Faculty Profiles - IWAMURO Masaya

Papers - IWAMURO Masaya

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馬場雄己, 安部真, 河原祥朗, 岡本雄貴, 大林由佳, 榮浩行, 濱田健太, 神崎洋光, 岩室雅也, 川野誠司, 津村宗近, 牧野琢丸, 野田洋平, 丸中秀格, 岡田裕之

耳鼻咽喉科展望 62 ( 5 ) 239 - 239 2019.10

Feasibility of flow cytometric analysis of restricted light chain in endoscopic biopsy specimens from patients with gastrointestinal tract B cell lymphoma: a pilot study. International journal

Katsunori Matsueda, Masaya Iwamuro, Takahide Takahashi, Sizuma Omote, Kenji Nishida, Takehiro Tanaka, Daisuke Ennishi, Fumio Otsuka, Tadashi Yoshino, Hiroyuki Okada

BMC research notes 12 ( 1 ) 571 - 571 2019.9

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: Gastrointestinal tract lymphomas are currently detected more frequently due to advances in endoscopic technology. The aim of this study was to assess the feasibility of flow cytometric analysis of restricted light chain in endoscopic biopsy specimens for the diagnosis of gastrointestinal tract B-cell lymphoma. We prepared viable cell suspensions from unfixed specimens obtained from 10 consecutive patients who had a previous histological diagnosis of gastrointestinal tract B-cell lymphoma. We performed immunophenotypic studies with multi-color flow cytometry and assessed clonality through examination of immunoglobulin light chain expression exclusively in a population identified by anti-CD45 or CD20 antibodies. RESULTS: We could perform light chain expression analysis with 2 endoscopic biopsy specimens from all 10 patients with gastrointestinal tract B-cell lymphoma. We conclude that flow cytometric analysis of endoscopic biopsy specimens is feasible and thus likely useful for the diagnosis of gastrointestinal tract B-cell lymphoma in clinical settings. Trial registration UMIN Clinical Trials Registry, UMIN000027730. Registered 12 June 2017.

DOI： 10.1186/s13104-019-4578-4

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Long-Term Outcome in Patients with a Solitary Peutz-Jeghers Polyp. Reviewed International journal

Masaya Iwamuro, Yuki Aoyama, Seiyuu Suzuki, Sayo Kobayashi, Tatsuya Toyokawa, Yuki Moritou, Shinichiro Hori, Kazuhiro Matsueda, Masao Yoshioka, Takehiro Tanaka, Hiroyuki Okada

Gastroenterology research and practice 2019 8159072 - 8159072 2019.9

Language：English Publishing type：Research paper (scientific journal)

Background: Clinical characteristics and prognosis of patients with a solitary Peutz-Jeghers polyp (PJP) have not been fully investigated. Methods: Solitary PJP was diagnosed when a single hamartomatous lesion was identified in the gastrointestinal tract of patients without mucocutaneous pigmentation or a family history of Peutz-Jeghers syndrome. We retrospectively reviewed 51 patients (32 men and 19 women) with a solitary PJP and analyzed the sex, age at diagnosis, endoscopic features, and outcomes in this patient group. The STK11/LKB1 germline mutation was not investigated in any of the patients. Results: The mean age of the 51 patients was 66.1 years. The polyp was found in the duodenum (N = 10), jejunum (N = 2), cecum (N = 2), transverse colon (N = 5), sigmoid colon (N = 21), or rectum (N = 11). Most of the polyps presented as a pedunculated lesion (N = 40), followed by semipedunculated (N = 9) and sessile (N = 2) morphologies. The mean size of a solitary PJP was 15.6 mm (range: 5 to 33 mm). During a mean endoscopic follow-up period of 4.5 years (range: 0.1 to 16.1 years), no recurrence was identified. Eighteen of the enrolled patients had a history of cancer or concomitant cancer. Five patients died due to non-gastrointestinal-related causes. No additional cancer or death directly related to solitary PJP was observed. Conclusions: Solitary PJPs did not recur in this study. Although examination of the entire gastrointestinal tract using esophagogastroduodenoscopy, enteroscopy, and colonoscopy is desirable to exclude Peutz-Jeghers syndrome, follow-up endoscopy after endoscopic polyp resection may be unnecessary, once the diagnosis of a solitary PJP is made.

