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：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本ヘリコバクター学会  

researchmap

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：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：(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）  

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：(NPO)日本食道学会  

researchmap

記述言語：英語  

A 63-year-old woman was admitted to our institution for severe pain in her right lower abdomen caused by the perforation of cecal cancer. She underwent emergency surgery, from which she was diagnosed with cecal carcinoma with liver, lung, and lymph node metastases. As she was taking aspirin to prevent cerebral infarction, anti-vascular endothelial growth factor (receptor) antibody and regorafenib therapy were not used. Thus, we started a modified FOLFOX 6+cetuximab regimen. This first-line treatment initially achieved a partial response (PR), but she then developed progressive disease (PD) after 14 months. We changed the regimen to FOLFIRI, followed by trifluridine/tipiracil, but her progression-free survival periods were 2.7 months and 1 month, respectively. Although we cycled through the available array of standard cancer drugs, the patient showed a good performance status, and some benefit from treatment still seemed plausible. We readministered the 5-fluorouracil oral preparation S-1, which maintained stable disease (SD) for 7 months. After PD emerged, we readministered the anti-epidermal growth factor receptor (EGFR) antibody panitumumab for 7.5 months of SD. Finally, 39 months after her diagnosis, she died from rapidly progressing disease. However, her relatively long survival implies that readministering drugs similar to those used in previous regimens might benefit patients with metastatic colorectal cancer.

DOI： 10.1155/2020/2351810

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Streptozocin (STZ) is a key agent for treating advanced pancreatic neuroendocrine tumors (pNET). Most STZ regimens for pNET are daily and also include 5-fluorouracil (5FU), whereas STZ monotherapy and weekly regimens have also been applied in daily practice in Japan. The present study aimed to evaluate responses to weekly regimens and to STZ monotherapy, and to identify a predictive marker of a response to STZ. METHODS: Clinical data regarding STZ-based chemotherapy for pNET were collected between 2015 and 2017 at 25 facilities. We analyzed the effects, safety, progression-free survival (PFS), and factors that correlate with responses to STZ. RESULTS: The overall objective response rate (ORR) of 110 patients who underwent STZ-based chemotherapy (monotherapy, 81.8%; weekly regimen 46.4%) was 21.8%, and PFS was 9.8 months. The ORR of weekly vs. daily regimens was 21.6 vs. 22.0% (P = 1.000), and that of monotherapy vs. combination therapy was 21.1 vs. 25.0% (P = 0.766). A Ki67 proliferation index (Ki67) of > 5% was a predictive marker of a response to STZ (P = 0.017), whereas regimen type, mono- or combination therapy, treatment line and liver tumor burden were not associated with responses. The frequencies of Grade ≥ 3 nausea and hematological adverse events were significantly lower for monotherapy than combination therapy (P = 0.032). CONCLUSIONS: The effects of weekly STZ monotherapy on pNET are comparable to those previously reported and the toxicity profile was acceptable. Ki67 > 5% was the sole predictive marker of an objective response.

DOI： 10.1007/s00280-018-3656-y

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.21037/tgh.2018.09.12

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：JOURNAL CLINICAL BIOCHEMISTRY & NUTRITION  

There was not available data about the overlap between functional dyspepsia (FD) and pancreatic diseases. We aimed to determine whether epigastric pain syndrome (EPS) accompanying with pancreatic enzyme abnormalities were associated with early chronic pancreatitis proposed by Japan Pancreas Society (JPS) using endosonography. We enrolled 99 consecutive patients presenting with typical symptoms of FD, including patients with postprandial distress syndrome (PDS) (n = 59), EPS with pancreatic enzyme abnormalities (n = 41) and EPS without pancreatic enzyme abnormalities (n = 42) based on Rome Ill criteria. Gastric motility was evaluated using the C-13-acetate breath test. Early chronic pancreatitis was detected by endosonography and graded from 0 to 7. The ratio of female patients among EPS patients (34/41) with pancreatic enzyme abnormalities was significantly (p = 0.0018) higher than the ratio of female EPS patients (20/42) without it. Postprandial abdominal distention and physical component summary (PCS) scores in EPS patients with pancreatic enzyme abnormalities were significantly disturbed compared to those in EPS patients without it. Interestingly, AUC(5) and AUC(15) values (24.85 +/- 1.31 and 56.11 +/- 2.51, respectively) in EPS patients with pancreatic enzyme abnormalities were also significantly (p = 0.002 and p = 0.001, respectively) increased compared to those (19.75 +/- 1.01 and 47.02 +/- 1.99, respectively) in EPS patients without it. Overall, 64% of EPS patients with pancreatic enzyme abnormalities were diagnosed by endosonography as having concomitant early chronic pancreatitis proposed by JPS. Further studies are warranted to clarify how EPS patients with pancreatic enzyme abnormalities were associated with early chronic pancreatitis proposed by JPS.

DOI： 10.3164/jcbn.17-41

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：SPRINGER JAPAN KK  

Acotiamide is a new drug that exhibits prokinetic activity by enhancing the release of acetylcholine. However, its effects on esophageal motility currently remain unknown. Therefore, we herein investigated the effects of acotiamide on esophageal motility in healthy, asymptomatic subjects.
Thirty healthy subjects received 100 mg of acotiamide or placebo three times a day for 7 days separated by a 28-day washout period in a randomized, double-blind, placebo-controlled crossover study. On the seventh day of treatment, esophagogastric junction pressure, integrated relaxation pressure, and primary peristalsis were assessed using high-resolution manometry.
Esophagogastric junction pressure was significantly higher in the acotiamide group (median 28.2 mmHg) than in the placebo group (24.0 mmHg), whereas no significant differences were observed in integrated relaxation pressure, the distal contractile integral, or contraction patterns between the two groups. Among 13 healthy subjects with peristaltic abnormalities, no significant differences were noted in integrated relaxation pressure or the distal contractile integral between the acotiamide and placebo groups; however, the esophagogastric junction pressure (acotiamide 23.4 mmHg; placebo 21.7 mmHg) significantly increased, the contraction pattern significantly improved, and the frequency of esophageal peristaltic abnormalities significantly decreased in the acotiamide group.
Acotiamide improves the peristaltic pattern in patients with peristaltic abnormalities by decreasing weak peristalsis with a small break.

DOI： 10.1007/s10388-016-0559-z

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  

Background: Vonoprazan (VPZ) is a novel potassium-competitive acid blocker that may be clinically beneficial for proton pump inhibitor (PPI)-resistant reflux esophagitis (RE). The aim of this study was to investigate the efficacies of VPZ therapy at 20 mg for 4 weeks in patients with PPI-resistant RE and VPZ maintenance therapy at 10 mg for 8 weeks in patients who have been successfully treated. Methods: Subjects comprised 24 patients with PPI-resistant RE (Los Angeles classification grade A/B/C/D: 3/7/11/3). After confirming PPI-resistant RE by endoscopy, 20 mg VPZ was administered. Endoscopy was performed 4 weeks after the initiation of VPZ. Symptoms were evaluated using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG). Maintenance therapy with 10 mg VPZ was performed and endoscopy was conducted after 8 weeks. Results: In 21 (87.5%) out of 24 patients, esophageal mucosal breaks were successfully treated by 20 mg VPZ. The median FSSG score was significantly lower on days 1-7, 14, and 28 after the initiation of VPZ than before its administration. Maintenance therapy with 10 mg VPZ prevented the relapse of esophageal mucosal breaks in 16 (76.2%) out of 21 patients. Conclusion: VPZ was effective for most patients with PPI-resistant RE. (C) 2017 S. Karger AG, Basel

DOI： 10.1159/000456072

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：KARGER  

Background: Recent updated guidelines of the Japanese Society of Gastroenterology recommend the use of a single dose of antiplatelet agents in patients undergoing endoscopic submucosal dissection (ESD). However, the postoperative bleeding risk after gastric ESD associated with the continuation or interruption of antithrombotic therapy remains controversial. We aimed to evaluate whether certain factors including interrupted antithrombotic therapy could affect early and delayed post-ESD bleeding risk. Methods: Three hundred sixty-four patients with gastric neoplasms were treated with ESD at our hospital between October 2005 and December 2012. Seventy-four patients with interrupted antithrombotic therapy were undertaken with ESD. Early and delayed postoperative bleeding patterns were estimated. Various clinical characteristics such as gender, age, tumor location, tumor size, ESD procedure time, platelet count, and comorbidity were evaluated. Results: There was a significant difference (p = 0.042) in the ESD procedure time between the patients with postoperative bleeding and those without it. There was no significant difference in postoperative bleeding between the patients on anti thrombotic therapy and not on it. Moreover, interrupted anti thrombotic therapy and platelet count were significantly (p = 0.0461 and p = 0.0059, respectively) associated with early postoperative bleeding in multivariate analysis. In addition, in univariate analysis, ESD procedure time was significantly (p = 0.041) associated with delayed postoperative bleeding. Conclusions: Antithrombotic therapy and prolonged ESD procedure time were significantly associated with early and delayed postoperative bleeding, respectively. (C) 2017 S. Karger AG, Basel

DOI： 10.1159/000475924

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：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：MEDICAL ASSOC NIPPON MEDICAL SCH  

Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan An 81-year-old man was admitted with upper abdominal pain and weight loss. Esophagogastroduodenoscopy revealed a large tumor located from the gastric angle to the body. Histological analysis of a biopsy revealed a moderately differentiated adenocarcinoma. Computed tomography revealed metastases in the liver and lung and the patient was subsequently diagnosed with metastatic advanced gastric cancer. He was treated with chemotherapy using S-1 (80 mg/m(2)) and cisplatin (CDDP) (60 mg/m(2)). Twenty-two months after chemotherapy, the gastric tumor, and the nodules in the liver and lung, had disappeared. We subsequently diagnosed a clinical complete response. The patient was treated with further S-1 monotherapy for 7 months after complete response assessment. He has lived for more than 7 years since the initial diagnosis without recurrence. Chemotherapy using S-1 and CDDP may be a potent strategy for improving survival in elderly patients with advanced gastric cancer.

DOI： 10.1272/jnms.83.199

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1111/cas.12959

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  

Background The aim of this study is to clarify whether acotiamide and rabeprazole combination therapy can improve clinical symptoms, gastric emptying, and satisfaction with treatment in functional dyspepsia (FD) patients more effectively than acotiamide or rabeprazole monotherapy alone. We also aimed to determine whether acotiamide affects these changes via its effect on gastric emptying and appetite-related hormones such as ghrelin. Methods We used Rome III criteria to evaluate upper abdominal symptoms and anxiety by the State-Trait Anxiety Inventory (STAI). Gastric motility was evaluated by the 13 C-acetate breath test. Eighty-one FD patients were treated with acotiamide (300 mg/day) (n = 35), acotiamide (300 mg/day) and rabeprazole (10 mg/day) (n = 28), or rabeprazole (10 mg/day) (n = 18) for a period of 4 weeks and followed after 4 weeks of no treatment. Adenocorticotropic hormone (ACTH), cortisol, leptin and ghrelin levels were measured in all FD patients. Key Results Acotiamide and rabeprazole combination therapy significantly improved postprandial distress syndrome (PDS)-like symptoms (p = 0.018, p = 0.04 and p = 0.041, respectively) and epigastric pain (p = 0.024) as wells as STAI-state scores (p = 0.04) compared to rabeprazole monotherapy. Both acotiamide monotherapy, and acotiamide taken in combination with rabeprazole, significantly (p = 0.001 and p = 0.02, respectively) improved satisfaction with treatment, compared to rabeprazole monotherapy. Acotiamide and rabeprazole combination therapy had no significant effect on ACTH and cortisol levels in FD patients. Of interest, acotiamide monotherapy, and acotiamide and rabeprazole combination therapy, significantly (p < 0.0001 and p = 0.018, respectively) increased acylated ghrelin/total ghrelin ratios and significantly (p = 0.04) improved impaired gastric emptying compared to rabeprazole monotherapy. Conclusions & Inferences Further studies are warranted to clarify how acotiamide treatment improves clinical symptoms in FD patients.

