucosal tumor (SMT) treated by endoscopic polypectomy were compared with those in 186 patients in the Japanese literature. In our series, endoscopic ultrasonography (EUS) was carried out as far as possible to evaluate the size, gross appearance, location in the layer structure and ultrasonic characteristics of the tumors. Endoscopic polypectomy was carried out only when the snare-wire loop was tightened within a few mm in diameter.<br> The final diagnosis of the 26 cases were 12 lipomas, 7 carcinoids, 3 leiomyomas, 2 lymphangiomas, one hemangioma and one mixed tumor. Complication of transient lower intestinal bleeding was observed after polypectomy only in one case of lipoma. Correct preoperative diagnosis was not obtained from 5 patients, and 3 of whom were not carried out of EUS. The average size of SMTs resected were 10.1 mm in our series and from 7.3 to 18.9 mm in 186 in the literature. The semipedunculated or pedunculated appearance of SMTs were seen in 54% in our series and 69% in the cases in literature.<br> In conclusion, endoscopic polypectomy can be indicated to colorectal SMTs in the following conditions ; 1) the benign SMT less than 20 mm in diameter showing pedunculated of semipedunculated appearance, and 2) carcinoid tumor less than 10 mm in diameter without any metastasis.

DOI： 10.11641/pdensks.45.0_166

researchmap

記述言語：日本語   出版者・発行元：一般社団法人 日本消化器内視鏡学会 関東支部  

症例は66歳女性。右下腹部痛，持続する微熱を主訴として当科を受診した。注腸造影検査で回盲部結核および盲腸の小隆起性病変を指摘され，精査加療目的で入院した。大腸内視鏡検査では回腸末端部の潰瘍と狭窄，回盲弁の変形，上行結腸から盲腸にかけて小潰瘍が認められた。盲腸には約1cm大の粘膜下腫瘍様病変があり，内視鏡的ポリペクトミーを行った。病理組織学的所見では，粘膜下層にLanghans巨細胞および乾酪壊死が存在し，腸結核による粘膜下腫瘍様病変と診断した。腸結核病変部に炎症性ポリープが認められることはあるが，粘膜下腫瘍様病変が存在し，その内視鏡的ポリペクトミーにより腸結核の確定診断ができた例はまれと考え報告した。

DOI： 10.11641/pdensks.43.0_231

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/1994162627

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

記述言語：日本語  

CiNii Research

researchmap

その他リンク： https://search.jamas.or.jp/link/ui/2019219004

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

社会の高齢化に伴い、抗血栓薬服用者の大腸憩室出血は増加している。消化管出血時における抗血栓薬の休薬や再開などの服薬マネジメントについて各国・各学会からガイドラインが策定されているが、これらはエビデンスが乏しく世界標準として一致した推奨はないのが現状である。憩室出血時、抗血栓薬の服薬管理は関連医師間で連携をとり、血栓塞栓リスクと出血リスクを勘案して個別に検討することが重要である。ワルファリンは一時的に休薬すべきとするガイドラインと、休薬は関連医師間で血栓塞栓と出血リスクを検討し決定すべきというガイドラインが存在する。アスピリンは、(1)一次予防で内服している患者、(2)重篤な(生命にかかわる)出血患者は専門医と相談のうえで中止することが望ましく、(3)血栓塞栓症の二次予防、(4)ステント留置後30日以内、(5)急性冠症候群90日以内、のケースでは内服継続が推奨される。なお、休薬後の再開までの日数は、いずれの抗血栓薬も定まった見解はないが、止血確認後の速やかな再開が推奨されることは共通している。急性下部消化管出血で大腸憩室出血を疑った場合は適正な補液・輸血を行ってバイタルサインを安定させ、腸管洗浄剤を用いた大腸内視鏡を24時間以内に行う。内視鏡的止血術にはクリップ法、局注法、凝固法などがあるが、憩室結紮術の有用性が報告されている。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

