Researcher Database

Shoko Ono
Hokkaido University Hospital Internal Medicine
Lecturer

Researcher Profile and Settings

Affiliation

  • Hokkaido University Hospital Internal Medicine

Job Title

  • Lecturer

J-Global ID

Research Areas

  • Life sciences / Gastroenterology

Research Activities

Published Papers

  • Yoshii S, Mabe K, Watano K, Ohno M, Matsumoto M, Ono S, Kudo T, Nojima M, Kato M, Sakamoto N
    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 0915-5635 2019/07 [Refereed][Not invited]
  • Ono S, Ono Y, Sakamoto N
    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 31 (3) e70 - e71 0915-5635 2019/05 [Refereed][Not invited]
  • Tsuda M, Kato M, Ono S, Matsuda K, Miyamoto S, Abiko S, Ono M, Mizushima T, Yamamoto K, Nakagawa M, Mabe K, Nakagawa S, Kudo T, Nishikawa K, Shimizu Y, Asaka M, Sakamoto N
    Digestion 1 - 9 0012-2823 2019/04 [Refereed][Not invited]
  • Miyamoto S, Tsuda M, Kato M, Mabe K, Muto S, Ono S, Shimizu Y, Sakamoto N
    Journal of clinical biochemistry and nutrition 64 (2) 174 - 179 0912-0009 2019/03 [Refereed][Not invited]
  • Ono S, Kato M, Tsuda M, Miyamoto S, Abiko S, Shimizu Y, Sakamoto N
    Digestion 98 (4) 222 - 230 0012-2823 2018/07 [Refereed][Not invited]
  • Mizushima T, Ohnishi S, Shimizu Y, Hatanaka Y, Hatanaka KC, Kuriki Y, Kamiya M, Homma A, Yamamoto K, Ono S, Urano Y, Sakamoto N
    Head & neck 40 (7) 1466 - 1475 1043-3074 2018/07 [Refereed][Not invited]
  • Abiko S, Shimizu Y, Miyamoto S, Ishikawa M, Matsuda K, Tsuda M, Mizushima T, Yamamoto K, Ono S, Kudo T, Ono K, Sakamoto N
    Journal of gastroenterology 53 (10) 1120 - 1130 0944-1174 2018/02 [Refereed][Not invited]
  • Masayoshi Ono, Mototsugu Kato, Shuichi Miyamoto, Momoko Tsuda, Takeshi Mizushima, Shouko Ono, Manabu Nakagawa, Katsuhiro Mabe, Soichi Nakagawa, Shuichi Muto, Yuichi Shimizu, Mineo Kudo, Shinichi Katsuki, Takashi Meguro, Naoya Sakamoto
    Journal of Gastroenterology 1 - 8 1435-5922 2018/01/05 [Refereed][Not invited]
     
    Background: The Rome III diagnostic criteria had been used to diagnose functional gastrointestinal disorders (FGIDs) world wide, and functional bowel disorders (FBDs) including irritable bowel syndrome (IBS) have recently attracted the attention of Japanese physicians. However, there have been few reports on the prevalence of FBDs diagnosed by the Rome III diagnostic criteria. Aims: The aim of this study was to determine the prevalence of FBDs diagnosed according to the diagnostic criteria of Rome III in Japan. Patients and methods: All patients who were booked for colonoscopy were enrolled from eight institutions in Japan. This study was a prospective observational study in the period from April 2013 to December 2013. Patients filled out FGID questionnaires of Rome III when they were waiting for colonoscopy. Results: Data for 1200 patients who underwent colonoscopy were analyzed. A total of 547 patients (45.6%) were diagnosed with FBDs. Out of those patients, 9.1% had IBS. According to the Rome III diagnostic criteria, 134 patients (11.2%) had functional bloating (FB), 73 (6.1%) had functional constipation (FC), 40 (3.3%) had functional diarrhea (FD), and 191 (15.9%) had unspecified functional bowel disorder (UFBD). Patients with FBDs had significantly higher rates of almost all symptoms (abdominal pain, hard or lumpy stools, loose or watery stools, and bloating) than those in the controls. Conclusions: In Japan, the prevalence of FBDs and IBS is high, similar to that in the US. Many patients with FBDs have multiple symptoms.
  • Shuichi Miyamoto, Mototsugu Kato, Momoko Tsuda, Kana Matsuda, Tetsuhito Muranaka, Satoshi Abiko, Masayoshi Ono, Takeshi Mizushima, Saori Omori, Keiko Yamamoto, Katsuhiro Mabe, Shoko Ono, Takahiko Kudo, Yuichi Shimizu, Naoya Sakamoto
    Gastroenterological Endoscopy 60 (1) 68 - 77 0387-1207 2018/01/01 [Refereed][Not invited]
     
    Background and Aim : Use of proton pump inhibitors (PPI) is histologically associated with oxyntic gland dilatations. Two interesting mucosal changes are often detected endoscopically in patients who use PPI : gastric cracked mucosa (GCM) and gastric cobblestone-like mucosa (GCSM). The aim of the present study was to clarify the relationship between PPI use and these mucosal changes. Methods : This was a single-center observational study. All successive subjects who underwent a routine esophagogastroduodenoscopy (EGD) between August and November 2014 in Hokkaido University Hospital were enrolled. Endoscopists carried out the assessment blinded to the use of PPI and checked for GCSM and GCM using original diagnostic criteria for GCM and GCSM. Subjects were divided into two groups : those who used PPI (PPI group) and those who did not (control group). Endoscopic findings and backgrounds were compared between the two groups. Results : A total of 538 patients were analyzed (control group : 374 patients, men/women : 204/170, median age : 65.2 years PPI group : 164 patients, men/women : 89/75, median age : 67.1 years). GCM was detected in 54 (10.0%) subjects, and GCSM was detected in 18 (3.3%) subjects. There was a significant difference in the prevalence rate of GCM between the control group (14/374, 3.7 %) and the PPI group (40/164, 24.4%) (P< 0.01). GCSM was significantly more prevalent in the PPI group (15/164, 9.1%) than in the control group (3/374, 0.8%) (P< 0.01). Conclusion : Novel GCM and GCSM endoscopic findings in the corpus area seem to be strongly associated with PPI use.
  • Shuichi Miyamoto, Yoshihiro Matsuno, Mototsugu Kato, Takahiko Kudo, Shouko Ono, Yuichi Shimizu, Naoya Sakamoto
    AMERICAN JOURNAL OF GASTROENTEROLOGY 112 (12) 1899 - 1901 0002-9270 2017/12 [Refereed][Not invited]
  • Shuichi Miyamoto, Takahiko Kudo, Satoshi Abiko, Shouko Ono, Yuichi Shimizu, Yoshihiro Matsuno, Naoya Sakamoto
    AMERICAN JOURNAL OF GASTROENTEROLOGY 112 (11) 1638 - 1638 0002-9270 2017/11 [Refereed][Not invited]
  • Ritsuko Oikawa, Yoshiyuki Watanabe, Shuichi Miyamoto, Yoshinori Sato, Shoko Ono, Katsuhiro Mabe, Hiroyuki Yamamoto, Mototsugu Kato, Fumio Itoh
    Tumor Biology 39 (10) 1 - 7 1423-0380 2017/10/01 [Refereed][Not invited]
     
    The eradication of Helicobacter pylori reduces the risk of gastric cancer. A clear understanding of the factors underlying mixed infection with multiple clarithromycin-susceptible and clarithromycin-resistant H. pylori strains is necessary to design more effective therapies against H. pylori. We aimed to assess how the abundance and prevalence of H. pylori strains vary after clarithromycin-based eradication therapy. Using gastric wash samples, which represent the entire stomach, we sequentially analyzed the abundance and prevalence of H. pylori DNA by 23S ribosomal RNA pyrosequencing before and 1, 2, and 3 years after eradication therapy. Low levels of H. pylori DNA were still detectable at the first-year follow-up in all samples with negative post-treatment urea breath test results. The abundance of H. pylori DNA decreased significantly until the 2-year follow-up, but it switched to an increase at the 3-year follow-up. Importantly, the ratio of the prevalence of mutant strains to the prevalence of wild-type strains had already increased at the first-year follow-up and continued to increase, suggesting the selection and growth of clarithromycin-resistant strains during the follow-up periods. Being sensitive and representative, our assay will be useful in effectively addressing gastric cancer development by enhancing the long-term success of intervention strategies and consecutive surveillance for H. pylori eradication.
  • Shoko Ono, Mototsugu Kato, Soichi Nakagawa, Katsuhiro Mabe, Naoya Sakamoto
    HELICOBACTER 22 (3) 1083-4389 2017/06 [Refereed][Not invited]
     
    BackgroundAlthough all Helicobacter pylori (H.pylori)-positive patients should receive eradication therapy, the therapy is a challenge for patients allergic to penicillin. There have been a few reports on the efficacy of eradication therapy for such patients. ObjectiveTo analyze the efficacy of vonoprazan or proton pump inhibitor (PPI)-based 7-day triple therapy in patients allergic to penicillin. Materials and MethodsA total of 88 consecutive patients allergic to penicillin who received H.pylori eradication therapy were retrospectively analyzed. Thirty-one patients had a history of failed eradication therapy. Four 7-day regimens were prescribed during the study period: clarithromycin-metronidazole-PPI (13 patients), clarithromycin-metronidazole-vonoprazan (14 patients), metronidazole-sitafloxacin-PPI (44 patients) and metronidazole-sitafloxacin-vonoprazan (17 patients). A C-13-urea breath test was used for confirmation of eradication, and efficacy of eradication was evaluated by intention-to-treat analysis and per-protocol analysis. ResultsIntention-to-treat and per-protocol eradication rates were 46.2%/54.6% for patients who received clarithromycin-metronidazole-PPI, 92.9/92.9% for patients who received clarithromycin-metronidazole-vonoprazan, 100/100% for patients who received metronidazole-sitafloxacin-PPI and 88.2/93.8% for patients who received metronidazole-sitafloxacin-vonoprazan. For first eradication, vonoprazan significantly raised the intention-to-treat efficacy of the triple therapy including clarithromycin-metronidazole (vonoprazan: 92.9%, PPI: 46.2%, P=.0128). A 7-day regimen consisting of metronidazole and sitafloxacin was effective for patients allergic to penicillin with or without past failure of eradication. ConclusionFor first eradication in patients allergic to penicillin, a 7-day triple therapy consisting of clarithromycin, metronidazole and vonoprazan could be a candidate eradication regimen.
  • Shuichi Miyamoto, Takahiko Kudo, Mototsugu Kato, Kana Matsuda, Satoshi Abiko, Momoko Tsuda, Takeshi Mizushima, Keiko Yamamoto, Shoko Ono, Yuichi Shimizu, Naoya Sakamoto
    Clinical Journal of Gastroenterology 10 (3) 220 - 223 1865-7265 2017/06/01 [Refereed][Not invited]
     
    A 68-year-old man with no symptoms presented to Hokkaido University Hospital for esophagogastroduodenoscopy screening. He had a history of Helicobacter pylori eradication. Initial esophagogastroduodenoscopy showed no gastric cobblestone-like mucosa or gastric cracked mucosa. After 1 year, he received esomeprazole (20 mg) once daily for heartburn at another hospital. Esophagogastroduodenoscopy was performed after 2 years of esomeprazole administration. Endoscopic findings showed that after H. pylori eradication, according to the Kyoto classification, gastric cobblestone-like mucosa presented in the gastric body area. Dilation of the oval crypt opening and intervening part in the gastric cobblestone-like mucosa was detected by endoscopy with narrow band imaging. Endoscopic ultrasonography revealed a thick gastric second layer and sporadic small a-echoic lesions in the low-echoic thickened second layer in the gastric cobblestone-like mucosa. The gastric cobblestone-like mucosa biopsy specimen showed parietal cell protrusions and oxyntic gland dilatations. Recently, we reported that gastric mucosal changes such as gastric cracked mucosa and gastric cobblestone-like mucosa were caused by proton-pump inhibitors however, the gastric cobblestone-like mucosa was not examined by endoscopic ultrasonography. In this case, endoscopic ultrasonography findings suggested that oxyntic gland dilatations caused the elevated gastric mucosa, such as gastric cobblestone-like mucosa, from the use of proton-pump inhibitors.
  • Shuichi Miyamoto, Mototsugu Kato, Momoko Tsuda, Kana Matsuda, Tetsuhito Muranaka, Satoshi Abiko, Masayoshi Ono, Takeshi Mizushima, Saori Omori, Keiko Yamamoto, Katsuhiro Mabe, Shoko Ono, Takahiko Kudo, Yuichi Shimizu, Naoya Sakamoto
    DIGESTIVE ENDOSCOPY 29 (3) 307 - 313 0915-5635 2017/05 [Refereed][Not invited]
     
    Background and Aim: Use of proton pump inhibitors (PPI) is histologically associated with oxyntic gland dilatations. Two interesting mucosal changes are often detected endoscopically in patients who use PPI: gastric cracked mucosa (GCM) and gastric cobblestone-like mucosa (GCSM). The aim of the present study was to clarify the relationship between PPI use and these mucosal changes. Methods: This was a single-center observational study. All successive subjects who underwent a routine esophagogastroduodenoscopy (EGD) between August and November 2014 in Hokkaido University Hospital were enrolled. Endoscopists carried out the assessment blinded to the use of PPI and checked for GCSM and GCM using original diagnostic criteria for GCM and GCSM. Subjects were divided into two groups: those who used PPI (PPI group) and those who did not (control group). Endoscopic findings and backgrounds were compared between the two groups. Results: A total of 538 patients were analyzed (control group: 374 patients, men/women: 204/170, median age: 65.2 years; PPI group: 164 patients, men/women: 89/75, median age: 67.1 years). GCM was detected in 54 (10.0%) subjects, and GCSM was detected in 18 (3.3%) subjects. There was a significant difference in the prevalence rate of GCM between the control group (14/374, 3.7%) and the PPI group (40/164, 24.4%) (P < 0.01). GCSM was significantly more prevalent in the PPI group (15/164, 9.1%) than in the control group (3/374, 0.8%) (P < 0.01). Conclusion: Novel GCM and GCSM endoscopic findings in the corpus area seem to be strongly associated with PPI use.
  • Osamu Dohi, Nobuaki Yagi, Shigeto Yoshida, Shoko Ono, Yoji Sanomura, Shinji Tanaka, Yuji Naito, Mototsugu Kato
    DIGESTION 96 (3) 127 - 134 0012-2823 2017 [Refereed][Not invited]
     
    Background/Aims: The diagnostic efficacy of magnifying blue laser imaging (M-BLI) and M-BLI in bright mode (M-BLIbright) in the identification of early gastric cancer (EGC) was evaluated for comparison to that of magnifying narrowband imaging (M-NBI). Methods: This prospective, multicenter study evaluated 114 gastric lesions examined using M-BLI, M-BLI-bright, and M-NBI between May 2012 and November 2012; 104 EGCs were evaluated by each modality. The vessel plus surface classification system was used to evaluate the demarcation line (DL), microvascular pattern (MVP), and microsurface pattern (MSP). Results: M-BLI, MBLI- bright, and M-NBI revealed a DL for 96.1, 98.1, and 98.1% and irregular MVP for 95.1, 95.1, and 96.2% of lesions, respectively, with no significant difference. Irregular MSP was observed by M-BLI, M-BLI-bright, and M-NBI in 97.1, 90.4, and 78.8% of lesions, respectively, with significant differences (p < 0.001). The proportion of moderately differentiated ad-enocarcinoma with irregular MSP on M-BLI and absent MSP on M-NBI was significantly higher than that with irregular MSP on M-BLI and M-NBI (35.0 and 9.9%, respectively; p = 0.002). Conclusion: M-BLI and M-BLI-bright provided excellent visualization of microstructures and microvessels similar to M-NBI. Irregular MSP in a moderately differentiated adenocarcinoma might be frequently visualized using M-BLI and M-BLI-bright compared with using M-NBI. (C) 2017 S. Karger AG, Basel
  • Shuichi Miyamoto, Mototsugu Kato, Kana Matsuda, Satoshi Abiko, Momoko Tsuda, Takeshi Mizushima, Keiko Yamamoto, Shoko Ono, Takahiko Kudo, Yuichi Shimizu, Kanako C. Hatanaka, Izumi Tsunematsu, Naoya Sakamoto
    INTERNAL MEDICINE 56 (14) 1825 - 1829 0918-2918 2017 [Refereed][Not invited]
     
    A 56-year-old man with gastroesophageal reflux disease (GERD) was referred to our hospital. Esophagogastroduodenoscopy (EGD) revealed no evidence of any polypoid lesions in the stomach, and the patient had no history of Helicobacter pylori infection. He received omeprazole (20 mg) once daily for the GERD. EGD was performed at 1 year after the start of omeprazole administration, and this time, gastric hyperplastic polyps (GHPs) were detected. The GHPs increased in size as the omeprazole treatment continued, but they markedly decreased in size following omeprazole discontinuation. Thus, the administration of proton pump inhibitors may be a risk factor for the development of GHP independent of H. pylori infection.
  • Shoko Ono, Yuji Ono, Naoya Sakamoto
    Journal of Japanese Society of Gastroenterology 114 (11) 1948 - 1956 1349-7693 2017 [Refereed][Not invited]
  • Katsuhiro Mabe, Mototsugu Kato, Koji Oba, Soichi Nakagawa, Hideyuki Seki, Shinichi Katsuki, Kentaro Yamashita, Shoko Ono, Yuichi Shimizu, Naoya Sakamoto
    Journal of gastroenterology 52 (1) 50 - 60 0944-1174 2017/01 [Refereed][Not invited]
     
    BACKGROUND: The management of antithrombotic agents for endoscopic procedures has recently focused on preventing periprocedural thrombosis in Western countries. However, this focus on shorter cessation of antithrombotic agents needs to be examined for its implications for post-procedural bleeding, with potential risk factors for such bleeding clarified in real-world clinical settings in Japan. METHODS: A Sapporo consensus group convened and developed a consensus document on the criteria for cessation of antithrombotic agents. In the multicenter, prospective, observational study that followed to validate the criteria in a real-world clinical setting, of all patients ≥20 years of age receiving antithrombotic agents and undergoing endoscopic procedures, all consenting patients were enrolled. All participating facilities were followed up on their adherence to the criteria and clinical outcomes, such as the occurrence of post-procedural bleeding and thrombosis. RESULTS: A total of 5250 patients, who accounted for 6944 endoscopic procedures, were enrolled from 19 study sites. The consensus criteria, which proved to be nearly consistent with the JSGE criteria revised in 2012, had been adhered to in a total of 6531 procedures performed in 4921 patients. Bleeding and thrombosis were reported in 53 (0.76 %) and two (0.03 %) patients, respectively, among those receiving antithrombotic agents. Post-procedural bleeding was significantly associated with high-bleeding-risk procedures, a high thromboembolic risk with heparin bridging, and the presence of renal failure/dialysis. CONCLUSIONS: With the new criteria in place for cessation of antithrombotic agents focused on prevention of periprocedural thrombosis, endoscopic procedures may be safely performed without substantially increasing bleeding in clinical practice in Japan.
  • Matsumoto M, Kato M, Oba K, Abiko S, Tsuda M, Miyamoto S, Mizushima T, Ono M, Omori S, Takahashi M, Ono S, Mabe K, Nakagawa M, Nakagawa S, Kudo T, Shimizu Y, Sakamoto N
    Gastroenterological Endoscopy 59 (7) 1537 - 1545 2017 [Refereed][Not invited]
  • Shuichi Miyamoto, Yoshiyuki Watanabe, Ritsuko Oikawa, Shoko Ono, Katsuhiro Mabe, Takahiko Kudo, Hiroyuki Yamamoto, Fumio Itoh, Mototsugu Kato, Naoya Sakamoto
    Tumor Biology 37 (8) 10123 - 10132 1423-0380 2016/08/01 [Refereed][Not invited]
     
