Faculty Profiles - IWAMURO Masaya

Papers - IWAMURO Masaya

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Review of the diagnosis of gastrointestinal lanthanum deposition. Reviewed International journal

Masaya Iwamuro, Haruo Urata, Takehiro Tanaka, Hiroyuki Okada

World journal of gastroenterology 26 ( 13 ) 1439 - 1449 2020.4

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

Lanthanum carbonate is used for treatment of hyperphosphatemia mostly in patients with chronic renal failure. Although lanthanum carbonate is safe, recently, lanthanum deposition in the gastrointestinal mucosa of patients has been reported in the literature. This review provides an overview of gastroduodenal lanthanum deposition and focuses on disease's endoscopic, radiological, and histological features, prevalence, and outcome, by reviewing relevant clinical studies, case reports, and basic research findings, to better understand the endoscopic manifestation of gastrointestinal lanthanum deposition. The possible relationship between gastric lanthanum deposition pattern and gastric mucosal atrophy is also illustrated; in patients without gastric mucosal atrophy, gastric lanthanum deposition appears as diffuse white lesions in the posterior wall and lesser curvature of the gastric body. In the gastric mucosa with atrophy, lanthanum-related lesions likely appear as annular or granular whitish lesions. Moreover, these white lesions are probably more frequently observed in the lower part of the stomach, where intestinal metaplasia begins.

DOI： 10.3748/wjg.v26.i13.1439

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Esophageal Papilloma Detected by Positron Emission Tomography. Reviewed

Masaya Iwamuro, Yuki Okamoto, Seiji Kawano, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 59 ( 7 ) 1003 - 1004 2020.4

Tolerability and efficacy of the concentration of iodine solution during esophageal chromoendoscopy: a double-blind randomized controlled trial. International journal

Tatsuhiro Gotoda, Hiromitsu Kanzaki, Yuki Okamoto, Yuka Obayashi, Yuki Baba, Kenta Hamada, Hiroyuki Sakae, Makoto Abe, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Gastrointestinal endoscopy 91 ( 4 ) 763 - 770 2020.4

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

BACKGROUND AND AIMS: Esophageal chromoendoscopy with iodine solution is an important diagnostic method for the detection of superficial esophageal cancer. However, the concentration of iodine solution has differed among reports. This study aimed to evaluate patient discomfort with different iodine concentrations. METHODS: We performed a prospective, double-blind, randomized study. We prospectively enrolled and analyzed 77 patients who were at high risk for esophageal carcinoma and scheduled to undergo EGD from March 2018 to January 2019. All patients were divided into 2 groups before the procedure to compare pain measurements: a 1% iodine solution group (group A) and a 2% iodine solution group (group B). The primary endpoint of this study was the difference in pain measurement between 1% and 2% iodine solution chromoendoscopy. Secondary endpoints were safety, detection yield, and color evaluation based on both the endoscopist's survey and color values, as determined using the Commission Internationale de l'Eclairage (CIELAB, Vienna, Austria) color evaluation system, in the iodine-faded and iodine-stained area of each group. RESULTS: Heartburn and retrosternal pain in group A were significantly lower than those in group B (P = .02). Eleven patients reported heartburn and retrosternal pain (group A, 2; group B, 9). Four patients reported pain above the sternal angle and 7 below the sternal angle. There was no significant difference between the 2 groups with regard to detection yield, color evaluation by the endoscopist's assessment, or color values. No patients had any adverse events, and all safely completed this study. CONCLUSIONS: The 2% iodine solution resulted in significantly greater pain than the 1% iodine solution, and the color of the stained esophageal images of each group was the same from this study. Therefore, the 1% iodine solution is recommended for esophageal chromoendoscopy. (Clinical trial registration number: UMIN 000029796.).

DOI： 10.1016/j.gie.2019.10.022

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Cytomegalovirus Colitis Followed by Colonic Pseudolipomatosis and Gastric Emphysema in a Post-resuscitation Patient. Reviewed

Masaya Iwamuro, Takehiro Tanaka, Nao Yamauchi, Yuri Nakashima, Takahira Wada, Sakiko Hiraoka, Yoshiro Kawahara, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 59 ( 4 ) 519 - 525 2020.2

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

A 64-year-old Japanese man suffered cardiopulmonary arrest, which may have resulted from sepsis and/or hyperosmolar hyperglycemic non-ketonic coma, and was admitted after successful resuscitation. He had watery diarrhea on day 18 and was diagnosed with cytomegalovirus enterocolitis. In addition, computed tomography performed on day 27 and colonoscopy revealed gastric emphysema and intestinal pseudolipomatosis, respectively. This report is the first to describe a patient with cytomegalovirus enterocolitis and subsequent gastric emphysema and pseudolipomatosis. Gastrointestinal cytomegalovirus infection may underlie gastric emphysema and intestinal pseudolipomatosis, particularly in patients with relative or obvious immune dysfunction.