大腸憩室出血に対する内視鏡的止血術の適応となる所見は、(1)活動性出血(active bleeding)、(2)非出血性の露出血管(non-bleeding visible vessel)、(3)付着凝血塊(adherent clot)である。これらは、最近出血した徴候(SRH)と定義されている。SRHを示す患者に止血術の介入をしないと30日以内の早期再出血率は53〜66%と高率であること、止血術の介入によって早期再出血率は低下すること、が報告されている。このため、SRHを示す大腸憩室は止血術の治療対象である。SRHを同定することによって、エピネフリン局注法、凝固法、クリップ法、結紮法などによる内視鏡的治療が可能となり、輸血量や入院期間、再出血率を低下させる。SRHの所見を得るためには検査の実施方法に留意が必要で、腸管洗浄剤による前処置、出血後24時間以内の大腸内視鏡、術者が内視鏡専門医であること、先端フードの装着、ウォータージェットスコープの使用、によって良好な結果が得られる。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

大腸憩室出血に対する内視鏡的止血術の適応となる所見は、(1)活動性出血(active bleeding)、(2)非出血性の露出血管(non-bleeding visible vessel)、(3)付着凝血塊(adherent clot)である。これらは、最近出血した徴候(SRH)と定義されている。SRHを示す患者に止血術の介入をしないと30日以内の早期再出血率は53〜66%と高率であること、止血術の介入によって早期再出血率は低下すること、が報告されている。このため、SRHを示す大腸憩室は止血術の治療対象である。SRHを同定することによって、エピネフリン局注法、凝固法、クリップ法、結紮法などによる内視鏡的治療が可能となり、輸血量や入院期間、再出血率を低下させる。SRHの所見を得るためには検査の実施方法に留意が必要で、腸管洗浄剤による前処置、出血後24時間以内の大腸内視鏡、術者が内視鏡専門医であること、先端フードの装着、ウォータージェットスコープの使用、によって良好な結果が得られる。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

＜文献概要＞消化管出血では,顕出血を伴わないときも常に小腸上皮性腫瘍を疑う必要がある.特に小腸癌は臨床症状を契機に精査されるとき,病変の検出は容易であり,速やかに診断し適切な治療へ導く.腹部-骨盤部X線造影CT検査で所見がないとき,カプセル内視鏡による精査は有用である.今日,小腸癌に対する補助化学療法の有用性を検証する動きが加速している.検査方法は進歩しているが,診断契機は臨床症状の出現であることは以前と変わりがない.そのため,診断時には既に進行していることが多く,早期診断が課題である.また,本邦の罹患率や予後などの疫学データの集積も,診断や治療の進歩を検証するために必要であり,今後の課題である.

DOI： 10.11477/mf.1403201389

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化管学会  

researchmap

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

J-GLOBAL

researchmap

記述言語：日本語  

CiNii Research

researchmap

その他リンク： https://search.jamas.or.jp/link/ui/2017203923

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(株)日本メディカルセンター  

小腸憩室はメッケル憩室を除くと非常にまれであり,多くは固有筋層をもたない後天性憩室であり,腸間膜付着側に存在する.回腸よりも空腸に多く,好発年齢は高齢者である.無症状のまま経過することが多いが,出血,憩室炎,穿孔,腹膜炎,腸閉塞などの非特異的な腹部症状を引き起こすことがある.検査は症状に応じて小腸造影,CT,血管造影,カプセル内視鏡,バルーン内視鏡などを適切に選択あるいは組み合わせることが重要である.出血に対してはバルーン内視鏡による内視鏡的止血術や血管造影による塞栓術で手術を回避することも可能である.また憩室炎には抗菌薬投与による保存的治療が選択されるが,穿孔による腹膜炎や腸閉塞などは外科的治療の適応である.(著者抄録)

DOI： 10.19020/J01937.2016223465

researchmap

J-GLOBAL

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本消化吸収学会  

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本消化吸収学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：大道学館出版部  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2014340028