    Helicobacter pylori is a key factor in the development of gastric cancer indeed, clearance of H. pylori helps prevent gastric cancer. However, the relationship between gastric cancer and the abundance and diversity of H. pylori genotypes in the stomach remains unknown. Here, we present, for the first time, a quantitative analysis of H. pylori genotypes in gastric washes. A method was first developed to assess diversity and abundance by pyrosequencing and analysis of single nucleotide polymorphisms in 23S ribosomal RNA (rRNA), a gene associated with clarithromycin resistance. This method was then validated using arbitrarily mixed plasmids carrying 23S rRNA with single nucleotide polymorphisms. Multiple strains were detected in many of 34 clinical samples, with frequency 24.3 ± 24.2 and 26.3 ± 33.8 % for the A2143G and A2144G strains, respectively. Importantly, results obtained from gastric washes were similar to those obtained from biopsy samples. The method provides opportunities to investigate drug resistance in H. pylori and assess potential biomarkers of gastric cancer risk, and should thus be validated in large-scale clinical trials.
  • Mio Matsumoto, Mototsugu Kato, Koji Oba, Satoshi Abiko, Momoko Tsuda, Shuichi Miyamoto, Takeshi Mizushima, Masayoshi Ono, Saori Omori, Masakazu Takahashi, Shoko Ono, Katsuhiro Mabe, Manabu Nakagawa, Soichi Nakagawa, Takahiko Kudo, Yuichi Shimizu, Naoya Sakamoto
    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 28 (5) 570 - 6 0915-5635 2016/07 [Refereed][Not invited]
     
    BACKGROUND AND AIM: Prophylactic clipping has been widely used to prevent post-procedural bleeding in colon polypctomy. However, its efficiency has not been confirmed and there is no consensus on the usefulness of prophylactic clipping. The aim of the present study was to evaluate the preventive effect of prophylactic clipping on post-polypectomy bleeding. METHODS: A multicenter randomized controlled study was conducted from January 2012 to July 2013 in Japan. Patients who had polyps <2 cm in diameter were divided into a clipping group and a non-clipping group by cluster randomization. After endoscopic polypectomy, patients allocated to the clipping group underwent prophylactic clipping, whereas the procedure was completed without clipping in patients allocated to the non-clipping group. Occurrence of post-polypectomy bleeding was compared between the two groups. RESULTS: Seven hospitals participated in this study. A total of 3365 polyps in 1499 patients were evaluated. The clipping group consisted of 1636 polyps in 752 patients, and the non-clipping group consisted of 1729 polyps in 747 patients. Post-polypectomy bleeding occurred in 1.10% (18/1636) of the cases in the clipping group, and in 0.87% (15/1729) of those in the non-clipping group. The difference was -0.22% (95% confidence interval [CI]: -0.96, 0.53). Upper limit of the 95% CI was lower than the non-inferiority margin (1.5%), and we could thus prove non-inferiority of non-clipping against clipping. CONCLUSION: Prophylactic clipping is not necessary to prevent post-polypectomy bleeding for polyps <2 cm in diameter.
  • Takeshi Mizushima, Shunsuke Ohnishi, Yuichi Shimizu, Yutaka Hatanaka, Kanako C. Hatanaka, Hidetaka Hosono, Yoshimasa Kubota, Mitsuteru Natsuizaka, Mako Kamiya, Shouko Ono, Akihiro Homma, Mototsugu Kato, Naoya Sakamoto, Yasuteru Urano
    BMC CANCER 16 411  1471-2407 2016/07 [Refereed][Not invited]
     
    Background: Detecting superficial head and neck squamous cell carcinoma (HNSCC) by endoscopy is challenging because of limited morphological hallmarks, and iodine cannot be applied to head and neck lesions due to severe mucosal irritation. Upsilon-glutamyltranspeptidase (GGT), a cell surface enzyme, is overexpressed in several cancers, and it has been reported that Upsilon-glutamyl hydroxymethyl rhodamine green (gGlu-HMRG), a fluorescent targeting agent which can be enzymatically activated and becomes fluorescent after cleavage of a GGT-specific sequence, can be activated within a few minutes after application to animal models. We investigated whether early HNSCC can be detected by applying gGlu-HMRG to clinical samples. Methods: gGlu-HMRG was applied to four HNSCC cell lines, and fluorescence was observed by fluorescence microscopy and flow cytometry. Immunohistological examination was performed in three recent cases of endoscopic submucosal dissection (ESD) to investigate GGT expression. Fluorescence imaging with gGlu-HMRG in eight clinical samples resected by ESD or surgery was performed, and fluorescence intensity of tumor and normal mucosa regions of interest (ROI) was prospectively measured. Results: All four gGlu-HMRG-applied cell lines emitted green fluorescence. Immunohistological examination demonstrated that GGT was highly expressed in HNSCC of the recent three ESD cases but barely in the normal mucosa. Fluorescence imaging showed that iodine-voiding lesions became fluorescent within a few minutes after application of gGlu-HMRG in all eight resected tumors. Tumor ROI fluorescence intensity was significantly higher than in the normal mucosa five minutes after gGlu-HMRG application. Conclusions: Fluorescence imaging with gGlu-HMRG would be useful for early detection of HNSCC.
  • Shoko Ono, Masayoshi Ono, Manabu Nakagawa, Yuichi Shimizu, Mototsugu Kato, Naoya Sakamoto
    Gastric Cancer 19 (2) 561 - 567 1436-3305 2016/04/01 [Refereed][Not invited]
     
    Background: Although second-look endoscopy is performed within several days after gastric endoscopic submucosal dissection (ESD), there has been no evidence supporting the usefulness of the intervention. We investigated the relationship between delayed bleeding and hemorrhage of mucosal defects after ESD on second-look endoscopy and analyzed risk factors of active bleeding on second-look endoscopy. Methods: A total of 441 consecutive ESD cases with gastric cancer or adenoma were retrospectively analyzed. Second-look endoscopy was performed in the morning after the day of ESD. Bleeding of mucosal defects on second-look endoscopy was classified according to the Forrest classification, and active bleeding was defined as Forrest Ia or Ib. Delayed bleeding was defined as hematemesis or melena after second-look endoscopy. Results: A total of 406 second-look endoscopies were performed, and delayed bleeding occurred in 11 patients. The incidence rate of delayed bleeding after second-look endoscopy in patients with Forrest Ia or Ib was significantly higher than that in patients with Forrest IIa, IIb or III (7.69 vs. 2.02 %, p <  0.05). Complication of a histological ulcer, large size of the resected specimen and long ESD procedure time were shown to be risk factors for hemorrhage of mucosal defects after ESD on second-look endoscopy by univariate analysis. Multivariate analysis indicated that only large size of the resected specimen was a risk factor. In a specimen size of > 35 mm, the odds ratio of active bleeding on second-look endoscopy was 1.9. Conclusion: Active bleeding of mucosal defects on second-look endoscopy is a risk factor for delayed bleeding.
  • Mio Matsumoto, Katsuhiro Mabe, Momoko Tsuda, Masayoshi Ono, Saori Omori, Masakazu Takahashi, Takeshi Yoshida, Shoko Ono, Manabu Nakagawa, Soichi Nakagawa, Yuichi Shimizu, Takahiko Kudo, Naoya Sakamoto, Mototsugu Kato
    BMC GASTROENTEROLOGY 15 89  1471-230X 2015/07 [Refereed][Not invited]
     
    Background: For endoscopic interventions, heparin bridging therapy is recommended in patients who are at high risk from interruption of antithrombotic therapy. Although heparin bridging has been reported to be effective in preventing thrombosis, several reports have raised concerns about increased risk of bleeding. The aim of this study was to clarify complications of hepari bridging therapy in therapeutic endoscopy. Methods: A nationwide multicenter survey using questionnaire was performed about patients undergoing therapeutic endoscopy with heparin bridging. Patients who underwent therapeutic endoscopy without heparin bridging therapy were considered as controls. Compliance scores of heparin bridging therapy guideline were employed, and association was analyzed between the score and occurrence of post-procedural bleeding. Results: The incidence of post-procedural bleeding was significantly higher (13.5 %, 33/245) in the heparin group compared with the control group (2.7 %, 299/11102)(p < 0.001). Thrombosis occurred in 1 patient each in the two groups. In the heparin group, post-procedural bleeding was more likely to be delayed bleeding. Dose adjustment of heparin was a significant factor contributing to bleeding. The compliance score of heparin bridging therapy guideline was significantly higher in those who suffered bleeding. Conclusions: Heparin bridging therapy significantly increased the risk of post-procedural bleeding compared with the control. The bleeding risk was associated with greater adherence with guidelines for heparin bridging therapy.
  • Kato M, Ono S, Shimizu Y, Sakamoto N, Mabe K
    Nihon rinsho. Japanese journal of clinical medicine 73 (7) 1215 - 1220 0047-1852 2015/07 [Refereed][Not invited]
  • Takeshi Mizushima, Mototsugu Kato, Ichiro Iwanaga, Fumiyuki Sato, Kimitoshi Kubo, Nobuyuki Ehira, Minoru Uebayashi, Shouko Ono, Manabu Nakagawa, Katsuhiro Mabe, Yuichi Shimizu, Naoya Sakamoto
    SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 29 (1) 133 - 139 0930-2794 2015/01 [Refereed][Not invited]
     
    Colorectal endoscopic submucosal dissection (ESD) is a widely accepted treatment for colorectal tumors, but is technically more difficult and has a higher risk of complications such as perforation than gastric ESD. Few studies have investigated the factors associated with technical difficulty and perforation in colorectal ESD. This study aimed to evaluate the technical difficulty according to location, and the risk factors for perforation, in colorectal ESD. This retrospective study included 134 consecutive colorectal tumors treated by ESD in 122 patients at the Division of Endoscopy of Hokkaido University Hospital and the Department of Gastroenterology of Kitami Red Cross Hospital from November 2011 to February 2013. To evaluate the technical difficulty of performing ESD for colorectal tumors at specific locations, the en bloc R0 resection rate, specimen diameter, procedure speed, and procedure time were compared among tumor locations using the chi (2) test or analysis of variance. Risk factors for perforation were identified by multiple logistic regression analysis. The en bloc R0 resection rate was 86.6 % (116/134), the mean tumor diameter was 27.1 mm, and the mean procedure time was 63.5 min. The mean speed of procedures was significantly slower in the sigmoid colon (24.7 min/cm(2)) than in other areas. Perforation occurred in nine cases (6.7 %). Submucosal fibrosis was the only factor independently associated with perforation (odds ratio 5.684, 95 % confidence interval 1.307-24.727). ESD was slower for sigmoid colon tumors than for tumors in other areas, suggesting that ESD was technically more difficult in the sigmoid colon than in other colorectal areas. Submucosal fibrosis was independently associated with perforation during colorectal ESD.
  • Yuichi Shimizu, Masakazu Takahashi, Takeshi Mizushima, Shouko Ono, Katsuhiro Mabe, Shunsuke Ohnishi, Mototsugu Kato, Masahiro Asaka, Naoya Sakamoto
    AMERICAN JOURNAL OF GASTROENTEROLOGY 110 (1) 193 - 194 0002-9270 2015/01 [Refereed][Not invited]
  • Masakazu Takahashi, Yuichi Shimizu, Masayoshi Ono, Mio Suzuki, Saori Omori, Takeshi Yoshida, Yasuaki Mori, Manabu Nakagawa, Shouko Ono, Soichi Nakagawa, Katsuhiro Mabe, Mototsugu Kato, Kanako Hatanaka, Masahiro Asaka, Naoya Sakamoto
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 29 (4) 762 - 768 0815-9319 2014/04 [Refereed][Not invited]
     
    Background and AimIt was previously reported that high-grade intraepithelial neoplasia of the esophagus turns pink within a few minutes after iodine staining (pink-color sign; PCS); however, iodine staining is uncomfortable. By using narrow band imaging (NBI), color change in the area between the intraepithelial papillary capillary loop (background coloration; BGC) is often observed within the brownish area. The diagnostic usefulness of BGC findings for differentiating high-grade intraepithelial neoplasia from low-grade intraepithelial neoplasia was evaluated. MethodsIn a prospective observational study from September 2010 to August 2012, 285 patients who were in a high-risk group for esophageal squamous cell carcinoma underwent endoscopic examination. Lesions with both endoscopic findings of dilated intraepithelial papillary capillary loop on NBI and iodine-unstained areas were studied, in which endoscopic biopsy or endoscopic resection was subsequently performed. The esophageal background mucosa was also evaluated on the basis of the iodine staining pattern (uniform type: Group U, scattered type: Group S). ResultsOne hundred three esophageal lesions in 87 patients were studied. When BGC was used as the differentiation index, sensitivity was 93.8%, specificity was 88.2%, and accuracy was 91.3%. When PCS was used, sensitivity was 97.9%, specificity was 88.2%, and accuracy was 93.2% (P=0.79). In Group U (n=54), BGC had an accuracy of 93.8%, and PCS had an accuracy of 92.3% (P=1.0). On the other hand, in Group S (n=33), BGC had an accuracy of 86.8%, while PCS had an accuracy of 94.7% (P=0.27). ConclusionsDiagnosis using BGC on NBI may substitute for diagnosis based on PCS in many patients.
  • Saori Omori, Katsuhiro Mabe, Kanako Hatanaka, Masayoshi Ono, Mio Matsumoto, Masakazu Takahashi, Takeshi Yoshida, Shoko Ono, Yuichi Shimizu, Nozomi Sugai, Akira Suzuki, Shinichi Katsuki, Takahiro Fujii, Mototsugu Kato, Masahiro Asaka, Naoya Sakamoto
    Pathology Research and Practice 210 (7) 440 - 443 1618-0631 2014 [Refereed][Not invited]
     
    It remains unclear whether or not human intestinal spirochetosis (HIS) has any associated symptoms or lesions. In this study, we assessed the prevalence of HIS in sessile serrated adenomas/polyps (SSA/Ps) and their possible association.Following identification of early cecal cancer with SSA/P accompanied by a colonization of HIS, we went on to conduct a retrospective case-control study using endoscopically resected SSA/P specimens to examine the frequency of HIS infection in SSA/Ps.Nineteen SSA/P cases and 172 controls were obtained. The rate of HIS infection was significantly higher at 52.6% (10/19) in the SSA/P cases compared to the controls at 8.1% (14/172).Our SSA/P series were associated with a remarkably higher rate of HIS than controls or than previously reported. This is the first report to provide evidence for potential association between HIS and SSA/Ps. © 2014 Elsevier GmbH.
  • Yuichi Shimizu, Masakazu Takahashi, Takeshi Yoshida, Shouko Ono, Katsuhiro Mabe, Mototsugu Kato, Masahiro Asaka, Naoya Sakamoto
    GASTROINTESTINAL ENDOSCOPY 79 (1) 178 - 179 0016-5107 2014/01 [Refereed][Not invited]
  • Shouko Ono, Mototsugu Kato, Saori Ishigaki, Yuichi Shimizu
    Gastrointestinal Endoscopy 79 (1) 163 - 164 0016-5107 2014/01 [Refereed][Not invited]
  • Shouko Ono, Mototsugu Kato, Manabu Nakagawa, Aki Imai, Keiko Yamamoto, Yuichi Shimizu
    Surgical Endoscopy and Other Interventional Techniques 27 (10) 3577 - 3583 0930-2794 2013/10 [Refereed][Not invited]
     
    Background: Endoscopic submucosal dissection (ESD) has become the standard endoscopic treatment for gastric neoplasms because of its safety and high rate of curability however, it is not easy for novice operators to learn the technique of ESD. In this study, predictive factors of gastric neoplasms in which novices could not finish ESD by self-completion were evaluated. Methods: Eighty consecutive ESD procedures performed by four novice operators were retrospectively analyzed. Standard ESD procedures were performed using an insulation-tipped (IT) knife under supervision. Self-completion rates, procedure time, and complete resection rates were evaluated, and predictive factors for "not self-completion" were assessed. Results: The overall self-completion rate and en bloc plus R0 resection rate were 87.5% (70/80) and 95.7 % (67/70), respectively. In "not self-completion" cases (n = 10), the procedure time was longer and resected specimens were larger than those in self-completion cases (83.7 ± 47.3 min vs. 189.5 ± 106.8 min, p < 0.05 641.2 ± 487.8 vs. 1,116 ± 480.4 mm2, p < 0.01). Predictive factors of "not self-completion" were tumor location in the middle or upper third of the stomach or in the greater curvature and size of resected specimens larger than 900 mm2. The self-completion rate of ESD was decreased in cases with more than two predictive factors. Conclusions: For novice operators, tumor location and resected areas are predictive factors for failure to finish gastric ESD by self-completion. Selection of cancer lesions could be a key factor for effectiveness of ESD training. © 2013 Springer Science+Business Media New York.
  • Omori S, Mabe K, Ono M, Suzuki M, Takahashi M, Ono S, Simizu Y, Kato M, Hatanaka K, Sakamoto N
    Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine 102 (8) 2046 - 2049 0021-5384 2013/08 [Refereed][Not invited]
  • Kato M, Ono S, Mabe K, Sakamoto N, Asaka M
    Nihon rinsho. Japanese journal of clinical medicine 71 (8) 1429 - 1435 0047-1852 2013/08 [Refereed][Not invited]
  • Yuichi Shimizu, Masakazu Takahashi, Takeshi Yoshida, Shouko Ono, Katsuhiro Mabe, Mototsugu Kato, Masahiro Asaka, Kanako Hatanaka, Naoya Sakamoto
    Gastrointestinal Endoscopy 78 (2) 351 - 358 0016-5107 2013/08 [Refereed][Not invited]
     
    Background: Recently, some patients have been found to have superficial squamous cell carcinoma (SCC) of the head and neck region during GI endoscopy however, endoscopic biopsy from a lesion in the head and neck region is troublesome. An endocytoscopy system has been reported to enable optical biopsy of an esophageal lesion. Objective: To evaluate the feasibility of in vivo cellular imaging with an integrated endocytoscopy system for patients with superficial SCC of the head and neck. Design: Experimental pilot study. Setting: University hospital. Patients: This study involved 12 patients who were found to have superficial SCC of the head and neck during GI endoscopy. Intervention: Endocytoscopic images were taken of each lesion and of the surrounding mucosa. The images were later reviewed by 1 pathologist and 2 endoscopists who were unaware of any other findings. Main Outcome Measurements: Correlation between endocytoscopy diagnosis and histologic diagnosis. Results: Adequate endocytoscopic images could be obtained in 11 of the 12 patients (15 of 16 lesions). For endocytoscopic images of 15 lesions and 12 areas of surrounding mucosa, the overall accuracy of endocytoscopic diagnosis in differentiating between nonmalignant and malignant histopathology by the pathologist, endoscopist 1, and endoscopist 2 were 96%, 96%, and 96%, respectively. The kappa value for interobserver agreement was 0.77. Limitations: Single-center experience, small number of patients. Conclusion: An endocytoscopy system has the potential to be used as an optical biopsy for superficial head and neck lesions.
  • Yuichi Shimizu, Masakazu Takahashi, Takeshi Yoshida, Shouko Ono, Katsuhiro Mabe, Mototsugu Kato, Masahiro Asaka, Naoya Sakamoto
    GASTROINTESTINAL ENDOSCOPY 77 (6) 972 - 973 0016-5107 2013/06 [Refereed][Not invited]
  • Yuichi Shimizu, Masakazu Takahashi, Takeshi Yoshida, Shouko Ono, Katsuhiro Mabe, Mototsugu Kato, Masahiro Asaka, Naoya Sakamoto
    Digestive Endoscopy 25 (1) 13 - 19 0915-5635 2013/03 [Refereed][Not invited]
     