DOI： 10.1111/nmo.12805

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  

Background: Impact of acid suppressants on lower gastrointestinal bleeding remains unclear in low-dose aspirin users; we aimed to investigate this relationship.
Methods: Retrospective cohort study of low-dose aspirin users who underwent coronary angiography for ischaemic heart disease in our institution between October 2005 and December 2006; patients were evaluated for upper or lower gastrointestinal bleedings within 3 years post-angiography.
Results: 538 patients were enrolled (males, 74.4%; mean age 67.4 +/- 10.6 years). Risk for upper gastrointestinal bleeding decreased with concomitant use of statins (HR, 0.37; 95% CI, 0.15-0.89), calcium channel blockers (HR, 0.29; 95% CI, 0.10-0.85), and histamine-2 receptor antagonists (HR, 0.26; 95% CI, 0.08-0.89). Concomitant use of proton pump inhibitors tended to decrease risk of upper gastrointestinal bleeding (HR, 0.27; 95% CI, 0.06-1.18). Risk for lower gastrointestinal bleeding increased with both concomitant use of warfarin (HR, 15.68; 95% CI, 4.43-55.53) and proton pump inhibitors (HR, 6.55; 95% CI, 2.01-21.32), but not with histamine-2 receptor antagonists. Hyperuricemia lowered risk for lower gastrointestinal bleeding (HR, 0.12; 95% CI, 0.02-0.88).
Conclusions: In low-dose aspirin users, concomitant use of proton pump inhibitors increased lower gastrointestinal bleeding risk, independent from effects on upper gastrointestinal bleeding. (C) 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.dld.2015.05.020

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：KOREAN SOC NEUROGASTROENTEROLOGY & MOTILITY  

Background/Aims
There are no available data about the relationship between ghrelin gene genotypes and early phase of gastric emptying in functional dyspepsia (FD) as defined by Rome Ill classification.
Methods
We enrolled 74 patients presenting with typical symptoms of FD and 64 healthy volunteers. Gastric motility was evaluated using the C-13-acetate breath test. We used Rome Ill criteria to evaluate upper abdominal symptoms and self-rating questionnaires for depression (SRQ-D) scores to determine status of depression. The Arg51GIn (346G > A), preproghrelin (3056T>C), Leu72Met (408C>A), GIn90Leu (3412T>A) and G-protein beta 3 (825C>T) polymorphisms were analyzed in the DNA from blood samples of enrolled subjects. Genotyping was performed by polymerase chain reaction.
Results
There was a significant relationship between the Gln90Leu3412 genotype and SRQ-D score in FD patients (P = 0.009). Area under the curve at 15 minutes (AUC(15)) value was significantly associated with the Leu72Met408 genotype (P = 0.015) but not with entire gastric emptying.
Conclusions
The Leu72Met (408C>A) single nucleotide polymorphism was significantly associated with early phase of gastric emptying in FD patients. Further studies will be necessary to clarify the association between ghrelin gene single nucleotide polymorphisms and early phase of gastric emptying in FD patients.

DOI： 10.5056/jnm14086

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：KOREAN SOC NEUROGASTROENTEROLOGY & MOTILITY  

Background/Aims
There is no available data on factors associated with healthcare-seeking behavior for functional dyspepsia (FD) symptoms at either tertiary or primary clinics in Japan. Therefore, we aimed to compare clinical symptoms and life styles such as sleep disorders and eating attitude in FD patients visiting general practitioners at primary clinics with those consulting gastroenterologists at tertiary clinics to clarify healthcare-seeking patterns in Japanese patients.
Methods
Fifty-one FD outpatients in a tertiary clinic (college hospital), 50 FD outpatients visiting primary clinics and 50 healthy volunteers were enrolled. Clinical symptoms, quality of life, sleep disorders, eating attitude and anxiety were estimated using the Gastrointestinal Symptom Rating Scale (GSRS), Social Functioning-8 (SF-8) test, Pittsburg Sleep Quality Index (PSQI) test and State-Trait Anxiety Inventory (STAI) for FD outpatients and healthy volunteers.
Results
FD outpatients exhibited higher mean scores of GSRS than healthy volunteers. The SF-8 physical component summary scores in the tertiary clinic group were significantly lower than those in the primary clinic group. GSRS scores were significantly (P < 0.001, P = 0.002) associated with global PSQI scores in FD outpatients as well as with STAI-trait scores (P = 0.006, P = 0.001) compared to healthy volunteers. The frequency of eating between meals in the primary clinic group was significantly (P < 0.05) higher than that in the tertiary clinic group.
Conclusions
It may be important for clarification of healthcare-seeking behavior to determine the difference in both impairment of physical quality of life and eating attitudes between tertiary clinic and primary clinic FD outpatients in Japan.

DOI： 10.5056/jnm14015

Web of Science

PubMed

researchmap

記述言語：日本語   掲載種別：研究論文（学術雑誌）  

A 62-year-old woman, with a past history of long-term non-steroidal anti-inflammatory drug use and gastric ulcer, was hospitalized for intestinal obstruction in April 2012. Two stenoses were identified in the ileum in association with small intestinal ulcers, and she underwent partial resection of the small intestine. Histologically, the two lesions were poorly differentiated adenocarcinomas; metastatic small intestinal cancer was suspected, but whole body examination revealed no other lesions. The final diagnosis was multiple primary small intestinal malignancies, necessitating additional resection of the small intestine in July. We report this case to raise awareness among physicians of the possibility of primary small intestinal cancer in patients with multiple small intestinal stenoses.

DOI： 10.11405/nisshoshi.111.1594

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  

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

Background and aim : Little is known about the clinical significance of treatment for endoscopically determined peptic ulcers (EPU), incidentally detected as surrogate endpoints for non-steroidal anti-inflammatory drugs (NSAIDs)-associated ulcers complication, such as overt bleeding and perforation. Even uncomplicated-EPU without overt bleeding signs when antithrombotic agents (AT) were cotherapied may be of potential bleeding sites. The aim of the present study was to evaluate whether microcytic anemia, implying potential bleeding, is associated with NSAIDs-associated EPU or cotherapies with AT. Methods : Two hundred and thirty-eight outpatients with rheumatoid arthritis under long-term NSAIDs therapies underwent upper endoscopy and were divided into the following four groups according to the pattern (presence : + or absence : -) of AT cotherapy/EPU, respectively : A, -/- (n = 165) : B, -/+ (n = 44) ; C, +/- (n = 25) ; and D, +/+ (n = 4). Results : EPU were found in 48 of the 238 studied patients (20.2%). After significant interactions among four groups hadstatistically been identified, hemoglobin (Hb) and mean corpuscular volume (MCV) as biomarkers for potential bleeding were compared between the groups. Hb and MCV were significantly lower in the D group than in the A, B, or C groups (Hb : P < 0.01, respectively ; P < 0.05, MCV ; P < 0.01 or P < 0.05, respectively). Conclusions : Patients with NSAIDs-associated EPU and AT cotherapy indicated significantly more severe microcytic anemia pattern than those without EPU or AT cotherapy, despite no evidence of overt bleeding. Even uncomplicated-EPU without overt bleeding when ATs were cotherapied may be of potential bleeding sites.

Scopus

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：KOREAN SOC NEUROGASTERONTEROL & MOTILITY  

Background/Aims
The association between clinical symptoms, gastric emptying, quality of life and sleep disorders in distinct functional dyspepsia (FD) patients has not been studied yet in detail.
Methods
We enrolled 79 FD patients (postprandial distress syndrome [PDS], n = 65; epigastric pain syndrome [EPS], n = 47; EPS-PDS overlap, n = 33) and 44 healthy volunteers. Gastric motility was evaluated. We used Rome III criteria to evaluate clinical symptoms and State-Trait Anxiety Inventory (STAI) scores to determine anxiety status. Sleep disorder was evaluated using the Pittsburgh Sleep Quality Index scores.
Results
There were no significant differences in age, sex and Helicobacter pylori positivity between FD subtypes and healthy volunteers. The scores of Glasgow dyspepsia severity scores (GDSS), SF-8 and Pittsburgh Sleep Quality Index (PSQI) in distinct subtypes of FD patients were significantly different from those in healthy volunteers. However, there were not significant differences in these scores, Tmax and T-1/2 among 3 subtypes of FD patients. PSQI score was significantly (P = 0.027, P = 0.002 and P = 0.039, respectively) associated with GDSS among EPS, PDS and EPS-PDS overlap patients. In addition, 8-item short form health survey (SF-8; Physical Component Score and Mental Component Score) was significantly associated with global PSQI score in PDS and EPS-PDS overlap patients. In contrast, SF-8 (Mental Component Score) only was significantly linked to global PSQI score in EPS patients.
Conclusions
Prevalences for sleep disorders, gastric motility and quality of life in 3 subtypes of FD patients were similar levels. In PDS and EPS-PDS overlap patients, SF-8 was significantly associated with global PSQI score.

DOI： 10.5056/jnm.2014.20.1.104

Web of Science

PubMed

researchmap

記述言語：英語   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）  

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：CENTER ACADEMIC PUBL JAPAN  

We investigated over time whether contemporary Japanese patients with complicated peptic ulcers have any water-soluble vitamin deficiencies soon after the onset of the complicated peptic ulcers. In this prospective cohort study, fasting serum levels of water-soluble vitamins (vitamins B-1, B-2, B-6, B-12, C, and folic acid) and homocysteine were measured at 3 time points (at admission, hospital discharge, and 3 mo after hospital discharge). Among the 20 patients who were enrolled in the study, 10 consecutive patients who completed measurements at all 3 time points were analyzed. The proportion of patients in whom any of the serum water-soluble vitamins that we examined were deficient was as high as 80% at admission, and remained at 70% at discharge. The proportion of patients with vitamin B-6 deficiency was significantly higher at admission and discharge (50% and 60%, respectively, p<0.05) than at 3 mo after discharge (10%). In conclusion, most patients with complicated peptic ulcers may have a deficiency of one or more water-soluble vitamins in the early phase of the disease after the onset of ulcer complications, even in a contemporary Japanese population.