記述言語：日本語   出版者・発行元：(株)医学書院  

本邦において,原因不明消化管出血に対してカプセル内視鏡を施行した場合,およそ30%の対象に潰瘍性病変が指摘される.NSAIDsを服用している場合においてはNSAIDs起因性と診断されることが多いが,正確な診断は簡単ではない.さらに,健常者においても10%程度は無症候性の小腸潰瘍性病変を有しており,原因疾患の診断は困難を極めている.近年,腸内細菌叢が小腸潰瘍性病変に深く関与している可能性が指摘されており,今後の解明が望まれている.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：SPANDIDOS PUBL LTD  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(有)科学評論社  

ダブルバルーン内視鏡(DBE)を施行した小腸癌16例を対象として、症状、腹部CT・カプセル内視鏡検査における所見陽性率、内視鏡所見などを検討した。その結果、症状は嘔吐50%、腹痛50%、出血症状50%であった。DBE前に腹部CT検査は全例で施行され、うち13例(81%)は病変を指摘できた。残る3例は腹部CTで病変を指摘できなかったが、いずれもカプセル内視鏡で病変が指摘された。また、全例でDBE時に生検が施行され、13例(81%)で組織学的診断が可能であった。平均観察期間24.1ヵ月における生存期間中央値は29.3ヵ月であった。

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2014156505

記述言語：日本語   出版者・発行元：(株)東京医学社  

門脈圧亢進症患者の小腸・大腸には、血管拡張性病変、静脈瘤、浮腫などの病変が知られている。しかし、門脈圧亢進症患者の多くは、同時に深刻な肝障害を伴っており、それらの腸病変が門脈圧と直接相関しているとは限らない。門脈圧と、小腸病変の相関を検討したところ、浮腫と門脈圧の相関は明らかであったが、孤立性の血管拡張性病変(angioectasia)との相関は明らかではなかった。このように門脈圧亢進症性腸症の解明には、門脈圧との相関を調べると同時に、門脈圧亢進をきたす原疾患との関連を顧慮しなければならない。この報告で主要な内視鏡像を紹介するが、この分野は用語の統一も十分ではなく、論文報告もここ数年以内が大半であり、これからの解明の待たれる分野である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本癌治療学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(有)科学評論社  

2003年6月から原因不明消化管出血に対してダブルバルーン内視鏡(DBE)を施行した215例(男性136例。女性79例、年齢19〜90歳、平均年齢61.8±15.3歳)中、DBEで最終診断可能であった111例(男性71例、女性40例、平均年齢62.7±16.0歳)の出血症状パターン、最終診断について検討した。その結果、1)潜在性出血での診断は腫瘍性病変7例(うちGISTが2例)、潰瘍・炎症性病変7例(うちクローン病5例)、血管性病変4例(うち血管拡張症3例)であった。2)顕出血での診断は潰瘍・炎症性病変28例、血管性病変26例、腫瘍性病変24例、憩室性疾患6例、小腸外病変9例であり、潰瘍・炎症性病変ではNSAIDs起因性腸炎11例、クローン病4例、原因不明潰瘍3例であった。また、血管性病変ではDieulafoy&#039;s lesionが14例、血管拡張症が9例、動静脈奇形が3例で、腫瘍性病変ではGISTが10例、癌が3例、悪性リンパ腫3例であった。以上より、顕出血の継続している状況(overt ongoing出血)では診断率が高く治療も行えるDBEが第一選択として望ましく、顕出血が停止している状態(overt previous出血)では他の放射線科学的な検索も出血源同定に有用である可能性が示唆された。

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2013325959

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

カプセル内視鏡(CE)の主要な適応に原因不明消化管出血(OGIB)がある.CEは,欧米で最もOGIBの原因疾患とされているangioectasiaや小潰瘍性病変などの小病変の検出に優れ,これらの小病変の検出に関してバルーン内視鏡(BE)や小腸造影検査などより診断率が優れている.したがって,CEでこれらの小病変を検出し,BEなどで治療する方針が有用である.粗大病変に関しては,CEでは全体像がとらえにくく,BEや小腸造影検査が有用である.近年では,CT・MRIなどを用いたバーチャル内視鏡の進歩が著しく,全体像の診断に対する第1選択検査に置き換わっていく可能性がある.(著者抄録)