DOI： 10.2169/internalmedicine.3633-19

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胃神経鞘腫はPET検査で中リスク胃GISTと同程度の高集積を呈する

岡上昇太郎, 岩室雅也, 田中健大, 馬場雄己, 榮浩行, 安部真, 神崎洋光, 川野誠司, 河原祥朗, 岡田裕之

日本内科学会雑誌 109 ( Suppl. ) 190 - 190 2020.2

肝細胞癌に対するシスプラチン肝動注化学療法後に大腸炎を発症した一例

山本峻平, 大西秀樹, 衣笠秀明, 神崎洋光, 岩室雅也, 原田馨太, 川野誠司, 平岡佐規子, 河原祥朗, 岡田裕之

日本消化管学会雑誌 4 ( Suppl. ) 291 - 291 2020.1

消化管悪性リンパ腫の診断における内視鏡下生検を用いたFlow Cytometry法の有用性

岩室雅也, 表静馬, 田中健大, 馬場雄己, 榮浩行, 安部真, 神崎洋光, 川野誠司, 河原祥朗, 岡田裕之

日本消化管学会雑誌 4 ( Suppl. ) 314 - 314 2020.1

Promising Gene Therapy Using an Adenovirus Vector Carrying REIC/Dkk-3 Gene for the Treatment of Biliary Cancer. Reviewed International journal

Emi Tanaka, Daisuke Uchida, Hidenori Shiraha, Hironari Kato, Atsushi Ohyama, Masaya Iwamuro, Masami Watanabe, Hiromi Kumon, Hiroyuki Okada

Current gene therapy 20 ( 1 ) 64 - 70 2020

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

BACKGROUND: We previously demonstrated that the reduced expression in immortalized cells (REIC)/dikkopf-3 (Dkk-3) gene was downregulated in various malignant tumors, and that an adenovirus vector carrying the REIC/Dkk-3 gene, termed Ad-REIC induced cancer-selective apoptosis in pancreatic cancer and hepatocellular carcinoma. OBJECTIVE: In this study, we examined the therapeutic effects of Ad-REIC in biliary cancer using a second- generation Ad-REIC (Ad-SGE-REIC). METHODS: Human biliary cancer cell lines (G-415, TFK-1) were used in this study. The cell viability and apoptotic effect of Ad-SGE-REIC were assessed in vitro using an MTT assay and Hoechst staining. The anti-tumor effect in vivo was assessed in a mouse xenograft model. We also assessed the therapeutic effects of Ad-SGE-REIC therapy with cisplatin. Cell signaling was assessed by Western blotting. RESULTS: Ad-SGE-REIC reduced cell viability, and induced apoptosis in biliary cancer cell lines via the activation of the c-Jun N-terminal kinase pathway. Ad-SGE-REIC also inhibited tumor growth in a mouse xenograft model. This effect was further enhanced in combination with cisplatin. CONCLUSION: Ad-SGE-REIC induced apoptosis and inhibited tumor growth in biliary cancer cells. REIC/Dkk-3 gene therapy using Ad-SGE-REIC is an attractive therapeutic tool for biliary cancer.

DOI： 10.2174/1566523220666200309125709

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Evaluation of the Usefulness and Convenience of the Kyoto Classification of Gastritis in the Endoscopic Diagnosis of the Helicobacter pylori Infection Status. Reviewed International journal

Hiroyuki Sakae, Masaya Iwamuro, Yuki Okamoto, Yuka Obayashi, Yuki Baba, Kenta Hamada, Tatsuhiro Gotoda, Makoto Abe, Yoshiyasu Kono, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Takehiro Tanaka, Hiroyuki Yanai, Hiroyuki Okada