DOI： 10.1155/2019/8159072

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Frequent Involvement of the Duodenum with Lanthanum Deposition: A Retrospective Observational Study. Reviewed

Masaya Iwamuro, Haruo Urata, Takehiro Tanaka, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 58 ( 16 ) 2283 - 2289 2019.8

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

Objective This study aimed to investigate the endoscopic features of lanthanum-associated duodenal lesions and the prevalence of duodenal involvement among patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Methods We retrospectively reviewed 24 patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Patients were subdivided into three groups: Group A, patients with pathologically-proven lanthanum deposition in the duodenum; Group B, patients without lanthanum deposition in the duodenum; and Group C, patients without a biopsy of the duodenum. Results A biopsy examination of the duodenum was performed in 19 patients, and lanthanum deposition was detected in 17 patients (17/19, 89.5%). In group A (n=17), whitish duodenal villi were detected in 15 patients during esophagogastroduodenoscopy (15/17, 88.2%). While the other two patients showed no whitish villi, a biopsy of the duodenal mucosa revealed lanthanum deposition. The deposition of a white substance showing a clear margin was visible within multiple villi under magnified observation in some patients of group A. Group B patients (n=2) also showed whitish villi. However, the whitish color was faint in one case and sparse in the other case. Conclusion Lanthanum deposits in the duodenum may resemble white villi. However, in some cases, these deposits may be unrecognizable during esophagogastroduodenoscopy due to the subtle degree of deposition. Endoscopists should biopsy the duodenum as well as the stomach, regardless of the presence or absence of white villi, for an accurate determination of lanthanum deposition in the gastrointestinal tract.

DOI： 10.2169/internalmedicine.2398-18

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男女別に見たHelicobacter pylori除菌前後での組織学的胃炎の変化

榮浩行, 岡上昇太郎, 大林由佳, 神崎洋光, 岩室雅也, 川野誠司, 河原祥朗, 田中健大, 岡田裕之

日本高齢消化器病学会誌 22 ( 1 ) 136 - 136 2019.7

A Huge Liver Cyst Manifesting Dyspnea and Edema. Reviewed

Satoko Nagao, Masaya Iwamuro, Hidenori Shiraha, Fumio Otsuka

Internal medicine (Tokyo, Japan) 58 ( 12 ) 1811 - 1812 2019.6

White globe appearance in gastric high-grade dysplasia. Reviewed International journal

Masaya Iwamuro, Hiroyuki Sakae, Takehiro Tanaka, Hiroyuki Okada

Gastrointestinal endoscopy 89 ( 6 ) 1254 - 1255 2019.6

葛西手術後にも消化管出血を繰り返した先天性胆道閉鎖症術後の一例

石田正也, 川野誠司, 岡本雄貴, 大林由佳, 濱田健太, 馬場雄己, 榮浩行, 後藤田達洋, 安部真, 井口俊博, 神崎洋光, 岩室雅也, 平岡佐規子, 岡田裕之, 河原祥朗, 楳田祐三, 八木孝仁

日本消化器病学会四国支部例会プログラム・抄録集 111回 70 - 70 2019.6

Anterior Cutaneous Nerve Entrapment Syndrome Possibly Triggered by Oral Contraceptives.

Daisuke Omura, Mikako Obika, Masaya Iwamuro, Satoko Nagao, Takahiro Nada, Takashi Matsuzaki, Yoshitaka Kondo, Fumio Otsuka

Internal medicine (Tokyo, Japan) 58 ( 10 ) 1507 - 1509 2019.5

Language：English Publishing type：Research paper (scientific journal)

We herein report a teenage girl who had been taking oral contraceptive pills for three months and complained of left lower abdominal pain that had continued for two months. A physical examination indicated anterior cutaneous nerve entrapment syndrome (ACNES), although no abnormality was found in various biochemical and imaging examinations. The pain was only transiently ameliorated by trigger-point injection, and neurectomy surgery was eventually effective. Sex steroids can be involved in the progress of local tissue edema causing ACNES. ACNES should be considered in cases of abdominal pain in patients taking oral contraceptives.

DOI： 10.2169/internalmedicine.1361-18

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A Bezoar Composed of Bilirubin Calcium, Calcium Carbonate, and Fatty Acid Calcium. Reviewed International journal

Masaya Iwamuro, Haruo Urata, Shoichiro Hirata, Toru Ueki, Tetsuro Hanabata, Sho Takeda, Akira Teraoka, Hiroyuki Okada

Case reports in gastrointestinal medicine 2019 5742672 - 5742672 2019.5

Language：English

A 68-year-old Japanese man was diagnosed with bezoar in the stomach, which was endoscopically retrieved. The bezoar was composed of bilirubin calcium, calcium carbonate, and fatty acid calcium. Due to the presence of bilirubin calcium in the bezoar, we performed imaging studies of the bile duct; gallstones and common bile duct stones were identified. Although bezoar with components similar to bile is infrequently encountered, our findings suggest that a bezoar originating from bile should be considered among the differential diagnoses in patients without a recent consumption history of persimmons who demonstrate a mass in the digestive tract. This case highlights the importance of component analysis of gastric bezoars because its findings may alter the treatment plan.