    Endoscopic resection (ER) has been widely accepted as an effective and minimally invasive treatment for patients with superficial esophageal squamous cell carcinoma (SCC). Techniques of conventional endoscopic mucosal resection (EMR) were first developed for ER. There are three representative methods of conventional EMR: endoscopic esophageal mucosal resection (EEMR)-tube method, EMR using a cap-fitted endoscope (EMRC) method and two-channel EMR method. In the past decade, techniques of endoscopic submucosal dissection (ESD) have become established as standard methods of ER. ESD allows en bloc resection of a lesion, irrespective of the size and shape of the lesion. Recently, results of retrospective cohort studies confirming that ESD is superior to EMR as a curative treatment for superficial esophageal SCC have been reported. Representative knives that are now frequently used in esophageal ESD include Hook knife, Triangle tip knife, IT knife nano, Flush knife-BT, Dual knife, SB knife, and so on. Although there are various knives developed for ESD, the basic techniques for safe and effective ESD are the same. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.
  • Masahira Haneda, Mototsugu Kato, Saori Ishigaki, Mio Suzuki, Masakazu Takahashi, Manabu Nakagawa, Shouko Ono, Yasuaki Mori, Katsuhiro Mabe, Shouichi Nakagawa, Takahiko Kudo, Yuichi Shimizu, Masahiko Asaka
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 28 (1) 78 - 83 0815-9319 2013/01 [Refereed][Not invited]
     
    Background and Aim: Pepsinogen (PG) method is widely used to identify high risk groups of gastric cancer. It is very useful before Helicobacter pylori eradication, but after eradication the method becomes useless because the PGI, PGII, PGI/II ratios change. Therefore, we aimed to identify a high risk group for gastric cancer using serum pepsinogen after successful eradication of H. pylori. Methods: A total of 261 participants were enrolled after successful eradication of H. pylori in Hokkaido University Hospital from 1995 to 2010. Participants with renal failure, taking proton pump inhibitors, and those with advanced gastric cancer were excluded. Serum levels of PGI and II were measured using chemiluminescent immunoassay method. Results: Receiver operating characteristic curves using cancerous and non-cancerous data in post-eradication determined the optimal cut-off value of PGI/II as 4.5. The sensitivity and the specificity were 65.9% and 79.3%, respectively. The usual PG method includes 48.9% of cancer cases, and the PGI/II <= 4.5 in post-eradication includes 65.9% of them, and it includes approximately half of the high risk group of diffuse type cancer. PGI/II <= 4.5 in post-eradication included many gastric cancer cases detected after eradication (12/16 = 75%). Conclusion: In the identification of a high risk group for gastric cancer, we suggest that the optimal cut-off value of PGI/II after successful eradication of H. pylori is 4.5. PGI/II <= 4.5 in post-eradication includes more gastric cancer cases compared with the traditional PG method, and 75% of gastric cancer cases detected after eradication.
  • Tamotsu Hata, Mototsugu Kato, Takahiko Kudo, Mutsumi Nishida, Urara Nishida, Aki Imai, Takeshi Yoshida, Jyojyo Hirota, Go Kamada, Shouko Ono, Manabu Nakagawa, Soichi Nakagawa, Yuichi Shimizu, Hiroshi Takeda, Masahiro Asaka
    DIGESTION 87 (1) 34 - 39 0012-2823 2013 [Refereed][Not invited]
     
    Background: Functional dyspepsia (FD) is a heterogeneous disease characterized by various upper abdominal symptoms. The major mechanism of FD includes impaired fundic accommodation, delayed gastric emptying and visceral hypersensitivity. We developed a novel drinking-ultrasonography test to combine a drink test with ultrasonography to assess gastric motility and sensory function of FD patients. Method: Subjects were 20 healthy volunteers and 26 successive FD patients according to the Rome III criteria. The subjects ingested 200 ml of water at 2-min intervals 4 times (total 800 ml) through a straw. The maximum cross section of the proximal stomach was visualized before water intake, after each water intake, and 5 and 10 min after the completion of drinking using extracorporeal ultrasonography. Abdominal symptoms were evaluated using the visual analog scale (VAS) a total of 5 times. Results: The mean cross-sectional area of the fornix after 800 ml of water intake was significantly lower in the FD group compared with the control group. In the FD group, marked abdominal symptoms developed immediately after initiation of water intake, and VAS Score differed significantly (p < 0.01) between the control and FD groups at each time point. Conclusion: We developed the novel drinking-ultrasonography test which revealed abnormalities in gastric accommodation and sensation in patients with FD compared with healthy controls. This approach can be readily performed and allows the simultaneous evaluation of gastric accommodation, emptying and sensation. copyright (C) 2013 S. Karger AG, Basel
  • Masakazu Takahashi, Yuichi Shimizu, Takeshi Yoshida, Yasuaki Mori, Manabu Nakagawa, Junji Yamamoto, Shoko Ono, Soichi Nakagawa, Katsuhiro Mabe, Takahiko Kudo, Mototsugu Kato, Masahiro Asaka
    GASTROINTESTINAL ENDOSCOPY 76 (6) 1270 - 1271 0016-5107 2012/12 [Refereed][Not invited]
  • Yuichi Shimizu, Masakazu Takahashi, Takeshi Yoshida, Shouko Ono, Katsuhiro Mabe, Mototsugu Kato, Masahiro Asaka
    GASTROINTESTINAL ENDOSCOPY 76 (5) 1073 - 1073 0016-5107 2012/11 [Refereed][Not invited]
  • Aki Imai, Mototsugu Kato, Shouko Ono, Yuichi Shimizu, Hiroshi Takeda, Masahiro Asaka
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 27 (10) 1623 - 1628 0815-9319 2012/10 [Refereed][Not invited]
     
    Background and Aim: Colonoscopy has the disadvantage of pain and discomfort for patients. It has been shown in randomized controlled trials that carbon dioxide (CO2) insufflations significantly reduce pain and discomfort in patients undergoing colonoscopy. However, there have been no studies in which CO2 insufflation in colonoscopy of patients with irritable bowel syndrome (IBS) was investigated. Methods: Randomized double-blind controlled study was conducted to assess the suffering from colonoscopy in patients with IBS and the efficacy of CO2 insufflation in colonoscopy for patients with IBS. Patients with IBS and controls who received colonoscopy were randomized into an air or CO2 insufflation group. Patients' symptoms such as distension and pain were compared using a 10-cm visual analog scale (VAS). Results: There were 18 patients in the IBS/air group, 19 patients in the IBS/CO2 group, 25 patients in the control/air group and 26 patients in the control/CO2 group. The mean value of severity of distension after colonoscopy and the mean value of severity of pain from during examination to one hour after the examination were higher in the IBS group than in the control group. The severity of these symptoms was reduced earlier in the CO2 group. CO2 insufflation in colonoscopy was more effective in the IBS group than in the control group from 15 min to one hour after the examination. Conclusion: Regarding colonoscopy-related suffering, IBS patients showed significant differences from non-IBS patients. CO2 insufflation in colonoscopy is effective for IBS patients, particularly for patients who commence activities after colonscopy.
  • Kato M, Ono S, Mabe K, Asaka M
    Nihon rinsho. Japanese journal of clinical medicine 10 70 1795 - 1801 0047-1852 2012/10 [Refereed][Not invited]
  • Mabe K, Kato M, Ono S, Asaka M, Sakamoto N
    Nihon rinsho. Japanese journal of clinical medicine 70 (10) 1726 - 1730 0047-1852 2012/10 [Refereed][Not invited]
  • Yuichi Shimizu, Masakazu Takahashi, Takeshi Yoshida, Shouko Ono, Katsuhiro Mabe, Mototsugu Kato, Masahiro Asaka
    GASTROINTESTINAL ENDOSCOPY 76 (2) 464 - 465 0016-5107 2012/08 [Refereed][Not invited]
  • Yuichi Shimizu, Takeshi Yoshida, Masakazu Takahashi, Shouko Ono, Katsuhiro Mabe, Mototsugu Kato, Tomonori Fujita, Masahiro Asaka
    GASTROINTESTINAL ENDOSCOPY 75 (5) 1108 - 1110 0016-5107 2012/05 [Refereed][Not invited]
  • Shotaro Nakamura, Toshiro Sugiyama, Takayuki Matsumoto, Katsunori Iijima, Shouko Ono, Masahiro Tajika, Akira Tari, Yasuhiko Kitadai, Hiroshi Matsumoto, Tadanobu Nagaya, Toshiro Kamoshida, Norihiko Watanabe, Toshimi Chiba, Hideki Origasa, Masahiro Asaka
    GUT 61 (4) 507 - 513 0017-5749 2012/04 [Refereed][Not invited]
     
    Objective A multicentre cohort follow-up study of a large number of patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma was conducted to elucidate the long-term outcome of the disease after Helicobacter pylori eradication. Methods 420 patients with gastric low-grade MALT lymphoma who had undergone successful H pylori eradication and been followed up for at least 3 years were registered from 21 participating institutes. Responders to treatment were defined as patients whose post-treatment biopsies showed complete histological response (ChR) or probable minimal residual disease (pMRD). Treatment failure was defined as the status of progressive disease or lymphoma relapse after ChR/pMRD. Results 323 patients (77%) responded to H pylori eradication. A logistic regression analysis showed that absence of H pylori, submucosal invasion determined by endoscopic ultrasonography and t(11; 18)/API2-MALT1 were independent predictors of resistance to H pylori eradication. During the follow-up periods ranging from 3.0 to 14.6 years (mean 6.5 years, median 6.04 years), the disease relapsed in 10 of 323 responders (3.1%) while progressive disease was found in 27 of 97 non-responders (27%). Thus, 37 of 420 patients (8.8%) were regarded as treatment failures. Of these 37 patients, transformation into diffuse large B cell lymphoma occurred in nine patients. Among the non-responders and relapsed patients, 17 patients were subjected to a 'watch and wait' strategy while 90 patients underwent second-line treatments including radiotherapy (n=49), chemotherapy (n=26), surgical resection (n=6), chemoradiotherapy (n=5), antibiotic treatment (n=2), rituximab monotherapy (n=1) or endoscopic resection (n=1). Probabilities of freedom from treatment failure, overall survival and event-free survival after 10 years were 90%, 95% and 86%, respectively. Cox multivariate analysis revealed endoscopic non-superficial type to be an independent prognostic factor for adverse freedom from treatment failure, overall survival and event-free survival. Conclusions The excellent long-term outcome of gastric MALT lymphoma after H pylori eradication was confirmed by this large-scale follow-up study.
  • Shouko Ono, Mototsugu Kato, Mio Suzuki, Saori Ishigaki, Masakazu Takahashi, Masahira Haneda, Katsuhiro Mabe, Yuichi Shimizu
    DIGESTION 86 (1) 59 - 65 0012-2823 2012 [Refereed][Not invited]
     
    Background: The definition of Helicobacter pylori-negative gastric cancer depends on the accuracy of diagnosis of H. pylori infection. The aim of this study was to determine the frequency of H. pylori-negative gastric cancer and to clarify relationships with histological atrophy, endoscopic atrophy, and serological atrophy. Methods: A total of 240 early gastric cancers were included in this study. The status of H. pylori infection was determined from the rapid urease test, C-13-urea breath test, H. pylori culture, histopathological examination and examination of IgG antibodies. In H. pylori-negative gastric cancer, histological atrophy and intestinal metaplasia, endoscopic atrophy and serological atrophy were assessed by pepsinogen. Results: The rate of H. pylori infection was 77.9% and 19 patients (7.9%) had a history of eradication. 34 patients (14.2%) were diagnosed with H. pylori-negative gastric cancer using diagnostic tools of H. pylori. However, most of the patients with H. pylori-negative gastric cancer had histological atrophy and intestinal metaplasia. Only 1 gastric cancer (0.42%) occurred in the mucosa without histological atrophy, endoscopic atrophy or serological atrophy. Conclusion: Early gastric cancers in the Japanese endoscopic submucosal dissection series were strongly related to current or past infection with H. pylori and to gastric mucosal atrophy. Copyright (c) 2012 S. Karger AG, Basel
  • Shouko Ono, Mototsugu Kato, Yuji Ono, Urara Nishida, Keiko Yamamoto, Yuichi Shimizu, Masahiro Asaka
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 26 (7) 1133 - 1138 0815-9319 2011/07 [Refereed][Not invited]
     
    Background and Aim: We have reported the characteristics of magnified endoscopic images of gastric mucosa-associated lymphoid tissue (MALT) lymphoma before and after treatment. In this study, we investigated the diagnostic efficacy of magnified endoscopic images for target biopsy and evaluation of clinical remission. Methods: Twenty-one patients diagnosed with localized gastric MALT lymphoma were enrolled. Magnified endoscopy was performed prior to treatment and at a mean period of 1.8 months (1-6 months) after therapy (Helicobacter pylori eradication in 19 patients and radiation therapy in two patients). Microstructural pattern and abnormal vessels in the lesions were assessed, and corpus mucosa without lymphoma was divided into H. pylori-negative mucosa and H. pylori-positive mucosa. Biopsy was the gold standard in this study. Results: Nonstructural areas with abnormal vessels were observed in all patients before treatment. Fifteen patients achieved pathological complete remission. Disappearance of nonstructural areas and abnormal vessels after therapy was associated with pathological remission. Sensitivities of these findings for diagnosis were 76.9% and 85.7%, respectively, and the specificities were 87.5% and 85.7%, respectively. H. pylori eradication therapy was invalid in three patients with H. pylori-negative mucosa in magnified images. Conclusions: Magnifying endoscopy may be useful for target biopsy of superficial gastric MALT lymphoma in clinical management.
  • Kato M, Ono S, Mabe K, Shimizu Y, Asaka M
    Nihon rinsho. Japanese journal of clinical medicine 6 69 (6) 1049 - 1056 0047-1852 2011/06 [Refereed][Not invited]
  • Urara Nishida, Mototsugu Kato, Mutsumi Nishida, Go Kamada, Shouko Ono, Yuichi Shimizu, Shunji Fujimori, Masahiro Asaka
    JOURNAL OF CLINICAL BIOCHEMISTRY AND NUTRITION 48 (3) 245 - 250 0912-0009 2011/05 [Refereed][Not invited]
     
    Low-dose acetylsalicylic acid has been widely used. We evaluated small bowel and gastric injuries during acetylsalicylic acid administration using video capsule endoscopy and gastroduodenal endoscopy. We also investigated blood flow using contrast-enhanced ultrasonography. Six healthy volunteers were enrolled in this preliminary study. The subjects were administered 100 mg of enteric-coated aspirin daily for 14 days. Video capsule endoscopy and gastroduodenal endoscopy were simultaneously performed before administration and on days 1, 3, 7 and 14. Contrast-enhanced ultrasonography was performed before administration and on day 2, and 8. Video capsule endoscopy after administration of low-dose acetylsalicylic acid revealed small bowel mucosal damages of petechiae and erythema in all cases, and denuded area in one case. The total number of lesions in the small bowel increased according to duration of low-dose acetylsalicylic acid administration. However, the total number of lesions in the stomach peaked on day 3. Contrast-enhanced ultrasonography showed that the time-intensity curve peak value and Areas under the curves after acetylsalicylic acid administration were reduced. We observed not only gastric mucosal injuries but also small intestinal injuries with short-term low-dose acetylsalicylic acid administration. Acetylsalicylic acid administration also caused a decrease in small intestinal blood flow. Contrast-enhanced ultrasonography is useful for evaluation blood flow in the small bowel mucosa.
  • Urara Nishida, Mototsugu Kato, Mutsumi Nishida, Go Kamada, Takeshi Yoshida, Shouko Ono, Yuichi Shimizu, Masahiro Asaka
    WORLD JOURNAL OF GASTROENTEROLOGY 17 (2) 226 - 230 1007-9327 2011/01 [Refereed][Not invited]
     
    AIM: To investigate the relationship between low-dose aspirin-induced small bowel mucosal damage and blood flow, and the effect of rebamipide. METHODS: Ten healthy volunteers were enrolled in this study. The subjects were divided into two groups: a placebo group given low-dose aspirin plus placebo and a rebamipide group given low-dose aspirin plus rebamipide for a period of 14 d. Capsule endoscopy and contrast-enhanced ultrasonography were performed before and after administration of drugs. Areas under the curves and peak value of time-intensity curve were calculated. RESULTS: Absolute differences in areas under the curves were -1102.5 (95% CI: -1980.3 to -224.7, P = = 0.0194) in the placebo group and -152.7 (95% CI: -1604.2 to 641.6, P = 0.8172) in the rebamipide group. Peak values of time intensity curves were -148.0 (95% CI: -269.4 to -26.2, P = 0.0225) in the placebo group and 28.3 (95% CI: -269.0 to 325.6, P = 0.8343) in the rebamipide group. Capsule endoscopy showed mucosal breaks only in the placebo group. CONCLUSION: Short-term administration of low-dose aspirin is associated with small bowel injuries and blood flow. (C) 2011 Baishideng. All rights reserved.
  • Ono S, Kato M, Asaka M
    Nihon rinsho. Japanese journal of clinical medicine 11 68 (11) 1978 - 1982 0047-1852 2010/11 [Refereed][Not invited]
  • Kato M, Ono S, Yoshida T, Mabe K, Shimizu Y, Asaka M
    Nihon rinsho. Japanese journal of clinical medicine 11 68 (11) 2089 - 2095 0047-1852 2010/11 [Refereed][Not invited]
  • Mototsugu Kato, Go Kamada, Keiko Yamamoto, Urara Nishida, Aki Imai, Takeshi Yoshida, Shouko Ono, Manabu Nakagawa, Soichi Nakagawa, Yuichi Shimizu, Masahiro Asaka
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 25 (10) 1631 - 1635 0815-9319 2010/10 [Refereed][Not invited]
     
    Background and Aim: The concomitant use of non-steroidal anti-inflammatory drugs is a risk factor for low-dose aspirin (LDA)-associated upper gastrointestinal toxicity. Lafutidine is an H2-receptor antagonist with gastroprotective activity, produced by acting on capsaicin-sensitive afferent neurons. To evaluate the preventive effect of lafutidine on gastric damage caused by LDA alone and by the combination of both LDA and loxoprofen, we conducted a clinical study using healthy volunteers. Methods: A randomized, double-blinded, placebo-controlled, crossover study was carried out. Sixteen healthy volunteers without Helicobacter pylori infection were randomly assigned to two groups. Both groups received 81 mg of aspirin once daily for 14 days (on days 1 to 14) and 60 mg of loxoprofen three times daily for the last 7 days (on days 8 to 14). Placebo or 10 mg of lafutidine was administered twice daily for 14 days in each group. After a 2-week washout period, placebo and lafutidine were crossed over. Endoscopic findings of gastric mucosal damage were evaluated according to the modified Lanza score. Results: The mean modified Lanza score was 2.19 +/- 1.06 (SD) for aspirin plus placebo as compared with 0.50 +/- 0.77 for aspirin plus lafutidine (P < 0.001), and 3.00 +/- 1.56 for aspirin plus loxoprofen and placebo as compared with 1.25 +/- 1.37 for aspirin plus loxoprofen and lafutidine (P < 0.01). Conclusions: The addition of loxoprofen to LDA increases gastric mucosal damage. Standard-dose lafutidine significantly prevents gastric mucosal damage induced by LDA alone or LDA plus loxoprofen in H. pylori-negative volunteers. Larger controlled studies are needed to strengthen these findings.
  • Shouko Ono, Mototsugu Kato, Kikuko Takagi, Junichi Kodaira, Kanako Kubota, Yoshihiro Matsuno, Yoshito Komatsu, Masahiro Asaka
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 25 (4) 804 - 809 0815-9319 2010/04 [Refereed][Not invited]
     