DOI： 10.11477/mf.1403113770

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

・カプセル内視鏡・バルーン内視鏡などの小腸鏡の進歩により、通常型NSAIDsにより50%近い服用者に小腸粘膜傷害の生じることが明らかとなった。・少なくともNSAIDsの中止により治癒を確認できない限り、特徴的な膜様狭窄を伴わないNSAIDs起因性小腸傷害の診断は容易ではない。・NSAIDsの直接作用による小腸上皮細胞間接合部障害・ミトコンドリア機能障害により粘膜透過性が増加し、腸管内容である胆汁や腸内細菌が細胞間を通って粘膜内、粘膜下に侵入して炎症が起き、そこにCOX-1阻害によるプロスタグランディンの低下による粘膜防御力低下が加わると小腸粘膜欠損が起こると考えられている。・プロスタグランディンを補充・増加させる薬剤としてミソプロストールやレバミピドなどの粘膜防御製剤、そのほか抗菌薬などがNSAIDs起因性小腸粘膜傷害予防・治療薬の候補となっている。(著者抄録)

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2013198865

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

小腸出血は小腸内視鏡検査の適応として最も多く、その診断にバルーン内視鏡は非常に有用である。消化管出血では、小腸出血を疑う前から詳細な上部消化管内視鏡や大腸内視鏡を行う。特に、十二指腸潰瘍や大腸憩室出血を正確に除外する。原因不明の消化管出血と判断されたら、臨床情報を踏まえ、速やかに症例に応じた診断戦略を立てることが正診につながるものと思われる。出血源を認められなかったときは、再出血直後にバルーン内視鏡を行い診断率向上に努めることが大切である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：MOSBY-ELSEVIER  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

NSAID腸炎の特に小腸内視鏡像を提示し、鑑別診断の要点を述べた。NSAID腸炎の潰瘍は回腸に多く、円形〜類円形潰瘍、輪状潰瘍と治癒過程に認められる膜様狭窄、稀ながら縦走潰瘍も認められる。Crohn病の特徴の一つに、病変の局在における腸間膜との位置関係があげられる。腸間膜付着側に病変の多いCrohn病に対し、NSAID腸炎の病変には一定の傾向は認められない。NSAID腸炎の特徴として、原因薬剤の休薬で速やかに治癒する傾向がある。好発年齢や服薬歴などの病歴からも鑑別に重要な情報が得られ、内視鏡的特徴の理解とともに、詳細な臨床情報のもと内視鏡検査を行うことで、Crohn病と類似する所見や分類困難な軽微な所見も鑑別することが可能である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(株)日本メディカルセンター  

非ステロイド性抗炎消薬(NSAIDs)は,小腸に多彩な病変を高頻度に起こすことが明らかになった.通常型NSAIDsを2週間服用すると50%を超える服用者に小腸粘膜欠損が現れる.NSAIDs小腸粘膜傷害の診断を,内視鏡所見で行うことは困難だが,小腸口側でみられる絨毛欠損は特徴的な所見である可能性が高い.診断は,NSAIDsの中止で治癒を確認することが基本である.NSAIDs起因性小腸粘膜傷害に対する予防薬・治療薬の候補を探すため複数の試験が行われた.今後は見込みのある薬に対して,大規模な臨床試験が望まれる.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

小腸内視鏡の進歩は、アスピリンが胃・十二指腸のみならず小腸に多彩な病変を起こすことを明らかにした。健常人ボランティアを対象に行われた試験によって、アスピリン腸溶錠の服用により上部小腸から潰瘍性病変が起こることが明らかとなった。腸溶錠が上部小腸で溶解するためではないかと考えられている。従来、アスピリン緩衝剤は小腸に病変を引き起こさないと考えられていたが、アスピリン緩衝剤による小腸潰瘍も報告されるようになってきている。まだ潰瘍の特徴を十分に示すことができるほど知見は多くはなく、今後の解明が望まれる。(著者抄録)