DOI： 10.3177/jnsv.59.503

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：MEDICAL ASSOC NIPPON MEDICAL SCH  

Background/Aims: The association between clinical symptoms and sleep disorders in functional dyspepsia (FD)-overlap syndrome has not been studied in detail.
Methods: The subjects were 139 patients with FD, 14 with irritable bowel syndrome (IBS), 12 with nonerosive reflux disease (NERD), and 41 healthy volunteers. Gastric motility was evaluated with the C-13-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and Self-Rating Questionnaire for Depression (SRQ-D) scores to determine depression status. Sleep disorders were evaluated with Pittsburgh Sleep Quality Index (PSQI) scores.
Results: There were no significant differences in age, body-mass index, alcohol intake, and smoking rate between patients with FD alone and those with FD-overlap syndrome. The postprandial abdominal fullness score in patients with FD-NERD-IBS was significantly greater than that in patients with FD-NERD overlap syndrome (p<0.001) or FD alone (p<0.001). The score for the feeling of hunger in patients with FD-NERD-IBS was significantly greater than that in patients with FD alone (p=0.0025), FD-NERD overlap syndrome (p=0.0088), or FD-IBS overlap syndrome (p=0.0057). The heartburn score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone (p=0.0035) or FD-IBS overlap syndrome (p=0.0026). The Tmax in patients with FD-overlap syndrome or FD alone was significantly higher than that in healthy volunteers. The Pittsburgh Sleep Quality Index score in subjects with FD-NERD-IBS overlap syndrome was significantly greater than that in subjects with FD alone.
Conclusion: Symptom scores, such as those for postprandial abdominal fullness, heartburn, and the feeling of hunger, in patients with FD-overlap syndromes are significantly greater than those in patients with FD alone. Further studies are necessary to clarify whether various symptoms are related to sleep disorders in patients with FD-NERD-IBS overlap syndrome.

DOI： 10.1272/jnms.80.362

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  

Background and Aims: The association between functional dyspepsia (FD) and sleep disorders has yet to be studied in detail. The aim of this study is to evaluate the risk factors associated with sleep disorders and the clinical response to nizatidine therapy for sleep disorders in Rome III-based FD patients.
Methods: We enrolled 94 FD patients and 52 healthy volunteers. We used Rome III criteria to evaluate upper abdominal symptoms, and the Self-Rating Questionnaire for Depression scores to determine depression status. Sleep disorder was evaluated using Pittsburgh Sleep Quality Index (PSQI) scores, and degree of anxiety by the State-Trait Anxiety Inventory. Gastric motility was evaluated. Thirty-four FD patients were treated with nizatidine (300 mg/day) or placebo for 4 weeks in a crossover trial. The primary end point of this study was to determine whether nizatidine could improve clinical symptoms and sleep disorders in FD patients.
Results: The global PSQI score for FD patients was significantly (P < 0.001) higher compared with healthy volunteers. There were significant correlations between global PSQI scores and total Gastrointestinal Symptom Rating Scale and Self-Rating Questionnaire for Depression scores (P < 0.001, P < 0.0001, respectively) in FD patients than in healthy volunteers. We found significant relationships between subjective sleep quality and both Tmax and T1/2 values in FD patients. Nizatidine significantly improved certain clinical symptoms, gastric emptying, and global PSQI score compared with placebo treatment.
Conclusion: Sleep disorders in FD patients correlated significantly with both clinical symptoms of dyspepsia and depression compared with healthy volunteers. Nizatidine significantly improved gastroesophageal reflux symptoms, gastric emptying, and sleep disorders in FD patients.

DOI： 10.1111/jgh.12236

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  

BackgroundIn Japanese routine clinical practice, endoscopy is generally carried out without sedation. The present study aimed to identify the factors essential for appropriate selection of transnasal esophagogastroduodenoscopy (TN-EGD) as an alternative to unsedated transoral esophagogastroduodenoscopy (TO-EGD).
Patients and methodsSubjects in this prospective cohort study comprised consecutive outpatients who underwent EGD at a single center. Factors predicting TO-EGD-induced distress were evaluated on a visual analog scale (VAS) and analyzed. Patients were classified into a two-layered system on the basis of these predictive factors, and the severity of distress between the TN-EGD and TO-EGD groups was compared using VAS and the change in the rate-pressure product as subjective and objective indices, respectively.
ResultsIn total, 728 outpatients (390 male, 338 female; mean age, 63.10.5 years; TO-EGD group, 630; TN-EGD group, 98)met the inclusion criteria. Multivariate logistic regression analysis confirmed that age<65 years (P<0.01; odds ratio [OR], 1.69; 95% confidence interval [CI], 1.14-2.52), gender (female; P<0.01; OR,1.97; 95% CI, 1.34-2.91), marital status (single; P<0.01; OR, 1.96; 95% CI, 1.18-3.27), and anxiety towards TO-EGD (P<0.001; OR, 3.62; 95% CI, 2.44-5.37) were independently associated with intolerance. Both indices were significantly higher in the TO-EGD subgroup than in the TN-EGD subgroup in the high predictive class, but not in the low predictive class.
ConclusionPredictive factors for detecting intolerance to unsedated TO-EGD may be useful to appropriately select patients who transpose unsedated TO-EGD to TN-EGD.

DOI： 10.1111/den.12006

Web of Science

PubMed

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：WILEY-BLACKWELL  

Background and aim Little is known about the clinical significance of treatment for endoscopically determined peptic ulcers (EPU), incidentally detected as surrogate endpoints for non-steroidal anti-inflammatory drugs (NSAIDs)-associated ulcers complication, such as overt bleeding and perforation. Even uncomplicated-EPU without overt bleeding signs when antithrombotic agents (AT) were cotherapied may be of potential bleeding sites. The aim of the present study was to evaluate whether microcytic anemia, implying potential bleeding, is associated with NSAIDs-associated EPU or cotherapies with AT. Methods Two hundred and thirty-eight outpatients with rheumatoid arthritis under long-term NSAIDs therapies underwent upper endoscopy and were divided into the following four groups according to the pattern (presence: + or absence: ) of AT cotherapy/EPU, respectively: A, / (n?=?165); B, /+ (n?=?44); C, +/ (n?=?25); and D, +/+ (n?=?4). Results EPU were found in 48 of the 238 studied patients (20.2%). After significant interactions among four groups hadstatistically been identified, hemoglobin (Hb) and mean corpuscular volume (MCV) as biomarkers for potential bleeding were compared between the groups.Hb and MCV were significantly lower in the D group than in the A,B, or C groups (Hb: P?<?0.01, respectively; P?<?0.05, MCV; P?<?0.01 or P?<?0.05, respectively). Conclusions Patients with NSAIDs-associated EPU and AT cotherapy indicated significantly more severe microcytic anemia pattern than those without EPU or AT cotherapy, despite no evidence of overt bleeding. Even uncomplicated-EPU without overt bleeding when ATs were cotherapied may be of potential bleeding sites.

DOI： 10.1111/j.1443-1661.2012.01334.x

Web of Science

PubMed

researchmap

記述言語：英語  

Sleep disorder is a common medical problem. Sleep disorder has been associated with several diseases, including pulmonary disease, gastroesophageal reflux disease (GERD) and fibromyalgia. Interest in sleep phenomenology and gastrointestinal functioning has recently increased, because sleep disorder causes significant morbidity, as evidenced by the increased need for general medical and mental health treatment for emotional problems. A number of studies have found an association between sleep disorders and functional gastrointestinal (GI) disorders. Although arousal from sleep serves several protective roles, such as increase in the speed of esophageal clearance and in airway refluxes to prevent aspiration, awakening from sleep unfortunately induces impairment of sleep quality. Some investigations about the relationship between psychogenic factors and gut motility are controversial. In addition, reports of alterations in gut motility during sleep have also been contradictory. We have evaluated sleep disorder in functional dyspepsia (FD) patients using Pittsburgh Sleep Quality Index (PSQI) score. In our recent data, PSQI score of FD patients was significantly higher compared to that in healthy volunteers. Another study has reported that the distribution of subjects who thought that they got enough sleep was significantly lower for the FD/iirritable bowel syndrome (IBS) subjects than for control subjects. Several studies have reported that anti-acid therapy and prokinetic agents are effective for certain FD patients. In addition, previous study has reported tricyclic antidepressants (TCA) drugs are effective for some FD patients. Finally, new drug, actiamide, a muscarinic antagonist and cholinesterase inhibitor, significantly improves Postprandial Distress Syndrome (PDS) symptoms. It might be critical issues for determination of precise mechanism for functional gastrointestinal disorders to clarify the relationship between gut motility and sleep disorders.

DOI： 10.1272/jnms.80.104

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：JAPAN SOC INTERNAL MEDICINE  

Objective An impairment of gastric motility is strongly associated with the pathophysiology of functional dyspepsia (FD). Plasma ghrelin is one of the key molecules linked to gastric motility. Therefore, this study aimed to evaluate whether ghrelin (GHRL) gene polymorphisms are associated with clinical symptoms, the plasma ghrelin levels and gastric emptying in patients with FD as defined by the Rome III classification.
Methods We enrolled 74 Helicobacter pylori-negative patients presenting with typical symptoms of FD (epigastric pain syndrome (EPS), n=23; postprandial distress syndrome (PDS), n=51) and 102 healthy volunteers. Gastric motility was evaluated according to the Tmax value and T-1/2 using the C-13-acetate breath test. We used the Rome III criteria to evaluate upper abdominal symptoms and SRQ-D scores to determine the depression status. The Arg51Gln(346G->A), preproghrelin3056T->C, Leu72Met(408C->A) and Gln90Leu (3412T->A) polymorphisms were analyzed in DNA in blood samples obtained from the enrolled subjects. Genotyping was performed using polymerase chain reaction.
Results There was a significant relationship (p=0.048) between the preproghrelin 3056TT genotype and the serum levels of acylated ghrelin in the H. pylori-negative FD patients. The preproghrelin 3056TT genotype was significantly (p=0.047) associated with the feeling of hunger in the H. pylori-negative FD patients.
Conclusion The preproghrelin 3056TT genotype is significantly associated with the acylated ghrelin levels and the feeling of hunger in H. pylori-negative FD patients. Further studies are needed to clarify the association between the preproghrelin 3056TT genotype and lower plasma acylated ghrelin levels and the impact of this relationship on the feeling of hunger in H. pylori-negative FD patients.

DOI： 10.2169/internalmedicine.52.8662

Web of Science

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background/Aims: In this crossover study, we investigated whether nizatidine, a H2-receptor antagonist, can alleviate clinical symptoms and gastric emptying in patients with Rome III-based functional dyspepsia (FD) with or without impaired gastric emptying. Methods: We enrolled 30 patients presenting with FD symptoms (epigastric pain syndrome, n = 6; postprandial distress syndrome, n = 24). Rome III-based FD patients were treated with nizatidine (300 mg/day) or placebo for 4 weeks in a crossover trial. Gastric motility was mainly evaluated with the Tmaxvalue using the13C-acetate breath test. Meal-related symptoms were defined as postprandial fullness and early satiation. Gastroesophageal symptom was defined as a burning feeling rising from the stomach or lower chest up toward the neck. Acylated-and desacylated ghrelin levels were evaluated by the ELISA method. Clinical symptoms, gastric emptying and ghrelin levels were evaluated at three different points during the study (pretreatment, after 4 weeks former treatment and after 4 weeks later treatment). The primary end point of this study was to determine whether nizatidine would improve clinical symptoms and gastric emptying in FD patients with or without impaired gastric emptying via affecting ghrelin levels. Results: Meal-related symptoms of the patients treated with nizatidine improved significantly (21/30; 70%) compared to those treated with placebo (3/30; 10%). In addition, nizatidine treatment also significantly improved gastroesophageal symptoms (16/30; 53%) compared to those treated with placebo (0/30; 0%). Nizatidine treatment in patients with FD accompanied by impaired gastric emptying significantly improved clinical symptoms and Tmaxvalue as a marker of gastric emptying (10/11, 91%; 9/11, 82%) compared to placebo therapy, respectively. There were no significant differences in ghrelin levels between nizatidine treatment and placebo therapy. Conclusion: Nizatidine administration significantly improved both gastric emptying and clinical symptoms in FD patients with impaired gastric emptying. © 2012 S. Karger AG, Basel.

