Faculty Profiles - IWAMURO Masaya

Papers - IWAMURO Masaya

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Gastric lanthanum phosphate deposition masquerading as white globe appearance. Reviewed International journal

Masaya Iwamuro, Haruo Urata, Takehiro Tanaka, Hiroyuki Okada

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 51 ( 1 ) 168 - 168 2019.1

[Peutz-Jeghers syndrome and cancer:a retrospective study in 14 Japanese patients with Peutz-Jeghers syndrome].

Masaya Iwamuro, Tatsuya Toyokawa, Yuki Moritou, Kazuhiro Matsueda, Shinichiro Hori, Masao Yoshioka, Takehiro Tanaka, Seiji Kawano, Hiroyuki Okada

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 116 ( 12 ) 1015 - 1021 2019

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

We retrospectively investigated 14 Japanese patients with Peutz-Jeghers (PJ) syndrome who were treated in six hospitals to determine the prevalence of cancer in Japanese patients with PJ syndrome. The study included seven males and seven females. The mean age at the time of diagnosis of PJ syndrome was 28.1 years (range 2-60 years). Hamartomatous polyps were observed in 13 (92.9%) patients, mucocutaneous pigmentation in 11 (78.6%), and positive family history in six patients (42.9%). The mean observation period after the diagnosis of PJ syndrome was 10.1 years (range 0-34 years). Although one patient died of cancer of unknown primary origin, the remaining 13 patients included in the study completed their last follow-up at each hospital. Cancers were detected in six patients (42.9%), including cancer of the uterine cervix (N=3), breast cancer (N=1), duodenal cancer (N=1), transverse colon cancer (N=1), and cancer of unknown primary origin (N=1). One patient presented with both cervical cancer and breast cancer. No patient presented with pancreatic cancer. This study highlights that patients with PJ syndrome are at high risk for intestinal and extra-intestinal cancers, such as uterine and breast cancer. Routine surveillance for intestinal and extra-intestinal malignancies is warranted in patients with PJ syndrome.

DOI： 10.11405/nisshoshi.116.1015

Two cases of gastric mucosa-associated lymphoid tissue (MALT) lymphoma masquerading as follicular gastritis. International journal

Masaya Iwamuro, Takehiro Tanaka, Kenji Nishida, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Tadashi Yoshino, Hiroyuki Okada

Ecancermedicalscience 13 933 - 933 2019

Language：English

In this report, we describe two cases of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of the stomach, which presented with multiple small, whitish nodules in the gastric body. The endoscopic appearance was similar to that of lymphoid follicular hyperplasia found in follicular gastritis or nodular gastritis. Both patients were positive for Helicobacter pylori, and the eradication treatment resulted in complete remission of the lymphoma. However, recurrence was noted in one patient. These cases indicate that, although infrequent, gastric MALT lymphoma can show a nodular appearance resembling that of follicular gastritis.

DOI： 10.3332/ecancer.2019.933

適応拡大前後における院内紹介例からみた小腸カプセル内視鏡施行内容の検討院内への啓発活動にむけて

川野誠司, 岩室雅也, 井口俊博, 杉原雄策, 原田馨太, 平岡佐規子, 岡田裕之

岡山医学会雑誌 130 ( 3 ) 155 - 159 2018.12

Language：Japanese Publisher：岡山医学会

当院でのカプセル内視鏡(VCE)施行症例のうち、院内紹介症例の特徴をそれ以外の症例と比較した。さらにVCE適応拡大前後におけるVCEの使用目的の推移、特に院内紹介例の推移を比較検討した。適応拡大前(2009年1月から2012年6月:A群)122例と拡大後(2012年7月から2016年2月:B群)292例を対象とした。VCE施行件数は2009年1月の導入以降緩やかに増加していたが、2012年の適応拡大に伴い著明に増加を認めた。原因不明消化管出血(OGIB)症例の頻度は57%から41%へと有意に低下を認める一方、overt OGIBやoccult OGIBは相対的に増加していた。院内紹介例99例の検討では、総数においては循環器内科が最も多く、次いで総合内科、血液内科など各内科系からの紹介症例が大多数を占めていた。適応拡大後に限っては総合内科が最も多くを占めていた。

肝移植後も消化管出血を繰り返した先天性胆道閉鎖症の一例

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

日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集 110回・121回 157 - 157 2018.12