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(株)日本メディカルセンター  

小腸の悪性リンパ腫の診断・治療について概説した.小腸悪性リンパ腫はさまざまな肉眼形態を呈し,組織型も多種に及ぶ.カプセル内視鏡の普及は小腸悪性リンパ腫の発見契機を増すであろうし,それにより組織診断の必要性からバルーン内視鏡の適応も今後ますます増えるものと予想される.肉眼形態から類推される悪性リンパ腫に対して,分子生物学的手法を含めた精密な組織診断と,詳細な全身検索による病期診断が,適切な治療のために不可欠である.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

小腸内視鏡の進歩は,非ステロイド性抗炎症薬(NSAID)により,胃のみならず小腸に多彩な病変が高頻度に起こることを明らかにした.特に通常型NSAIDでは2週間で50%を超える服用者に小腸粘膜障害が現れる.NSAID起因性小腸粘膜傷害には粘膜障害と絨毛欠損という異なる2種類の形態があり,小腸粘膜傷害の起因には複数の因子が関与している.NSAID起因性胃粘膜傷害に対して予防法・治療法が確立したため,NSAID服用者の下部消化管傷害に対する対応の確立が急務となっている.本邦を中心として,NSAID起因性小腸粘膜傷害に対する予防薬・治療薬の候補を探すため二重盲検無作為化比較試験を含む複数の試験が小規模ながら行われた.今後は見込みのある薬に対して,より大規模な臨床試験が望まれる.(著者抄録)

DOI： 10.11477/mf.1403102123

researchmap

記述言語：日本語   出版者・発行元：(社)日本大腸検査学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(株)癌と化学療法社  

小腸癌は多岐にわたる症状を有するが特異的な症状に乏しい。また従来の内視鏡検査では深部小腸への挿入が難しく、X線検査による画像診断に依存していたため、早期発見や術前診断は困難であった。しかしダブルバルーン内視鏡の登場により、全小腸の観察や病理診断が可能となった。内視鏡所見の特徴は、不整な腫瘤や潰瘍を形成し、管腔が狭小化することである。現状では症状がなければ診断が困難であり、診断時には病期が進行していることも多い。予後の改善には早期発見が必須であり、従来のX線検査にカプセル内視鏡やダブルバルーン内視鏡を組み合わせた積極的な小腸検査が必要である。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

researchmap

記述言語：日本語   出版者・発行元：(株)日本メディカルセンター  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(株)ヴァンメディカル  

カプセル内視鏡により、アスピリンを含む非ステロイド性抗炎症剤(NSAID)を常用する患者の60%以上に小腸粘膜傷害が生じていることがわかった。また、最近の研究で通常型NSAIDを2週間服用しただけで潰瘍性病変を含む小腸粘膜傷害が60%近い服用者に生じることが明らかとなった。NSAID/アスピリン起因性消化管傷害にはCOX-1阻害によるプロスタグランディン(PG)の産生低下が重要で、PGを同時投与することで小腸においても粘膜傷害を軽減できる可能性が高く、本邦からカプセル内視鏡を用いた検討が報告された。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

カプセル内視鏡によりNSAIDs起因性小腸粘膜傷害の実態が明らかになりつつある.アスピリンを含むNSAIDsの常用患者の70%以上に,また通常型NSAIDsの2週間の内服で60%近い服用者に小腸の粘膜傷害が認められた.選択的COX-2阻害薬は短期的には小腸粘膜傷害の発生を軽減させるが,長期的には通常型NSAIDsと粘膜傷害の頻度に差がないという報告もあり,NSAIDs起因性小腸粘膜傷害の治療・予防薬が望まれる.近年,本邦でミソプロストールやレバミピドを用いてNSAIDs起因性小腸粘膜傷害の抑制効果を調べた研究が行われ有望な結果が得られた.今後,他の薬剤を含め投与法,投与量などの検討が望まれる.(著者抄録)

DOI： 10.11477/mf.1403101872

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本創傷治癒学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(有)科学評論社  