    Background and Aim: According to a few recent reports on the long-term clinical outcome of gastric marginal zone B-cell mucosa associated lymphoid tissue lymphoma (MALT lymphoma); localized gastric MALT lymphoma generally has a favorable prognosis. However, the risk of metachronous gastric cancer has not been evaluated. In this study, we analyzed long-term outcomes of localized gastric MALT lymphoma including the incidence of metachronous gastric cancer. Methods: Between April 1996 and May 2008, 60 patients (31 men and 29 women; mean age 58.1 years) with localized gastric MALT lymphoma (stage I and II1 according to Lugano classification) were analyzed retrospectively. Results: Forty-eight patients (82.6%) achieved complete remission by eradication therapy. Radiation therapy was conducted on eight patients as second-line treatment, and all of them achieved remission. The median follow-up period was 76 months (range, 12-157 months). One patient had local relapse after remission for 5 years and three patients developed early gastric cancer without recurrence of lymphoma (5%). All of the three gastric cancers appeared in the same areas where MALT lymphoma had been eradicated. Conclusion: Eradication therapy and radiation therapy for localized gastric MALT lymphoma have a favorable long-term outcome, though regular follow-up endoscopy should be performed for detecting metachronous early gastric cancer.
  • Yuichi Shimizu, Takeshi Yoshida, Mototsugu Kato, Jojo Hirota, Shouko Ono, Manabu Nakagawa, Takahiko Kobayashi, Kanako Kubota, Masahiro Asaka
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 25 (2) 314 - 318 0815-9319 2010/02 [Refereed][Not invited]
     
    Background and Aims: It has not been determined whether low-grade squamous dysplasia (LGD) of the esophagus is a precancerous lesion or not. If LGD progresses to squamous cell carcinoma, early carcinoma lesions that have such a natural history might contain a remaining LGD component. Methods: The lesions in the 68 patients with early invasive squamous cell carcinoma who underwent endoscopic mucosal resection were examined for the presence of an LGD component. If LGD components were observed, the degrees of architectural and cytological abnormalities of LGD components and those of tumor invasive fronts in the same lesions were studied. The degrees of abnormalities of 28 small LGD lesions were also studied. Results: Histological examination of resected specimens confirmed LGD components in 43% of the squamous cell carcinoma lesions. The lesions of lamina propria mucosae (m2) cancer contained a significantly broader area of LGD component than did the lesions of muscularis mucosae (m3) and submucosal layer (sm) cancer (P = 0.037). Mean score for the degrees of cytological abnormalities of LGD component was similar to that of tumor invasive front (P = 0.457) and significantly higher than that of small LGD lesions (P < 0.001). Conclusion: Our results indicate the possibility that the lesion was formed by a combination of small lesions that arose as a multicentric occurrence of squamous cell carcinoma and dysplasia. Our results also suggest that an LGD component would transform to carcinoma along with tumor progression. However, the concept of 'basal cell layer type carcinoma in situ' may be suitable for squamous cell lesions with a high degree of cytological abnormalities confined to the lower half of the epithelium.
  • Mototsugu Kato, Urara Nishida, Mutsumi Nishida, Tamotsu Hata, Rumiko Asaka, Masahira Haneda, Keiko Yamamoto, Aki Imai, Takeshi Yoshida, Shouko Ono, Yuichi Shimizu, Masahiro Asaka
    DIGESTION 82 (3) 162 - 166 0012-2823 2010 [Refereed][Not invited]
     
    Background: Functional dyspepsia (FD) is a heterogeneous disease characterized by various upper abdominal symptoms. The major mechanism of FD symptoms includes impaired fundic accommodation, delayed gastric emptying, and visceral hypersensitivity. We developed a novel drinking-ultrasonography test to combine a drink test with ultrasonography to assess gastric motility and sensory function of FD patients. Method: Subjects were 60 successive FD patients according to the Rome III criteria. A drinking-ultrasonography test was performed after subjects had fasted. The subjects ingested 200 ml of water at 2-min intervals 4 times (total 800 ml) through a straw. The maximum cross section of the proximal stomach was visualized before water intake, after each water intake, and 5 and 10 min after the completion of drinking using extracorporeal ultrasonography. Abdominal symptoms were evaluated using the visual analog scale (VAS) a total of 5 times. The normal range of cross-sectional area and VAS were set using average 8 standard deviations of 33 healthy volunteers. Cases outside the normal range were diagnosed with a motor or sensory disorder. Results: The drinking-ultrasonography test classified FD patients into four groups without adverse effect or trouble. The distribution of each group was 27% in the normal group, 15% in the impaired relaxation group, 10% in the delayed emptying group, and 48% in the visceral hypersensitivity group. There was no significant correlation between the pathophysiological classification and subtypes of FD defined by the Rome III criteria. Conclusion: We developed a novel drinking-ultrasonography test that was effective in classifying FD patients according to pathophysiological features. Copyright (C) 2010 S. Karger AG, Basel
  • Y. Shimizu, T. Yoshida, M. Kato, S. Ono, A. Homma, N. Oridate, M. Asaka
    Endoscopy 42 (8) 686 - 687 0013-726X 2010 [Refereed][Not invited]
  • Shouko Ono, Mototsugu Kato, Aki Imai, Takeshi Yoshida, Jyojyo Hirota, Tamotsu Hata, Kikuko Takagi, Go Kamada, Yuji Ono, Manabu Nakagawa, Souichi Nakagawa, Yuichi Shimizu, Hiroshi Takeda, Masahiro Asaka
    JOURNAL OF CLINICAL BIOCHEMISTRY AND NUTRITION 45 (2) 248 - 253 0912-0009 2009/09 [Refereed][Not invited]
     
    Although low-dose aspirin is widely used, since it is a cheap and effective means of prevention of cardiovascular events, it can cause hemorrhagic gastrointestinal complications. The aim of this study was to evaluate the efficacy of rebamipide in preventing low-dose aspirin-induced gastric injury. A randomized, double-blind, placebo-controlled, crossover trial was performed in twenty healthy volunteers. Aspirin 81 mg was administered with placebo or rebamipide 300 mg three times daily for 7 consecutive days. The rebamipide group exhibited significant prevention of erythema in the antrum compared with the placebo group (p = 0.0393, respectively). Results for the body and fornix did not differ significantly between the placebo and rebamipide groups. In conclusion, short-term administration of low-dose aspirin induced slight gastric mucosal injury in the antrum, but not in the body or fornix. Rebamipide may be useful for preventing low-dose aspirin-induced gastric mucosal injury, especially which confined to the antrum.
  • Yoshida T, Shimizu Y, Ono S, Oridate N, Kato M, Asaka M
    Endoscopy 41 (6) 568 - 9; author reply 570 0013-726X 2009/06 [Refereed][Not invited]
  • Shouko Ono, Mototsugu Kato, Yuji Ono, Yuichi Shimizu, Masahiro Asaka
    GASTROINTESTINAL ENDOSCOPY 69 (6) 1169 - 1170 0016-5107 2009/05 [Refereed][Not invited]
  • Shouko Ono, Mototsugu Kato, Yuji Ono, Aki Imai, Takeshi Yoshida, Yuichi Shimizu, Masahiro Asaka
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 24 (4) 639 - 645 0815-9319 2009/04 [Refereed][Not invited]
     
    Histamine 2 receptor antagonists and proton-pump inhibitors, drugs that are widely used for the treatment of acid-related diseases, have different clinical characteristics. The objective of this study was to compare the acid-suppressing effects of ranitidine hydrochloride and those of rabeprazole sodium at the first administration and re-administration after withdrawal. The study was designed as an open-label, randomized, two-way cross-over trial. Seven Helicobacter pylori-negative healthy volunteers were enrolled in this study. Ranitidine hydrochloride (300 mg/day) or rabeprazole sodium (20 mg/day) was administered from days 1 to 7 and from days 11 to 13. The percentage of time with gastric pH < 4 and the median gastric pH were evaluated for 15 consecutive days by a Bravo capsule fixed to the stomach. On day 1, there was no significant difference between the acid-suppressing effects of the two drugs (ranitidine vs rabeprazole: not significant). Although rabeprazole sodium maintained a potent and stable effect from days 2 to 7 (ranitidine vs rabeprazole: P < 0.05), the effect of ranitidine hydrochloride was attenuated after day 4. In addition, the effect of ranitidine hydrochloride at re-administration was attenuated (days 11, 12, and 13 vs pre-administration: not significant). In view of our observations, we expect symptoms associated with gastric acidity to be more adequately controlled with rabeprazole sodium in the short term when compared to ranitidine hydrochloride.
  • Y. Shimizu, T. Yoshida, M. Kato, S. Ono, M. Nakagawa, A. Homma, N. Oridate, M. Asaka
    ENDOSCOPY 41 (4) 374 - 376 0013-726X 2009/04 [Refereed][Not invited]
     
    Patients with early stage hypopharyngeal carcinoma can be treated with endoscopic resection. However, strict indication for endoscopic resection in cases of hypopharyngeal carcinoma is unclear. in this paper, we evaluated the long-term outcome after endoscopic resection in patients with hypopharyngeal carcinoma invading the subepithelium. Among 16 patients with hypopharyngeal carcinoma who underwent endoscopic resection, eight patients who were histologically confirmed to have tumors with shallow invasion of the subepithelium were studied. Depth of tumor invasion in the subepithelium in those patients ranged from 300 to 720 mu m (mean +/- SD, 490 140 pm). During a median follow-up period of 40 months, none of the eight patients had local recurrence or metastasis. Kaplan-Meier estimates of relapse-free survival rates at 5 years in the eight patients were 100%. The results of this study suggest that hypopharyngeal carcinoma with slight invasion to the subepithelium can be successfully treated by endoscopic resection.
  • T. Yoshida, Y. Shimizu, J. Hirota, M. Nakagawa, S. Ono, N. Oridate, M. Kato, M. Asaka
    ENDOSCOPY 40 E204 - E205 0013-726X 2008/12 [Refereed][Not invited]
  • Shouko Ono, Mototsugu Kato, Yuji Ono, Tomoo Itoh, Kanako Kubota, Manabu Nakagawa, Yuichi Shimizu, Masahiro Asaka
    GASTROINTESTINAL ENDOSCOPY 68 (4) 624 - 631 0016-5107 2008/10 [Refereed][Not invited]
     
    Background: The utility of magnifying endoscopy for diagnosisof epithelial tumors has been reported, but there are few reports for nonepithelial tumors. Objective: To determine the characteristics of magnified images of gastric extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MAI.T lymphoma) before and after treatment. Design. This was a tretrospective study. Setting: Endoscopy Unit, Hokkaido University Hospital. Patients: Eleven patients diagnosed with MALT lymphoma were enrolled. Interventions: The microstructural pattern, collecting venules, and abnormal vessels in gastric MALT lymphoma were assessed before treatment and at 4 to 7 months after treatment by using magnifying endoscopy. Main Ourcome Mesurement and Results: The characteristics of magnified endoscopic images before treatment were the disappearance of gastric pits and the appearance of abnormal vessels. Ten cases of Helocobacter pylori-infected MAI.T lymphoma were treated by H pylori eradiction, and 1 H pylori-negative case was treated by radiation therapy after eradication therapy. Ten patients achieved complete disease remission. After the treatment, recovery of gastric pits and subepithelial capillary network, and the disappearance of abnormal vesels were revealed by magnifying endoscopy. Limitation: This was a small pilot study. Conclusions: Magnified findings of gastric MAI.T lymphoma before and after therapy seem to correlate with complete response and no response.
  • Ono S, Kato M, Ono Y, Nakagawa M, Shimizu Y, Takeda H, Asaka M
    Journal of clinical gastroenterology 8 42 (8) 960  0192-0790 2008/09 [Refereed][Not invited]
  • Shouko Ono, Mototsugu Kato, Yuji Ono, Masahiro Asaka
    WORLD JOURNAL OF GASTROENTEROLOGY 13 (47) 6410 - 6413 1007-9327 2007/12 [Refereed][Not invited]
     
    AIM: Consecutive monitoring of intragastric pH using the Bravos capsule. METHODS: We put threads through a Bravos capsule and then affixed it to the gastric wall by endoscopic hemoclipping in seven subjects. Study data were uploaded to a computer via Datalink every 48 h. In this way, repeated monitoring of intragastric pH was undertaken. RESULTS: All subjects were able to monitor gastric pH over a 1-wk period, and five for > 2 wk. No complications were encountered during the monitoring. After pH monitoring, we safely retrieved the capsule endoscopically. CONCLUSION: Clipping a Bravos capsule onto the gastric wall enabled long-term intragastric pH monitoring. This is a methodological report of pH monitoring over a period of > 2 wk. (c) 2007 WJG. All rights reserved.
  • Kato M, Ono S, Nakagawa M, Shimizu Y, Asaka M, Nakagawa S
    Nihon rinsho. Japanese journal of clinical medicine 10 65 (10) 1760 - 1767 0047-1852 2007/10 [Refereed][Not invited]
  • Ono S, Kato M, Asaka M, Ono Y, Yokoyama A
    Nihon rinsho. Japanese journal of clinical medicine 10 65 (10) 1792 - 1800 0047-1852 2007/10 [Refereed][Not invited]
  • Kato M, Ono S, Nakagawa M, Shimizu Y, Asaka M
    Nihon rinsho. Japanese journal of clinical medicine 5 65 865 - 871 0047-1852 2007/05 [Refereed][Not invited]
  • Kato M, Shimizu Y, Ono S
    Nihon rinsho. Japanese journal of clinical medicine 65 Suppl 2 Pt. 1 299 - 304 0047-1852 2007/02 [Refereed][Not invited]
  • Motosugu Kato, Masahiro Asaka, Shouko Ono, Manabu Nakagawa, Souichi Nakagawa, Yuichi Shimizu, Makoto Chuma, Hiroshi Kawakami, Yoshito Komatsu, Shuhei Hige, Hiroshi Takeda
    JOURNAL OF GASTROENTEROLOGY 42 16 - 20 0944-1174 2007/01 [Refereed][Not invited]
     
    Because most gastric cancers develop from a background of Helicobacter pylori-infected gastric mucosa, H. pylori plays an important role in gastric carcinogenesis. Therefore, eradication of H. pylori may inhibit the incidence of gastric cancers. In experimental studies, H. pylori eradication has proved to act as a prophylaxis against gastric cancer. However, the results of recent randomized controlled studies are absolutely contradictory. In Japan, mucosal gastric cancer is usually resected by endoscopic treatment. As only a small part of the gastric mucosa is resected, secondary gastric cancer after endoscopic resection of the primary gastric cancer often develops at another site in the stomach. A nonrandomized Japanese study involving 132 early gastric cancer patients reported that eradication of H. pylori after endoscopic resection tended to reduce the development of secondary gastric cancer. Also, a retrospective multicenter survey indicated that the incidence rate of secondary gastric cancer in H. pytori-eradicated patients was about one-third that among patients in the noneradication group. We conducted a large-scale multicenter randomized trial to confirm the effect of H. pylori eradication on secondary and residual gastric cancer after endoscopic resection. This study was begun in 2003 and is ongoing at present. Diagnosis of a new carcinoma at another site of the stomach is defined as the primary end point, and recurrence of tumors at the resection site as a secondary end point. A total of 542 subjects have been enrolled in the study. This study will have the statistical power to demonstrate whether H. pylori eradication decreases the incidence and recurrence of gastric cancer.
  • M. Fujishiro, N. Yahagi, N. Kakushima, S. Kodashima, Y. Muraki, S. Ono, K. Kobayashi, T. Hashimoto, N. Yamamichi, A. Tateishi, Y. Shimizu, M. Oka, K. Ogura, T. Kawabe, M. Ichinose, M. Omata
    ENDOSCOPY 38 (10) 1001 - 1006 0013-726X 2006/10 [Refereed][Not invited]
     
    Background and study aims: Endoscopic submucosal dissection (ESD) is a novel technique used for the treatment of gastrointestinal neoplasia. One of its major limitations, however, is the complication of perforation. Patients and methods: We included in our study all the cases of perforation that occurred during ESD procedures for gastrointestinal epithelial neoplasia between February 2000 and February 2005. Clinical outcomes after perforation were investigated. Results: Perforation was experienced at 27 lesions in 27 patients (four in the esophagus, fourteen in the stomach, seven in the colon, and two in the rectum). Fibrosis under the lesions was confirmed histologically in seven patients (26%). Immediate closure using endoclips was performed in all patients except for three asymptomatic patients in whom a stomach perforation was first noticed when free air was noticed on a radiograph the morning after the ESD procedure. Air accumulation was detected radiographically in 21 patients (78%). The mean duration of antibiotic treatment was 6.7 days and the patients were fasted for a mean period of 5.3 days. The mean maximum body temperature was 37.3 degrees C, the mean white blood cell count was 9733/mm(3), and the mean C-reactive protein level was 5.0 mg/dl. All the patients were discharged well from the ward after a mean time of 12.1 days after ESD, and no recurrence caused by tumor spread from the perforation occurred in any patient after a median follow-up period of 36 months (range 9 - 52 months). Conclusion: Successful nonsurgical management after ESD complicated by perforation is a highly feasible option if intensive conservative treatments are used following immediate endoscopic closure of the perforation.
  • M Fujishiro, N Yahagi, M Nakamura, N Kakushima, S Kodashima, S Ono, K Kobayashi, T Hashimoto, N Yamamichi, A Tateishi, Y Shimizu, M Oka, K Ogura, T Kawabe, M Ichinose, M Omata
    ENDOSCOPY 38 (5) 493 - 497 0013-726X 2006/05 [Refereed][Not invited]
     
    Background and Study Aims: The technique of endoscopic submucosal dissection (ESD) has recently been developed for en-bloc resection of gastric tumors. For oncological reasons and in order to improve the patients' quality of life, it may be desirable to use the same technique for rectal neoplasia. Patients and Methods: Thirty-five consecutive patients with rectal neoplasia who had a preoperative diagnosis of large intraepithelial neoplasias with submucosal fibrosis or located on the rectal folds were enrolled. ESD was carried out with the same technique previously described for the stomach, with some modifications. The efficacy, complications, and follow-up results of the treatment were assessed. Results: The rates of en-bloc resection and en-bloc plus R0 resection were 88.6% (31 of 35) and 62.9% (22 of 35), respectively. Hemoglobin levels did not drop by more than 2 g/dl in any of the patients after ESD. None of the patients had to receive blood transfusions or undergo emergency colonoscopy due to bleeding during ESD or hematochezia after ESD. Perforation during ESD occurred in two patients (5.7%), who were managed with conservative medical treatment after endoscopic closure of the perforation. Excluding three patients in whom additional surgery was carried out, all but one of 32 patients were free of recurrence during a mean follow-up period of 36 months (range 12-60 months). The exception was a patient in whom a multiple-piece resection was required; the recurrent (residual) tumor, found 2 months after ESD, was a small adenoma that was again treated endoscopically. Conclusions: ESD is applicable in the rectum with promising results, but the technique is still at a developmental stage and patients should be informed of the potential risks.
  • M Fujishiro, N Yahagi, M Nakamura, N Kakushima, S Kodashima, S Ono, K Kobayashi, T Hashimoto, N Yamamichi, A Tateishi, Y Shimizu, M Oka, K Ogura, T Kawabe, M Ichinose, M Omata
    GASTROINTESTINAL ENDOSCOPY 63 (2) 243 - 249 0016-5107 2006/02 [Refereed][Not invited]
     
    Background: Endoscopic submucosal dissection (ESD) has recently been developed for endoscopic treatment of GI tumors, which enables Lis to resect even large tumors en bloc. However, a considerable frequency of perforation has become another problem. The best way to prevent perforation is to create a sufficient submucosal fluid cushion (SFC). The aim of this study is to find out the feasibility of ESD by using a mixture of 1900 KDa hyaluronic acid (Suvenyl) and, a 10% glycerin plus 5% fructose Solution (Glyceol). Methods: Sixty-seven consecutive GI tumors in 54 patients who met indication criteria of ESD were enrolled. The mixing ratios of Suvenyl and Glyceol were 1:3 for esophageal/colorectal tumors and stomach tumors with I scar, and 1:7 for stomach tumors without scar. After creation of SFCs, mucosal incision around the tumors and submucosal dissection under the tumors were made by Cutting devices. The clinical outcomes were investigated. Results: Mean resected and tumor sizes were 38.6 and 25.6 mm, respectively Perforation occurred in one colon tumor with severe fibrosis (1.5%), which was managed by endoscopic clipping without salvage surgery No blood transfusion was performed. In one stomach and in one rectal tumor (3%), endoscopic hemostasis was necessary because of postoperative bleeding. Overall endoscopic and histologic en bloc resection rates were 94% (63/67) and 78% (52/67), respectively and there was no recurrence after follow-up of 1 year. Conclusions: ESD when using a mixture of Suvenyl and Glyceol results in excellent outcomes, and this injection solution should be used for ESD.
  • Y Shimizu, M Kato, J Yamamoto, Y Ono, T Katsurada, S Ono, Y Mori, M Nakagawa, S Nakagawa, T Itoh, M Asaka
    GASTROINTESTINAL ENDOSCOPY 63 (1) 16 - 21 0016-5107 2006/01 [Refereed][Not invited]
     