DOI： 10.1159/000339111

Scopus

PubMed

researchmap

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background G-protein dysfunction related alteration of intracellular signal transduction might be linked to various abnormalities of functional gastrointestinal (GI) disorders. Serotonin (5-hydroxytryptamine; 5-HT) as well as G-protein is also key signaling molecule sensorimotor functions in the GI tract. Thus, this study aims to evaluate the correlation between gastric emptying and GNβ3 and 5-HTs polymorphisms in functional dyspepsia (FD) as defined by Rome III classification. Methods Seventy-four patients presenting with typical symptoms of FD (epigastric pain syndrome: EPS, n=24; postprandial distress syndrome: PDS, n=51) and sixty-four healthy volunteers were enrolled. Gastric motility was evaluated with the Tmaxvalue using the13C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms and SRQ-D scores to determine depression status. GNβ3-C825T, 5-HT1A-C1019G, 5-HT2A-G1438A, 5-HT3A-C42T, and 5-HT4A-G353+6A polymorphisms were analyzed in DNA from blood samples of enrolled subjects. Genotyping was performed by polymerase chain reaction. Key Results There was a significant relationship (P=0.045) between GNβ3 825CC genotype and PDS patients without gastro-esophageal reflux symptoms with impaired gastric emptying. In Japanese, GNβ3 825CC genotype in FD patients was significantly associated (P=0.0485) with the feeling of hunger compared with GNβ3 825CT and TT genotypes. Conclusions & Inferences Our results suggest that the GNβ3 825CC genotype is significantly associated with PDS patients without gastro-esophageal reflux with impairments of gastric emptying and also with the feeling of hunger in patients with FD. Further studies are needed to clarify whether the GNβ3 825CC genotype is linked to disturbances of gastric emptying via altered signal transduction responses. © 2011 Blackwell Publishing Ltd.

DOI： 10.1111/j.1365-2982.2011.01781.x

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: Endoscopic submucosal dissection (ESD) is more invasive than other common endoscopic procedures and may increase the risk for deep vein thrombosis (DVT)/pulmonary embolism. The incidence of DVT/pulmonary embolism after ESD has not been adequately studied.
Objective: To evaluate DVT incidence and disease-specific features of D-dimer levels in ESD patients.
Design: Prospective cohort study.
Setting: Single academic center.
Patients: This study involved 60 patients with superficial gastric neoplasms indicated for ESD.
Intervention: For all patients who underwent ESD, ultrasonography of the lower limbs was performed to detect DVT the day after ESD. D-dimer levels were measured 3 times: before ESD, immediately after ESD, and the day after ESD.
Main Outcome Measurements: DVT incidence after ESD.
Results: The DVT incidence was 10.0% (6/60). At all 3 time points, D-dimer measurements were higher in patients with DVT than in patients without DVT. According to receiver operating characteristic curve analysis, the resulting cut-off value of the D-dimer level the day after ESD was 1.9 mu g/mL (sensitivity 83.3%; specificity 79.6%) for ESD patients, with superior association to pre-ESD or immediately after ESD. In univariate analyses, high D-dimer levels the day after ESD and the presence of comorbidities were significantly associated with DVT development.
Limitations: Single center and small number of patients.
Conclusion: ESD procedures have a moderate risk for venous thromboembolism. In patients undergoing ESD, D-dimer levels, especially on the day after ESD, may have specific features associated with DVT development. (Gastrointest Endosc 2011;74:798-804.)

DOI： 10.1016/j.gie.2011.06.015

Web of Science

PubMed

researchmap

記述言語：英語   出版者・発行元：MEDICAL ASSOC NIPPON MEDICAL SCH  

Functional dyspepsia is a highly prevalent and heterogeneous disorder. Functional dyspepsia involves many pathogenic factors, such as gastric motility disorders, visceral hypersensitivity, psychological factors, Helicobacter pylori infection, and excessive gastric acid secretion. The present article provides pathophysiologic mechanisms. (J Nippon Med Sch 2011; 78: 280-285)

DOI： 10.1272/jnms.78.280

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：NATURE PUBLISHING GROUP  

OBJECTIVES: Recent studies have shown that postinfectious functional dyspepsia (FD) symptoms may persist after elimination of gastrointestinal (GI) infection as well as postinfectious irritable bowel syndrome accompanying colonic inflammation. However, it is unclear whether intestinal chronic inflammation can contribute to clinical symptoms of certain FD patients such as postinfectious FD. To determine the relationship between local inflammation of the duodenum and clinical symptoms, we evaluated the infiltration of several phenotypes of duodenal inflammatory cells as well as gastric motility using (13)C urea breath test in postinfectious FD patients.
METHODS: We enrolled 136 consecutive patients diagnosed with FD according to Rome III criteria, and 20 healthy controls, after upper GI endoscopy. Gastric motility was evaluated by gastric emptying time (T-max) using the (13)C-acetate breath test. Upper abdominal symptoms including epigastric pain, epigastric burning, postprandial fullness, abdominal distension, and early satiety were assessed by questionnaire scores. We obtained biopsy specimens from the stomach and duodenum during upper GI endoscopy. Histological gastritis and duodenitis were assessed as mild, moderate, or severe according to previously described criteria. Characteristics of inflammatory cells and neuroendocrine cells were determined immunohistochemically with antibodies to CD3, CD68, CCR2, Vdelta1 TCR, and serotonin.
RESULTS: Endoscopic duodenitis was observed in only 5.7% of postinfectious FD patients. However, the rates of histological duodenitis in duodenal biopsies of postinfectious FD patients were 17% for mild, 26% for moderate, and 57% for severe grades of duodenitis. The degree of histological duodenitis of postinfectious FD patients was significantly greater than that of healthy volunteers. There was a significant correlation between epigastric burning and the degree of duodenitis in postinfectious FD patients. There was no significant difference in histological duodenitis and T-max value in the postinfectious FD patients with or without Helicobacter pylori infection. In addition, CD68-positive cell number in postinfectious FD patients was significantly increased compared with the numbers in subjects with epigastric pain syndrome or postprandial distress syndrome and in healthy volunteers. CCR2-/CD68-double positive cell number in postinfectious FD patients was significantly (P = 0.009) increased compared with those in healthy volunteers.
CONCLUSIONS: Migration of inflammatory cells, in particular, duodenal CCR2-positive macrophages, may have an important function in the pathophysiology of postinfectious FD patients.

DOI： 10.1038/ajg.2010.151

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：SPRINGER TOKYO  

Previous studies have shown that non-erosive reflux disease (NERD) patients are less sensitive to proton pump inhibitor (PPI) treatment than patients with erosive reflux disease. The aim of this study was to investigate whether treatment with prokinetics in addition to omeprazole therapy would improve clinical symptoms, gastric emptying and esophageal peristalsis in PPI-resistant NERD patients with or without delayed gastric emptying.
Subjects were 64 consecutive patients presenting with typical symptoms of PPl-resistant NERD (n = 44) and 20 healthy volunteers. PPI-resistant NERD patients underwent mosapride citrate (15 mg/day) and omeprazole (20 mg/day) co-therapy for 12 weeks. We evaluated the clinical symptoms as well as gastric emptying and esophageal manometry before and after combined therapy. We measured both acylated- and des-acylated plasma ghrelin levels by the ELISA method. The primary endopoint was to investigate whether co-administration of mosapride citrate and omeprazole would improve clinical symptoms and gastric emptying in PPI-resistant NERD patients with delayed gastric emptying.
T (max) value in PPI-resistant NERD patients was significantly higher than in healthy volunteers. Combination therapy with the prokinetic agent mosapride citrate and omeprazole significantly improved reflux symptoms and T (max) value in T (max) > 65 min NERD patients. Co-therapy also significantly reduced des-acylated-ghrelin levels in NERD patients with delayed gastric emptying.
Administration of mosapride citrate in addition to omeprazole improved gastro-esophageal reflux and gastric emptying in PPI-resistant NERD patients with delayed gastric emptying.

DOI： 10.1007/s00535-009-0173-0

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：KARGER  

Background/Aims: To see whether celecoxib prevents gastric cancer occurrence by disrupting the progression of chronic gastritis into gastric carcinoma through its inhibition of the migration of CD133-positive cells, one of the surface markers of bone marrow-derived cells, in Helicobacter pylori infected gerbils. Methods: 70 gerbils were divided into six groups. Group 1 gerbils served as control (n = 6). 10 gerbils were given N-methyl-N-nitrosourea (MNU), 30 ppm (group 2). 6 short-term Helicobacter pylori-infected gerbils (group 3) were sacrificed after 8 weeks of H. pylori infection and 6 long-term H. pylori-infected gerbils were sacrificed after 42 weeks of H. pylori infection (group 4). 20 gerbils were given MNU pretreatment and long-term H. pylori infection (group 5). In addition, after H. pylori inoculation, 22 gerbils also received a celecoxib in their diet (group 6). CD133 and CCR2 expression in gastric tissues was evaluated by Western blot analysis and immunostaining. Results: CD133-positive cells were mainly localized in the bottom of the gastric epithelial cells. CD133-positive cells also migrated into gastric cancer tissues in this model. CD133-positive cells in MNU-pretreated H. pylori-infected gerbils were significantly increased compared to those in H. pylori short-term infected gerbils. Celecoxib treatment significantly reduced CD133-positive cell migration and CCR2 expression levels. CD133- and CCR2-positive cells were colocalized in H. pylori-infected gastritis and gastric cancer tissues. Celecoxib treatment significantly reduced the number of CD133- and CCR2-positive cells. Conclusions: Celecoxib inhibits CD133-positive cell migration via the reduction of CCR2 in this model. Further studies are needed to clarify the precise mechanisms driving H. pylori infection-induced CD133-positive cell migration and its link to the progression of chronic gastritis into gastric cancer. Copyright (C) 2010 S. Karger AG, Basel

DOI： 10.1159/000252790

Web of Science

PubMed

researchmap

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 ESD, 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. © Georg Thieme Verlag KG Stuttgart.

DOI： 10.1055/s-0029-1215221

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：WILEY-BLACKWELL PUBLISHING, INC  

The establishment of an optimal second-line regimen for Helicobacter pylori infection is required. Although quadruple therapy should overcome resistance to either clarithromycin or metronidazole, the effects of a quadruple regimen in second-line therapy are unknown. This study aims to evaluate the efficacy of triple therapy composed of proton pump inhibitor/amoxicillin plus metronidazole with the combined additive effects of clarithromycin as a second-line quadruple therapy against H. pylori infection.
Participants were 104 patients in whom first-line therapy containing proton pump inhibitor-amoxicillin-clarithromycin failed. Before starting second-line therapy, patients underwent endoscopy to obtain H. pylori strain for antibiotic susceptibility tests. Patients were randomized to receive rabeprazole (10 mg), amoxicillin (750 mg), and metronidazole (250 mg), either with clarithromycin (200 mg; RAMC group) or without (RAM group); all treatments were administered twice daily for 7 days. H. pylori eradication was confirmed by (13)C-urea breath tests performed 2 to 3 months post-therapy.
As shown by intention-to-treat/per-protocol analyses, the cure rates for H. pylori infection were 88.5%/93.9% and 82.7%/84.3% for the RAMC and RAM groups. Although the study probably had an insufficient power to show a significant difference between the cure rates of the two regimens, the eradication rates showed a clear trend in favor of the RAMC group. There were no severe side-effects in any group.
In Japan, the RAMC regimen is thought to be a promising alternative strategy for second-line eradication of H. pylori infection.

