Faculty Profiles - IWAMURO Masaya

Papers - IWAMURO Masaya

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敗血症を呈したYersinia pseudotuberculosis感染症の一例

大重和樹, 萩谷英大, 長谷川功, 岩室雅也, 頼冠名, 草野展周, 大塚文男

日本病院総合診療医学会雑誌 13 ( 1 ) 161 - 161 2017.7

口腔内潰瘍で発症し骨髄不全症候群と腸管ベーチェット病の合併が疑われた1例

山本紘一郎, 木村耕介, 岩室雅也, 岡浩介, 安田美帆, 長谷川功, 頼冠名, 大塚文男

日本病院総合診療医学会雑誌 13 ( 1 ) 165 - 165 2017.7

総合内科を受診した高IgG4血症患者の臨床的特徴の解析

長谷川功, 花山宜久, 大村大輔, 岡浩介, 木村耕介, 岩室雅也, 頼冠名, 早稲田公一, 近藤英生, 片岡仁美, 大塚文男

日本病院総合診療医学会雑誌 13 ( 1 ) 78 - 79 2017.7

胃切除が要因と考えられた男性骨粗鬆症の1例

安藤明美, 花山宜久, 灘隆宏, 長谷川功, 頼冠名, 岩室雅也, 小比賀美香子, 片岡仁美, 大塚文男

日本病院総合診療医学会雑誌 13 ( 1 ) 120 - 120 2017.7

抗甲状腺薬に対する肝障害のため治療に難渋したバセドウ病の1例

長谷川功, 喜多村勇大朗, 岡浩介, 安田美帆, 木村耕介, 大村大輔, 中道晶子, 灘隆宏, 岩室雅也, 頼冠名, 三好智子, 小川弘子, 小比賀美香子, 花山宜久, 近藤英生, 片岡仁美, 大塚文男

日本病院総合診療医学会雑誌 13 ( 1 ) 121 - 121 2017.7

造影CT検査にて確定診断に至ったモンドール病の1例

太田友, 岩室雅也, 岩本高行, 花山宜久, 小比賀美香子, 頼冠名, 大塚文男

日本病院総合診療医学会雑誌 13 ( 1 ) 166 - 166 2017.7

女性ホルモン製剤の関与が疑われた前皮神経絞扼症候群の1例

大村大輔, 小比賀美香子, 長尾聡子, 中道晶子, 灘隆宏, 岩室雅也, 頼冠名, 小野大輔, 松崎孝, 大塚文男

日本病院総合診療医学会雑誌 13 ( 1 ) 168 - 168 2017.7

Evaluation of the bleeding risk with various antithrombotic therapies after gastric endoscopic submucosal dissection. International journal

Tatsuhiro Gotoda, Keisuke Hori, Masaya Iwamuro, Yoshiyasu Kono, Kou Miura, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Endoscopy international open 5 ( 7 ) E653-E662 2017.7

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

BACKGROUND AND STUDY AIMS : Patients receiving antithrombotic drugs have a higher risk of postoperative bleeding and thromboembolic events related to endoscopic procedures. The aim of this study was to evaluate the relationship between various antithrombotic therapies and bleeding after gastric endoscopic submucosal dissection (ESD) (post-ESD bleeding). PATIENTS AND METHODS: Among 529 consecutive gastric ESD procedures (483 patients with 579 legions), 100 patients with 121 lesions who underwent 108 procedures were on antithrombotic therapy (group A) and 382 patients with 458 lesions who underwent 421 procedures were not on antithrombotic therapy (group B). The ratio of post-ESD bleeding between the two groups and the bleeding risk related to various antithrombotic therapies were investigated. RESULTS : Postoperative bleeding was more frequent in group A (11.1 %) than in group B (3.3 %). No thromboembolic events were reported in either group. Further investigation of antithrombotic therapies in group A demonstrated that various combinations of antithrombotic agents and heparin replacement were associated with a higher ratio of post-ESD bleeding. Multivariate analyses revealed that dual antiplatelet therapy (odds ratio [OR] 10.9, 95 % confidence interval [CI] 2.1 - 49.5; P = 0.005) and heparin replacement (OR 34.4, 95 %CI 9.4 - 133.2; P < 0.001) were associated with the increased risk of post-ESD bleeding. In patients on antiplatelet therapy, post-ESD bleeding tended to occur in the early postoperative period compared with patients on anticoagulant therapy. CONCLUSIONS: It is necessary to be cautious regarding post-ESD bleeding in patients requiring antithrombotic therapy, especially patients receiving dual antiplatelet therapy and heparin replacement. A further prospective study with a large sample will be needed to confirm these findings.