著者らが大腸内視鏡検査を行った458例を対象に血清葉酸濃度と大腸腺腫の関係を調べ、大腸腺腫発生を有効に減少させる血清葉酸濃度の設定を試みた。その結果、1)男性・女性ともに血清葉酸濃度で層別化して頻度を計算したところ、血清葉酸濃度8.0ng/ml未満になると濃度減少に従って大腸腺腫の頻度は増加し、血清葉酸濃度6.0ng/ml未満では8.0ng/ml以上に対して大腸腺腫の頻度は男性で約1.4倍、女性で約1.3倍であった。2)血清葉酸濃度8.0ng/mlで全例を男女別に2群に分けてオッズ比を求めたところ、血清葉酸濃度8.0ng/ml未満に対して8.0ng/ml以上のオッズ比は男性で0.49(95%信頼区間0.32〜0.66)、女性で0.77(0.50〜1.05)となった。以上、これらのことからも、血清葉酸濃度8.0ng/ml未満の症例に対して葉酸の補充を行うことが、大腸腺腫発生の頻度を減少させる目的において有用であると考えられた。

researchmap

記述言語：日本語   出版者・発行元：大道学館出版部  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2010053750

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(株)日本メディカルセンター  

カプセル内視鏡によりNSAIDs起因性小腸粘膜傷害の実体が明らかになってきた.アスピリンを含むNSAIDsを常用する患者の60%以上に,また通常型NSAIDsを2週間服用しただけで60%近い服用者に,潰瘍性病変を含む小腸粘膜傷害が認められた.COX-2選択的阻害薬は短期的に小腸粘膜傷害の発生を軽減するが長期的には予防困難との報告があり,NSAIDs起因性小腸粘膜傷害を予防,治療する薬剤が望まれる.近年,本邦でミソプロストールやレバミピドなどを用いてアスピリンを含むNSAIDs起因性小腸粘膜傷害を抑制可能か調べる試験が行われ,有望な結果が得られている.今後,他の薬剤を含めて投与法,投与量,組み合わせなどの検討が望まれる.(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(株)ヴァンメディカル  

researchmap

記述言語：日本語   出版者・発行元：(株)新興医学出版社  

カプセル内視鏡は低侵襲の小腸検査だが偶発症にカプセルの滞留がある。カプセル内視鏡は病変の指摘、観察に適していて、生検が治療ができるバルーン内視鏡と相補助な関係にある。原因不明消化管出血で出血が止まっているとき、診断効率面ではカプセル内視鏡が第一選択検査である。カプセル内視鏡では粘膜下腫瘍や憩室など粘膜に異常のない病変を指摘できないことがあり、腹部CTやバルーン内視鏡などを必要に応じて組み合わせる。カプセル内視鏡によりNSAIDs起因性小腸傷害が70%近いNSAIDs服用者に起こることが明らかになった。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(NPO)日本高齢消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(株)ヴァンメディカル  

カプセル内視鏡により、アスピリンを含むNSAIDsを常用する患者の60%以上に小腸粘膜傷害が生じていることがわかった。さらに、最近の研究で通常型NSAIDsを2週間服用しただけで潰瘍性病変を含む小腸傷害が60%近い対象者に生じることが明らかとなった。COX-2選択的阻害剤は短期的に小腸粘膜傷害を抑制するが、長期的には予防困難とする報告があり、NSAIDs起因性小腸粘膜傷害を予防、治療する薬剤が望まれている。近年、本邦でミソプロストールやレバミピドなどがアスピリンを含むNSAIDs起因性小腸粘膜傷害を抑制することが可能かどうかを調べる試験が行われ、有望な結果が得られている。今後、いずれの薬剤についても投与法、投与量、組み合わせなどの検討が望まれる。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

カプセル内視鏡やダブルバルーン内視鏡による,10mm以下の小さな小腸上皮性腫瘍に関しての報告を,遡及的に調査し現状を概説した.新しい小腸内視鏡検査が施行されている現状においても,臨床症状の出現が小腸の主な検査動機となっていることから,微小な病変は偶発的に認められたわずかな報告しか存在しない.症例の蓄積による小腸上皮性腫瘍の高危険群の設定が必要である.その際に内視鏡を含めた肉眼所見に関しても,コンセンサスの得られた共通の表現を用いて症例を集積する必要がある.(著者抄録)

DOI： 10.11477/mf.1403101683

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：MOSBY-ELSEVIER  

Web of Science

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：MOSBY-ELSEVIER  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(有)科学評論社  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