DOI： 10.1111/j.1523-5378.2009.00664.x

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：SPRINGER TOKYO  

Rheumatoid arthritis (RA) patients are at increased risk of peptic ulcers (PU) induced by nonsteroidal antiinflammatory drugs (NSAIDs). However, the impact of potential drug interactions on the development of PU has yet to be determined in a daily clinical setting. The aim was to estimate the clinical important interactions for PU presented by comedication in Japanese RA outpatients on long-term NSAID treatment.
This retrospective cohort study enrolled 196 consecutive RA outpatients on NSAID medication for at least 3 months. Potential risk factors for endoscopic PU were analyzed in RA outpatients on longterm NSAID treatment.
PU incidence was 31% with bisphosphonate co-therapy and 17% without the co-therapy. PU incidence was only 5% in subjects with proton pump inhibitors (PPI) or prostaglandin E1 analogues (PG) co-therapy, 14% with histamine-H(2) receptor antagonists(H2RA) co-therapy, and 27% without anti-ulcer agents. In multivariate logistic regression analysis, bisphosphonate co-therapy remained a significant risk factor for PU (OR, 2.29; 95% CI, 1.09-4.81). Other risk factors for ulcer development were advanced age (greater than 60 years) and smoking (OR, 2.58; 95% CI, 1.03-6.49 and OR, 2.71; 95% CI, 1.13-5.53, respectively.) Factors that significantly reduced the incidence of PU were H2RA or PPI/PG cotherapies (OR, 0.29; 95% CI, 0.12-0.68.).
Bisphosphonate co-therapy as well as advanced age and smoking was found to be a significant risk factor in PU, while co-therapies of standard-dose H2RA or PPI/PG proved effective in preventing PU in Japanese RA patients on long-term NSAID treatment.

DOI： 10.1007/s00535-008-2278-2

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：KARGER  

Background and Aims: The symptoms of postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS), the two subtypes of functional dyspepsia (FD) under the new Rome III classification, tend to overlap with those of non-erosive reflux disease (NERD). Plasma ghrelin levels have been associated with gastric motility; however, clinical studies have yet to examine this relationship among patients with PDS, EPS or NERD. Thus, this study aims to evaluate the correlation between gastric emptying and ghrelin levels as possible candidate factors for gastric motility in these diseases. Methods: One hundred and fifty-one patients presenting with typical symptoms of FD (EPS, n = 36; PDS, n = 76) or NERD (n = 39), and 20 healthy volunteers were enrolled. Gastric motility was evaluated with the T(max) value as a marker of gastric emptying using the (13)C-acetate breath test. We used Rome III criteria to evaluate upper abdominal symptoms, and SRQ-D scores to determine depression status. We measured both acylated and des-acylated ghrelin levels by ELISA methods. Results: The T(max) value in PDS patients was significantly higher than in healthy volunteers. Acylated ghrelin levels were significantly lower in NERD and PDS patients than in healthy volunteers. Interestingly, there was significant correlation between the acylated ghrelin levels and T(max) value in PDS patients but not in EPS or NERD patients. Conclusion: Our results suggest that acylated ghrelin might play an important role in the pathophysiology of PDS patients through its effect on gastric emptying. Copyright (C) 2009 S. Karger AG, Basel

DOI： 10.1159/000205740

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 PUBLISHING, INC  

Recent studies have shown that CD40, a key player in angiogenesis and tubular formation, is an extracellular receptor of the heat shock protein 70 (HSP70)-peptide complex in endothelial cells. The aim of the present study was to determine the effect of extracellular HSP70 treatment on CD40L-suppressed apoptosis and CD40L-induced tubular formation in human umbilical vein endothelial cells (HUVEC).
The apoptotic index of CD40L-stimulated HUVEC with or without recombinant human HSP70 was evaluated using terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling assay analysis. Binding of HSP70-peptide complex to CD40 on HUVEC was determined by double-labeling immunofluorescence methods. To evaluate the biological activity of CD40 engagement pretreated with rhHSP70 (0.5, 1 and 3 ng/mL), the extent of new capillary-like networking structure (tubular formation) formation in HUVEC was counted using an Olympus digital camera. Vascular invasion into MNK-28 cell clusters was assessed by counting the number of tubular structures extending from the HUVEC into growth factor-depleted Matrigel. Scores for CD34, HSP70 and CD40L expression levels in gastric cancer tissues were determined by immunostaining.
CD40L stimulation inhibited vincristine-induced apoptosis of HUVEC in a dose-dependent manner. Extracellular HSP70 treatment significantly blocked the inhibition of apoptosis by CD40L in HUVEC exposed to vincristine. HSP70-peptide complex bound to CD40 on HUVEC. Extracellular HSP70 treatment also significantly reduced CD40L-induced tubular formation in a dose-dependent manner. HSP70 treatment also suppressed invasive tubular formation into MKN-28 cells clusters by CD40L-activated HUVEC. There was a significant relationship between CD40L expression levels and microvessel density; however, the relationship between HSP70 expression level and microvessel density in gastric cancer tissues was not significant.
Extracellular HSP70 treatment blocks CD40L inhibition of apoptosis and CD40L induction of tubular formation in HUVEC.

DOI： 10.1111/j.1440-1746.2008.05442.x

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  

Background andAim: Apurinic/apyrimidinic endonuclease-1 (APE-1) is a key enzyme in DNA base excision repair (BER), linked to cancer chemosensitivity. However, little is known about the localization of APE-1 in Helicobacter pylori-infected gastric mucosa or its role in the development of gastric cancer. To investigate the role of APE-1 in the development of gastric cancer, we examined APE-1 expression and localization in cultured cells and gastric biopsies from patients with H. pylori-infected gastritis or gastric adenoma, and from surgically resected gastric cancer.
Methods: APE-1 mRNA and protein expression were determined in H. pylori (CagA+) water-extract protein (HPWEP)-stimulated MKN-28 cells, gastric adenocarcinoma cell-line (AGS) cells, and human peripheral macrophages by real-time polymerase chain reaction and Western blot analysis. APE-1 expression and 8-OHdG as a measure of oxidative DNA damage were evaluated by immunostaining. Localization of APE-1 and I kappa B alpha phosphorylation in gastric adenoma and gastric cancer tissues were evaluated by single- and double-label immunohistochemistry.
Results: In studies in vitro, HPWEP-stimulation significantly increased APE-1 mRNA expression levels in both MKN-28 cells and human peripheral macrophages. Hypo/reoxygenation treatment significantly increased APE-1 protein expression in HPWEP-stimulated MKN-28 cells. HPWEP stimulation significantly increased both APE-1 expression and I kappa B alpha phosphorylation levels in MKN-28 and AGS cells. In human tissues, APE-1 expression in H. pylori-infected gastritis without goblet cell metaplasia was significantly increased as compared to that in tissues from uninfected subjects. Eradication therapy significantly reduced both APE-1 and 8-OHdG expression levels in the gastric mucosa. APE-1 expression was mainly localized in epithelial cells within gastric adenoma and in mesenchymal cells of gastric cancer tissues. APE-1 expression in gastric cancer tissues was significantly reduced compared to that in H. pylori-infected gastric adenoma, while 8-OHdG index and I kappa B alpha phosphorylation levels did not differ between these two neoplastic tissue types. Co-localization of APE-1 and I kappa B alpha phosphorylation was observed not in gastric cancer cells but in gastric adenoma cells.
Conclusion: H. pylori infection is associated with increased APE-1 expression in human cell lines and in gastric tissues from subjects with gastritis and gastric adenomas. The observed distinct expression patterns of APE-1 and 8-OHdG in gastric adenoma and gastric cancer tissues may provide insight into the progression of these conditions and warrants further investigation.

DOI： 10.1111/j.1523-5378.2008.00605.x

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：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

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  

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：KARGER  

Background and Aims: The aim of this study was to see whether administration of celecoxib, a selective cyclooxy-genase-2 (COX-2) inhibitor, could prevent the development of gastric cancer via inhibition of apurinic/apyrimidinic endonuclease-1 (APE-1) expression induced by Helicobacter pylori infection. Methods: 70 Mongolian gerbils were divided into 6 groups. Group 1 gerbils served as controls (n=6). Ten gerbils were given N-methyl-N-nitrosourea (MNU), 30 ppm, 5 times biweekly (group 2). Short-term H. pylori infection was induced in 6 gerbils which were sacrificed 8 weeks after H. pylori infection (group 3). Long-term H. pylori infection was induced in 6 other gerbils which were sacrificed 44 weeks after H. pylori infection (group 4). Twenty gerbils were given MNU pretreatment 5 times biweekly and long-term H. pylori infection (group 5). In addition, after H. pylori inoculation, group 6 gerbils also received celecoxib with their diet for 26 weeks. APE-1 expression alone or with COX-2 in gastric tissues was evaluated by Western blot and immunohistological analysis. Myeloperoxidase (MPO) activity and thiobarbituricacid-reactive substance (TBARS) levels were also evaluated. Results: APE-1 was localized in gastric epithelial cells and mesenchymal cells including macrophages in H. pylori-infected gerbils. The numbers of APE-1-positive cells in group 4 and 5 were significantly increased compared to those of group 3. Celecoxib treatment significantly reduced MPO activity, TBARS levels and the incidence of gastric cancer. APE-1 and I kappa B alpha phosphorylation levels were significantly increased in MNU-pretreated H. pylori-infected gerbils compared to those in MNU-only gerbils. Celecoxib significantly reduced APE-1 and I kappa B alpha phosphorylation levels in MNU-pretreated H. pylori-infected gerbils. COX-2 and APE-1 were coexpressed in the macrophages of H. pylori-infected gerbils. Conclusion: Celecoxib prevented gastric cancer in MNU-pretreated H. pylori-infected gerbils with a reduction in APE-1 expression thereby suggesting the implication of APE-1 in gastric carcinogenesis in this model. Copyright (c) 2008 S. Karger AG, Basel

DOI： 10.1159/000167978

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：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

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 PUBLISHING  

Background and Aims: The purpose of this study was to investigate possible factors that could impact on gamma delta T cell accumulation in the gastric mucosa.
Method: Subjects were 22 Helicobacter pylori (H. pylori)-free and 75 H. pylori-infected mucosa biopsies classified into grades I similar to III gastritis as per our previous study. The number of gamma delta- and 45 RO-positive T cells were determined by immunostaining. Gastric mucosal anti-H. pylori urease specific antibodies and interleukin (IL)-1 beta, IL-2, 4, 7, 10 and IL-12 levels were assayed by enzyme-linked immunosorbent assay (ELISA). CC chemokine receptor 2 (CCR2) expression levels, migration, and cytokine production in gamma delta T cells stimulated by H. pylori urease were also evaluated.
Results: The gamma delta T cell count was significantly higher in grade III gastritis which exhibits strong immunoglobulin (Ig)A and IgG responses to H. pylori urease with lymphoid follicles than in other groups. gamma delta T cell count was significantly correlated with IL-1 beta and interleukin-7 (IL-7) levels in the gastric mucosa. H. pylori urease immunoreactivity was detected in lamina propria of grade III gastritis, along with many gamma delta T cells. After H. pylori eradication therapy, the gamma delta T cell count in grade III gastritis significantly decreased. H. pylori urease stimulated significant increases in CCR2 expression levels, although to a lesser degree than those induced by IL-7 stimulation in both peripheral and mucosal gamma delta T cells. Interferon (IFN)-gamma and IL-10 production was also stimulated by H. pylori urease in peripheral gamma delta T cells.
Conclusions: Gastric mucosal increases in IL-7 and IL-1 beta closely corresponded to the accumulation of gamma delta T cells in gastric mucosa. An association was also seen between gamma delta T cell accumulation and H. pylori urease-specific Ig levels.

