Faculty Profiles - IWAMURO Masaya

Prediction of disseminated intravascular coagulation by liver function tests in patients with japanese spotted fever

Yuichi Miyashima, Masaya Iwamuro, Michihiko Shibata, Yoshio Miyabe, Yoshinari Kawai, Masanobu Kaihara, Takehide Mitogawa, Masaru Harada

Internal Medicine 57 ( 2 ) 197 - 202 2018

Language：English Publishing type：Research paper (scientific journal) Publisher：Japanese Society of Internal Medicine

Objective Cases of Japanese spotted fever (JSF) are sometimes complicated by disseminated intravascular coagulation (DIC) with an abnormal liver function, resulting in unfavorable outcomes. The aim of the present study was to clarify the correlation between liver function test results and DIC scores. Methods Twenty patients diagnosed with JSF between April 2010 and April 2014 were enrolled. Age, gender, disturbance of consciousness, body temperature, pulse rate, presence of diffuse erythema, eschar and swelling of lymph nodes, laboratory test results at the time of initial presentation such as blood cell count, C-reactive protein, liver function, renal function and blood coagulation and fibrinolysis, maximum Japanese Association for Acute Medicine (JAAM) DIC score during the course of JSF, treatment and the prognosis were retrospectively reviewed. Results The median age of the patients (8 men, 12 women) was 68.3 years. There were significant differences in the alkaline phosphatase (ALP) and rothrombin time international normalized ratio (PT-INR) between the DIC and non-DIC groups using Mann-Whitney’s U test. A multiple logistic regression analysis showed that the ALP and blood urea nitrogen (BUN) levels at the time of initial presentation were independent predictors of the occurrence of DIC. Conclusion We should pay special attention to JSF patients showing high levels of ALP at the initial presentation, since such patients may have a higher likelihood of developing DIC over the course of JSF and unfavorable outcomes than those with lower levels.

DOI： 10.2169/internalmedicine.8420-16

Prolonged epigastric pain caused by a leaf stem embedded in the gastric wall

Takahiro Yoshioka, Masaya Iwamuro, Haruo Takeda, Toshiyoshi Fujiwara

Internal Medicine 57 ( 17 ) 2497 - 2500 2018

Language：English Publishing type：Research paper (scientific journal) Publisher：Japanese Society of Internal Medicine

A 67-year-old woman underwent esophagogastroduodenoscopy to determine the cause of her prolonged epigastric pain. During the examination, a sharp-pointed foreign body was observed
the edge of the object had been embedded in the gastric wall. The object was removed via an endoscope, and the patients’ symptoms improved immediately. Based on a dietary history and an electron microscope examination, we identified the object as a stem of mizuna, a potherb mustard. Our report indicates that commonly eaten leafy green vegetables can act as sharp-pointed foreign bodies with the potential to injure the upper gastrointestinal tract.

DOI： 10.2169/internalmedicine.0751-17

A magnesium oxide bezoar

Masaya Iwamuro, Shunsuke Saito, Masao Yoshioka, Haruo Urata, Kumiko Ueda, Kazuhide Yamamoto, Hiroyuki Okada

Internal Medicine 57 ( 21 ) 3087 - 3091 2018

Language：English Publishing type：Research paper (scientific journal) Publisher：Japanese Society of Internal Medicine

A 75-year-old Japanese woman presented with nausea and appetite loss. Computed tomography showed a radiopaque substance in the stomach. Esophagogastroduodenoscopy revealed bezoars in the stomach, which were endoscopically retrieved. The bezoars were mainly composed of magnesium and oxide. Although bezoar formation associated with magnesium oxide consumption is infrequently encountered, the present case indicates that pharmacobezoar should be considered among the differential diagnoses in patients who demonstrate a radiopaque mass in the digestive tract and have a history of magnesium oxide use.

DOI： 10.2169/internalmedicine.1124-18

Pulmonary intravascular lymphoma detected by FDG-PET

Takahiro Nada, Masaya Iwamuro, Kousuke Kimura, Fumio Otsuka

Journal of General and Family Medicine 18 ( 6 ) 477 - 478 2017.12

Neck schwannoma mimicking a thyroid tumor.