    Background: Biopsy specimens obtained from esophageal lesions detected in endoscopic screening with iodine staining have often been diagnosed as high-grade intraepithelial squamous neoplasia (WHO 2000). However, a management strategy for such lesions has not been established. The purpose of this study was to perform EMR for such lesions and to determine the actual tumor stage in patients with complete resection and the outcomes after EMR. Patients: During the study period, 51 patients were found to have esophageal lesions diagnosed as high-grade intraepithelial squamous neoplasia by using endoscopic iodine staining in biopsy specimens. All of the patients underwent EMR, and resected specimens were reviewed microscopically Results: Histologic examination of totally resected specimens revealed that 12 (23.5%) of the 51 patients had tumor invasion of the lamina propria mucosae and that 4 (7.8%) had tumor invasion of the muscularis mucosae. The remaining 35 patients (68.6%) were confirmed to have high-grade intraepithelial squamous neoplasia. The invasive focus in all of the 16 lesions of invasive squamous-cell carcinoma was surrounded by high-grade intraepithelial squamous neoplasia. After a median of 23 months of follow-tip, there were two recurrences, and those patients required second EMR. Conclusions: Histologic results suggested that high-grade intraepithelial squamous neoplasia of the esophagus has characteristics of carcinoma in the preinvasive stage. EMR Should be performed for esophageal lesions diagnosed by endoscopic biopsy as high-grade intraepithelial squamous neoplasia, not only because of its probable malignant potential but also because more than 30% of such lesions are actually invasive carcinoma.
  • 【逆流性食道炎をめぐる新たな知見】 内視鏡陰性逆流性食道炎に対する拡大内視鏡観察の有用性
    山本 純司, 清水 勇一, 加藤 元嗣, 小野 尚子, 森 康明, 布施 望, 結城 敏志, 武居 正明, 中川 学, 小平 純一, 中川 宗一, 河原崎 暢, 小松 嘉人, 武田 宏司, 杉山 敏郎, 浅香 正博
    消化器科 (有)科学評論社 38 (2) 172 - 176 0289-8756 2004/02 [Not refereed][Not invited]
     
    拡大内視鏡で観察されるIPCLの形態と胃食道逆流症(GERD)病理所見,臨床症状との関連性を検討して,拡大内視鏡による内視鏡陰性GERD診断の可能性を探ることを目的とし前向き研究を行った.61例中,33例がRtypeを示し,平均年齢は50.1歳であった.27例がDtypeを示し,平均年齢は60.3歳であった.Itypeは1例(78歳男),Otypeは3例(女)であった.QUEST陽性率はRtypeで19.4%,Dtype,Itypeは71,4%であった.QUEST陽性者は有意にIPCLが拡張して認められた.Rtypeの基底層は上皮厚の11.7±3.4%を占め,Dtypeの基底層は14.7±3.0%を占めた.Dtypeには有意な基底層の肥厚が認められた.また,Rtypeの上皮内乳頭は上皮厚の67.5±10.6%を占めたが,Dtypeでは乳頭が74.7±8.3%を占めた.Dtypeには有意な乳頭の伸長が認められた
  • 【消化管悪性リンパ腫に対する治療法の選択】 H.pylori陰性胃MALTリンパ腫の治療方針
    小平 純一, 結城 敏志, 布施 望, 武居 正明, 小野 尚子, 森 康明, 山本 純司, 中川 学, 古川 滋, 河原崎 暢, 小松 嘉人, 武田 宏司, 杉山 敏郎, 浅香 正博, 中川 宗一, 清水 勇一, 加藤 元嗣
    消化器科 (有)科学評論社 38 (1) 6 - 12 0289-8756 2004/01 [Not refereed][Not invited]

MISC

  • LCIGの導入後にPEG/Jチューブにより十二指腸潰瘍を発症した1例
    芳野 正修, 白井 慎一, 大嶌 祐貴, 水島 慶一, 江口 克紀, 脇田 雅大, 佐藤 智香, 長沼 亮滋, 上床 尚, 岩田 育子, 松島 理明, 矢部 一郎, 小野 尚子, 浦 茂久, 太田 勝久, 佐々木 秀直  臨床神経学  59-  (6)  396  -396  2019/06  [Not refereed][Not invited]
  • LCIGの導入後にPEG/Jチューブにより十二指腸潰瘍を発症した1例
    芳野 正修, 白井 慎一, 大嶌 祐貴, 水島 慶一, 江口 克紀, 脇田 雅大, 佐藤 智香, 長沼 亮滋, 上床 尚, 岩田 育子, 松島 理明, 矢部 一郎, 小野 尚子, 浦 茂久, 太田 勝久, 佐々木 秀直  臨床神経学  59-  (6)  396  -396  2019/06  [Not refereed][Not invited]
  • 【腸管感染症-最新の話題を含めて】 最近注目される腸管感染症 サイトメガロウイルス腸炎
    松田 可奈, 小野 尚子, 石川 麻倫, 宮本 秀一, 安孫子 怜史, 津田 桃子, 山本 桂子, 工藤 俊彦, 清水 勇一, 松野 吉宏, 坂本 直哉  胃と腸  53-  (4)  446  -450  2018/04  [Not refereed][Not invited]
     
    <文献概要>サイトメガロウイルス(CMV)感染症は易感染性宿主の日和見感染症として知られている.多くは造血幹細胞移植後,自己免疫性疾患や炎症性腸疾患などの免疫抑制状態や易感染状態を背景としてCMV再活性化がみられるが,慢性腎不全や侵襲的な手術後などにも発症しうる.CMV腸炎は消化器症状,内視鏡検査所見および生検による病理組織学的診断をもって診断される.内視鏡像としては打ち抜き様潰瘍が特徴的とされているが,多彩な潰瘍やびらん性病変を呈することが多い.一方で,発赤・浮腫などの非特異的な炎症所見も多く認められる.治療は抗ウイルス薬であるガンシクロビルが第一選択薬となる.
  • 【変わりゆく早期胃癌のスペクトラム-H.pylori未感染・現感染・除菌後は違う!】 H.pylori除菌後、感染既往のある胃癌治療後のサーベイランス
    小野 尚子, 石川 麻倫, 松田 可奈, 安孫子 怜史, 津田 桃子, 宮本 秀一, 山本 桂子, 工藤 俊彦, 清水 勇一, 坂本 直哉  消化器内視鏡  30-  (1)  85  -91  2018/01  [Not refereed][Not invited]
     
    本邦の多施設共同ランダム化比較試験により「胃癌内視鏡治療後のH.pyloriの除菌治療は異時性胃癌の発生を1/3に減少させる」ことが示されてから、約10年が経過した。異時多発胃癌のリスクは個々の症例で異なるが、特にリスクが高いのは除菌前の高度萎縮、胃癌の既往と高齢男性である。除菌後胃癌の発生部位は、多発性病変を含めてL領域が中心であるが、高度萎縮粘膜では体部や大彎にも病変がみられている。胃癌既往者では既往のない患者に比べて、除菌後の胃癌発生リスクは明らかに高く、除菌後も長期にわたり胃癌を繰り返す症例がある。そのため、サーベイランスは除菌後も長期に継続する必要があり、除菌前の萎縮部位を意識し、画像強調内視鏡を併用して色調差に着目するのが効率的である。(著者抄録)
  • プロトンポンプ阻害薬による胃粘膜変化の検討 ひび割れ粘膜と敷石様粘膜
    宮本 秀一, 加藤 元嗣, 津田 桃子, 松田 加奈, 村中 徹人, 安孫子 怜史, 大野 正芳, 水島 健, 大森 沙織, 山本 桂子, 間部 克裕, 小野 尚子, 工藤 俊彦, 清水 勇一, 坂本 直哉  Gastroenterological Endoscopy  60-  (1)  68  -77  2018/01  [Not refereed][Not invited]
     
    【目的】プロトンポンプ阻害薬(以下PPI:Proton pump inhibitor)により胃底腺の拡張や壁細胞の内腔突出といった病理学的変化が報告されている。また、PPI服用者における上部消化管内視鏡検査では、ひび割れ粘膜(以下GCM:Gastric cracked mucosa)や敷石様粘膜(以下GCSM:Gastric cobblestone-like mucosa)などの胃粘膜変化を体部領域に認めることが多いことが知られている。しかし、これらの胃粘膜変化とPPIの関連についての検討はこれまでに報告されておらず、本検討ではPPIと胃粘膜変化(GCM、GCSM)との関連を明らかにすることを目的とする。【方法】単施設、観察研究。対象は2014年8月から2014年11月までに北海道大学病院で上部消化管内視鏡検査を施行した連続症例。内視鏡施行医と画像確認医師2人の合計3人でPPI内服状況を伏せた状態でGCSM、GCMの有無を評価した。対象をPPI服用者(PPI group)とPPI非服用者(Control group)の2つのグループに分け、胃粘膜所見を比較検討した。【結果】除外症例を除き最終的に解析対象症例となったのは538症例(Control group:374人、男性/女性:204人/170人、平均年齢:65.2歳;PPI group:164人、男性/女性:89人/75人、平均年齢:67.1歳)であった。全解析症例の54人(10%)にひび割れ粘膜を認め、18人(3.3%)に敷石様粘膜を認めた。PPI groupでは、ひび割れ粘膜は40人(24.4%)、敷石様粘膜は15人(9.1%)に認め、Control groupと比較し有意差をもってひび割れ粘膜や敷石様粘膜を多く認めた。【結語】PPI服用者にひび割れ粘膜と敷石様粘膜を多く認め、PPIとの関連が示唆された。(著者抄録)
  • 【ここまでできるIEE】 [胃・十二指腸] 精密診断 量的診断(staging) BLIを中心に
    小野 尚子, 石川 麻倫, 松田 可奈, 安孫子 怜史, 津田 桃子, 宮本 秀一, 山本 桂子, 工藤 俊彦, 清水 勇一, 坂本 直哉  消化器内視鏡  29-  (12)  2178  -2185  2017/12  [Not refereed][Not invited]
     
    拡大内視鏡検査は早期胃癌の範囲診断のうえで最も重要なツールである。レーザー光を使用した狭帯域光画像であるblue laser imagingの波長は、白色光も含まれた多波長であり、被写界深度が大きく、拡大内視鏡観察においても焦点が合わせやすい。近接弱拡大でも表面微細構造は明瞭に観察できることが多く、demarcation lineを同定しやすい。さらに中拡大〜強拡大観察では、微小血管構築と表面微細構造がともに明瞭に視認され、特に表面微細構造の描出に優れていることが特徴である。(著者抄録)
  • 内視鏡的粘膜下層剥離術後に骨転移をきたした食道表在癌(SM1)の一例
    松田 宗一郎, 清水 勇一, 水島 健, 安孫子 怜史, 松田 可奈, 宮本 秀一, 津田 桃子, 坂本 直哉, 高橋 正和, 山本 桂子, 小野 尚子, 森 康明, 中川 学, 中川 宗一, 工藤 俊彦  北海道医学雑誌  92-  (2)  112  -113  2017/11  [Not refereed][Not invited]
  • 内視鏡的粘膜下層剥離術後に骨転移をきたした食道表在癌(SM1)の一例
    松田 宗一郎, 清水 勇一, 水島 健, 安孫子 怜史, 松田 可奈, 宮本 秀一, 津田 桃子, 坂本 直哉, 高橋 正和, 山本 桂子, 小野 尚子, 森 康明, 中川 学, 中川 宗一, 工藤 俊彦  北海道医学雑誌  92-  (2)  112  -113  2017/11  [Not refereed][Not invited]
  • 粘膜下局注併用APCと標準的APCの生体ブタ組織に対する焼灼効果の検討
    安孫子 怜史, 清水 勇一, 大西 俊介, 水島 健, 加藤 麻倫, 松田 可奈, 宮本 秀一, 津田 桃子, 山本 桂子, 小野 尚子, 工藤 俊彦, 坂本 直哉  Gastroenterological Endoscopy  59-  (Suppl.2)  2223  -2223  2017/09  [Not refereed][Not invited]
  • 【ピロリ除菌時代の胃癌の診断・治療】 ピロリ除菌時代の胃癌の診断・治療 オーバービュー
    加藤 元嗣, 西村 友佑, 久保 公利, 間部 克裕, 山本 桂子, 小野 尚子  消化器・肝臓内科  2-  (1)  1  -6  2017/07  [Not refereed][Not invited]
  • 松本 美桜, 加藤 元嗣, 大庭 幸治, 安孫子 怜司, 津田 桃子, 宮本 秀一, 水島 健, 大野 正芳, 大森 沙織, 高橋 正和, 小野 尚子, 間部 克裕, 中川 学, 中川 宗一, 工藤 俊彦, 清水 勇一, 坂本 直哉  Gastroenterological Endoscopy  59-  (7)  1537  -1545  2017/07  [Not refereed][Not invited]
     
    【背景】現在大腸ポリープの切除に際し、切除後の出血予防にクリップをかけることが一般的である。しかし、クリップの有無については術者の裁量に委ねられており、かつ、クリップの出血予防効果についても明らかとはなっていない。今回、クリップの効果を明らかにすべく、われわれは2cm以下のポリープを対象に多施設共同の無作為化比較試験を行った。【方法】検討期間は2004年4月から2013年7月の間、内視鏡的にポリープ切除を行う2cm以下のポリープを持つ20歳以上の患者を対象とし、ポリープ切除後の出血の有無を調査した。肝硬変や透析症例、ヘパリン置換例など重篤な合併症を持つものは除外とした。クリップ施行群ではポリープ切除後に全例でクリップをかけ、非施行群ではクリップを施行せずに処置終了とした。切除時に露出血管または静脈性出血が見られた場合には、スネアの先端で凝固焼灼を追加した上でそれぞれの群に応じた処置を行い終了としたが、動脈性出血が見られた場合には適切な止血処置を行い検討からは除外した。切除後は慎重な経過観察を行い、顕性出血やHb2以上の低下であった場合には緊急内視鏡を行い出血部位を同定した。【結果】北海道の7施設が研究に参加し、1,499人3,365ポリープが解析対象となった。そのうちクリップ群は752人1,636ポリープ、非クリップ群は747人1,729ポリープであった。後出血率はクリップ群で1.10%(18/1,636)、非クリップ群で0.88%(15/1,729)であった。その差は-0.22%(95%Cl:-0.96、0.53)で、95%信頼区間上限が非劣性マージン1.5%を下回り、非クリップ群のクリップ群に対する非劣性が証明された。次いで、クリップ群、非クリップ群それぞれに出血に関わる因子を検討したところ、両群でサイズが有意な因子となった。さらに非クリップ群ではさらに切除後の凝固焼灼の追加も有意なリスク因子であった。【結語】大腸ポリープにおける後出血予防としてのクリップ施行は必ずしも必要でないことが明らかになった。さらに、後出血の危険因子として凝固焼灼の追加が挙げられ、高周波を使用しないコールドポリペクトミーの有用性も示唆された。(著者抄録)
  • 小野 尚子, 加藤 元嗣, 松田 可奈, 安孫子 怜史, 津田 桃子, 宮本 秀一, 水島 健, 山本 桂子, 工藤 俊彦, 清水 勇一, 坂本 直哉  胃と腸  52-  (7)  885  -891  2017/06  [Not refereed][Not invited]
     
    Helicobacter pylori(H.pylori)除菌は明らかな消化性潰瘍再発予防効果を認めるものの,除菌成功後にもわずかながら潰瘍の発生,再発を認める.その原因はH.pylori再陽性化によるH.pylori潰瘍とH.pyloriに起因しない非H.pylori潰瘍の2つに分かれ,後者は薬剤性潰瘍とりわけアスピリンを含む非ステロイド性抗炎症薬(NSAIDs)潰瘍が大部分を占める.また,原因を特定できない特発性潰瘍もまれながら存在し,その再発率は高い.再発潰瘍への対応としては,酸分泌抑制薬の投与に加え,H.pyloriの再検査,服用薬の確認など潰瘍の誘因を調べることが大切である.(著者抄録)
  • Beyondボノプラザン標準療法 ペニシリンアレルギーに対するボノプラザンを用いたHelicobacter pylori除菌治療の成績
    松田 可奈, 小野 尚子, 宮本 秀一, 津田 桃子, 水島 健, 山本 桂子, 工藤 俊彦, 間部 克裕, 加藤 元嗣, 中川 宗一, 西川 恵子  日本ヘリコバクター学会学術集会プログラム・抄録集  23回-  86  -87  2017/06  [Not refereed][Not invited]
  • H.pylori感染胃炎の内視鏡診断の進歩 内視鏡での胃癌リスク評価における画像強調観察の有用性
    津田 桃子, 小野 尚子, 松田 可奈, 宮本 秀一, 高橋 正和, 水島 健, 山本 桂子, 中川 学, 中川 宗一, 工藤 俊彦  日本ヘリコバクター学会学術集会プログラム・抄録集  23回-  115  -115  2017/06  [Not refereed][Not invited]
  • 自己記入問診票からみたH.pylori関連ディスペプシアの特徴
    津田 桃子, 加藤 元嗣, 松田 可奈, 宮本 秀一, 山本 桂子, 小野 尚子, 工藤 俊彦, 中川 宗一, 西川 恵子, 間部 克裕, 浅香 正博  日本ヘリコバクター学会学術集会プログラム・抄録集  23回-  161  -161  2017/06  [Not refereed][Not invited]
  • 除菌後の胃癌表層上皮と周囲粘膜との関係
    山本 桂子, 小野 尚子, 松田 可奈, 津田 桃子, 安孫子 怜史, 宮本 秀一, 工藤 俊彦  日本ヘリコバクター学会学術集会プログラム・抄録集  23回-  197  -197  2017/06  [Not refereed][Not invited]
  • T1a-MM食道扁平上皮癌EMR/ESD症例の長期予後 5年以上経過例の検討
    安孫子 怜史, 清水 勇一, 水島 健, 松田 可奈, 宮本 秀一, 津田 桃子, 山本 桂子, 小野 尚子, 工藤 俊彦, 坂本 直哉  日本食道学会学術集会プログラム・抄録集  71回-  P20  -1  2017/06  [Not refereed][Not invited]
  • H.pylori感染胃炎の内視鏡診断の進歩 人間ドックにおける京都分類による胃炎の内視鏡的診断能の検討
    松本 美櫻, 間部 克裕, 大野 正芳, 吉井 新二, 小野 尚子, 工藤 俊彦, 加藤 元嗣, 野島 正寛  日本ヘリコバクター学会学術集会プログラム・抄録集  23回-  106  -106  2017/06  [Not refereed][Not invited]
  • サイトメガロウイルス腸炎の内視鏡像 腸管GVHD合併例と非合併例の比較
    松田 可奈, 小野 尚子, 宮本 秀一, 安孫子 怜史, 津田 桃子, 水島 健, 山本 桂子, 工藤 俊彦, 清水 勇一, 坂本 直哉  Gastroenterological Endoscopy  59-  (Suppl.1)  1024  -1024  2017/04  [Not refereed][Not invited]
  • 山本桂子, 加藤元嗣, 松田可奈, 津田桃子, 安孫子怜史, 宮本秀一, 水島健, 小野尚子, 工藤俊彦, 清水勇一, 松野吉宏, 坂本直哉  Helicobacter Research  21-  (2)  123‐129  2017/04/01  [Not refereed][Not invited]
  • Shoko Ono, Satoshi Abiko, Mototsugu Kato  DIGESTIVE ENDOSCOPY  29-  (2)  230  -231  2017/03  [Not refereed][Not invited]
  • 当院における除菌後発見胃癌の臨床病理学的再評価
    山本 桂子, 安孫子 怜史, 宮本 秀一, 水島 健, 小野 尚子, 工藤 俊彦, 清水 勇一, 松田 可奈, 津田 桃子, 坂本 直哉  胃病態機能研究会誌  49-  17  -17  2017/02  [Not refereed][Not invited]
  • 水島健, 清水勇一, 宮本秀一, 安孫子怜史, 津田桃子, 大野正芳, 村中徹人, 中積宏之, 坂本直哉, 高橋正和, 小野尚子, 中川学, 中川宗一, 小松嘉人  北海道医学雑誌  91-  (2)  91  2016/11/01  [Not refereed][Not invited]
  • 下咽頭上皮下浸潤癌EMR/ESD施行症例の病理組織学的検討
    安孫子 怜史, 清水 勇一, 水島 健, 松田 可奈, 宮本 秀一, 津田 桃子, 高橋 正和, 山本 桂子, 森 康明, 中川 学, 小野 尚子, 中川 宗一, 工藤 俊彦, 坂本 直哉  Gastroenterological Endoscopy  58-  (Suppl.2)  1990  -1990  2016/10  [Not refereed][Not invited]
  • S. Ono, S. Nakagawa, N. Sakamoto, K. Mabe, M. Kato  HELICOBACTER  21-  154  -154  2016/09  [Not refereed][Not invited]
  • M. Tsuda, M. Kato, S. Ono, S. Nakagawa, K. Nishikawa, K. Mabe, M. Asaka, N. Sakamoto  HELICOBACTER  21-  140  -140  2016/09  [Not refereed][Not invited]
  • Shouko Ono, Kana Matsuda, Nobuyuki Ehira, Satoshi Abiko, Takeshi Mizushima, Keiko Yamamoto, Shinji Yoshii, Kazuhiro Takahashi, Mototsugu Kato, Naoya Sakamoto  GASTROINTESTINAL ENDOSCOPY  83-  (5)  AB265  -AB265  2016/05  [Not refereed][Not invited]
  • 【H.pylori除菌後の諸問題】 H.pylori除菌がGERD発症にどのように影響するのか
    加藤 元嗣, 小野 尚子, 中川 学, 中川 宗一, 安孫子 怜史, 宮本 秀一, 水島 健, 津田 桃子, 大野 正芳, 大西 俊介, 清水 勇一, 坂本 直哉, 間部 克裕  The GI Forefront  11-  (2)  106  -109  2016/01  [Not refereed][Not invited]
     