DOI： 10.1055/s-0043-110050

PubMed

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PBL(問題基盤型学習)を用いたIPE(inter-professional education 多学部間教育)の効果

三好智子, 岩室雅也, 早稲田公一, 村上和敏, 小川弘子, 花山宜久, 小比賀美香子, 片岡仁美, 大塚文男, 那須保友

日本病院総合診療医学会雑誌 13 ( 1 ) 83 - 83 2017.7

頻回の鎮痛薬の筋肉内注射により多発膿瘍形成をきたした一例

原田洸, 岩室雅也, 戸川雄, 柏原尚子, 灘隆宏, 花山宜久, 大塚文男

日本病院総合診療医学会雑誌 13 ( 1 ) 112 - 112 2017.7

メトロニダゾールが有効であった胸部大動脈グラフト感染症の1例

戸川雄, 灘隆宏, 砂田匠彦, 長尾聡子, 大村大輔, 大重和樹, 中道晶子, 萩谷英大, 岩室雅也, 小川弘子, 増田善逸, 草野展周, 大塚文男

日本病院総合診療医学会雑誌 13 ( 1 ) 105 - 105 2017.7

Endoscopic features of lanthanum deposition in the gastroduodenal mucosa

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

Gastroenterological Endoscopy 59 ( 6 ) 1428 - 1434 2017.6

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Gastroenterological Endoscopy Society

The purpose of this study was to investigate the endoscopic features of lanthanum deposition in the gastrointestinal mucosa. We retrospectively reviewed the endoscopic images of 10 patients who had received a histological diagnosis of lanthanum deposition in the gastroduodenal mucosa. The patients were 9 men and 1 woman with an average age of 64.3 years( range: 42 to 77 years). All patients were undergoing hemodialysis for chronic renal failure, and had been receiving lanthanum carbonate for 12 to 86 months. All patients had lanthanum deposition in the stomach, which presented as white lesions. Magnifying endoscopic observation, which was performed in six patients, also demonstrated the deposition of white microgranules. Three patients had lanthanum deposition in the duodenum, which manifested as white duodenal mucosa. In conclusion, lanthanum deposition in the gastroduodenal mucosa typically manifests as white lesions. Endoscopists should suspect lanthanum deposition when they detect white lesions in the gastroduodenal mucosa of patients who are taking lanthanum carbonate.

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胃・十二指腸粘膜へのランタン沈着症における内視鏡像の検討

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 59 ( 6 ) 1428 - 1434 2017.6

Language：Japanese Publisher：(一社)日本消化器内視鏡学会

当院で胃・十二指腸へのランタン沈着症と診断した10症例について、内視鏡所見および臨床背景を後ろ向きに検討した。10例(男性9例、女性1例)の平均年齢は64.3歳(42歳～77歳)であり、全例が慢性腎不全のため血液透析中であった。炭酸ランタンの服用期間は12～86ヵ月。全例で胃にランタン沈着があり、通常観察にて白色病変として観察された。拡大観察を行った6例では微細顆粒状の白色沈着物がみられた。3例では十二指腸にもランタン沈着があり、いずれも白色の粘膜を呈した。これらの所見がみられた場合には、ランタン沈着症として経過を追跡する必要があると考えられた。(著者抄録)

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2017&ichushi_jid=J00192&link_issn=&doc_id=20170713320006&doc_link_id=10.11280%2Fgee.59.1428&url=https%3A%2F%2Fdoi.org%2F10.11280%2Fgee.59.1428&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

Lanthanum phosphate deposition in the duodenum Commentary Reviewed

Masaya Iwamuro, Takehiro Tanaka, Haruo Urata, Katsuhiko Kimoto, Hiroyuki Okada

GASTROINTESTINAL ENDOSCOPY 85 ( 5 ) 1103 - 1104 2017.5

Endoscopic Manifestations and Clinical Characteristics of Cytomegalovirus Infection in the Upper Gastrointestinal Tract Reviewed

Masaya Iwamuro, Eisei Kondo, Takehiro Tanaka, Hideharu Hagiya, Seiji Kawano, Yoshiro Kawahara, Fumio Otsuka, Hiroyuki Okada

ACTA MEDICA OKAYAMA 71 ( 2 ) 97 - 104 2017.4

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

We retrospectively analyzed the cases of 14 patients (9 women, 5 men, mean age: 51.6 years) with cytomegalovirus (CMV) involvement in the esophagus, stomach, and/or duodenum diagnosed at a single center, to determine their endoscopic features and clinical backgrounds. Thirteen patients (92.9%) had hematologic disease; the other had rheumatoid arthritis. Of the former, 12 patients underwent allogeneic hematopoietic stem cell transplantation, and 9 of these patients had graft-versus-host disease (GVHD) before undergoing esophagogastroduodenoscopy (EGD). All 14 patients had been taking one or more immunosuppressive agents including cyclosporine (n=10), corticosteroids (n= 9), mycophenolic acid (n= 6), tacrolimus (n=3), and methotrexate (n=1). Tests for CMV antigenemia were positive in 11 patients (78.6%). EGD examinations revealed esophageal (n=3), gastric (n=9), and duodenal involvement (n=6). Macroscopically, esophageal lesions by CMV infection presented as redness (n=1), erosions (n=1), and ulcers (n=1). Gastric lesions manifested as redness (n=7), erosions (n=3), exfoliated mucosa (n=2), and verrucous erosions (n=1). Mucosal appearances in the duodenum varied: redness (n=2), ulcers (n=2), multiple erosions (n=2), single erosion (n=1), edema (n=1). CMV was detected even in the intact duodenal mucosa (n=1). In conclusion, physicians must recall the relevance of CMV infection when any mucosal alterations exist in the upper gastrointestinal tract of immunosuppressed patients.