Kosuke Oka, Masaya Iwamuro, Fumio Otsuka

Journal of general and family medicine 18 ( 6 ) 473 - 474 2017.12

電子顕微鏡を用いた異物解析技術が糞便内の混入物の同定に有用であった1例

岩室雅也, 浦田晴生, 頼冠名, 大塚文男

日本病院総合診療医学会雑誌 13 ( 3 ) 26 - 31 2017.11

Language：Japanese Publisher：(一社)日本病院総合診療医学会

症例は糞便中の混入物の精査希望で紹介受診された80歳男性。便中に「蚕の繭状の小さな白い塊」「吸盤状の物体」「球状の物体」が混入していることに気づき、混入物を持参され受診。内視鏡検査および造影CT検査では消化管に異常を認めなかった。電子顕微鏡観察およびエネルギー分散型X線分析を行ったところ、糞便中の混入物はそれぞれ紙片、トマトもしくは他の野菜・果実類の種子、胡麻と推定された。糞便中の混入物を訴える患者の診療にあたることは稀であるが、混入物の同定に至れば治療計画の立案に繋がるだけでなく、患者にとって安心感、満足感が得られる。(著者抄録)

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J05937&link_issn=&doc_id=20171208460005&doc_link_id=%2Ffg3byoin%2F2017%2F001303%2F005%2F0026-0031%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffg3byoin%2F2017%2F001303%2F005%2F0026-0031%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

The Usefulness of Colonoscopy for the Detection of Ileal Involvement in Intestinal Follicular Lymphoma Patients Reviewed

Masaya Iwamuro, Katsuyoshi Takata, Eiko Hayashi, Seiji Kawano, Sakiko Hiraoka, Yoshiro Kawahara, Tadashi Yoshino, Hiroyuki Okada

ACTA MEDICA OKAYAMA 71 ( 5 ) 391 - 398 2017.10

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

To evaluate the usefulness of colonoscopy for the detection of ileal involvement in patients with intestinal follicular lymphoma, seventeen patients with intestinal follicular lymphoma who underwent colonoscopy and biopsy sampling from the terminal ileum were enrolled. The patients were divided into 2 groups: cases with ileal involvement (n=6) and cases without ileal involvement (n=11). Patients' clinical backgrounds were compared between the two groups. Subsequently, 10 board-certified endoscopists independently evaluated the endoscopic pictures and determined whether the ileum was involved with follicular lymphoma. Infiltration of follicular lymphoma cells were identified in 6 patients (35.3%). Cases with positive ileal involvement were diagnosed with follicular lymphoma at a younger age than were cases without ileal involvement (55.4 +/- 7.4 vs. 68.1 +/- 10.3 years, p=0.011). Macroscopically, in patients with ileal involvement, there were multiple polypoid elevations smaller than 5 mm in 4 cases, single polypoid elevation smaller than 5 mm in 1 case, and single polypoid elevation larger than 5 mm in 1 case. In patients without ileal involvement, there were no lesions in the terminal ileum in 7 cases, and multiple polypoid elevations smaller than 5 mm were seen in 4 cases. The accuracy of the macroscopic evaluation by 10 board-certified endoscopists was 68.8%. Colonoscopy is particularly recommended during the initial workup of patients with follicular lymphoma diagnosed at age <= 60 years. The diagnosis of ileal involvement based on morphology alone is difficult; thus, biopsy and pathologic diagnosis are required for accurate diagnosis.

DOI： 10.18926/AMO/55436

Perimandibular abscess associated with bisphosphonate-related osteonecrosis of the jaw. Reviewed

Kazuki Ocho, Masaya Iwamuro, Hideharu Hagiya, Soichiro Ibaragi, Fumio Otsuka

Journal of general and family medicine 18 ( 5 ) 305 - 306 2017.10

Promising therapeutic efficacy of a novel reduced expression in immortalized cells/dickkopf-3 expressing adenoviral vector for hepatocellular carcinoma Reviewed

Hiroaki Sawahara, Hidenori Shiraha, Daisuke Uchida, Hironari Kato, Ryo Kato, Atsushi Oyama, Teruya Nagahara, Masaya Iwamuro, Shigeru Horiguchi, Koichiro Tsutsumi, Mari Mandai, Tetsushige Mimura, Nozomu Wada, Yasuto Takeuchi, Kenji Kuwaki, Hideki Onishi, Shinichiro Nakamura, Masami Watanabe, Masakiyo Sakaguchi, Akinobu Takaki, Kazuhiro Nouso, Takahito Yagi, Yasutomo Nasu, Hiromi Kumon, Hiroyuki Okada

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 32 ( 10 ) 1769 - 1777 2017.10