    H.pylori感染は胃酸分泌との関わりからGERDの影響因子である。実際、H.pylori感染率とGERD有病率については相反する関係にあり、H.pylori感染がGERD発症に防御的に作用している可能性がある。一方、H.pylori除菌がGERDの発症を増加させるかについては、いくつかのメタ解析の結果から否定的である。むしろ、GERD症状はH.pylori除菌によって軽減する傾向がある。したがって、GERDの存在がH.pylori除菌の妨げとはならない。(著者抄録)
  • 【慢性胃炎を見直す】 胃炎の内視鏡診断 通常光観察
    加藤 元嗣, 小野 尚子, 中川 学, 中川 宗一, 安孫子 怜史, 宮本 秀一, 水島 健, 津田 桃子, 大野 正芳, 大西 俊介, 清水 勇一, 坂本 直哉, 間部 克裕  胃と腸  51-  (1)  42  -51  2016/01  [Not refereed][Not invited]
     
    組織学的所見と内視鏡所見が一致しないために,慢性胃炎はこれまで組織学的に診断されてきた.しかし,最近の内視鏡機器の進歩により,組織学的胃炎と一致する内視鏡所見が次第に明らかになった.胃粘膜におけるH. pylori感染状態は,H. pylori未感染,H. pylori感染,H. pylori既感染・除菌後に分けることができる.新たな内視鏡による胃炎分類である京都分類では,19の胃炎所見を定義して,H. pylori感染状態との関連性を整理した.RAC,びまん性発赤,地図状発赤は,それぞれH. pylori未感染,H. pylori感染,H. pylori除菌後の特徴的な所見である.H. pylori感染状態によって,発生胃癌のリスクや特徴は異なるため,胃炎の診断は胃癌スクリーニングにおいても重要である.(著者抄録)
  • 【胃がん検診・健康診断におけるHelicobacter pylori感染診断】内視鏡検査におけるHelicobacter pylori感染診断法
    間部 克裕, 吉井 新二, 小野 尚子, 加藤 元嗣  Helicobacter Research  19-  (6)  560  -564  2015/12  [Not refereed][Not invited]
     
    Helicobacter pyloriが胃がんの原因であり、日本では胃がんのほとんどがH.pylori感染にもとづく。胃がんリスクは内視鏡的胃粘膜萎縮の程度で異なり、除菌治療によって胃がんリスクは低下する。2013年2月に内視鏡検査で胃炎を認めた場合、H.pylori感染検査と除菌治療が保険適用となった。このため、内視鏡検査ではH.pylori感染胃炎の診断をおこなうことが求められる。検診・健診における内視鏡検査においても日常診療と同様にH.pylori感染胃炎の診断をおこない、萎縮の程度などによる胃がんリスク評価をおこなうことが重要となる。(著者抄録)
  • Shuichi Miyamoto, Mototsugu Kato, Shouko Ono, Katsuhiro Mabe, Yuichi Shimizu, Naoya Sakamoto  GASTROINTESTINAL ENDOSCOPY  81-  (5)  AB465  -AB465  2015/05  [Not refereed][Not invited]
  • K. Mabe, S. Miyamoto, T. Mizushima, M. Ono, S. Omori, S. Ono, Y. Shimizu, M. Kato, M. Asaka  HELICOBACTER  19-  162  -162  2014/09  [Not refereed][Not invited]
  • M. Kato, S. Ono, K. Mabe, N. Sakamoto, M. Asaka  HELICOBACTER  19-  125  -125  2014/09  [Not refereed][Not invited]
  • S. Ono, K. Mabe, M. Kato, N. Sakamoto  HELICOBACTER  19-  108  -108  2014/09  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 大野正芳, 松本美櫻, 大森沙織, 高橋正和, 吉田武史, 清水勇一, 坂本直哉, 中川学, 中川宗一  モダンフィジシャン  34-  (5)  610  -614  2014/05/01  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 吉田武史, 清水勇一, 坂本直哉, 中川学, 中川宗一  臨床消化器内科  29-  (3)  329  -336  2014/02/20  [Not refereed][Not invited]
  • 間部克裕, 加藤元嗣, 津田桃子, 大野正芳, 大森沙織, 松本美櫻, 高橋正和, 吉田武史, 小野尚子, 中川学, 中川宗一, 清水勇一, 坂本直哉  Helicobacter Res  18-  (1)  34  -38  2014/02/01  [Not refereed][Not invited]
  • 小野尚子, 加藤元嗣, 清水勇一, 坂本直哉, 浅香正博  日本臨床  72-  370  -373  2014/01/20  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 清水勇一, 坂本直哉  日本臨床  72-  673  -680  2014/01/20  [Not refereed][Not invited]
  • 高橋正和, 加藤元嗣, 大野正芳, 津田桃子, 大森沙織, 松本美櫻, 吉田武史, 森康明, 中川学, 小野尚子, 中川宗一, 間部克裕, 清水勇一, 坂本直哉  救急医学  38-  (1)  3  -8  2014/01/10  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 大野正芳, 松本美櫻, 大森沙織, 高橋正和, 吉田武史, 清水勇一, 坂本直哉, 中川学, 中川宗一  消化器内視鏡  25-  (12)  1938  -1944  2013/12/25  [Not refereed][Not invited]
  • 高橋正和, 清水勇一, 吉田武史, 大野正芳, 大森沙織, 松本美櫻, 坂本直哉, 小野尚子, 間部克裕, 加藤元嗣  耳鼻咽喉科展望  56-  (6)  399  2013/12/15  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 大野正芳, 松本美櫻, 大森沙織, 高橋正和, 吉田武史, 清水勇一, 坂本直哉, 中川学, 中川宗一  Helicobacter Res  17-  (6)  551  -555  2013/12/01  [Not refereed][Not invited]
  • 大野正芳, 大森沙織, 鈴木美櫻, 高橋正和, 清水勇一, 小野尚子, 間部克裕, 加藤元嗣, 結城敏志, 小松嘉人, 山本純司, 中川学, 中川宗一, 坂本直哉  Gastroenterol Endosc  55-  (Supplement 2)  2817  2013/09/10  [Not refereed][Not invited]
  • 大森沙織, 加藤元嗣, 大野正芳, 高橋正和, 鈴木美櫻, 吉田武史, 森康明, 中川学, 小野尚子, 中川宗一, 間部克裕, 清水勇一, 坂本直哉  月刊消化器内科  57-  (2)  125  -130  2013/08/28  [Not refereed][Not invited]
  • 清水勇一, 高橋正和, 吉田武史, 小野尚子, 間部克裕, 加藤元嗣, 坂本直哉  耳鼻咽喉科展望  56-  (4)  214  2013/08/15  [Not refereed][Not invited]
  • 大森沙織, 間部克裕, 大野正芳, 鈴木美櫻, 高橋正和, 小野尚子, 清水勇一, 加藤元嗣, 畑中佳奈子, 坂本直哉  日本内科学会雑誌  102-  (8)  2046  -2049  2013/08/10  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 森康明, 中川学, 中川宗一, 間部克裕, 大野正芳, 石垣沙織, 鈴木美櫻, 高橋正和, 吉田武史, 清水勇一, 坂本直哉  消化器の臨床  16-  (4)  367  -371  2013/08/10  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 坂本直哉, 浅香正博  日本臨床  71-  (8)  1429  -1435  2013/08/01  [Not refereed][Not invited]
  • 小野尚子, 加藤元嗣, 浅香正博  月刊消化器内科  57-  (1)  17  -21  2013/07/28  [Not refereed][Not invited]
  • 高橋正和, 清水勇一, 大野正芳, 石垣沙織, 鈴木美櫻, 坂本直哉, 小野尚子, 間部克裕, 加藤元嗣  耳鼻咽喉科展望  56-  (3)  148  2013/06/15  [Not refereed][Not invited]
  • 清水勇一, 高橋正和, 吉田武史, 小野尚子, 間部克裕, 加藤元嗣, 坂本直哉  消化器の臨床  16-  (3)  311  -315  2013/06/10  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 森康明, 中川学, 中川宗一, 工藤俊彦, 大野正芳, 石垣沙織, 鈴木美櫻, 高橋正和, 吉田武史, 清水勇一, 坂本直哉, 浅香正博  Helicobacter Res  17-  (3)  216  -211  2013/06/01  [Not refereed][Not invited]
  • 光の臨床応用 近赤外蛍光イメージングとBlue LASER Imaging
    大西 俊介, 田中 栄一, 小野 尚子, 加藤 元嗣  JSMI Report  6-  (2)  59  -59  2013/05  [Not refereed][Not invited]
  • 大野正芳, 石垣沙織, 鈴木美櫻, 高橋正和, 清水勇一, 小野尚子, 間部克裕, 加藤元嗣, 結城敏志, 小松嘉人, 山本純司, 中川学, 中川宗一, 坂本直哉  Gastroenterol Endosc  55-  (Supplement 1)  1150  2013/04/15  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕  Helicobacter Res  17-  (2)  116  -121  2013/04/01  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 清水勇一, 坂本直哉  Clinician  60-  (617)  344  -351  2013/03/01  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 森康明, 中川学, 間部克裕, 工藤俊彦, 中川宗一, 大野正芳, 石垣沙織, 鈴木美櫻, 高橋正和, 清水勇一, 坂本直哉, 青木利佳, 安田貢  Helicobacter Res  16-  (6)  528  -532  2012/12/01  [Not refereed][Not invited]
  • 小野尚子, 加藤元嗣, 浅香正博  臨床消化器内科  27-  (13)  1685-1690  2012/11/20  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕  臨床検査  56-  (11)  1192-1193  2012/10/30  [Not refereed][Not invited]
  • 清水勇一, 高橋正和, 吉田武史, 小野尚子, 間部克裕, 加藤元嗣, 坂本直哉  月刊消化器内科  55-  (4)  449-452  2012/10/28  [Not refereed][Not invited]
  • KATO MOTOTSUGU, ONO SHOKO, MORI YASUAKI, NAKAGAWA MANABU, MABE KATSUHIRO, KUDO TAKAHIKO, NAKAGAWA SOICHI, ONO MASAYOSHI, ISHIGAKI SAORI, SUZUKI MIO, TAKAHASHI MASAKAZU, SHIMIZU YUICHI, SAKAMOTO NAOYA, YAMAMOTO KEIKO  胃と腸  47-  (11)  1640-1648  2012/10/25  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 大野正芳, 鈴木美櫻, 石垣沙織, 高橋正和, 清水勇一, 坂本直哉  消化器内視鏡  24-  (10)  1636-1641  2012/10/25  [Not refereed][Not invited]
  • 小野尚子, 加藤元嗣, 浅香正博  日本医師会雑誌  141-  S174S-175,S16  2012/10/15  [Not refereed][Not invited]
  • 間部克裕, 加藤元嗣, 小野尚子, 浅香正博, 坂本直哉  日本臨床  70-  (10)  1726-1730  2012/10/01  [Not refereed][Not invited]
  • 加藤元嗣, 小野尚子, 間部克裕, 浅香正博  日本臨床  70-  (10)  1795-1801  2012/10/01  [Not refereed][Not invited]
  • K. Mabe, M. Ohno, S. Ishigaki, M. Suzuki, M. Takahashi, S. Ono, Y. Shimizu, M. Kato, M. Asaka  HELICOBACTER  17-  112  -112  2012/09  [Not refereed][Not invited]
  • 高橋正和, 清水勇, 小野尚子, 間部克裕, 加藤元嗣, 新館伸彦  耳鼻咽喉科展望  55-  (4)  255  2012/08/15  [Not refereed][Not invited]
  • 間部克裕, 大野正芳, 石垣沙織, 鈴木美櫻, 高橋正和, 小野尚子, 清水勇一, 森康明, 中川学, 中川宗一, 加藤元嗣, 坂本直哉  Helicobacter Res  16-  (4)  311  -315  2012/08/01  [Not refereed][Not invited]
  • Takahiko Kudo, Mutsumi Nishida, Haneda Masahira, Mio Suzuki, Saori Ishigaki, Masakazu Takahashi, Yasuaki Mori, Manabu Nakagawa, Shouko Ono, Katsuhiro Mabe, Soichi Nakagawa, Yuichi Shimizu, Mototsugu Kato  GASTROENTEROLOGY  142-  (5)  S467  -S467  2012/05  [Not refereed][Not invited]
  • Keiko Yamamoto, Mototsugu Kato, Masakazu Takahashi, Masahira Haneda, Keisuke Shinada, Urara Nishida, Takeshi Yoshida, Norikazu Sonoda, Shoko Ono, Manabu Nakagawa, Yasuaki Mori, Soichi Nakagawa, Katsuhiro Mabe, Yuichi Shimizu, Jun Moriya, Kanako Kubota, Yoshihiro Matsuno, Tadakazu Shimoda, Hidenobu Watanabe, Masahiro Asaka  HELICOBACTER  16-  (3)  210  -216  2011/06  [Not refereed][Not invited]
     
    Background and Aims: The results of a randomized controlled study and meta-analysis study have recently proved that Helicobacter pylori eradication has a preventive effect against the development of metachronous and primary gastric cancer. However, gastric cancer is sometimes detected after successful eradication. There is a lack of study about gastric cancers in eradicated patients. To clarify the characteristics of gastric cancers detected after H. pylori eradication, we analyzed the clinicopathological features of these cancers. Methods: The subjects were 18 early-stage gastric cancer specimens resected from 17 patients who had received successful eradication of H. pylori from February 1995 to March 2009. The control group consisted of 36 specimens from noneradicated patients with persistent H. pylori infection who were matched with the subjects in age, sex, and depth of invasion. Clinicopathological features and mucin phenotypes of gastric cancer were clinically and immunohistologically evaluated. Results: The average diameter of gastric cancer was smaller and Ki-67 index was lower in the eradication group. The morphological distribution of depression types was significantly lower in the control group. Immunohistochemical phenotyping revealed that 72.2% of the lesions in the eradicated group were complete gastric type or gastric predominant mixed type, whereas the percentages of gastric type and intestinal type in the control group were similar. Conclusion: Our findings indicate that the clinicopathological characteristics of gastric cancers detected after H. pylori eradication are different from those of gastric cancers in patients with persistent H. pylori infection. H. pylori eradication may suppress intestinalization during the development of gastric cancer.
  • Shotaro Nakamura, Katsunori Iijima, Shouko Ono, Masahiro Tajika, Akira Tari, Yasuhiko Kitadai, Hiroshi Matsumoto, Tadanobu Nagaya, Toshiro Kamoshida, Norihiko Watanabe, Toshimi Chiba, Takayuki Matsumoto, Hideki Origasa, Masahiro Asaka, Toshiro Sugiyama  GASTROENTEROLOGY  140-  (5)  S872  -S872  2011/05  [Not refereed][Not invited]
  • Motosugu Kato, Urara Nishida, Shouko Ono, Katsuhiro Mabe, Yuichi Shimizu, Masahiro Asaka  GASTROENTEROLOGY  140-  (5)  S60  -S60  2011/05  [Not refereed][Not invited]
  • 【胃腫瘍の拡大内視鏡診断】 胃腫瘍性病変の拡大内視鏡診断 MALTリンパ腫,悪性リンパ腫
    小野 尚子, 加藤 元嗣, 久保田 佳奈子, 松野 吉宏, 高橋 正和, 羽田 政平, 山本 桂子, 西田 麗, 品田 恵佐, 吉田 武史, 間部 克裕, 清水 勇一, 浅香 正博  胃と腸  46-  (6)  892  -901  2011/05  [Not refereed][Not invited]
     
    胃癌の診断に加え,Helicobacter pylori胃炎やMALTリンパ腫の診断や治療後評価に拡大内視鏡観察を行った.MALTリンパ腫は,その多彩な内視鏡像が特徴であるが,拡大内視鏡で観察すると,腺管構造が消失した無構造領域と不規則に走行する微小血管が高率に観察される.組織学的には,著明な腫瘍細胞浸潤と腺管構造の破壊を反映しており,寛解するとこれらの所見は消失し,背景粘膜と類似した表面構造に変化する.無構造領域の生検は,サンプリングエラーを減らし,診断や治療後評価の狙撃生検に有用である.(著者抄録)
  • ONO SHOKO, KATO MOTOTSUGU, KUBOTA KANAKO, TAKAHASHI MASAKAZU, SHIMIZU YUICHI, HASHINO SATOSHI, ASAKA MASAHIRO, SHIGEMATSU AKIO  胃と腸  46-  (3)  283-293  2011/03/25  [Not refereed][Not invited]
  • 【Helicobacter pylori除菌後GERDの実態】 Helicobacter pylori感染とGERD 現状は?
    加藤 元嗣, 小野 尚子, 高橋 正和, 品田 恵佐, 羽田 政平, 山本 桂子, 吉田 武史, 間部 克裕, 清水 勇一, 浅香 正博, 中川 学, 中川 宗一, 森 康明  Helicobacter Research  15-  (1)  14  -19  2011/02  [Not refereed][Not invited]
     
