2022/05/03 更新

写真a

ハラダ ケイタ
原田 馨太
HARADA Keita
所属
医歯薬学域 講師
職名
講師

学位

  • 博士(医学) ( 2008年6月   岡山大学 )

  • 博士(医学) ( 2008年6月   岡山大学 )

  • 医学博士 ( 2008年6月   岡山大学大学院医学研究科 )

研究キーワード

  • 消化器内視鏡学

研究分野

  • ライフサイエンス / 内科学一般

  • ライフサイエンス / 消化器内科学

学歴

  • 岡山大学   Graduate School of Medicine   Internal Medicine

    1999年4月 - 2008年6月

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    国名: 日本国

    備考: Doctoral course

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  • 岡山大学   Medical School   Faculty of Medicine

    1993年4月 - 1999年3月

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    国名: 日本国

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経歴

  • 岡山大学学術研究院医歯薬学域   消化器・肝臓内科学   講師

    2022年5月 - 現在

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  • 岡山大学病院   消化器内科   助教

    2017年1月 - 2022年4月

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    国名:日本国

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  • 岡山大学病院   光学医療診療部   助教

    2012年1月 - 2016年12月

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    国名:日本国

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  • 福山市民病院   内科

    2008年1月 - 2011年12月

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    国名:日本国

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  • 岡山大学医学部附属病院   消化器・肝臓・感染症内科

    2002年10月 - 2003年9月

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    国名:日本国

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  • 財団法人津山慈風会 津山中央病院   内科

    2000年10月 - 2002年9月

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    国名:日本国

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  • 岡山大学医学部附属病院   第一内科

    2000年5月 - 2000年9月

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    国名:日本国

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所属学協会

  • 日本大腸肛門病学会

    2020年 - 現在

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  • 日本消化管学会

    2017年 - 現在

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  • 日本カプセル内視鏡学会

    2008年 - 現在

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  • 日本癌学会

    2006年 - 現在

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  • 日本消化器内視鏡学会

    2000年 - 現在

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  • 日本内科学会

    2000年 - 現在

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  • 日本消化器病学会

    2000年 - 現在

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委員歴

  • 日本消化器病学会   評議員  

    2020年1月 - 現在   

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    団体区分:学協会

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  • 日本消化器内視鏡学会   和文誌 査読委員  

    2017年12月 - 現在   

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    団体区分:学協会

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  • 日本消化器内視鏡学会   学術評議員  

    2017年5月 - 現在   

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    団体区分:学協会

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  • 日本消化器病学会中国支部   評議員  

    2013年1月 - 現在   

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    団体区分:学協会

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  • 日本消化器内視鏡学会中国支部   評議員  

    2012年7月 - 現在   

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    団体区分:学協会

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論文

  • Encouraging participation in colorectal cancer screening for people with schizophrenia: A randomized controlled trial. 国際誌

    Masaki Fujiwara, Yuto Yamada, Taichi Shimazu, Masafumi Kodama, Ryuhei So, Takanori Matsushita, Yusaku Yoshimura, Shigeo Horii, Maiko Fujimori, Hirokazu Takahashi, Naoki Nakaya, Kyoko Kakeda, Tempei Miyaji, Shiro Hinotsu, Keita Harada, Hiroyuki Okada, Yosuke Uchitomi, Norihito Yamada, Masatoshi Inagaki

    Acta psychiatrica Scandinavica   144 ( 4 )   318 - 328   2021年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: We examined the efficacy of a case management approach to improve participation in colorectal cancer screening among people with schizophrenia. METHODS: This was a randomized, parallel group trial. We recruited outpatients with schizophrenia aged 40 years or over from two psychiatric hospitals in Japan. Participants were randomly assigned (1:1) to treatment as usual or case management intervention plus treatment as usual using a web-based system. Attending clinicians and participants were unmasked to the allocation. Case management included education and patient navigation for colorectal cancer screening using a fecal occult blood test. Treatment as usual included direct mail government recommendations. The primary endpoint was participation in colorectal cancer screening assessed using municipal records. We also assessed the secondary endpoint of participation in other cancer screenings (lung, gastric, breast, and cervical). RESULTS: Between 3 June and 9 September 2019, 172 eligible participants were randomly assigned to the case management plus treatment as usual group (n = 86) or treatment as usual group (n = 86). One participant was ineligible and another withdrew consent; both were excluded from analysis. A significantly higher proportion of participants received colorectal cancer screening in the case management plus treatment as usual group than in the treatment as usual group (40 [47.1%] of 85 participants vs. 10 [11.8%] of 85 participants, p < 0.0001). The proportion of lung cancer screening also increased. No serious adverse events associated with the study intervention occurred. CONCLUSION: The case management intervention to encourage participation in colorectal cancer screening was effective for patients with schizophrenia.