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

Background and Aim: Reduced expression in immortalized cells (REIC)/dickkopf-3 (Dkk-3) is a tumor suppressor gene that is downregulated in various cancers. In our previous study of prostate cancer, the REIC/Dkk-3-expressing adenoviral vector (Ad-REIC) was found to induce cancer-selective apoptosis. This study recently developed a novel super gene expression (SGE) system and used this system to re-construct an Ad-REIC vector, termed the Ad-SGE-REIC, to achieve more effective therapeutic outcomes. In this study, the therapeutic effects of Ad-SGE-REIC on hepatocellular carcinoma (HCC) was assessed.
Methods: Human HCC cell lines (HLE, Huh7, HepG2, HLF, SK-Hep1, and PLC), human HCC tissues, and mouse HCC cell line (Hepa1-6) were used in this study. REIC/Dkk-3 expression was assessed by immunoblotting and immunohistochemistry. The relative cell viability and the apoptotic effect were examined in vitro, and the anti-tumor effects of Ad-SGE-REIC treatment were analyzed in the mouse xenograft model. This study additionally assessed anti-tumor immunological effects on the immunocompetent mice.
Results: REIC/Dkk-3 expression was decreased in HCC cell lines and HCC tissues. Ad-SGE-REIC reduced cell viability and induced apoptosis in HCC cell lines (HLE and Huh7), inhibited tumor growth in the mouse xenograft model, and demonstrated in vivo anti-cancer immunostimulatory effects on the HCC cell line (Hepa1-6).
Conclusions: Ad-SGE-REIC treatment not only enhanced cell killing effects in vitro but also elicited significant therapeutic effects, with tumor growth suppression, in vivo. REIC/Dkk-3 gene therapy using Ad-SGE-REIC potentially represents an innovative new therapeutic tool for HCC.

DOI： 10.1111/jgh.13757

Multiple abscesses caused by repetitive intramuscular injections.

Ko Harada, Naoko Kashihara, Masaya Iwamuro, Fumio Otsuka

Journal of general and family medicine 18 ( 5 ) 301 - 302 2017.10

Linked color imaging (LCI), a novel image-enhanced endoscopy technology, emphasizes the color of early gastric cancer. International journal

Hiromitsu Kanzaki, Ryuta Takenaka, Yoshiro Kawahara, Daisuke Kawai, Yuka Obayashi, Yuki Baba, Hiroyuki Sakae, Tatsuhiro Gotoda, Yoshiyasu Kono, Ko Miura, Masaya Iwamuro, Seiji Kawano, Takehiro Tanaka, Hiroyuki Okada

Endoscopy international open 5 ( 10 ) E1005-E1013 2017.10

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

Background and study aims: Linked color imaging (LCI) and blue laser imaging (BLI) are novel image-enhanced endoscopy technologies with strong, unique color enhancement. We investigated the efficacy of LCI and BLI-bright compared to conventional white light imaging (WLI) by measuring the color difference between early gastric cancer lesions and the surrounding mucosa. Patients and methods: Images of early gastric cancer scheduled for endoscopic submucosal dissection were captured by LCI, BLI-bright, and WLI under the same conditions. Color values of the lesion and surrounding mucosa were defined as the average of the color value in each region of interest. Color differences between the lesion and surrounding mucosa (ΔE) were examined in each mode. The color value was assessed using the CIE L*a*b* color space (CIE: Commission Internationale d'Eclairage). Results: We collected images of 43 lesions from 42 patients. Average ΔE values with LCI, BLI-bright, and WLI were 11.02, 5.04, and 5.99, respectively. The ΔE was significantly higher with LCI than with WLI ( P < 0.001). Limited to cases of small ΔE with WLI, the ΔE was approximately 3 times higher with LCI than with WLI (7.18 vs. 2.25). The ΔE with LCI was larger when the surrounding mucosa had severe intestinal metaplasia ( P = 0.04). The average color value of a lesion and the surrounding mucosa differed. This value did not have a sufficient cut-off point between the lesion and surrounding mucosa to distinguish them, even with LCI. Conclusion: LCI had a larger ΔE than WLI. It may allow easy recognition and early detection of gastric cancer, even for inexperienced endoscopists.