【知っておきたい十二指腸病変】十二指腸非乳頭部隆起性病変十二指腸リンパ腫の診断

岡田裕之, 田中健大, 岩室雅也, 神崎洋光, 川野誠司, 河原祥朗, 高田尚良, 吉野正

胃と腸 53 ( 12 ) 1587 - 1594 2018.11

Language：Japanese Publisher：(株)医学書院

＜文献概要＞十二指腸リンパ腫は組織型によって特徴的な内視鏡像を呈する例も多い.過半数を占める濾胞性リンパ腫は,十二指腸下行脚の白色調のびまん性小顆粒状所見が特徴的であり,小腸病変も高率に併存するため,小腸内視鏡検査も施行すべきである.びまん性大細胞型B細胞性リンパ腫は潰瘍型が多いが,隆起型や混在型もみられる.MALTリンパ腫はMLP(multiple lymphomatous polyposis)型,隆起型が多く,Helicobacter pylori感染陽性例では除菌により寛解に至る例も多い.マントル細胞リンパ腫は診断時既に進行期であることが多く,また,消化管にも広範囲に分布していることが多い.十二指腸ではMLP型を呈しているものが多い.

Two Cases of White Globe Appearance in Autoimmune Atrophic Gastritis. Reviewed International journal

Masaya Iwamuro, Takehiro Tanaka, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Case reports in gastrointestinal medicine 2018 7091520 - 7091520 2018.10

Language：English

In this report, we described two patients with white globe appearance in autoimmune atrophic gastritis. Endoscopy revealed multiple white substances in the stomach in both cases. Biopsied specimens from the lesions contained dilated glands and showed a decrease in parietal cells. Intraglandular necrotic debris and carcinoma were absent. These results confirmed that white globe appearance can be observed in autoimmune atrophic gastritis. Moreover, microscopic features for white globe appearance observed in these cases were different from those reported previously in gastric cancer lesions and were similar to those observed for noncancerous stomach.

DOI： 10.1155/2018/7091520

Dipeptide γ-secretase inhibitor treatment enhances the anti-tumor effects of cisplatin against gastric cancer by suppressing cancer stem cell properties. Reviewed International journal

Ryo Kato, Masaya Iwamuro, Hidenori Shiraha, Shigeru Horiguchi, Emi Tanaka, Ken Matsumoto, Atsushi Ohyama, Hiroaki Sawahara, Teruya Nagahara, Daisuke Uchida, Koichiro Tsutsumi, Hiroyuki Okada

Oncology letters 16 ( 4 ) 5426 - 5432 2018.10

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

The γ-secretase inhibitor blocks Notch activity by preventing its cleavage at the cell surface. In the present study, the effect of the γ-secretase inhibitor on the viability of gastric cancer cells when administered in combination with cisplatin was investigated, with particular focus on CD44highLgr-5high cancer cells. The four gastric cancer cell lines, MKN45, MKN74, SC-6-JCK and SH-10-TC, were used for the experiments. In the MTT assay, treatment with 25 µM dipeptide γ-secretase inhibitor (DAPT) alone did not affect cell proliferation in any of the four cell lines. Gastric cancer cells subjected to combination treatment with DAPT and cisplatin exhibited decreased viability when compared with those treated with cisplatin alone. Flow cytometry was performed to evaluate the expression of cluster of differentiation (CD)-44 and leucine-rich repeat-containing G-protein coupled receptor 5 (Lgr-5), two cancer stem cell markers in gastric cancers. Treatment with cisplatin alone significantly increased the proportion of CD44highLgr-5high cells. However, the addition of DAPT to cisplatin reduced the CD44highLgr-5high fraction, suggesting that DAPT reduced the number of gastric cancer cells. In conclusion, the present study demonstrated the synergistic effects of DAPT in combination with cisplatin by decreasing the survival of gastric cancer cells. In addition, combination treatment with DAPT reduced the number of CD44highLgr-5high cells, which are thought to exhibit cancer stem cell properties. These results highlight the therapeutic potential of DAPT in gastric cancer treatment.