Web of Science

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Other Link： http://orcid.org/0000-0003-0995-9405

抗甲状腺薬が奏効し多臓器の腫大を呈したバセドウ病の1例

安田美帆, 大重和樹, 長谷川功, 灘隆宏, 岩室雅也, 三好智子, 小川弘子, 小比賀美香子, 花山宜久, 大塚文男

日本内分泌学会雑誌 93 ( 1 ) 278 - 278 2017.4

Idiopathic adult ileo-colonic intussusception.

Masaya Iwamuro, Takahiro Nada, Kosuke Kimura, Yoshihisa Hanayama, Fumio Otsuka

Journal of general and family medicine 18 ( 2 ) 94 - 95 2017.4

Balloon Dilation and Electrohydraulic Lithotripsy for Treating an Impacted Duodenal Bezoar Reviewed

Masaya Iwamuro, Koichiro Tsutsumi, Hiroyuki Okada

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 15 ( 3 ) E67 - E68 2017.3

Multicenter Prospective Study on the Safety of Upper Gastrointestinal Endoscopic Procedures in Antithrombotic Drug Users Reviewed

Yoshiyasu Kono, Minoru Matsubara, Tatsuya Toyokawa, Ryuta Takenaka, Seiyu Suzuki, Junichirou Nasu, Masao Yoshioka, Masahiro Nakagawa, Motowo Mizuno, Hiroyuki Sakae, Makoto Abe, Tatsuhiro Gotoda, Ko Miura, Hiromitsu Kanzaki, Masaya Iwamuro, Keisuke Hori, Takao Tsuzuki, Masahide Kita, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

DIGESTIVE DISEASES AND SCIENCES 62 ( 3 ) 730 - 738 2017.3

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

The Japan Gastroenterological Endoscopy Society updated its guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment in July 2012. However, the safety of endoscopic procedures in antithrombotic drug users has not been fully investigated.
To evaluate the safety of upper gastrointestinal endoscopic procedures in antithrombotic drug users.
From September 2013 to September 2015, patients who were taking antithrombotic drugs and who underwent upper gastrointestinal endoscopic procedures were prospectively enrolled at five hospitals. Incidences of bleeding and thrombosis during endoscopic procedures were evaluated.
A total of 270 patients [221 for endoscopic mucosal biopsy and 49 for endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) were enrolled. The bleeding rate was 0.9% for endoscopic mucosal biopsy and 22% for EMR/ESD, respectively. The bleeding rate after endoscopic mucosal biopsy was not significantly high, even if antithrombotic drugs were continued (0 vs. 1%, P > 0.99), while it was significantly higher among multiple antithrombotic drug users than single drug users (5.9 vs. 0%, P < 0.05). The bleeding rate after EMR/ESD was also higher among multiple antithrombotic drug users than single drug users, but was not significantly different (33 vs. 14%, P = 0.17). Moreover, there were no differences in bleeding rates according to the cessation or continuance of antithrombotic drugs (20 vs. 25%, P = 0.74). There were no thromboembolisms in all cases.
Upper gastrointestinal endoscopic procedures performed under the new guidelines appear acceptable. However, endoscopic procedures among multiple antithrombotic drug users show a greater potential for bleeding.

DOI： 10.1007/s10620-016-4437-2

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Lanthanum Deposition in the Stomach: Usefulness of Scanning Electron Microscopy for Its Detection Reviewed

Masaya Iwamuro, Haruo Urata, Takehiro Tanaka, Akemi Ando, Takahiro Nada, Kosuke Kimura, Kenji Yamauchi, Chiaki Kusumoto, Fumio Otsuka, Hiroyuki Okada

ACTA MEDICA OKAYAMA 71 ( 1 ) 73 - 78 2017.2

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

After having been treated with lanthanum carbonate administration for 4 years for hyperphosphatemia, a 75-year-old Japanese woman undergoing hemodialysis was diagnosed with lanthanum phosphate deposition in the stomach. The deposition, seen as white microgranules, was observed using esophagogastroduodenoscopy with magnifying observation. To the best of our knowledge, these are the minutest endoscopy images of lanthanum phosphate deposition in the gastric mucosa. Scanning electron microscopy (SEM) observation enabled easier identification of the deposited material, which was visible as bright areas. The present case suggests the usefulness of SEM observation in the detection of lanthanum phosphate deposition in the gastrointestinal tract.

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Papers - IWAMURO Masaya