DOI： 10.1155/2019/5742672

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A multicenter observational study on the clinicopathological features of gastric cancer in young patients.

Yoshiyasu Kono, Hiromitsu Kanzaki, Takao Tsuzuki, Masahiro Takatani, Junichirou Nasu, Daisuke Kawai, Ryuta Takenaka, Takehiro Tanaka, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Toshiyoshi Fujiwara, Hiroyuki Okada

Journal of gastroenterology 54 ( 5 ) 419 - 426 2019.5

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The details of gastric cancer in young patients remain unclear because of the low prevalence of the disease. This study aimed to clarify the clinicopathological features and prognosis of gastric cancer in young patients. METHODS: From January 2007 to January 2016, patients in their 20s and 30s who were diagnosed with primary gastric cancer at 4 hospitals were enrolled. Their clinical characteristics and prognosis were evaluated. RESULTS: The total number of patients was 72. The median age was 36 years, and the ratio of males to females was 1:1. The dominant histological type was undifferentiated type (66/72, 92%). Helicobacter pylori (H. pylori) was positive in 81% (54/67). Although there were some asymptomatic patients in stages I-III, all stage IV patients had some clinical symptoms at the diagnosis. The percentage of stage IV was significantly higher in patients in their 20s than in those in their 30s (75% vs. 25%, P < 0.001). The Kaplan-Meier method showed that the overall survival of patients in their 20s was significantly lower than that of patients in their 30s (P = 0.037). CONCLUSIONS: A high rate of H. pylori infection was revealed in young gastric cancer patients. The patients in their 20s had a worse prognosis than those in their 30s. We should consider examining the H. pylori infection status for young patients as well as older patients to identify high-risk populations.

DOI： 10.1007/s00535-018-1525-4

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Clinicopathological Features and Outcomes of Endoscopic Submucosal Dissection for Superficial Cancer of the Pharynx.

Makoto Abe, Masaya Iwamuro, Yoshiro Kawahara, Hiromitsu Kanzaki, Seiji Kawano, Takehiro Tanaka, Munechika Tsumura, Takuma Makino, Yohei Noda, Hidenori Marunaka, Kazunori Nishizaki, Hiroyuki Okada

Acta medica Okayama 73 ( 2 ) 109 - 115 2019.4

Language：English Publishing type：Research paper (scientific journal)

The efficacy and safety of endoscopic submucosal dissection (ESD) for superficial cancer of the pharynx are still unclear. To identify clinicopathological features of superficial pharyngeal cancer, and the efficacy and safety of ESD, we retrospectively assessed 70 pharyngeal cancers in 59 patients who underwent ESD. Of these patients, 61.0% and 50.8% had a history of esophageal cancer and head and neck cancer, respectively. The median tumor size was 15 mm, and 75.7% of the lesions were located at the piriform sinus. The en bloc resection rate was 94.9%. Treatment-related adverse events occurred in 8 cases, but there was no treatment-related death. The lateral margin was positive for neoplasm in 3 lesions (4.3%) and inconclusive in 27 lesions (38.6%), but no local recurrence was observed. Cervical lymph node metastasis was observed in 6 patients, and was successfully treated by cervical lymph node dissection. The three-year overall survival rate was 91.5% (95%CI: 76.6-97.3%) and the cause-specific survival rate was 97.6% (95%CI: 84.9-99.7%). In conclusion, ESD for superficial pharyngeal cancer was safe and effective. "Resect and watch" is probably a feasible and rational strategy for treatment of patients with superficial pharyngeal cancer.

DOI： 10.18926/AMO/56646

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Gastric Emphysema in a Critically Ill Patient Successfully Treated without Surgery. Reviewed International journal

Hiromi Ihoriya, Tetsuya Yumoto, Masaya Iwamuro, Noritomo Fujisaki, Takaaki Osako, Hiromichi Naito, Atsunori Nakao

Case reports in critical care 2019 1824101 - 1824101 2019.3

Language：English

Gastric emphysema is a relatively rare clinical entity caused by injury to the gastric mucosa. A 62-year-old Japanese male with a history of heavy alcohol consumption and smoking was admitted to the emergency intensive care unit due to severe hypercapnic respiratory acidosis. His body mass index was only 12.6. Ten days after initiation of enteral feeding, he complained of abdominal pain. Computed tomography revealed intraluminal air in the distended gastric wall. Esophagogastroduodenoscopy showed diffuse edema, redness, and erosion throughout the stomach. Based on the findings of narrow angle and short distance of the aorta-superior mesenteric artery, the patient was diagnosed with gastric emphysema associated with superior mesenteric artery syndrome. He was successfully managed nonoperatively with treatments including intravenous antibiotics, gastric decompression, and bowel rest. Physicians should be aware of this unusual condition in such critically ill patients complaining of abdominal pain and needing close monitoring and observation to exclude gastric necrosis or perforation.