    逆流性食道炎/GERDの発症には胃酸分泌、食道下部括約筋圧(LES)の低下、食道内の酸クリアランスの低下が関与している。Helicobacter pylori(H.pylori)感染は胃酸分泌とのかかわりからGERDの影響因子である。実際、H.pylori感染率と逆流性食道炎/GERDの発症については相反する関係にあり、H.pylori感染がGERD発症に防御的に作用している可能性がある。逆流性食道炎に関連するバレット粘膜についても同様である。わが国ではH.pylori罹患率の低下とともに、今後はGERDの頻度が上昇することが懸念されている(著者抄録)
  • 【多発胃癌 最新の知見を含めて】 Helicobacter pylori除菌後の多発胃癌
    加藤 元嗣, 小野 尚子, 高橋 正和, 品田 恵佐, 羽田 政平, 山本 桂子, 吉田 武史, 間部 克裕, 清水 勇一, 浅香 正博, 森 康明, 中川 学, 中川 宗一  胃と腸  46-  (1)  75  -82  2011/01  [Not refereed][Not invited]
     
    胃癌は組織型を問わずH. pylori感染に伴う慢性胃炎を背景として発症する.胃癌治療には内科治療と外科治療があるが,外科切除後の残胃癌に比べ内視鏡治療後の異時性多発癌の頻度が高い.最近では,内視鏡治療の進歩により,胃癌の内視鏡治療の適応拡大がなされ,多発胃癌の重要性が増している.内視鏡治療後の遺残再発はほとんどが術後2年以内に発生するが,内視鏡治療後の異時性多発癌は術後長期にわたって出現する.H. pylori除菌が内視鏡治療後の異時性多発癌の発生を抑制することが,わが国における多施設共同の無作為化試験で証明された.胃粘膜の高度萎縮症例ではH. pylori除菌後での異時性多発癌のリスクが高く注意を要した.しかし,外科切除後の異時性多発癌については,H. pylori感染に加え十二指腸液の逆流,迷走神経切離による脱神経支配など術後の胃内環境の変化が関与する.(著者抄録)
  • 【Dyspepsia症状と内視鏡所見】 Dyspepsiaと鳥肌胃炎
    羽田 政平, 高橋 正和, 品田 恵佐, 山本 桂子, 西田 麗, 吉田 武史, 森 康明, 間部 克裕, 清水 勇一, 浅香 正博, 加藤 元嗣, 小野 尚子, 中川 学, 中川 宗一  消化器内科  51-  (5)  482  -488  2010/11  [Not refereed][Not invited]
  • 【救命・救急と内視鏡】 消化管出血 消化管出血に対する診断・治療戦略
    吉田 武史, 清水 勇一, 加藤 元嗣, 高橋 正和, 浅香 瑠美子, 羽田 政平, 山本 桂子, 西田 麗, 森 康明, 中川 学, 中川 宗一, 間部 克裕, 小野 尚子, 浅香 正博  消化器内視鏡  22-  (9)  1370  -1377  2010/09  [Not refereed][Not invited]
     
    緊急内視鏡および内視鏡的止血術は、今日の消化管出血の診断・治療におけるfirst choiceとなっている。消化管出血の初動において最も重要なことは、全身状態の把握と管理にあり、まずバイタルサインのチェックと血管確保を行う。ショックインデックスが1.5以上のショックを認める場合には、輸液・輸血などの抗ショック対策を行い、バイタルサインの安定に務める。バイタルサインが安定していれば十分なインフォームド・コンセントを得た後、緊急内視鏡に移行し、出血源の検索と内視鏡的止血を行う。止血不能例や再出血を繰り返す症例に対しては、内視鏡に固執せず、緊急IVRや緊急外科手術を選択する。(著者抄録)
  • 【GERDの病態解明と治療はどこまで進んだか】 内視鏡によるGERD診断
    吉田 武史, 清水 勇一, 加藤 元嗣, 高橋 正和, 浅香 瑠美子, 羽田 政平, 山本 桂子, 西田 麗, 森 康明, 中川 学, 中川 宗一, 小野 尚子, 浅香 正博  消化器の臨床  13-  (4)  413  -421  2010/08  [Not refereed][Not invited]
     
    逆流性食道炎の正確な診断はGERD診療の要であり、下部食道柵状血管領域を十分洗浄後に、深吸気の上、丁寧に観察を行う。画像強調観察や拡大内視鏡観察は、びらん性GERD(ERD)、非びらん性GERD(NERD)に対する診断のクルーとなるばかりでなく、Montreal DefinitionでGERDとみなされるBarrett食道、Barrett腺癌に対してもいまや欠かせない存在となりつつある。これらのツールを上手に使い、ERDのみならずNERDを正確に診断し、observer valianceをなくす努力と協力が、今後国内外で必要である。(著者抄録)
  • 【胃癌の最新知見 H.pyloriとの関連に焦点をあてて】 除菌後胃癌の特徴
    加藤 元嗣, 小野 尚子, 高橋 正和, 品田 恵佐, 羽田 政平, 山本 桂子, 吉田 武史, 清水 勇一, 浅香 正博, 中川 学, 中川 宗一, 園田 範和  Pharma Medica  28-  (8)  55  -59  2010/08  [Not refereed][Not invited]
  • T. Yoshida, Y. Shimizu, J. Hirota, Y. Ono, M. Nakagawa, S. Ono, S. Nakagawa, M. Kato, M. Asaka  ENDOSCOPY  42-  E176  -E177  2010/07  [Not refereed][Not invited]
  • 【広がりつつある胃酸関連疾患 新ガイドラインに基づく最新治療を取り上げます!】 機能性胃腸症 FDの症状と診断
    加藤 元嗣, 小野 尚子, 清水 勇一, 羽田 政平, 山本 桂子, 西田 麗, 今井 亜希, 吉田 武史, 浅香 正博, 中川 学, 中川 宗一, 森 康明  治療  92-  (3)  490  -498  2010/03  [Not refereed][Not invited]
     
    <プライマリ・ケアにおけるポイント>FDは症候学的な疾患であり、慢性胃炎を混同しないで使い分ける。Rome IIIでは、FDは食後愁訴症候群(B1a postprandial distress syndrome:PDS)と、心窩部痛症候群(B1b epigastric pain syndrome:EPS)に分類される。FDのキーとなる4症状(食後のもたれ感、早期飽満感、心窩部痛、心窩部灼熱感)を詳しく問診する。症状の発現時期にも注意する。問診には各種の問診票を使用することで、効率的に症状の評価ができ、治療後には治療効果の評価にも応用できる。器質的疾患の除外については、上部消化管内視鏡検査や腹部エコー検査は必須である。GERDやIBSなどのオーバーラップの頻度は高い。精神的疾患との鑑別が難しいことがある。(著者抄録)
  • 大腸内視鏡前処置用腸管洗浄剤の腸管内動態の検討
    今井 亜希, 羽田 政平, 浅香 瑠美子, 山本 桂子, 西田 麗, 吉田 武史, 桂田 武彦, 森 康明, 浅香 正博, 小野 尚子, 清水 勇一, 加藤 元嗣, 西田 睦, 中川 学, 中川 宗一  日本大腸肛門病学会雑誌  63-  (3)  186  -186  2010/03  [Not refereed][Not invited]
  • 【H.pylori除菌後に発見された胃癌】 除菌後に発見された胃癌の粘液形質からみた臨床病理学的検討
    山本 桂子, 羽田 政平, 浅香 瑠美子, 西田 麗, 今井 亜希, 吉田 武史, 森 康明, 中川 学, 中川 宗一, 清水 勇一, 浅香 正博, 小野 尚子, 加藤 元嗣, 久保田 佳奈子, 松野 吉宏, 渡辺 英伸  消化器内科  50-  (1)  33  -39  2010/01  [Not refereed][Not invited]
  • 【食道小扁平上皮癌の診断】 食道小扁平上皮癌の拾い上げ診断 通常観察と生検診断
    清水 勇一, 吉田 武史, 加藤 元嗣, 羽田 政平, 浅香 瑠美子, 西田 麗, 山本 桂子, 今井 亜希, 中川 学, 小野 尚子, 浅香 正博  胃と腸  44-  (11)  1647  -1654  2009/10  [Not refereed][Not invited]
     
    主に10mm以下のHGIN(high grade intraepithelial neoplasia)もしくは浸潤癌を食道小扁平上皮癌とした場合,通常内視鏡観察において重要な粘膜面の所見は,通常の早期食道癌と同様,かすかな発赤,細血管の乱れ,消失,わずかな凹凸,光沢の消失,白濁などであり,特に重要なのは発赤所見である.また,境界部分における細血管の途絶も重要な所見であり,小病変でも認識は困難ではない.さらに,やはりヨード染色を行うと発見は容易であり,ヨード不染帯が,HGIN以上かどうかの鑑別には,pink color signが有用である.小病変といえどもHGINは,浸潤癌となっていく可能性が高いと思われ,その発見に努力を注ぐべき対象であると考える.(著者抄録)
  • S. Ono, M. Kato, K. Takagi, J. Kodaira, K. Kubota, Y. Matsuno, Y. Komatsu, M. Asaka  ANNALS OF ONCOLOGY  20-  (10)  1748  -1749  2009/10  [Not refereed][Not invited]
  • 【背景粘膜からみた胃癌ハイリスクグループ】 Helicobacter pylori感染と胃癌 除菌による胃癌の予防は可能か
    加藤 元嗣, 小野 尚子, 清水 勇一, 羽田 政平, 小林 智絵, 浅香 瑠美子, 山本 桂子, 西田 麗, 今井 亜希, 吉田 武史, 浅香 正博, 中川 学, 中川 宗一  胃と腸  44-  (9)  1402  -1411  2009/08  [Not refereed][Not invited]
     
    H. pylori感染は胃発癌と最も強く関連する因子であり,胃癌予防としてのH. pylori除菌が注目されている.胃発癌をエンドポイントとした5件の無作為化比較試験が報告されているが,これらの各試験およびメタ解析においては,H. pylori除菌による胃癌抑制に関して有意な結果が得られなかった.わが国からは,胃・十二指腸潰瘍患者を対象にした非無作為化の前向き試験が3件報告されているが,いずれも除菌群での胃癌発症は非除菌群より有意に低値であった.さらに,早期胃癌の内視鏡治療後の二次癌に対する多施設による無作為比較試験がわが国から報告され,H. pylori除菌は有意に二次癌の発症を抑制することがわかった.胃発癌をエンドポイントとした無作為化試験の中で初めて有意差を認め,H. pylori除菌の胃癌予防効果を明確にした.観察期間が3年と短いことから,この試験で除菌治療によって抑制された癌は潜在癌と考えられた.また,遺残再発に対しては除菌効果が認められないことから,ある程度の大きさになった癌に対しては,除菌効果は十分に発揮できないと考えられる.胃癌撲滅のためにはH. pylori除菌を基本に据えた対策が重要である.(著者抄録)
  • 【NERD・RE・Barrett食道と内視鏡】 Barrett食道とBarrett腺癌の内視鏡診断、その最前線
    吉田 武史, 清水 勇一, 加藤 元嗣, 浅香 瑠美子, 羽田 政平, 山本 桂子, 西田 麗, 今井 亜希, 森 康明, 中川 学, 中川 宗一, 小野 尚子, 浅香 正博  消化器内視鏡  21-  (8)  1185  -1198  2009/08  [Not refereed][Not invited]
     
    Barrett食道およびBarrett腺癌診断の第一歩は、食道胃接合部の正確な把握にあり、十分に洗浄した後、深吸気のうえ、ゆっくり観察を行う。Barrett食道では、わずかな色調や粘膜変化を見逃さないことが表在癌発見の要であり、NBIやFICEあるいは色素法、酢酸散布、そして拡大内視鏡併用観察を行うことで、より精密な診断が可能となった。しかし、Barrett腺癌発生に関する国内外での統一的な見解はなく不明であり、Barrett食道のサーベイランスも含め、今後更なる症例の蓄積と検討が必要な分野である。(著者抄録)
  • S. Ono, M. Kato, Y. Ono, M. Nakagawa, S. Nakagawa, Y. Shimizu, M. Asaka  ENDOSCOPY  41-  (4)  299  -303  2009/04  [Not refereed][Not invited]
     
    Background and aims: The effectiveness of preoperative administration of proton Pump inhibitors (PPIs) for the prevention of bleeding after endoscopic submucosal dissection (ESD) is unclear. Our aim was to evaluate the benefit of starting PPI treatment 1 day before ESD to prevent bleeding after the procedure. Patients and methods: This was a prospective randomized controlled trial. Data for 155 patients who underwent ESD (preoperative administration group: n = 81; postoperative administration group: n = 74) were analyzed. All patients received standard ESD using an insulation-tipped knife. Patients in the preoperative group were administered omeprazole from the day before ESD, and patients in the postoperative group received omeprazole after ESD. Follow-up endoscopy was performed on day 1, day 7, and day 28. Intragastric pH was measured from samples of gastric juice. The primary endpoint of this study was major bleeding related to ESD, and the secondary endpoint was minor bleeding. Results: Major bleeding occurred in one patient from the postoperative group who had hematemesis. Minor bleeding Occurred on day 1 in six patients from the preoperative group and five patients from the postoperative group (7.7% vs. 7.4%). There was no significant difference between major and minor bleeding ratios in the two groups. Intragastric pH at ESD in the postoperative group was lower than that in the preoperative group (P < 0.05). Conclusions: Preoperative administration of omeprazole offers no additional benefit over postoperative administration alone in the prevention of bleeding after ESD among elderly Japanese people.
  • 岩永一郎, 結城敏志, 川本泰之, 曽我部進, 上畠寧子, 小野尚子, 浅香正博, 小松嘉人  日本消化器病学会雑誌  106-  A185  2009/03/20  [Not refereed][Not invited]
  • 壊死性強膜炎を合併した多発腸潰瘍の一例
    平山 剛, 桂田 武彦, 浅香 瑠美子, 山本 桂子, 西田 麗, 今井 亜希, 吉田 武史, 小野 尚子, 清水 勇一, 加藤 元嗣, 浅香 正博, 武田 宏司, 有賀 俊英, 西堀 宗樹  日本消化器病学会雑誌  106-  (臨増総会)  A349  -A349  2009/03  [Not refereed][Not invited]
  • 術前に診断困難であった早期胃癌2症例
    石垣 沙織, 穂刈 格, 岡原 聡, 吉井 新二, 小平 純一, 松本 岳士, 高橋 宏明, 塚越 洋元, 小野 尚子, 佐藤 利宏, 藤田 昌宏  日本消化器病学会雑誌  106-  (臨増総会)  A392  -A392  2009/03  [Not refereed][Not invited]
  • T. Yoshida, Y. Shimizu, S. Ono, N. Oridate, M. Kato, M. Asaka  ENDOSCOPY  41-  (2)  184  -184  2009/02  [Not refereed][Not invited]
  • 【Helicobacter pylori除菌後胃癌の特徴】 Helicobacter pylori感染胃癌と除菌後胃癌の臨床病理学的比較
    山本 桂子, 加藤 元嗣, 浅香 瑠美子, 西田 麗, 今井 亜希, 吉田 武史, 森 康明, 清水 勇一, 浅香 正博, 中川 学, 小野 尚子, 中川 宗一, 渡辺 英伸  Helicobacter Research  13-  (1)  10  -15  2009/02  [Not refereed][Not invited]
     
    胃癌の大半はHelicobacter pylori(H.pylori)の持続感染を背景として発癌に至ると考えられる。近年、免疫病理学的な研究の発展により、粘膜形質の側面から胃癌研究を再評価する動きがみられている。臨床研究においては最近H.pylori除菌による二次癌の出現抑制が大規模無作為化比較試験によって証明された。しかし組織発生、進行のメカニズムには未解明の課題が残されており、H.pylori感染が胃癌の発育進展に与える影響については明確になっていない。そこで、除菌後胃癌の特徴の検討がなされている。除菌成功後に発見された胃癌はH.pylori感染持続状態の胃癌とくらべサイズが有意に小さく、形態は陥凹性のものが多い傾向があり、その特徴は除菌による胃内環境の変化に関連していると考えられる。(著者抄録)
  • T. Yoshida, Y. Shimizu, S. Ono, N. Oridate, M. Kato, M. Asaka  Endoscopy  41-  (6)  568  -569  2009  [Not refereed][Not invited]
  • 【H.pylori除菌治療の選択と拡大】 早期胃癌内視鏡治療後におけるH.pylori除菌の効果
    加藤 元嗣, 小野 尚子, 浅香 瑠美子, 山本 桂子, 西田 麗, 今井 亜希, 吉田 武史, 森 康明, 清水 勇一, 浅香 正博, 中川 学, 中川 宗一  消化器科  48-  (1)  70  -74  2009/01  [Not refereed][Not invited]
     
    内視鏡治療を施行したHelicobacter pylori(H. pylori)陽性の早期胃癌51施設749例を対象に、H. pylori除菌治療255例(男195例・女60例・平均68歳:A群)と非治療250例(男191例・女59例・平均69歳:B群)に無作為に割り付け、経過を比較した。A群で除菌に成功したのは203例、B群では経過観察中に12例が陰性化した。目標とした3年間の経過観察を終了したのはA群167例、B群157例であった。経過観察中、33例に異時癌を認め、A群9例、B群24例であった。これらの間に年齢、性別、出現部位、組織型、深達度、大きさに差は認めなかった。除菌の成否に関係なく、観察期間調整をせず層別ロジスティック回帰分析を行ったintention-to-treat(ITT)解析では、H. pylori除菌の異時癌のオッズ比は0.353であった。層別比例ハザードモデルを用いた訂正ITT解析では、異時癌は1000症例×年においてA群14.1例、B群40.5例であった。累積発症率においても両群間に有意差を認めた。
  • 【消化器癌化学予防の現状】 胃癌化学予防 Hericobacter pylori除菌療法を中心に
    加藤 元嗣, 小野 尚子, 浅香 瑠美子, 山本 桂子, 西田 麗, 今井 亜希, 牧山 裕顕, 吉田 武史, 清水 勇一, 浅香 正博, 中川 学, 中川 宗一  臨床消化器内科  23-  (12)  1651  -1658  2008/10  [Not refereed][Not invited]
     
    胃癌の成因には多くの因子が複雑に関与しているが、なかでもHericobacter pylori(H.pylori)感染はもっとも重要な因子である。組織型に関係なくほとんどの胃癌はH.pylori感染に伴う慢性胃炎を背景として発生する。これまでの疫学、動物実験、臨床成績からH.pylori感染と胃癌の関連性は明らかにされている。H.pylori除菌に成功すると、組織学的胃炎の改善、H.pylori関連疾患である消化性潰瘍、胃MALTリンパ腫などの治癒をもたらす。したがって、H.pylori除菌による胃癌予防が期待されている。動物実験においてはH.pylori除菌による胃癌予防効果は証明され、感染早期での除菌のほうが胃癌の予防効果が強いことが示されている。非無作為化による臨床成績では、H.pylori除菌が胃癌を抑制することが報告された。また一次癌に対する無作為化試験とした無作為化試験では有意に胃癌を抑制した。胃癌予防を目的としたH.pylori除菌は積極的におこなわれるべきである。(著者抄録)
  • 【早期食道癌の診断 最近の進歩】 早期食道癌存在診断・質的診断の進歩 高画質通常内視鏡による診断
    清水 勇一, 吉田 武史, 加藤 元嗣, 浅香 瑠美子, 西田 麗, 山本 桂子, 今井 亜希, 廣田 ジョージョ, 中川 学, 小野 尚子, 浅香 正博  胃と腸  43-  (10)  1422  -1430  2008/09  [Not refereed][Not invited]
     