Digestion 101 ( 6 ) 771 - 778 2020

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

BACKGROUND/AIMS: The Kyoto Classification of Gastritis was published in 2014. Although this classification is now widely used in Japan, its usefulness and convenience have not been sufficiently evaluated. This study aimed to evaluate the usefulness and convenience of this classification in the endoscopic diagnosis of Helicobacter pylori infection. METHODS: We made a test for the endoscopic diagnosis of H. pylori infection comprising 30 cases who had representative endoscopic features of non-, active, or inactive gastritis. Thirty-eight participants took the test before and after a brief mini-lecture on the Kyoto Classification of Gastritis. Eighteen participants took the test again 3 months later. We investigated the accuracy before, just after, and 3 months after the mini-lecture. RESULTS: The accuracy of endoscopists after the lecture was significantly improved in comparison to before the lecture (77.6 vs. 83.3%). Medical students also showed significantly improved accuracy after the lecture (56.7 vs. 71.7%). Among endoscopists, this improvement was maintained after 3 months. Before the lecture, the accuracy of diagnosing non-gastritis was 90.3%; it tended to be further improved 3 months later (96.5%). A >10% point increase was observed in diagnosing active (72.7-83.3%) and inactive gastritis (73.2-84.3%) at 3 months after the lecture in comparison to before the lecture. CONCLUSION: A brief mini-lecture on the Kyoto Classification of Gastritis improved the accuracy in the endoscopic diagnosis of gastritis, indicating that understanding this classification is useful for the prompt diagnosis of H. pylori infection during esophagogastroduodenoscopy.

DOI： 10.1159/000502573

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Technique for single-step lymphocyte isolation from an endoscopic biopsy specimen for the diagnosis of gastrointestinal lymphoma. Reviewed International journal

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

MethodsX 7 101095 - 101095 2020

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

In this paper, we introduce a simplified, one-step procedure for lymphocyte isolation from an endoscopically biopsied fragment. For lymphocyte isolation, an endoscopically harvested specimen and 5 mL of normal saline solution were placed in a wire mesh strainer set in a porcelain bowl. To obtain the lymphocyte suspension, the solid specimen was crushed using the rubber portion of a plunger of a 10 mL injection syringe. Flow cytometry was performed using the lymphocyte suspension. For validating our methods, the one-step lymphocyte isolation technique was used to perform flow cytometry on samples from 23 patients with (n = 12) or without (n = 11) gastrointestinal lymphoma. Flow cytometry of light chain expression was performed in all patient samples (feasibility: 100%). Sensitivity was 83.3% (10/12) and specificity was 100% (11/11). In conclusion, lymphocytes isolated from a single endoscopic biopsy specimen using our simplified and quick procedure are suitable for flow cytometry. Considering that flow cytometry has an important advantage of providing the results on the examination day itself, the results of this study suggest that flow cytometric analysis using our single-step lymphocyte isolation technique can be potentially used to diagnose lymphoma in the gastrointestinal mucosa. •We introduce a simplified, one-step procedure for lymphocyte isolation from an endoscopically biopsied fragment.•Our technique is feasible for flow cytometric analysis in patients with gastrointestinal lymphoma as well as those with gastrointestinal lesions that are suspected to be lymphoma.

DOI： 10.1016/j.mex.2020.101095

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[IgA vasculitis with massive hemorrhage from the jejunum after steroid administration].

Nao Yamauchi, Masaya Iwamuro, Seiji Kawano, Tatsuhiro Yamazaki, Yuki Baba, Tomoko Tsumura, Yuta Hara, Junro Kataoka, Tatsuya Toyokawa, Hiroyuki Okada

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 117 ( 1 ) 64 - 71 2020

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

A 45-year-old Japanese man presenting with leg purpura, abdominal pain, and arthralgia was diagnosed with IgA vasculitis. His symptoms resolved after the intravenous administration of prednisolone. However, on day 20 of admission, he experienced bloody discharge and hypovolemic shock. The bleeding point was not identified on contrast-enhanced computed tomography scanning. The blood loss was approximately 10800ml and the patient received transfusions of 48 units of concentrated red blood cells, 18 units of fresh frozen plasma, and 30 units of concentrated platelets. Laparotomy and enteroscopy were performed through the incision of the jejunum to detect the bleeding source. Spurting bleeding was observed during the enteroscopy and partial resection of the jejunum was performed. Histopathological examination of the resected specimen revealed large vessels beneath the jejunal ulcer scar, suggesting bleeding from a Dieulafoy's lesion. Leukocytoclastic vasculitis or cytomegalovirus infection was not observed in the resected specimen. Gastrointestinal symptoms in patients with IgA vasculitis usually improve with bowel rest and conservative treatment. Administration of steroids or factor XIII is recommended for patients with severe abdominal pain refractory to conservative management. Rarely, massive bleeding, perforation, intussusception, and/or intestinal obstruction occur in the gastrointestinal tract and these complications affect patients' prognoses. The clinical course in the present patient indicated that severe bleeding from the gastrointestinal tract can occur even after symptom remission in patients with IgA vasculitis. In such cases, prompt treatment, including laparotomy and/or enteroscopy, is essential.