DOI： 10.1111/j.1440-1746.2005.04148.x

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：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 < 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   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Non-steroidal anti-inflammatory drugs (NSAIDs) induced gastric mucosal injury occurs through subsequent events following free radical production derived from activated neutrophils. In this study, we hypothesized that rebamipide, a novel anti-ulcer agent, exerts a protective effect on NSAID-induced gastric injury through its antioxidant properties. The protective effect of rebamipide in a mouse model of indomethacin-induced gastric injury and mechanisms for this effect were investigated. Pretreatment with rebamipide significantly inhibited indomethacin-induced gastric mucosal injury in mice. Gastric thiobarbituric acid reactive substances (TBARS) levels and myeloperoxidase (MPO) activity substantially increased 3 hr after indomethacin administration. These increases were significantly inhibited by pre-treatment with rebamipide. Furthermore, rebamipide pre-treatment notably decreased intercellular adhesion molecule-1 (ICAM- 1) expression that was up-regulated in gastric tissue treated with indomethacin. Therefore, rebamipide may reduce indomethacin-induced gastric mucosal injuries through its antioxidant effect, which inhibits the neutrophil activation step following up-regulation of ICAM-1 expression on endothelial cells.

DOI： 10.1007/s10620-005-2811-6

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：TAYLOR & FRANCIS AS  

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 (TBARS) 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 TBARS 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.

DOI： 10.1080/00365520510015827

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：NATURE PUBLISHING GROUP  

Recently, three different prostaglandin E-2 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)-1beta 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-1beta 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

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 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-1beta-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-1beta 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-1beta-induced PGE2 release at the 8-h time point, while totally inhibiting PGE2 at the later stage. However, MK-886 did inhibit IL-1beta-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-1beta-induced mPGES-1 protein expression preferentially coupled with COX-2 protein at late stages of PGE2 production and that IL-1beta-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

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  

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-1alpha or IL-1beta in the presence or absence of NS-398, a selective COX-2 inhibitor. Supernatant VEGF and PGE(2) 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 PGE(2) production in gastric fibroblasts via COX-2 induction. NS-398 significantly suppressed VEGF and PGE(2) release from IL-1-stimulated gastric fibroblasts; concurrent addition of PGE(2) 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

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：BLACKWELL PUBLISHING INC  

Background. The role of teprenone in Helicobacter pylori-associated gastritis has yet to be determined.
To investigate the effect of teprenone on inflammatory cell infiltration, and on H. pylon colonization of the gastric mucosa in H. pylori-infected patients, we first compared the effect of teprenone with that of both histamine H2 receptor antagonists (H2-RA) and sucralfate on the histological scores of H. pylori gastritis. We then examined its in vitro effect on H. pylori-induced interleukin (IL)-8 production in MKN28 gastric epithelial cells.
Materials and Methods. A total of 68 patients were divided into three groups, each group undergoing a 3-month treatment with either teprenone (150 mg/day), H2-RA (nizatidine, 300 mg/day), or sucralfate (3 g/day). All subjects underwent endoscopic examination of the stomach before and after treatment. IL-8 production in MKN28 gastric epithelial cells was measured by enzyme-linked immunosorbent assay (ELISA).
Results. Following treatment, the teprenone group showed a significant decrease in both neutrophil infiltration and H. pylon density of the corpus (before vs. after: 2.49 +/- 0.22 vs. 2.15 +/- 0.23,p =.009; 2.36 +/- 0.25 vs. 2.00 +/- 0.24,p =.035, respectively), with no significant differences seen in either the sucralfate or H2-RA groups. Teprenone inhibited H. pylon-enhanced IL-8 production in MKN28 gastric epithelial cells in vitro, in a dose-dependent manner.
Conclusions. Teprenone may modify corpus H. pylori-associated gastritis through its effect on neutrophil infiltration and H. pylori density, in part by its inhibition of IL-8 production in the gastric mucosa.

DOI： 10.1111/j.1083-4389.2004.00209.x

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：SPRINGER-VERLAG TOKYO  

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

Web of Science

PubMed

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：英語   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：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：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)日本消化管学会  

researchmap

記述言語：日本語   出版者・発行元：(株)日本臨床社  

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：(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：(NPO)日本食道学会  

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：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   出版者・発行元：SPRINGER JAPAN KK  

DOI： 10.1007/s10388-017-0576-6

Web of Science

researchmap

記述言語：日本語   出版者・発行元：(一社)日本ヘリコバクター学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本ヘリコバクター学会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本ヘリコバクター学会  

researchmap

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：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：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：WILEY-BLACKWELL  

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：(NPO)日本食道学会  

researchmap

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：研究発表ペーパー・要旨（国際会議）   出版者・発行元：AMER ASSOC CANCER RESEARCH  

DOI： 10.1158/1538-7445.AM2016-3135

Web of Science

researchmap

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：日本語   出版者・発行元：(一社)日本潰瘍学会  

国際的診断基準のRome IIIに従い診断された機能的ディスペプシア患者で、胃痛を主体とするepigastric pain syndrome(EPS)群と、食後の腹部膨満感などを主体とするpostprandial distress syndrome(PDS)群の消化器症状はGSRSを用いてスコア化(7段階)した。胃運動能は13C-acetate呼気試験を用い、Tmax≦65minを胃排出能異常とした。血液検査で血清ACTH、cortisol、膵酵素を測定し、心気症状(不安)はState-Trait Anxiety Inventoryの自己記入式で評価した。心窩部痛症候群のGSRSは平均3.05であり、超音波・ERCP所見で膵機能障害を認めた患者のGSRSは平均1.90と有意に低く、膵機能障害を合併する心窩部痛症候群の平均ACTH値(pg/ml)/Cortisol値(μg/ml)は20.42/11.8、膵機能が正常のEPS群では25.09/12.04と有意差はなかった。超音波内視鏡所見では、膵実質の点状エコーや膵管壁肥厚を認め、早期慢性膵炎の診断基準を満たす症例を認めた。

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

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  

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：日本内科学会-関東地方会  

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：WILEY-BLACKWELL  

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：WILEY-BLACKWELL  

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：(一財)日本消化器病学会  

NSAIDsを長期服用し胃潰瘍の既往を持つ62歳女性。腸閉塞で入院。回腸に2ヶ所の狭窄部を認め、小腸部分切除術を行ったところ低分化腺癌であった。転移性小腸癌を疑い全身検索したが、他に病変を認めなかった。原発性多発小腸癌の最終診断で追加腸切除を行い、所属リンパ節に転移を認めた。多発する小腸狭窄例において原発性小腸癌も鑑別診断として考慮する必要がある。(著者抄録)

DOI： 10.11405/nisshoshi.111.1594

researchmap

その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J01118&link_issn=&doc_id=20140819040007&doc_link_id=1390001206402270208&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1390001206402270208&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_3.gif

記述言語：日本語   出版者・発行元：日本臨床生理学会  

Helicobacter pylori(H.pylori)は、胃上皮細胞に接着するとIV型分泌機構を発現し、その内腔を通してH.pyloriの病原因子であるcytotoxin-associated antigen A(CagA)蛋白を上皮細胞内へ直接注入し、様々な形で胃粘膜上皮細胞に障害を引き起こすことがわかっている。H.pylori感染と胃癌の進展機構に対する新たな知見を含め紹介した。また、cyclooxygenase-2と胃癌との関係についても触れた。

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  

背景および目的:内視鏡的消化性潰瘍は、非ステロイド性抗炎症薬(NSAID)に関連する消化性潰瘍合併症(顕在性の出血および穿孔)の代用マーカーとして偶発的に発見され、潰瘍合併症の疫学的調査に使用されてきた。たとえ偶発的に発見される無症候性の内視鏡的消化性潰瘍でさえ、抗血栓薬の併用が潜在性出血の原因となっているかもしれない。そこで、今回われわれは、潜在性出血を示唆する小球性貧血が、NSAIDに関連する内視鏡的消化性潰瘍または抗血栓薬の併用とどのような関連があるか検討した。方法:238人の長期NSAIDを服用する関節リウマチ患者が上部内視鏡検査を行い、その結果から抗血栓薬の併用および内視鏡的消化性潰瘍の有無のパターンの組み合わせから4つのグループに分類(抗血栓薬の併用/内視鏡的消化性潰瘍があり:+またはなし:-)した:それぞれ:A、-/-(n=165);B、-/+(n=44);C、+/-(n=25);and D、+/+(n=4)。結果:内視鏡的消化性潰瘍は、48人(20.2%)に認められた。4群間に統計学的な有意な相互作用が見られることを同定した上で、ヘモグロビン(Hb)とmean corpuscular volume(MCV)を潜在性出血の指標として、各グループ間において比較した。HbとMCVはいずれも、A、BおよびC群よりD群において有意に低値であった(Hb:それぞれP<0.01;P<0.05、MCV;それぞれP<0.01またはP<0.05)。結論:抗血栓薬を併用しかつ内視鏡的消化性潰瘍を有する長期NSAID服用者は、顕性出血のエビデンスがなくても、他の長期NSAID服用者と比べ、有意に高度な小球性貧血が認められた。たとえ無症候性の内視鏡的消化性潰瘍であったとしても、抗血栓薬併用時には、潜在性に出血すると考えられた。(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：(NPO)日本高齢消化器病学会  

低用量アスピリンによる消化管出血のリスクは、非ステロイド性抗炎症薬(NSAIDs)と同等またはそれ以上と考えられ、低用量アスピリン潰瘍の予防として酸分泌抑制薬を併用する機会が増えている。筆者らの検討では、プロトンポンプ阻害薬(PPI)の併用は、従来型のNSAIDsと同様、アスピリンに関連する下部消化管出血のリスクを高める。このPPIの影響は高齢者ではなく、非高齢者において顕著であった。したがって、PPIによる消化性潰瘍予防が一般化すればするほど、低用量アスピリンによる下部消化管傷害や出血が増加する可能性がある。今後、酸分泌抑制薬の併用が、どのようにアスピリン消化管傷害および出血に影響するか、さらなる検討が必要と思われた。(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：日本臨床生理学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床生理学会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床生理学会  

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)日本癌治療学会  

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：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：(NPO)日本食道学会  

researchmap

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：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：日本医科大学医学会  

症例は54歳男性で、嚥下困難を主訴に紹介入院となった。食道造影検査では頸胸部食道に長径6cm、左側から圧排する狭窄像が認められた。腫瘍露出部の生検で扁平上皮癌を認め、頸胸部MRI検査では第7頸椎〜第2胸椎レベルに27×27×53mm大の腫瘍性病変が認められた。消化器外科、頭頸部外科、消化器内科、放射線治療科の合同カンファレンスで画像所見を評価し、切除可能と診断した。消化器内科にてシスプラチン/5-FU併用ネオアジュバント化学療法を施行し、主病巣は15%程度縮小した。消化器外科にて胸腔鏡下食道切除、腹腔鏡補助下胃管作製を、頭頸部外科にて喉頭温存食道全摘、下咽頭空腸・空腸胃管吻合を施行した。術後経過および経口摂取は比較的良好で、現在外来にて加療中である。

DOI： 10.1272/manms.9.20

researchmap

記述言語：日本語   出版者・発行元：(一社)日本腹部救急医学会  

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)東京内科医会  

researchmap

記述言語：日本語   出版者・発行元：日本臨床生理学会  

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：(一財)日本消化器病学会  

researchmap

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：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)日本食道学会  

researchmap

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：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