DOI： 10.3892/ol.2018.9301

胃・十二指腸へのランタン沈着症の特徴

岩室雅也, 神崎洋光, 川野誠司, 河原祥朗, 田中健大, 岡田裕之

Gastroenterological Endoscopy 60 ( Suppl.2 ) 2140 - 2140 2018.10

Pseudolipomatosis of the Colon and Cecum Followed by Pneumatosis Intestinalis. Reviewed

Masaya Iwamuro, Takehiro Tanaka, Tomoko Kawabata, Yuusaku Sugihara, Keita Harada, Sakiko Hiraoka, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 57 ( 17 ) 2501 - 2504 2018.9

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

A 74-year-old Japanese woman was diagnosed with pseudolipomatosis of the cecum and ascending colon. Colonoscopy was performed, which revealed the presence of slightly elevated white lesions, while a magnifying observation showed microbubbles within the mucosa. A month after colonoscopy, the patient was diagnosed with pneumatosis intestinalis. Although the exact pathogenesis is unclear, pneumatosis intestinalis may arise secondary to pseudolipomatosis. This case also indicates that a magnifying observation during colonoscopy may aid in the diagnosis of pseudolipomatosis of the large intestine, since it shows microbubbles within the mucosa, which may be a distinctive feature reflecting the pathology of this disease.

DOI： 10.2169/internalmedicine.0730-17

Diffuse redness in linked color imaging is useful for diagnosing current Helicobacter pylori infection in the stomach. Reviewed

Masaya Iwamuro, Hiroyuki Sakae, Hiromitsu Kanzaki, Hiroyuki Okada

Journal of general and family medicine 19 ( 5 ) 176 - 177 2018.9

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

Esophagogastroduodenoscopic examination shows diffuse redness of the mucosa of the gastric body, which can be identified as a deep reddish color. The present case underscores the importance of diffuse redness as a key endoscopic feature that enables prompt diagnosis of current Helicobacter pylori infection.

DOI： 10.1002/jgf2.195

All carbonated beverages effectively dissolve phytobezoars. Reviewed

Iwamuro M, Yamauchi K, Shiraha H, Okada H

Clinics and research in hepatology and gastroenterology 42 ( 4 ) e66 - e67 2018.9

Enterovaginal and colovesical fistulas as late complications of pelvic radiotherapy.

Masaya Iwamuro, Kou Hasegawa, Yoshihisa Hanayama, Hitomi Kataoka, Takehiro Tanaka, Yoshitaka Kondo, Fumio Otsuka

Journal of general and family medicine 19 ( 5 ) 166 - 169 2018.9

Language：English

A 72-year-old Japanese woman presented with a fever, diarrhea, intermittent spotting, and constant fluid discharge from the vagina. Imaging studies revealed an enterovaginal fistula. She underwent radical hysterectomy and radiotherapy 35 years previously. She also had a surgical history of nephrostomy, nephrectomy, ileoascending anastomosis, and colostomy. As bleeding from the enterovaginal fistula was uncontrollable, ileocecal resection was performed. However, a colovesical fistula with urinary tract infection occurred 3 months later. The present case indicates that fistula formation occurs and causes various symptoms in patients who underwent postpelvic radiotherapy, particularly in those with prior surgeries in the irradiated field.

DOI： 10.1002/jgf2.184

Primary Localized Esophageal Mucosa-associated Lymphoid Tissue Lymphoma Treated by Endoscopic Submucosal Dissection.

Sayo Kobayashi, Masaya Iwamuro, Kenji Nishida, Takehiro Tanaka, Seiji Kawano, Yoshiro Kawahara, Tadashi Yoshino, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 57 ( 16 ) 2347 - 2352 2018.8

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

A 69-year-old Japanese woman presented to our hospital for the further investigation of an esophageal subepithelial tumor. A diagnosis of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) was made by an endoscopic biopsy. The patient had no involvement other than the esophagus. The tumor was resected using endoscopic submucosal dissection. Lymphoma recurrence has not been documented in the 57 months since resection. This case suggests that although a detailed preoperative evaluation is required to determine the extent of tumor, endoscopic resection may be an option for the long-term disease control of MALT lymphoma of the esophagus.