カプセル内視鏡により、リウマチなどでNSAIDsを常用する患者の60%以上に何らかの小腸傷害が生じていることがわかった。カプセル内視鏡は苦痛がなく、非侵襲性が高いことから、複数回検査の受容性が高く、NSAIDsを中心とする薬剤の投薬前後に検査を行うことで、その小腸傷害を高い精度で知ることができる。最近の報告では、通常型NSAIDsを2週間服用しただけで、潰瘍性病変を含む小腸傷害が50〜60%近い対象者に生じることが明らかとなった。さらに、COX-2選択的阻害剤と通常型NSAIDsの小腸傷害に対する比較試験や、プロスタグランジンやレバミピドがNSAIDsの小腸傷害を抑制できるかどうかを調べる試験が行われ、新たな知見が明らかにされてきている。これらの研究から、NSAIDsの小腸傷害は一定の素因により増悪する可能性が高く、その素因の特定が望まれる。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：(株)東京医学社  

わが国において、上部消化管出血における危険性は、アスピリンで5.5倍、通常型NSAIDで6.1倍も増加すると報告された。また、海外のVIGOR試験では通常型NSAIDにおいて、上部消化管出血は1.4%、下部消化管出血も0.89%で認められた。NSAIDsによる消化管副作用は上部消化管出血だけではなく、下部消化管出血も重要であることが示された。また、まだ報告は少ないが、原因不明消化管出血(OGIB)の10%程度はNSAIDs起因性の小腸出血によると考えられている。NSAIDsによる主な小腸障害は潰瘍性病変であり、その特殊型として膜様狭窄がある。海外だけでなく、わが国においても2週間の通常型NSAIDの連続投与で50%以上の健常人に潰瘍性の小腸粘膜障害が発生することが確認された。COX-2選択的阻害剤には、通常型NSAIDの消化管障害を軽減させることが期待され、海外では良い結果が示されているが、わが国における検討はこれからである。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(株)日本メディカルセンター  

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：W B SAUNDERS CO-ELSEVIER INC  

Web of Science

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：MOSBY-ELSEVIER  

Web of Science

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：MOSBY-ELSEVIER  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(株)南江堂  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2007177270

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：南江堂  

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2007160132

記述言語：英語  

Background: Both adenomatous polyposis coli (APC) gene mutation and cyclo-oxygenase (COX)-2 are thought to play key roles in colorectal carcinogenesis. Nuclear accumulation of β-catenin results from APC gene mutation, which leads to enhanced transcription and activation of target genes, including cyclin D1. In vitro studies suggest that Cox-2 transcription is directly regulated by β-catenin/TCF complexes. Aim: To investigate the relationship between cellular localization of β-catenin and COX-2 in colorectal cancer. Methods: We performed immunohistochemical analysis of β-catenin, cyclin D1 and COX-2 expression in 50 resected colorectal cancer cases. Results: The proportion of cases positive for cyclin D1 was higher in nuclear β-catenin-positive cases than in negative cases (P &lt; 0.001). Serial sections revealed that the co-localization of cyclin D1 and nuclear β-catenin was most frequently evident in the tumour cells at the advancing margin of invasive carcinoma. Conversely, there was no association between COX-2 and nuclear β-catenin expression, either topographically or statistically. The staining patterns for COX-2 and nuclear β-catenin differed; COX-2 was diffuse and homogeneous, whereas nuclear β-catenin was focal and preferentially distributed at the invasive margin of cancer cells. Conclusions: These two important modulators of colorectal tumourigenesis are differentially expressed. Cox-2 and β-catenin transcription may be activated by different pathways. © 2006 The Authors.

DOI： 10.1111/j.1365-2036.2006.00039.x

Web of Science

Scopus

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

DOI： 10.11477/mf.1403100687

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：NATURE PUBLISHING GROUP  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本消化器内視鏡学会  

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：ELSEVIER SCIENCE BV  

Web of Science

researchmap

記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：ELSEVIER SCIENCE BV  

Web of Science

researchmap