    最新の診断機器が開発された近年においても,通常スクリーニングの際に早期癌を発見するためには,通常白色光内視鏡所見をいかに捉えるかが大切である.早期食道扁平上皮癌を拾い上げるにあたり重要な粘膜面の所見は,かすかな発赤,細血管の乱れ,消失,わずかな凹凸,光沢の消失,白濁などであり,特に重要なのは発赤所見である.通常観察にて所見を捉えた場合やハイリスクグループに対しては,高画質内視鏡を用いた場合でも,やはりヨード染色を行うことが望ましい.ヨード不染帯がhigh grade intraepithelial squamous neoplasia以上かどうかの鑑別には,pink color signが有用であり,特にヨード不染帯の多発を伴うまだら食道症例に対しては極めて有用である.(著者抄録)
  • 低用量アスピリンおよびNSAID併用における胃粘膜障害とヒスタミン受容体拮抗薬の予防効果の検討
    鎌田 豪, 加藤 元嗣, 浅香 正博, 西田 麗, 今井 亜季, 吉田 武史, 高木 貴久子, 桂田 武彦, 中川 学, 小野 尚子, 清水 勇一, 中川 宗一, 西田 睦  Gastroenterological Endoscopy  50-  (Suppl.2)  2262  -2262  2008/09  [Not refereed][Not invited]
  • カプセル内視鏡で観察された低用量アスピリンによる経時的な小腸粘膜障害について
    西田 麗, 今井 亜希, 吉田 武史, 幡 有, 高木 貴久子, 廣田 ジョージョ, 桂田 武彦, 鎌田 豪, 武田 宏司, 浅香 正博, 中川 学, 小野 尚子, 清水 勇一, 加藤 元嗣, 中川 宗一  Gastroenterological Endoscopy  50-  (Suppl.2)  2275  -2275  2008/09  [Not refereed][Not invited]
  • 中川学, 小野尚子, 清水勇一, 加藤元嗣, 西田麗, 今井亜希, 吉田武史, 幡有, 高木貴久子, 廣田ジョージョ, 桂田武彦, 小松嘉人, 武田宏司, 浅香正博, 中川宗一  日本大腸こう門病学会雑誌  61-  (5)  275  2008/05  [Not refereed][Not invited]
  • Mototsugu Kato, Go Kamada, Shoko Ono, Manabu Nakagawa, Souichi Nakagawa, Yuichi Shimizu, Masahiro Asaka  GASTROENTEROLOGY  134-  (4)  A737  -A737  2008/04  [Not refereed][Not invited]
  • Go Kamada, Mototsugu Kato, Masahiro Asaka, Mutsumi Nishida, Yuichi Shimizu, Manabu Nakagawa, Shouko Ono, Soichi Nakagawa, Jojo Hirota, Takehiko Katsurada, Tamotsu Hata  GASTROENTEROLOGY  134-  (4)  A341  -A341  2008/04  [Not refereed][Not invited]
  • 【腹部救急疾患の標準的治療】 消化管出血
    中川 学, 小野 尚子, 清水 勇一, 加藤 元嗣, 西田 麗, 今井 亜希, 吉田 武史, 幡 有, 桂田 武彦, 廣田 ジョージョ, 鎌田 豪, 浅香 正博, 中川 宗一  消化器外科  31-  (4)  499  -504  2008/04  [Not refereed][Not invited]
  • 胃腫瘍および背景粘膜における超拡大内視鏡(Endo-Cytoscopy)の使用経験
    今井 亜希, 西田 麗, 吉田 武史, 幡 有, 桂田 武彦, 高木 貴久子, 廣田 ジョージョ, 鎌田 豪, 武田 宏司, 浅香 正博, 小野 尚子, 中川 学, 清水 勇一, 加藤 元嗣, 伊藤 智雄, 中川 宗一  Gastroenterological Endoscopy  50-  (Suppl.1)  829  -829  2008/04  [Not refereed][Not invited]
  • 当科で経験したH.pylori除菌後胃癌19症例のまとめ
    西田 麗, 今井 亜希, 吉田 武史, 幡 有, 高木 貴久子, 廣田 ジョージョ, 桂田 武彦, 鎌田 豪, 武田 宏司, 浅香 正博, 中川 学, 小野 尚子, 清水 勇一, 加藤 元嗣, 中川 宗一  Gastroenterological Endoscopy  50-  (Suppl.1)  864  -864  2008/04  [Not refereed][Not invited]
  • 機能性ディスペプシアにおける飲水超音波検査を用いた病態検討
    幡 有, 西田 麗, 吉田 武史, 今井 亜希, 廣田 ジョージョ, 高木 貴久子, 桂田 武彦, 鎌田 豪, 武田 宏司, 中川 学, 小野 尚子, 清水 勇一, 加藤 元嗣, 中川 宗一, 浅香 正博, 西田 睦  Therapeutic Research  29-  (4)  536  -537  2008/04  [Not refereed][Not invited]
  • 食道上皮内癌におけるHuman papillomavirus感染の検討(第二報)
    吉田 武史, 清水 勇一, 廣田 ジョージョ, 西田 麗, 今井 亜希, 幡 有, 桂田 武彦, 鎌田 豪, 小野 尚子, 中川 学, 中川 宗一, 武田 宏司, 加藤 元嗣, 浅香 正博  日本消化器病学会雑誌  105-  (臨増総会)  A172  -A172  2008/03  [Not refereed][Not invited]
  • 低用量アスピリンとNSAID併用時の胃粘膜傷害および胃粘膜血流の検討
    鎌田 豪, 加藤 元嗣, 浅香 正博, 西田 麗, 今井 亜希, 吉田 武史, 幡 有, 高木 貴久子, 桂田 武彦, 廣田 ジョージョ, 中川 学, 小野 尚子, 清水 勇一, 武田 宏司, 溝口 恵美, 増田 香織, 佐藤 恵, 西田 睦, 中川 宗一  日本消化器病学会雑誌  105-  (臨増総会)  A212  -A212  2008/03  [Not refereed][Not invited]
  • クローン病を発症したSLEの1例
    桂田 武彦, 西田 麗, 今井 亜希, 吉田 武史, 幡 有, 廣田 ジョージョ, 鎌田 豪, 武田 宏司, 浅香 正博, 小野 尚子, 中川 学, 清水 勇一, 加藤 元嗣, 中川 宗一  日本消化器病学会雑誌  105-  (臨増総会)  A403  -A403  2008/03  [Not refereed][Not invited]
  • S. Ono, M. Kato, Y. Ono, M. Nakagawa, S. Nakagawa, H. Takeda, M. Asaka  DIGESTION  77-  67  -67  2008  [Not refereed][Not invited]
  • 食道m2癌、m3癌の免疫組織学的検討 腫瘍増殖能、浸潤能、および免疫応答について
    廣田 ジョージョ, 清水 勇一, 西田 麗, 山 英仁, 今井 亜希, 吉田 武史, 幡 有, 高木 貴久子, 桂田 武彦, 鎌田 豪, 小野 尚子, 中川 学, 中川 宗一, 武田 宏司, 加藤 元嗣, 浅香 正博  日本消化器病学会雑誌  104-  (臨増大会)  A580  -A580  2007/09  [Not refereed][Not invited]
  • 中川学, 加藤元嗣, 浅香正博, 中川宗一, 清水勇一, 小野尚子, 小野雄司, 廣田ジョージョ, 高木貴久子, 幡有, 今井亜希, 吉田武史, 結城敏史, 布施望, 小松嘉人, 武田宏司, 鎌田豪  Gastroenterol Endosc  49-  (Supplement 1)  925  2007/04/05  [Not refereed][Not invited]
  • 中川学, 加藤元嗣, 中川宗一, 清水勇一, 小松嘉人, 吉田武史, 廣田ジョージョ, 今井亜希, 小野雄司, 小野尚子, 幡有, 武田宏司, 浅香正博, 鎌田剛  日本大腸こう門病学会雑誌  60-  (4)  242  -243  2007/04  [Not refereed][Not invited]
  • 【胃食道逆流症の食道外病変の診断と治療】 LPR診断における下咽頭拡大内視鏡観察の有用性
    山本 純司, 清水 勇一, 武田 宏司, 桂田 武彦, 小野 雄司, 森 康明, 小野 尚子, 中川 学, 小平 純一, 早川 敏文, 中川 宗一, 加藤 元嗣, 浅香 正博, 折舘 伸彦  消化器科  44-  (3)  246  -251  2007/03  [Not refereed][Not invited]
     
    2003年5月〜2004年4月に頸部・胸部症状で受診した62例(男女各31名、28〜86歳・平均63.7歳)を対象に患者からインフォームド・コンセントを得て、内視鏡検査を行い、拡大内視鏡で観察される下咽頭粘膜の乳頭内毛細血管(IPCL)の形態と胃食道逆流症(GERD)内視鏡所見、病理所見との関連性を検討し、拡大内視鏡による咽喉頭逆流(LPR)診断法の確立のための前向き研究を行った。胸部症状36名、咽喉頭症状16名、両症状を有するものは10名であった。38名がRタイプを、22名がDタイプを、2名がOタイプを示した。各群で内視鏡的GERDを示した割合はRタイプ21.1%、Dタイプ45.5%でDタイプで有意に高率に内視鏡的GERDを認めた。咽喉頭の有症状率はRタイプで31.6%、Dタイプで63.6%でDタイプでは有意に高率に自覚症状を認めた。またDタイプには有意な基底層の肥厚を認めた。
  • S. Ono, M. Kato, Y. Ono, M. Nakagawa, Y. Shimizu, M. Asaka  ENDOSCOPY  39-  E328  -E328  2007/02  [Not refereed][Not invited]
  • 多発大腸ポリープの背景粘膜の検討
    森 康明, 桂田 武彦, 吉田 武史, 幡 有, 廣田 ジョージョ, 小野 雄司, 中川 学, 小野 尚子, 横山 朗子, 中井 義仁, 早川 敏文, 武田 宏司, 浅香 正博, 中川 宗一, 清水 勇一, 加藤 元嗣  日本大腸肛門病学会雑誌  59-  (6)  364  -364  2006/06  [Not refereed][Not invited]
  • Shouko Ono, Mototsugu Kato, Takeshi Toshida, Tamotsu Hata, Yuji Ono, Manabu Nakagawa, Souichi Nakagawa, Yuichi Shimizu, Masahiro Asaka  GASTROINTESTINAL ENDOSCOPY  63-  (5)  AB165  -AB165  2006/04  [Not refereed][Not invited]
  • Mototsugu Kato, Takeshi Yoshida, Tamotsu Hata, Yuji Ono, Shouko Ono, Manabu Nakagawa, Souichi Nakagawa, Yuichi Shimizu, Masahiro Asaka  GASTROENTEROLOGY  130-  (4)  A158  -A158  2006/04  [Not refereed][Not invited]
  • Yuji Ono, Yuichi Shimizu, Mototsugu Kato, Takeshi Yoshida, Tamotsu Hata, Jojo Hirota, Shoko Ono, Yasuaki Mori, Manabu Nakagawa, Souichi Nakagawa, Masahiro Asaka  GASTROINTESTINAL ENDOSCOPY  63-  (5)  AB271  -AB271  2006/04  [Not refereed][Not invited]
  • 11C-酢酸PETを用いた13C-酢酸呼気試験における酢酸の体内動態の検討
    中川 学, 桂田 武彦, 小野 雄司, 小野 尚子, 森 康明, 三浦 洋輔, 山本 純司, 早川 敏文, 浅香 正博, 中川 宗一, 清水 勇一, 加藤 元嗣  Therapeutic Research  27-  (4)  686  -688  2006/04  [Not refereed][Not invited]
     
    13C-酢酸呼気試験法(13C-酢酸BT)の有用性を検討するため,11C-酢酸をトレーサーとしたポジトロンCT(PET)と13C-酢酸BTを同時に施行して,経口投与された11C-酢酸の体内動態を調べ,13C-酢酸BTの結果との関連性を検討した.健常男性4名(平均29.5歳)を対象に検討を行い,胃排出,肝臓,呼気排出曲線を得た.その結果,呼気試験法の結果は,肝臓でのC濃度を正確に反映していることが示された.又,呼気試験の結果のうち,頂点までの曲線が胃排出を表しているものと考えられた
  • 幡有, 森康明, 吉田武史, 小野雄司, 広田ジョージョ, 小野尚子, 横山朗子, 中井義仁, 早川敏文, 武田宏司, 浅香正博, 中川学, 中川宗一, 清水勇一, 加藤元嗣, 橋野聡, 太田秀一  日本消化器病学会雑誌  103-  A293  2006/03/20  [Not refereed][Not invited]
  • 内視鏡の読み方 胃形質細胞腫の1例
    小野 尚子, 桂田 武彦, 武田 宏司, 浅香 正博, 清水 勇一, 加藤 元嗣  臨床消化器内科  20-  (12)  1729  -1732  2005/10  [Not refereed][Not invited]
  • 胃の炎症性疾患に対する拡大内視鏡観察
    森 康明, 中川 宗一, 加藤 元嗣, 清水 勇一, 桂田 武彦, 小野 雄司, 小野 尚子, 中川 学, 山本 純司, 早川 敏文, 武田 宏司, 浅香 正博  Gastroenterological Endoscopy  47-  (Suppl.2)  1999  -1999  2005/09  [Not refereed][Not invited]
  • M Kato, Y Shimizu, S Nakagawa, M Nakagawa, Y Mori, S Ono, Y Ono, T Hayakawa, M Asaka  GASTROINTESTINAL ENDOSCOPY  61-  (5)  AB169  -AB169  2005/04  [Not refereed][Not invited]
  • M Kato, Y Shimizu, S Nakagawa, M Nakagawa, Y Ono, S Ono, T Hayakawa, Y Mori, M Asaka  GASTROENTEROLOGY  128-  (4)  A561  -A561  2005/04  [Not refereed][Not invited]
  • M Nakagawa, S Nakagawa, Y Shimizu, N Kato, Y Ono, T Katsurada, S Ono, Y Miura, Y Mori, J Yamamoto, T Hayakawa, Y Komatsu, H Takeda, M Asaka  GASTROINTESTINAL ENDOSCOPY  61-  (5)  AB234  -AB234  2005/04  [Not refereed][Not invited]
  • Y Shimizu, M Kato, J Yamamoto, Y Ono, T Katsurada, S Ono, Y Mori, M Nakagawa, S Nakagawa, T Itoh, M Asaka  GASTROINTESTINAL ENDOSCOPY  61-  (5)  AB143  -AB143  2005/04  [Not refereed][Not invited]
  • 盲腸に陥頓し腹部症状を呈した回腸形質細胞腫の一例
    森 康明, 小野 雄司, 桂田 武彦, 中川 学, 小野 尚子, 山本 純司, 工藤 真弓, 三浦 洋輔, 早川 敏文, 武田 宏司, 杉山 敏郎, 浅香 正博, 中川 宗一, 清水 勇一, 加藤 元嗣, 前田 好章, 近藤 正男, 佐藤 裕二, 藤堂 省  日本大腸肛門病学会雑誌  58-  (4)  234  -234  2005/04  [Not refereed][Not invited]
  • 安全性の向上を目的とした内視鏡的粘膜下層剥離術(ESD)における治療手技の標準化
    中川 学, 浅香 正博, 加藤 元嗣, 桂田 武彦, 小野 雄司, 小野 尚子, 山本 純司, 三浦 洋輔, 森 康明, 早川 敏文, 小松 嘉人, 武田 宏司, 中川 宗一, 清水 勇一  Gastroenterological Endoscopy  47-  (Suppl.1)  803  -803  2005/04  [Not refereed][Not invited]
  • LPRD診断における下咽頭拡大内視鏡観察の有用性の検討
    山本 純司, 清水 勇一, 桂田 武彦, 森 康明, 小野 尚子, 中川 学, 小平 純一, 中川 宗一, 武田 宏司, 加藤 元嗣, 杉山 敏郎, 浅香 正博, 折舘 伸彦  Therapeutic Research  26-  (4)  697  -700  2005/04  [Not refereed][Not invited]
     
    Laryngopharyngeal reflux disease(LPRD)診断法を確立するため,頸部・胸部の有症状者62名に下咽頭粘膜に対する拡大内視鏡観察を施行し,下咽頭粘膜の乳頭内毛細血管(IPCL)の性状と胃食道逆流症(GERD)内視鏡所見,病理所見,咽喉頭症状との関連性について検討した.拡大観察による下咽頭IPCLの形態を,regular(R) type,dilated(D) type,obscured(O) typeの3タイプに分類したところ,R type:38例,D type:22例,O type:2例であった.下咽頭IPCL形態別の内視鏡的GERD患者数は,D typeで有意に内視鏡的GERDを高率に認めた.病理学的評価では,下咽頭IPCL形態別にみた下部食道上皮の基底層厚/上皮厚では,D typeで有意な基底層の肥厚が認められたが,下部食道上皮の乳頭長/上皮厚では,D typeとR typeの間に有意差は認められなかった.下咽頭IPCL形態別の咽喉頭症状の有無では,D typeで有意に咽喉頭症状が認められた.LPRD診断に拡大内視鏡が有用である可能性が示唆された
  • 【症候性GERDの病態と治療】 拡大内視鏡観察による内視鏡陰性GERD治療効果の評価
    山本 純司, 清水 勇一, 加藤 元嗣, 桂田 武彦, 小野 尚子, 森 康明, 小野 雄司, 中川 学, 早川 敏文, 中川 宗一, 武田 宏司, 浅香 正博  消化器科  40-  (3)  275  -280  2005/03  [Not refereed][Not invited]
     
    内視鏡陰性GERD(胃食道逆流症)28例の治療前後に拡大内視鏡で下部食道粘膜の乳頭内毛細血管(IPCL)の形態変化を観察し,病理所見,自覚症状との相関を統計学的に解析した.明らかな相関が認められ,IPCLの形態変化が治療効果判定の有用なマーカーになることが示唆された
  • 【H.pylori除菌療法】 除菌判定における尿素呼気試験の偽陽性とその対策
    加藤 元嗣, 中川 宗一, 早川 敏文, 清水 勇一, 桂田 武彦, 森 康明, 小野 尚子, 小野 雄司, 中川 学, 山本 純司, 浅香 正博  消化器科  40-  (1)  30  -34  2005/01  [Not refereed][Not invited]
  • 【胃癌診断の新しい視点】 毛細血管像からみた過形成性ポリープ・腺腫と胃癌の鑑別
    加藤 元嗣, 中川 宗一, 早川 敏文, 中村 雄一, 宮崎 広亀, 清水 勇一, 桂田 武彦, 森 康明, 小野 尚子, 小野 雄司, 三浦 洋輔, 中川 学, 山本 純司, 浅香 正博  消化器内視鏡  16-  (11)  1735  -1742  2004/11  [Not refereed][Not invited]
     
    拡大内視鏡検査では粘膜表面の微細構造と微細血管が観察可能である.既存の微細血管の変化や腫瘍血管などの新生血管の観察が注目されている.過形成性ポリープの拡大内視鏡像は,表面微細構造は不規則に拡張した腺口と幅広い間質が特徴的で,微細血管模様では間質にさまざまに増生した血管像を観察する.胃腺腫の拡大内視鏡像は,周辺粘膜と境界を有する異型腺管の増生を反映する小型の表面構造が認められる.間質には拡張したcapillary networkを認めるが,異常な微細血管である腫瘍血管を認めない.その点が隆起型胃癌との鑑別になる.しかし,細胞異型は強いが構造異型が中等度で腺管構造が保たれている例については,その診断能に限界がある.ルーチン検査として拡大内視鏡スコープを用いることで,拡大内視鏡による診断学は更なる発展が期待できる(著者抄録)
  • 金マーカーの埋め込みを上部消化管内視鏡下に行ったReal-time Tumor Tracking Radiotherapy
    森 康明, 小野 雄司, 桂田 武彦, 小野 尚子, 山本 純司, 中川 学, 三浦 洋輔, 工藤 真弓, 結城 敏志, 武居 正明, 宮下 憲暢, 小松 嘉人, 浅香 正博, 中川 宗一, 清水 勇一, 加藤 元嗣, 橋本 孝之, 白土 博樹  Gastroenterological Endoscopy  46-  (Suppl.2)  1895  -1895  2004/09  [Not refereed][Not invited]

Educational Activities

Teaching Experience

  • 医学総論
    開講年度 : 2019
    課程区分 : 博士後期課程
    開講学部 : 医学研究科


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