DOI： 10.2169/internalmedicine.0487-17

Lanthanum deposition corresponds to white lesions in the stomach Reviewed

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

Pathology Research and Practice 214 ( 7 ) 934 - 939 2018.7

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier GmbH

Objective: Although lanthanum deposition in the stomach has been most frequently reported to occur as white lesions, no study has investigated whether the white lesions observed during esophagogastroduodenoscopy are truly lanthanum-related. Here, we retrospectively investigated the amount of lanthanum in endoscopic biopsy specimens. Methods: We reviewed four patients showing gastric white spots or annular whitish mucosa in the gastric white lesions (Bw) and peripheral mucosa where the white substance was not endoscopically observed (Bp) during biopsy. We also reviewed three patients with diffuse whitish mucosa and three patients with no whitish lesions. We performed scanning electron microscopy and energy dispersive X-ray spectrometry to quantify the lanthanum elements (wt%) in the biopsy specimens. Results: The amount of lanthanum in the Bw ranged from 0.15–0.31 wt%, whereas that of Bp was 0.00–0.13 wt%. The difference was statistically significant (P &lt
0.05). The amount of lanthanum in the Bw, endoscopically presented with white spots or annular whitish mucosa, was significantly higher than that of no whitish lesions (0.05–0.14 wt%, P &lt
0.05). The amount of lanthanum was also higher in the diffuse whitish mucosa (0.21–0.23 wt%) compared with no whitish lesions (P &lt
0.01). Conclusions: This study is the first to reveal that pathological lanthanum deposition corresponds to the endoscopically observed white lesions in the gastric mucosa. Therefore, during esophagogastroduodenoscopy, physicians should pay attention to possible presence of white lesions in patients treated with oral lanthanum carbonate to ensure prompt identification of associated issues.

DOI： 10.1016/j.prp.2018.05.024

Manifestation of Central Diabetes Insipidus in a Patient with Thyroid Storm.

Akiko Nakamichi, Kazuki Ocho, Kosuke Oka, Miho Yasuda, Kou Hasegawa, Masaya Iwamuro, Mikako Obika, Kammei Rai, Fumio Otsuka

Internal medicine (Tokyo, Japan) 57 ( 13 ) 1939 - 1942 2018.7

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

We herein report a case of central diabetes insipidus complicated with thyroid storm. A middle-aged woman who was receiving treatment for Graves' disease suddenly complained of polydipsia, polyuria and general fatigue. Laboratory tests showed hyperthyroidism, hypernatremia, hypoosmolar urine and a decreased plasma vasopressin level. The occurrence of central diabetes insipidus with hyperthyroidism was revealed on the basis of pituitary magnetic resonance imaging, a water deprivation test and a desmopressin test. The clinical co-existence of diabetes insipidus and hyperthyroidism is very rare; however, the complication should be considered when hypernatremia and/or dehydration progress in patients with Graves's disease as a common autoimmune-related etiology.

DOI： 10.2169/internalmedicine.0063-17

巨大肝嚢胞により複数の臓器障害を来した1例

長尾聡子, 岩室雅也, 灘隆宏, 戸川雄, 頼冠名, 小比賀美香子, 白羽英則, 大塚文男

日本病院総合診療医学会雑誌 14 ( 4 ) 441 - 441 2018.7

Severe Gastritis after Administration of Nivolumab and Ipilimumab

Yoshito Nishimura, Miho Yasuda, Kazuki Ocho, Masaya Iwamuro, Osamu Yamasaki, Takehiro Tanaka, Fumio Otsuka

Case Reports in Oncology 11 ( 2 ) 549 - 556 2018.5

Publishing type：Research paper (scientific journal)

© 2018 The Author(s). Immune checkpoint inhibitors such as ipilimumab, a cytotoxic T-lymphocyte-Associated antigen-4 inhibitor, have been widely used for advanced malignancies. As these inhibitors improve antitumor immunity via T-cell modulation, immune-mediated adverse events associated with T-cell activation, such as colitis, might occur. Herein, we describe a 75-year-old Japanese woman with metastatic malignant melanoma who developed hemorrhagic gastritis after ipilimumab treatment. There was no macroscopic or clinical improvement of gastritis after proton pump inhibitor treatment. However, her condition improved after approximately 3 weeks of corticosteroid therapy and Helicobacter pylori eradication. This case suggests a potential association between severe gastritis and immune checkpoint inhibitor treatment. Although several reports have mentioned ipilimumab-Associated colitis, gastritis is considered to be rare. In the present case, H. pylori-Associated gastritis might have been exacerbated by the T-cell modulation effect of ipilimumab. To date, no report has clarified the mechanism by which ipilimumab modifies H. pylori infection. The present treatment course provides a helpful perspective for similar cases.