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：日本語   出版者・発行元：(NPO)日本食道学会  

researchmap

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：日本語  

CiNii Books

researchmap

記述言語：日本語   出版者・発行元：(一社)日本潰瘍学会  

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：(株)ヴァンメディカル  

低用量アスピリンはアテローム硬化症がもたらす心血管系疾患の予防を目的とした抗血小板療法において中心的な役割を果たしている。一方で、低用量アスピリン療法に関連した粘膜傷害や潰瘍出血イベントが問題となっている。アスピリン潰瘍の有病率はおおむね10〜15%であり、従来型非ステロイド性抗炎症薬(non-steroidal anti-inflammatory drugs:NSAIDs)と比べやや低率である。抗血小板薬としてのアスピリンは低用量のため、粘膜傷害作用は基本的に弱いことが、アスピリンとNSAIDsによる潰瘍発症リスクの違いに反映していると思われる。しかし、低用量アスピリンによる潰瘍出血リスクは、従来型のNSAIDsと同等と考えられる。(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：MOSBY-ELSEVIER  

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  

高齢者では、非ステロイド系抗炎症薬(NSAIDs)だけでなく、抗血栓薬併用時における消化性潰瘍(PU)への対応策が求められている。3ヵ月以上NSAIDを服用するRA外来患者を対象とし、内視鏡的PUを調査した。PU発症率は、高齢者(61歳以上)群が非高齢者群と比べ有意に高率であった。高齢者群における、抗リウマチ薬、ビスフォスフォネートおよび抗血栓薬の併用は、PU発症率を高めた。プロトンポンプ阻害薬(PPI)またはプロスタグランジンE1製剤(PG)は、年齢に関係なくPU予防効果を認めたが、高齢者におけるヒスタミンH2-受容体拮抗薬(H2-RA)によるPU予防効果は非高齢者に比べ低かった。高齢者はNSAID潰瘍リスクが高く、併用薬がPU発症に影響を及ぼしやすい。長期NSAIDsを服用する高齢者では、PPIまたはPGによる潰瘍予防が望まれる。(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：(一財)日本消化器病学会  

researchmap

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

DOI： 10.1272/jnms.79.100

Scopus

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：WILEY-BLACKWELL  

Web of Science

researchmap

記述言語：日本語   出版者・発行元：日本臨床生理学会  

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：WILEY-BLACKWELL  

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)医学書院  

DOI： 10.11477/mf.1407103720

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)日本消化器内視鏡学会  

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)勁草書房コミュニケーション事業部  

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：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：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：(一財)日本消化器病学会  

researchmap

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。

CiNii Books

researchmap

その他リンク： http://search.jamas.or.jp/link/ui/2011192855

記述言語：日本語   出版者・発行元：日本臨床生理学会  

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：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：(NPO)日本食道学会  

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  

PPI(オメプラゾール)抵抗性非びらん性胃食道逆流症(NERD)患者に対するモサプリドの追加投与が、食道蠕動および胃排出を改善し、消化器症状を軽減するか二重盲検法で検討した。PPI抵抗性NERD患者は、健康ボランティアと比較してTmax値が有意に低下し、胃排出能が低下していた。PPI抵抗性NERD患者にモサプリドを追加投与すると、消化器症状の改善が示唆され、特に胃排出能が低下している患者群では、逆流や便秘の治癒率が高かった。

researchmap

記述言語：英語   出版者・発行元：日本癌学会  

researchmap

記述言語：日本語   出版者・発行元：(株)勁草書房コミュニケーション事業部  

researchmap

記述言語：日本語   出版者・発行元：(有)科学評論社  

CiNii Books

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)勁草書房コミュニケーション事業部  

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  

低用量アスピリン(L-ASA)長期服用者における、消化管出血関連症状(吐下血、無症候性貧血)と内視鏡的消化性潰瘍(UL)との関連を検討した。対象は、心臓カテーテル検査(CAG)を行った長期L-ASAを服用した虚血性心疾患患者で、CAG後2年間に施行した上部内視鏡検査記録および診療録から情報を抽出した。患者538例のうち96例に上部内視鏡検査を行い、そのうち出血症状を認めた33例中14例でULを認めたが、症状がない63例では2例のみであった。抗潰瘍薬併用例のUL発症率は、非併用例と比べ有意に低かった。長期L-ASA服用患者では明らかな吐下血がないULでも、潜在性出血をきたす可能性があり、抗潰瘍薬を用いた予防・治療が望まれる。(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  

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：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：(株)ライフ・サイエンス  

75歳以上の切除不能胃癌症例を対象に、S-1ベース化学療法が有効か検討した。切除不能胃癌と診断した75歳以上の患者(高齢者群)8例と、75歳未満の患者(非高齢者群)10例を対象とした。S-1単独療法かS-1+低用量CDDP療法のいずれかを施行した。S-1ベース化学療法全体の生存期間中央値(MST)は、非高齢者群9.7ヵ月、高齢者群9.5ヵ月で有意差はなかった。非高齢者群でのS-1単独療法と、S-1+低用量CDDP療法のMSTはそれぞれ、15ヵ月、8.65ヵ月、高齢者群でそれぞれ10.5ヵ月、7.75ヵ月であった。grade3/4の有害事象は、非高齢者群では10例中、白血球減少、貧血、疲労、皮疹が各1例で、高齢者群では8例中、白血球減少が2例、貧血、クレアチニン上昇、食欲不振、下痢が各1例であった。いずれも治療関連死はなく、容認可能な範囲であった。

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：日本医科大学医学会  

胃液中の酸、ペプシンによる消化作用によって形成される胃・十二指腸潰瘍が消化性潰瘍と総称されてきた。現在ではHelicobacter pylori感染、非ステロイド性抗炎症薬(NSAID)およびストレスによる粘膜防護機構の破綻が、潰瘍発症の主因と考えられている。消化性潰瘍の現状について、潰瘍の2大要因である、H.pylori感染とNSAIDを中心に、消化性潰瘍の解明と治療の工夫について概説した。

DOI： 10.1272/manms.6.7

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：(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：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)勁草書房コミュニケーション事業部  

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：(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)勁草書房コミュニケーション事業部  

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：日本医師会  

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：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：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：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：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)日本血液学会-東京事務局  

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：(株)ライフ・サイエンス  

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：同愛記念病院学術雑誌部  

67歳女。就寝中に突然の下腹部痛、嘔吐の出現後に血便と下痢を来たし、近医にてBlumberg徴候を伴う圧痛を認め、虚血性大腸炎を疑われて当科紹介となった。腹部造影CTで上腸間膜動脈に動脈解離を疑う内腔の線状構造を認めたが大動脈解離は認めず、下行結腸壁が浮腫様に肥厚して内腔が狭小化していた。Volume Rendering CTより上腸間膜動脈が腹腔動脈より分枝し、下行結腸の支配管は上腸間膜動脈主体と思われ、孤立性上腸間膜動脈解離による虚血性大腸炎と診断した。腸管虚血を認めないため保存的治療を選択し、1週間後には下行結腸の壁肥厚は改善傾向を示し腹痛も消失したため、第13病日より経口摂取、抗血小板薬による抗凝固療法を開始した。第18病日の退院後、定期的に外来フォローアップし、退院後2ヵ月の注腸検査で虚血性大腸炎の瘢痕の下行結腸の狭窄部を認めた。抗凝固療法は継続中で症状の再燃は認めなかった。

researchmap

記述言語：日本語   出版者・発行元：同愛記念病院学術雑誌部  

61歳男。皮膚黄染で受診し腹部CTで肝右葉に巨大腫瘍、多発性のリンパ節腫大を認め精査加療目的で入院した。画像所見と検査所見から、肝内巨大腫瘤および肝門部リンパ節腫脹による閉塞性黄疸と診断しERCPを施行したが、総胆管中部は先細りで狭窄し、胆管は拡張し胆嚢腫大を伴っていた。ENBDチューブを留置し、減黄を試みた。胆汁の細胞診ではClass IIIaであったが血清sIL-2Rの高値を認めた。右鼠径リンパ節生検より大型から中型のリンパ腫細胞をび漫性に認め、diffuse large B cell lymphomaと診断した。骨髄検査ではリンパ腫細胞の浸潤を認め、非ホジキンリンパ腫と診断した。ENBD施行後、ERBDステントを留置してビリルビン低下後にCHOP療法を開始した。化学療法に対する反応は良好で心窩部右側の腫瘤や表在リンパ節の縮小傾向を認めた。ビリルビンは正常化して2コース目はrituximab併用のCHOP療法を施行し、4コース終了後胆道系の閉塞解除を認めERBDステントも抜去した。計8コースのR-CHOP療法を実施したが完全寛解に至らず病変が残存したため再度R-ACE療法によるサルベージを開始した結果、3コース目に寛解となり4コースを終了して外来観察とした。

researchmap

記述言語：日本語   出版者・発行元：同愛記念病院学術雑誌部  

researchmap

記述言語：日本語   出版者・発行元：(有)科学評論社  

長期通院中のリウマチ患者232名をその服用パターンによってコントロール群25例(C群)、非ステロイド性消炎鎮痛薬(NSAID)群174例(N群)、NSAID+アスピリン(LA)群11例(NL群)、NSAID+ NSAID群22例(NN群)に分類し、NSAID+LA併用による内視鏡的消化性潰瘍の有病率を検討した。その結果、1)潰瘍有病率はC群に比べてNSAID服用群で有意に高く、NN群が他の3群と比べて有意に高率であった。2)NL群の潜在性出血マーカーを他の3群と比較すると有意差はなかったが、各群で潰瘍を伴うサブグループを抽出すると、NL群のサブグループは他群に比べて明らかな小球性貧血が認められた。3)N群、NN群はC群と比べて消化性潰瘍の有病率は高いが、潜在性出血マーカーに有意差はなく、内視鏡的消化性潰瘍を有するサブグループにおいても、他群と比較して潜在性出血マーカーに有意差はなかった。4)無症候性小潰瘍であっても、LAは抗血小板作用を介して潜在性出血をもたらす可能性があると示唆された。

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：(株)ヴァンメディカル  

FD患者の30〜70%はIBSやGERD症状を合併したoverlap syndromeであると報告されている。このoverlapの病態として内臓知覚過敏、消化管運動障害、感染、うつ傾向、遺伝素因などが指摘されているが、いまだ詳細は不明である。今後、overlapの観点からFDの病態を解析することは、FDだけでなくGERDやIBSを含む消化管全体の機能障害の病態解明に貢献する可能性があり期待される。(著者抄録)

researchmap

記述言語：日本語   出版者・発行元：(株)文光堂  

researchmap

記述言語：日本語   出版者・発行元：日本内科学会-関東地方会  

researchmap

記述言語：日本語   出版者・発行元：(一社)日本ヘリコバクター学会  

researchmap

記述言語：日本語   出版者・発行元：(株)医学書院  

非ステロイド性抗炎症薬(non-steroidal anti-inflammatory drug;NSAID)はその使用量の増加とともに,NSAIDによる粘膜傷害が上部だけでなく下部消化管においても注目されている.その予防的治療は抗潰瘍薬を用いて経験的に行われてきた.しかしながら,近年,抗潰瘍薬だけでなく,選択的COX-2阻害薬,Helicobacter pylori(H.pylori)除菌療法によるNSAID潰瘍予防に関する大規模臨床試験が,欧米を中心に精力的に行われ,PPI,prostaglandin製剤による予防効果および選択的COX-2阻害薬の有効性が明らかとなりつつある.除菌療法の効果については結論が得られていないが,NSAID投与前に除菌することが推奨されている.日本人は,酸分泌量が少なく,H.pylori感染率も高いことを考慮すると,今後,わが国独自のNSAID潰瘍の実態調査ならびに治療と予防に関する介入試験が望まれる.(著者抄録)