DOI： 10.1055/s-0043-117881

Letter: a potassium-competitive acid blocker vs a proton pump inhibitor for healing endoscopic submucosal dissection-induced artificial ulcers after treatment of gastric neoplasms Reviewed

H. Ban, M. Sugimoto, T. Otsuka, M. Murata, T. Nakata, H. Hasegawa, M. Fukuda, O. Inatomi, S. Bamba, R. Kushima, A. Andoh

ALIMENTARY PHARMACOLOGY & THERAPEUTICS 46 ( 5 ) 564 - 565 2017.9

Management of gastric mucosa-associated lymphoid tissue lymphoma in patients with extra copies of the MALT1 gene Reviewed

Masaya Iwamuro, Ryuta Takenaka, Masahiro Nakagawa, Yuki Moritou, Shunsuke Saito, Shinichiro Hori, Tomoki Inaba, Yoshinari Kawai, Tatsuya Toyokawa, Takehiro Tanaka, Tadashi Yoshino, Hiroyuki Okada

WORLD JOURNAL OF GASTROENTEROLOGY 23 ( 33 ) 6155 - 6163 2017.9

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：BAISHIDENG PUBLISHING GROUP INC

AIM
To identify the clinical features of gastric mucosa-associated lymphoid tissue (MALT) lymphoma with extra copies of MALT1.
METHODS
This is a multi-centered, retrospective study. We reviewed 146 patients with MALT lymphoma in the stomach who underwent fluorescence in situ hybridization analysis for t(11; 18) translocation. Patients were subdivided into patients without t(11; 18) translocation or extra copies of MALT1 (Group A, n = 88), patients with t(11; 18) translocation (Group B, n = 27), and patients with extra copies of MALT1 (Group C, n = 31). The clinical background, treatment, and outcomes of each group were investigated.
RESULTS
Groups A and C showed slight female predominance, whereas Group B showed slight male predominance. Mean ages and clinical stages at lymphoma diagnosis were not different between groups. Complete response was obtained in 61 patients in Group A (69.3%), 22 in Group B (81.5%), and 21 in Group C (67.7%). Helicobacter pylori (H. pylori) eradication alone resulted in complete remission in 44 patients in Group A and 13 in Group C. In Group B, 14 patients underwent radiotherapy alone, which resulted in lymphoma disappearance. Although the difference was not statistically significant, event-free survival in Group C tended to be inferior to that in Group A (p = 0.10).
CONCLUSION
Patients with t(11; 18) translocation should be treated differently from others. Patients with extra copies of MALT1 could be initially treated with H. pylori eradication, similar to patients without t(11; 18) translocation or extra copies of MALT1.

DOI： 10.3748/wjg.v23.i33.6155

早期胃癌に対するLCI(linked color image)とAIM色素を併用した画像強調内視鏡(IEE)の有用性

河原祥朗, 神崎洋光, 河野吉泰, 後藤田達洋, 岩室雅也, 榮浩行, 大林由佳, 馬場雄己, 川野誠司, 田中健大, 岡田裕之

Gastroenterological Endoscopy 59 ( Suppl.2 ) 2132 - 2132 2017.9

当院での潰瘍性大腸炎患者における上部消化管病変の検討

加藤諒, 岩室雅也, 平岡佐規子, 高嶋志保, 半井明日香, 井口俊博, 岡田裕之

Gastroenterological Endoscopy 59 ( Suppl.2 ) 2237 - 2237 2017.9

Deterioration of duodenal lymphangiectasia after radiotherapy for gastric malt lymphoma Reviewed

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

ecancermedicalscience 11 2017.7

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

A 68-year-old Japanese woman underwent radiotherapy for gastric lymphoma. Although lymphangiectasia was sparsely observed in the second portion of the duodenum before radiotherapy, the number of pinpoint white spots obviously increased after the treatment. Although the duodenal lymphangiectasia gradually progressed, the patient had no features of protein-losing enteropathy. This case highlights the importance of endoscopic observation of the duodenum after irradiation to the abdomen as radiotherapy may secondarily cause intestinal lymphangiectasia.

DOI： 10.3332/ecancer.2017.752

十二指腸偽メラノーシスの1例

岩室雅也, 岡昌平, 神崎洋光, 田中健大, 川野誠司, 河原祥朗, 岡田裕之

日本消化器病学会雑誌 114 ( 7 ) 1264 - 1268 2017.7

Language：Japanese Publisher：(一財)日本消化器病学会

83歳男性。クエン酸第一鉄、β遮断薬、利尿剤(フロセミド、スピロノラクトン、トルバプタン)などを内服中、スクリーニングで実施した上部消化管内視鏡検査にて、十二指腸球部に点状の暗褐色の色素沈着をびまん性に認めた。生検では絨毛内に褐色色素を貪食したマクロファージを認め、褐色色素は鉄染色陽性であり、偽メラノーシスと診断した。エネルギー分散型X線による解析では沈着部位に鉄およびイオウ元素が検出された。(著者抄録)