DOI： 10.1159/000491862

Bleeding in patients who underwent scheduled second-look endoscopy 5 days after endoscopic submucosal dissection for gastric lesions Reviewed

Koichi Izumikawa, Masaya Iwamuro, Tomoki Inaba, Shigenao Ishikawa, Kenji Kuwaki, Ichiro Sakakihara, Kumiko Yamamoto, Sakuma Takahashi, Shigetomi Tanaka, Masaki Wato, Hiroyuki Okada

BMC Gastroenterology 18 ( 1 ) 2018.4

Language：English Publishing type：Research paper (scientific journal) Publisher：BioMed Central Ltd.

Background: Bleeding after endoscopic submucosal dissection (ESD) in antithrombotic drug users is still one of the important issues to be solved. We performed scheduled second-look endoscopy (SLE) 5 days after ESD, when the resumption of antithrombotic agents is assumed to have achieved a steady state, rather than on the day after ESD. We investigated bleeding incidence and the status of ulcers. Methods: A total of 299 lesions in 299 patients subjected to ESD for gastric neoplasms were enrolled. A double dose of proton pump inhibitors was administered after ESD. SLE was planned 5 days after ESD. Post-ESD bleeding occurring before SLE was defined as early phase post-ESD bleeding, whereas bleeding after SLE was defined as later phase post-ESD bleeding. Forrest IIa and IIb ulcers are defined as high-risk ulcers requiring prophylactic hemostasis. We investigated risk factors for post-ESD bleeding, particularly focusing on the use of antithrombotic agents and the presence of high-risk ulcers requiring prophylactic hemostasis during SLE. Results: Under a double dose of proton pump inhibitors, early phase post-ESD bleeding occurred in 2.3% of non-users (5/218) and 6.2% of users of antithrombotic agents (5/81). High-risk ulcers were found in 19.0% of the cases during scheduled SLE (55/289). Later phase bleeding occurred in 5.5% of cases [2.8% of non-users (6/213) and 13.2% of users of antithrombotic agents (10/76)]. Cox regression analysis revealed that the risk factor for post-ESD bleeding was antithrombotic treatment (HR: 3.56
95% CI: 1.63-8.02, p = 0.002) alone. Among patients with high-risk ulcers, a statistically significant increase in bleeding was observed in the later phase in patients under antithrombotic therapy, compared to those not receiving any antithrombotic agents (p = 0.001). Conclusions: Antithrombotic treatment is a risk factor for post-ESD bleeding despite SLE being scheduled 5 days after ESD. Later phase post-ESD bleeding was observed in 13.2% of the patients under antithrombotic treatment even after prophylactic hemostasis for high-risk ulcers.

DOI： 10.1186/s12876-018-0774-2

Evaluation of the Upper Gastrointestinal Tract in Ulcerative Colitis Patients. Reviewed

Ryo Kato, Masaya Iwamuro, Sakiko Hiraoka, Shiho Takashima, Toshihiro Inokuchi, Masahiro Takahara, Yoshitaka Kondo, Takehiro Tanaka, Hiroyuki Okada

Acta medica Okayama 72 ( 2 ) 105 - 113 2018.4

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

To analyze the clinical characteristics of patients with ulcerative colitis who have upper gastrointestinal lesions, we retrospectively reviewed the data of 216 patients with ulcerative colitis who underwent esophagogastroduodenoscopy at our institute in April 2008-March 2016. We investigated the endoscopic features and compared the clinical characteristics between the patients with and without upper gastrointestinal lesions. Forty-two patients (19.4%) had upper gastrointestinal lesions, including multiple erosions (n=18), bamboo joint-like appearance (n=17), mucosa with white spots (n=4), friable mucosa (n=2), ulcer (n=1), and purulent deposits within the mucosa (n=1) in the stomach and/or duodenum. Compared to the patients without upper gastrointestinal lesions, those with upper gastrointestinal lesions showed significantly more frequent extraintestinal manifestations (19.0% vs. 8.0%, p<0.05) and a significant history of colectomy (33.3% vs. 12.1%, p<0.01). There were no significant differences with regard to the sex ratio, age at esophagogastroduodenoscopy, gastrointestinal symptoms, time since the diagnosis of ulcerative colitis, type of colitis at the initial diagnosis of ulcerative colitis, or gastric atrophy between the groups. In conclusion, gastroduodenal lesions were identified in 19.4% of the patients with ulcerative colitis. Esophagogastroduodenoscopy is particularly recommended for ulcerative colitis patients who show extraintestinal manifestations and for those who have undergone a colectomy.

DOI： 10.18926/AMO/55850

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