    DOI: 10.1111/acps.13348

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  • Virtual scale function of gastrointestinal endoscopy for accurate polyp size estimation in real-time: a preliminary study. 国際誌

    Masato Yoshioka, Yuichi Sakaguchi, Daisuke Utsunomiya, Shinichiro Sonoda, Takeichi Tatsuta, Satoshi Ozawa, Yuichi Teramura, Keita Harada, Hideaki Kinugasa, Hiroyuki Okada

    Journal of biomedical optics   26 ( 9 )   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    SIGNIFICANCE: Polyp size is important for selecting the surveillance interval or treatment policy. Nevertheless, it is challenging to accurately estimate the polyp size during endoscopy. An easy and cost-effective function to assist in polyp size estimation is required. AIM: To propose a virtual scale function for endoscopy and evaluate its performance and expected accuracy. APPROACH: An adaptive virtual scale behavior was demonstrated. The measurement error of the virtual scale along the distance between the tip of the endoscope and the object plane was evaluated using graph paper. The accuracy of polyp size estimation by an expert endoscopist was compared with the accuracy of the biopsy forceps method using phantom images. RESULTS: The measurement errors of the virtual scale were   ≤  0.7  mm when the distance to the graph paper, which faced the tip of the endoscope, varied from 4 to 30 mm. The accuracy with the virtual scale was significantly higher than that obtained with biopsy forceps (5.3  ±  5.5  %   versus 11.9  ±  9.4  %  , P  <  0.001). CONCLUSIONS: The virtual scale function, which operates in real-time without any additional device, can be used to estimate polyp sizes easily and accurately with endoscopy.

    DOI: 10.1117/1.JBO.26.9.096002

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  • Evaluation of complete cold forceps polypectomy resection rate for 3- to 5-mm colorectal polyps. 国際誌

    Yasushi Yamasaki, Keita Harada, Shumpei Yamamoto, Eriko Yasutomi, Mami Hirai, Masayasu Ohmori, Shohei Oka, Toshihiro Inokuchi, Hideaki Kinugasa, Yuusaku Sugihara, Masahiro Takahara, Sakiko Hiraoka, Takehiro Tanaka, Toshiharu Mitsuhashi, Hiroyuki Okada

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   33 ( 6 )   948 - 954   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND STUDY AIMS: The propriety of cold forceps polypectomy (CFP) using jumbo biopsy forceps for diminutive polyps remains controversial. We conducted a prospective study to evaluate the complete CFP resection rate of 3-5-mm polyps using additional endoscopic mucosal resection (EMR) specimens following CFP. PATIENTS AND METHODS: Patients with 3-5-mm protruded or flat elevated colorectal polyps diagnosed endoscopically as adenomas or serrated lesions were prospectively enrolled. CFP using jumbo biopsy forceps was used to remove the eligible polyps and repeated until the absence of residuals were confirmed via image-enhanced endoscopy or chromoendoscopy. After CFP, saline was injected at the defect, and the marginal specimen of the defect was resected using EMR to histologically evaluate the residue. The primary outcome was the complete CFP resection rate, which was defined as no residue at the EMR site. Other outcomes were the number of CFP bites and the complete resection rate by lesion size. RESULTS: Eighty patients with 120 polyps were enrolled. The mean polyp size was 4.1 ± 0.7 mm. The overall complete resection rate was 96.7% (95% confidence interval [CI], 91.7-98.7), and the rates for 3-, 4- and 5-mm polyps were 100% (95% CI, 86.7-100), 96.0% (95% CI, 86.5-98.9) and 95.5% (95% CI, 85.1-98.8), respectively. The one-bite CFP rates were 92%, 60% and 31% for the 3-, 4- and 5-mm polyps, respectively. CONCLUSIONS: The complete CFP resection rate for 3-5-mm polyps was acceptable, although the one-bite clearance rate decreased as the polyp size increased (UMIN000028841).

    DOI: 10.1111/den.13895

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  • A novel clip closure method using precutting and a reopenable clip after colorectal endoscopic submucosal dissection. 国際誌

    Masayasu Ohmori, Yasushi Yamasaki, Shumpei Yamamoto, Hideaki Kinugasa, Keita Harada, Sakiko Hiraoka, Hiroyuki Okada

    Endoscopy   2021年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1055/a-1559-1586

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  • Heterogeneous distribution of Fusobacterium nucleatum in the progression of colorectal cancer. 国際誌

    Shumpei Yamamoto, Hideaki Kinugasa, Mami Hirai, Hiroyuki Terasawa, Eriko Yasutomi, Shohei Oka, Masayasu Ohmori, Yasushi Yamasaki, Toshihiro Inokuchi, Keita Harada, Sakiko Hiraoka, Kazuhiro Nouso, Takehiro Tanaka, Fuminori Teraishi, Toshiyoshi Fujiwara, Hiroyuki Okada