DOI： 10.11405/nisshoshi.117.64

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Eosinophilic Gastritis in a Patient Previously Treated with Dupilumab. Reviewed International journal

Masaya Iwamuro, Toshi Murakami, Takehiro Tanaka, Shohei Oka, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Case reports in gastrointestinal medicine 2020 6381670 - 6381670 2020

Authorship：Lead author,　Corresponding author Language：English

A 77-year-old Japanese man with bronchial asthma was treated with dupilumab. Dupilumab treatment was discontinued at the patient's request after two injections separated by a 2-week interval. The blood eosinophil count was elevated, and an esophagogastroduodenoscopy performed 3 months after dupilumab treatment revealed gastric ulcers; subsequently, eosinophilic gastritis was diagnosed from biopsy examinations. The gastric lesions were resolved by steroid administration. This case report underscores that eosinophil-associated gastrointestinal diseases should be considered in the differential diagnosis of gastric lesions occurring in patients who were treated with dupilumab.

DOI： 10.1155/2020/6381670

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Hepatic Stellate Cells in Liver Tumor. International journal

Hidenori Shiraha, Masaya Iwamuro, Hiroyuki Okada

Advances in experimental medicine and biology 1234 43 - 56 2020

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

Hepatocellular carcinoma and intrahepatic cholangiocarcinoma are the most common types of primary liver cancers. Moreover, the liver is the second most frequently involved organ in cancer metastasis after lymph nodes. The tumor microenvironment is crucial for the development of both primary and secondary liver cancers. The hepatic microenvironment consists of multiple cell types, including liver sinusoidal endothelial cells, Kupffer cells, natural killer cells, liver-associated lymphocytes, and hepatic stellate cells (HSCs). The microenvironment of a normal liver changes to a tumor microenvironment when tumor cells exist or tumor cells migrate to and multiply in the liver. Interactions between tumor cells and non-transformed cells generate a tumor microenvironment that contributes significantly to tumor progression. HSCs play a central role in the tumor microenvironment crosstalk. As this crosstalk is crucial for liver carcinogenesis and liver-tumor development, elucidating the mechanism underlying the interaction of HSCs with the tumor microenvironment could provide potential therapeutic targets for liver cancer.

DOI： 10.1007/978-3-030-37184-5_4

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Appendiceal Orifice Inflammation in Ulcerative Colitis Mimicking Mucosa-Associated Lymphoid Tissue Lymphoma in the Cecum. Reviewed International journal

Masaya Iwamuro, Takahide Takahashi, Takehiro Tanaka, Tomohiro Toji, Sakiko Hiraoka, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Case reports in gastrointestinal medicine 2020 8893604 - 8893604 2020

Authorship：Lead author,　Corresponding author Language：English

A 55-year-old Japanese woman, who had been diagnosed with ulcerative colitis at 18 years of age, underwent screening endoscopy examinations. Esophagogastroduodenoscopy revealed an extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of the stomach. Colonoscopy showed a slightly elevated reddish lesion with dilated microvessels but no erosions or ulcers. Although MALT lymphoma in the cecum was endoscopically suspected, flow cytometry and pathological analyses led to the diagnosis of appendiceal orifice inflammation in ulcerative colitis. This case highlights the diversity of the endoscopic appearance of appendiceal orifice inflammation in ulcerative colitis.