DOI： 10.11477/mf.1403101228

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)日本臨床社  

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：(株)勁草書房コミュニケーション事業部  

researchmap

記述言語：日本語   出版者・発行元：(株)勁草書房コミュニケーション事業部  

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：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(株)勁草書房コミュニケーション事業部  

researchmap

記述言語：日本語   出版者・発行元：(株)勁草書房コミュニケーション事業部  

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：(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：日本臨床生理学会  

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：(株)勁草書房コミュニケーション事業部  

researchmap

記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

NSAIDsはH.pylori感染と並ぶ消化性潰瘍の二大要因である.今回われわれは当院リウマチ科との共同研究により,長期NSAIDs服用RA患者の粘膜病変の実態調査を行ったところ,前庭部小彎に平坦・陥凹型胃癌との鑑別を要する症例を経験した.典型例を3例提示し,うち1例のLADG手術標本組織所見から,早期胃癌様の形態を呈する原因について若干の考察を加えて報告する(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：(一財)日本消化器病学会  

researchmap

記述言語：日本語   出版者・発行元：(株)ライフ・サイエンス  

血管新生因子として代表的なvascular endothelial growth factor(VEGF)に着目し,H.pyloriに感染した胃上皮細胞からのVEGF産生,およびこのVEGF産生に与えるteprenoneの影響を検討した.H.pylori感染MKN28細胞から産生される上清中のIL-8とVEGF産生は,H.pylori感染後,3,6,12および24時間においていずれも経時的に増加した.VEGF産生に対するteprenoneの影響を,H.pylori感染後24時問の培養上清で検討した.H.pyloriを添加していないMKN28細胞では,VEGF産生はわずかしかみられず,VEGF産生に対するteprenoneによる影響も認められなかった.H.pyloriを添加したMKN28細胞では,VEGF産生が有意に亢進し,teprenoneはその亢進したVEGF産生を用量依存的に抑制した

researchmap

記述言語：日本語   出版者・発行元：(株)中外医学社  

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-関東支部  

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-関東支部  

50歳男.下血と心窩部痛を主訴に来院し,上部消化管内視鏡にて胃角部に血管断端を伴う活動性胃潰瘍および十二指腸球部に潰瘍瘢痕が認められ,内視鏡的止血後に入院となった.入院後H2ブロッカー点滴静注を開始し,Helicobacter pylori(H.pylori)陽性所見から第30病日から除菌療法を施行した.8週間のプロトンポンプインヒビター(PPI)投与により除菌2ヵ月後の内視鏡ではH1 stageに改善していた.その後,受診が中断されていたが,除菌8ヵ月後に再び心窩部痛が出現,内視鏡では潰瘍は瘢痕化していたが,以前からの十二指腸球部前壁の瘢痕に加えA1 stageの潰瘍を認めたためPPI内服を再開した.5週間後の内視鏡で瘢痕化を認めPPIの服用を中止し,6ヵ月経過後には胃潰瘍は瘢痕化したままであったが,上十二指腸角近傍には再び線状のA2 stageの潰瘍が再発した.本症例のように非H.pylori,非NSAIDsの潰瘍再発症例が増加傾向にあり,今後,症例集積と病態解明が必要と考えられた

DOI： 10.11641/pde.64.2_28

researchmap

記述言語：日本語   出版者・発行元：(株)総合医学社  

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)東京内科医会  

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)日本消化器内視鏡学会-関東支部  

researchmap

記述言語：英語   出版者・発行元：東京医科大学医学会  

インドメタシン,選択的COX-2阻害薬であるNS-398,この2種のNSAIDsのICAM-1発現に対する作用を,ヒト臍帯静脈内皮細胞(HUVEC),胃線維芽細胞を用いて調べた.内皮細胞,胃線維芽細胞においてIL-1β10ng/ml刺激でICAM-1発現は著増した.内皮細胞ではインドメタシン,NS-398はICAM-1発現に影響しなかったが,胃線維芽細胞では両者とも有意にIL-1β刺激によるICAM-1発現を抑制したが,COX-2発現の影響はうけなかった.胃線維芽細胞ではPGE2を作用させるとNSAIDsの作用を打ち消さず,むしろ相加的にICAM-1発現を抑制した.NF-κB阻害薬MG-132を作用させると,IL-1βによるICAM-1発現は著明に抑制された

researchmap

記述言語：日本語   出版者・発行元：胃病態機能研究会  

マウスを用いて急性の胃粘膜病変を作製し,粘膜修復に深く関わっているとされるシクロオキシゲナーゼ-2(COX-2)蛋白が虚血再灌流実験で認められた粘膜局所の好中球浸潤にどのように関わっているのかを検討した.マウス胃の虚血再灌流障害において,COX-2は細胞間接着分子-1の発現の抑制を介して好中球の組織浸潤をおさえ,粘膜障害に防御的に働いている可能性が示唆された

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：(株)先端医学社  

胃粘膜内T細胞はヘルパーT細胞(Th)1型のT細胞が胃炎の増悪に深く関与しており,Th1型をTh2型にシフトすることができれば,胃炎の増悪の制御に貢献できると思われる.しかし,胃粘膜局所におけるT細胞のサイトカインプロファイル,消化管上皮や間葉系細胞から産生され,T細胞の分化・増殖に関与するサイトカインの役割やγδT細胞のはたらきなど,まだまだ不明な点も多い.Helicobacter pylori(H.pylori)除菌療法に対する耐性菌が増加しつつあるいまこそ,T細胞を含めた胃粘膜に本来備わっている防御機構を検証することが重要であると考えられる

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：日本語   出版者・発行元：日本医科大学医学会  

researchmap

記述言語：日本語   出版者・発行元：(株)新興医学出版社  

52歳男.主訴はタール便,上腹部不快感.右上下肢の不全麻痺と深部反射の亢進が認められた.諸検査結果から胃悪性リンパ腫と診断し,H.pyloriの除菌療法を行った.しかし胃内視鏡所見に改善なく,腹部CT検査により腹腔内リンパ節の増大を認めた為,CHOP療法を開始した.sIL-2値の低下を認め,心窩部痛が出現した為,急性膵炎と診断し,メシル酸ガベキセートの点滴投与を行った.血清アミラーゼ値は126IU/lと改善したが,腹部CT検査で膵周囲に多数のリンパ節腫脹とリンパ節による膵の圧排像,大動脈周囲のリンパ節腫脹を認めた為,ESHAP療法を開始した.しかし治療効果が認められず,中等量のAraC療法を開始したが,急性腎不全,鬱血性腎不全を合併し,治療を行うも死亡した

researchmap

記述言語：日本語   出版者・発行元：(一社)日本潰瘍学会  

マウスの腹腔動脈を結紮して30分の虚血状態とした後に再灌流を行った.胃粘膜傷害は対照群に比較して有意に増悪し,再灌流の時間を経るにしたがってその傾向は増大した.MPO活性も再灌流時間にしたがって上昇した.COX-1蛋白は胃粘膜中の発現量に変化を認めなかったが,対照群で認めなかったCOX-2蛋白は再灌流90分後に発現を認め,120分後には更に明瞭となった.又,NS-398前処理においては胃粘膜傷害の増悪傾向を認め,MPO活性値の上昇傾向を認めた

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  

DOI： 10.11405/nisshoshi1964.99.88sokai_A175

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：ライフサイエンス出版(株)  

スナネズミをHelicobacter pylori(H.pylori)に感染させH.pylori感染モデルを作成し,胃粘膜中にCOX-2蛋白を誘導させ,NSAIDにより生じた胃粘膜障害に対するH.pyloriの影響を検討した.その結果,NSAIDの投与期間により胃粘膜障害に有意差が見られ,又,indomethacinの投与期間によりCOX活性の抑制程度に差が見られた

researchmap

記述言語：日本語   出版者・発行元：(一社)日本内科学会  

researchmap

記述言語：日本語   出版者・発行元：茨城県消化器病懇話会  

経管栄養患者の胃粘膜中のHelicobacter pylori(Hp)感染率を胃内視鏡的胃瘻造設術(PEG)施行時に,病理組織,培養法,迅速ウレアーゼ試験を行い検討した.経口摂取患者では潰瘍群83例中61例(73%)で,非潰瘍群49例中29例(59%)でHpに感染していたのに対し,経管栄養患者群では52例中21例(40%)と感染率は低く,このうち胃瘻造設時では39例中18例(46%)であったものが,胃瘻交換時では13例中3例(23%)と経管栄養が続いた患者でHp感染率は低かった.PEG施行時にHp陽性であった4例中3例では胃瘻交換時にHpは陰性化していた.胃瘻造設後に点滴静注した抗生物質(ABPC)の胃液中の濃度は投与後1〜2時間後に増加し,HpのABPCに対する最小発育阻止濃度より高かった.以上の結果から経管栄養患者では経静脈的に投与された抗生物質によりHpが除菌された可能性が示唆された

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  

DOI： 10.11405/nisshoshi1964.97.42taikai_A571

researchmap

記述言語：日本語   出版者・発行元：(株)ライフ・サイエンス  

40匹のmongolian gerbilを,H.pylori感染・非感染群,NSAID投与・非投与群に分類し,H.pyloriとNSAIDの関係を調べた.NSAIDの投与期間は,2日間と7日間とした.その結果,2日間のNSAID連続投与では,H.pylori非感染群よりH.pylori感染群の方が組織所見上,胃粘膜傷害がわずかに軽度であったが,7日間の連続投与後では,H.pylori感染群の方が胃粘膜傷害がより増悪していた.また,H.pylori感染群では,胃粘膜固有層にCOX-2陽性細胞を認めた.H.pylori感染群においては,NSAID 2日間連続投与によりCOX活性は有意には抑制されなかったが,7日間の連続投与では,COX-1,COX-2ともに有意に抑制された.したがって,H.pylori感染によって誘導されたCOX-2蛋白は,胃粘膜に対し,防御的に働くと考えられ,H.pylori感染とNSAID投与によって生ずる胃粘膜に対する影響には,COX活性も深く係わっていると思われた

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：(一社)日本消化器内視鏡学会-関東支部  

A 52-year-old man was admitted to our hospital because of exacerbation of the symptoms, such as limp and tremor. HTLV-1 associated myelopathy (HAM) , which it was six years since he was diagnosed. Then he started to take Predonisolone (PSL) 30-60 mg/day. After treatment by PSL, symptoms of HAM were gradually improving. But from 50th hospital day, epigastralgia, nausea and vomitting were appeared, following by bloody stool. An X-ray film of the abdomen showed the small bowel gas with the fluid level. Endoscopic examination revealed diffuse redness, erosion and swelling in the duodenal second portion and bulb, and circumferential redness and swelling of esophageal mucosa from pharyngoesophageal junction to esophagogastric mucosal junction (EG junction) , and with two or three linar erosion near EG junction. The biopsy specimen from the duodenum showed larvae of Strongyloides stercoralis, but not the esophagus. This case was thought that severe Strongyloidiasis with esophageal lesion was developed while giving steroid therapy for HAM.

DOI： 10.11641/pdensks.55.2_72

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：(一社)日本血液学会-東京事務局  

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：(有)科学評論社  

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