DOI： 10.1155/2019/1824101

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高齢者における早期胃癌に対するESD非治癒切除症例の検討

岡本雄貴, 後藤田達洋, 濱田健太, 馬場雄己, 大林由佳, 榮浩行, 安部真, 神崎洋光, 岩室雅也, 川野誠司, 田中健大, 河原祥朗, 岡田裕之

日本高齢消化器病学会誌 21 ( 2 ) 6 - 13 2019.3

Language：Japanese Publisher：(NPO)日本高齢消化器病学会

胃内視鏡的粘膜下層剥離術(Endoscopic Submucosal Dissection:ESD)非治癒切除症例の治療方針決定のためのスコアリングシステム(eCura system)が報告された。75歳以上の高齢者に対して当科で施行した早期胃癌に対するESD361例のうち非治癒切除66例を対象とし、追加切除群(A群)22例と経過観察群(B群)44例の2群に分類、治療成績、長期予後を比較検討した。予後栄養指数(prognostic nutritional index:PNI)≦40は有意にB群で多く、治療成績はA群で有意に深達度SM2以深、脈管侵襲が多かった。経過観察選択の因子として多変量解析ではPNI≦40、eCura system<5点が挙げられた。長期予後は観察期間中央値49ヵ月、A群/B群の5年生存率:76/80%で原病死は認めず、PNI≦40、eCura system<5点の高齢者非治癒切除症例については経過観察も一つの選択肢となることが示唆された。(著者抄録)

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消化管神経内分泌腫瘍の臨床病理学的特徴

神崎洋光, 筑木隆雄, 岡田裕之, 岡本雄貴, 大林由佳, 馬場雄己, 濱田健太, 安部真, 後藤田達洋, 岩室雅也, 原田馨太, 川野誠司

日本消化器病学会雑誌 116 ( 臨増総会 ) A269 - A269 2019.3

早期胃がんの内視鏡治療後にダビガトラン起因性食道炎を呈した1例

岩室雅也, 川野誠司, 河原祥朗, 田中健大, 岡田裕之

内科 123 ( 3 ) 465 - 468 2019.3

Language：Japanese Publisher：(株)南江堂

症例は78歳男性で、心房細動に対してdabigatranを内服中である。2年前に2ヶ所の胃腺腫を指摘され、以後は定期的に内視鏡検査を行い経過観察中であった。腺腫の増大を認め、生検でgroup 4と判定されたため内視鏡的粘膜下層剥離術(ESD)を施行した。DabigatranはESD前日および当日のみ休薬し、ESD翌日より内服を再開した。術後経過に問題はなく、ESDの7日後に上部消化管内視鏡検査を実施したところ、中部〜下部食道にび漫性に白色の膜様物の付着を認めダビガトラン起因性食道炎と診断した。Dabigatran内服は継続し、十分な飲水量での服用と内服後30分の臥位を避けるよう指導した。また、ESD後の潰瘍底はフィブリンで被覆されており、出血や露出血管は認めなかったため、クリニカルパスに従ってESD 8日後に退院となった。

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尋常性天疱瘡でみられた生検時の食道上皮剥離

岩室雅也, 田中健大, 岡田裕之

Gastroenterological Endoscopy 61 ( 3 ) 286 - 286 2019.3

咽頭ESD後の下咽頭の変形と誤嚥性肺炎の発症に関する検討

安部真, 河原祥朗, 岡本雄貴, 大林由佳, 馬場雄己, 榮浩行, 後藤田達洋, 神崎洋光, 岩室雅也, 川野誠司, 津村宗近, 牧野琢丸, 野田洋平, 丸中秀格, 岡田裕之

耳鼻咽喉科展望 62 ( 1 ) 51 - 51 2019.2

Heterotopic bone formation in the esophagus. International journal

Masaya Iwamuro, Hiroyuki Sakae, Takehiro Tanaka, Hiroyuki Okada

Gastrointestinal endoscopy 89 ( 2 ) 429 - 430 2019.2

消化管悪性リンパ腫の診断における生検材料を用いたFlow Cytometry法の有用性

岩室雅也, 松枝克典, 表静馬, 大塚文男, 岡田裕之

日本内科学会雑誌 108 ( Suppl. ) 215 - 215 2019.2

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Papers - IWAMURO Masaya