DOI： 10.1155/2020/8893604

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【消化管症候群(第3版)-その他の消化管疾患を含めて-】胃腫瘍性疾患胃GIST

岩室雅也, 田中健大, 岡田裕之

日本臨床別冊 ( 消化管症候群I ) 319 - 322 2019.12

A Phase I/Ib trial of Ad-REIC in liver cancer: study protocol. Reviewed International journal

Astushi Oyama, Hidenori Shiraha, Daisuke Uchida, Masaya Iwamuro, Hironari Kato, Akinobu Takaki, Fusao Ikeda, Hideki Onishi, Tetsuya Yasunaka, Yasuto Takeuchi, Nozomu Wada, Yoshiaki Iwasaki, Masahiro Sakata, Hiroyuki Okada, Hiromi Kumon

Future oncology (London, England) 15 ( 31 ) 3547 - 3554 2019.11

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

This study will assess the safety and efficacy of the administration of adenoviral vector expressing the human-reduced expression in immortalized cells (Ad-REIC) to a liver tumor in patients with hepatocellular carcinoma (HCC) or liver metastasis of pancreatic cancer. A Phase I clinical study of Ad-REIC administration to a liver tumor in a patient with HCC or liver metastasis of pancreatic cancer will be conducted. The study is a single-arm, prospective, nonrandomized, noncomparative, open-label, single-center trial performed in Okayama University Hospital, Okayama, Japan. Ad-REIC will be injected into the liver tumor under ultrasound guidance. Ad-REIC administration will be repeated a total of three-times every 2 weeks. The primary end point is the dose-limiting toxicity and incidence of adverse events. The secondary end points are the objective response rate and disease control rate. This study aims to expand the indication of Ad-REIC by assessing its safety and efficacy in patients with HCC or liver metastasis of pancreatic cancer.

DOI： 10.2217/fon-2019-0115

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食道上皮性腫瘍と診断された好酸球性食道炎の3例

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

日本消化器病学会中国支部例会プログラム・抄録集 112回 148 - 148 2019.11

蘇生後にサイトメガロウイルス腸炎を発症し、胃気腫症と腸管偽リポマトーシスを合併した一例

山内菜緒, 岩室雅也, 田中健大, 中島有理, 和田嵩平, 高原政宏, 川野誠司, 平岡佐規子, 河原祥朗, 岡田裕之

日本消化器病学会中国支部例会プログラム・抄録集 112回 83 - 83 2019.11

Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery.

Shumpei Yamamoto, Masaya Iwamuro, Muneaki Miyake, Naoyuki Nishimura, Motowo Mizuno, Hiroyuki Okada

Internal medicine (Tokyo, Japan) 58 ( 20 ) 2949 - 2955 2019.10

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

A 49-year-old man with diabetes taking clopidogrel and celecoxib underwent interbody fusion surgery for spinal spondylolysis. Ten days after the surgery, he vomited a large amount of fresh blood. A blood examination revealed hemodynamic failure. Esophagogastroduodenoscopy showed an adherent blood clot and multiple superficial ulcers in the esophagus. Endoscopic hemostasis was successfully achieved. Biopsy specimens from the esophageal ulcer showed positive immunohistochemical staining results for anti-CMV antibodies. The esophageal ulcer improved after the oral administration of ganciclovir. This case emphasizes that CMV esophagitis with bleeding can occur in a diabetic patient with a poor nutritional status due to relative immune dysfunction.

DOI： 10.2169/internalmedicine.2908-19

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A Granulation Polyp in the Colon Masquerading as Metastatic Cancer. Reviewed

Masaya Iwamuro, Masahiro Takahara, Tatsuhiro Yamazaki, Takehiro Tanaka, Yoshitaka Kondo, Sakiko Hiraoka, Hiroyuki Okada

Acta medica Okayama 73 ( 5 ) 457 - 461 2019.10

Authorship：Lead author,　Corresponding author Language：English

A 60-year-old Caucasian male was diagnosed with lung adenocarcinoma and multiple metastases to the bone, spleen, and brain. He underwent radiotherapy for the brain and lumbar spine metastases, plus chemotherapy (cisplatin and pemetrexed). The chemotherapy was discontinued due to vomiting and hyponatremia, and nivolumab was then administered. Eight months later, 18F-fluorodeoxyglucose positron emission tomography showed tracer uptake in the colon. Colonoscopy revealed a reddish multinodular polyp in the sigmoid colon. The polyp showed irregular microvessels. No colonic mucosal surface structures were observed. Colonic metastasis of the lung carcinoma was highly suspected; the polyp was therefore surgically removed. The histological analysis revealed granulation tissue and suppurative inflammation without neoplastic changes. We diagnosed the lesion as a granulation polyp. Despite the difficulty in diagnosing these lesions due to their rarity and similarity to metastatic colon tumors, we suggest that recognizing the endoscopic features of the polyp surface may allow a preoperative diagnosis.

DOI： 10.18926/AMO/57377

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Papers - IWAMURO Masaya