    Journal of gastroenterology and hepatology   36 ( 7 )   1869 - 1876   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIM: Fusobacterium nucleatum (Fn) is involved in colorectal cancer (CRC) growth and is a biomarker for patient prognosis and management. However, the ecology of Fn in CRC and the distribution of intratumoral Fn are unknown. METHODS: We evaluated Fn and the status of KRAS and BRAF in 200 colorectal neoplasms (118 adenomas and 82 cancers) and 149 matched adjacent normal mucosas. The differentiation status between "surface" and "deep" areas of cancer tissue and matched normal mucosa were analyzed in 46 surgical samples; the Ki-67 index was also evaluated in these samples. RESULTS: Fusobacterium nucleatum presence in the tumor increased according to pathological stage (5.9% [adenoma] to 81.8% [stage III/IV]), while Fn presence in normal mucosa also increased (7.6% [adenoma] to 40.9% [stage III/IV]). The detection rates of Fn on the tumor surface and in deep areas were 45.7% and 32.6%, while that of normal mucosa were 26.1% and 23.9%, respectively. Stage III/IV tumors showed high Fn surface area expression (66.7%). Fn intratumoral heterogeneity (34.8%) was higher than that of KRAS (4.3%; P < 0.001) and BRAF (2.2%; P < 0.001). The Ki-67 index in Fn-positive cases was higher than that in negative cases (93.9% vs 89.0%; P = 0.01). CONCLUSIONS: Fusobacterium nucleatum was strongly present in CRC superficial areas at stage III/IV. The presence of Fn in the deep areas of adjacent normal mucosa also increased. The intratumoral heterogeneity of Fn is important in the use of Fn as a biomarker, as Fn is associated with CRC proliferative capacity.

    DOI: 10.1111/jgh.15361

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  • Two Cases of Endometriosis in the Cecum Detected by Contrast-enhanced Computed Tomography with Air/Carbon Dioxide Insufflation.

    Masaya Iwamuro, Takehiro Tanaka, Yuusaku Sugihara, Keita Harada, Sakiko Hiraoka, Yoshitaka Kondo, Hiroyuki Okada

    Internal medicine (Tokyo, Japan)   60 ( 11 )   1697 - 1701   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We herein report two patients with endometriosis in the cecum. Both patients presented with a protruding, subepithelial tumor on colonoscopy and were diagnosed with cecal endometriosis after surgical resection. It is notable that the cecal lesions were not initially identified on computed tomography (CT), while CT colonography with air/carbon dioxide insufflation resulted in the detection of the cecal tumor. These cases highlight the possibility of false-negative results on conventional CT in patients with cecal endometriosis. We consider CT colonography with air/carbon dioxide insufflation useful for detecting cecal tumors in such cases.

    DOI: 10.2169/internalmedicine.6418-20

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  • Leucine-rich alpha-2 glycoprotein as a marker of mucosal healing in inflammatory bowel disease. 国際誌

    Eriko Yasutomi, Toshihiro Inokuchi, Sakiko Hiraoka, Kensuke Takei, Shoko Igawa, Shumpei Yamamoto, Masayasu Ohmori, Shohei Oka, Yasushi Yamasaki, Hideaki Kinugasa, Masahiro Takahara, Keita Harada, Masaki Furukawa, Kouichi Itoshima, Ken Okada, Fumio Otsuka, Takehiro Tanaka, Toshiharu Mitsuhashi, Jun Kato, Hiroyuki Okada

    Scientific reports   11 ( 1 )   11086 - 11086   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Leucine-rich alpha-2 glycoprotein (LRG) may be a novel serum biomarker for patients with inflammatory bowel disease. The association of LRG with the endoscopic activity and predictability of mucosal healing (MH) was determined and compared with those of C-reactive protein (CRP) and fecal markers (fecal immunochemical test [FIT] and fecal calprotectin [Fcal]) in 166 ulcerative colitis (UC) and 56 Crohn's disease (CD) patients. In UC, LRG was correlated with the endoscopic activity and could predict MH, but the performance was not superior to that of fecal markers (areas under the curve [AUCs] for predicting MH: LRG: 0.61, CRP: 0.59, FIT: 0.75, and Fcal: 0.72). In CD, the performance of LRG was equivalent to that of CRP and Fcal (AUCs for predicting MH: LRG: 0.82, CRP: 0.82, FIT: 0.70, and Fcal: 0.88). LRG was able to discriminate patients with MH from those with endoscopic activity among UC and CD patients with normal CRP levels. LRG was associated with endoscopic activity and could predict MH in both UC and CD patients. It may be particularly useful in CD.

    DOI: 10.1038/s41598-021-90441-x

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  • Optimal surveillance interval after piecemeal endoscopic mucosal resection for large colorectal neoplasia: a multicenter randomized controlled trial. 国際誌

    Takeshi Nakajima, Taku Sakamoto, Shinichiro Hori, Shinya Yamada, Hiroaki Ikematsu, Keita Harada, Han-Mo Chiu, Shinsuke Kiriyama, Tomoki Michida, Kinichi Hotta, Naoto Sakamoto, Takashi Abe, Akiko Chino, Masakatsu Fukuzawa, Nozomu Kobayashi, Kazutoshi Fukase, Takahisa Matsuda, Yoshitaka Murakami, Hideki Ishikawa, Yutaka Saito

    Surgical endoscopy   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIMS: Colorectal neoplastic lesions (≥ 20 mm) are commonly treated via piecemeal endoscopic mucosal resection (p-EMR) but have a high rate of local recurrence. We aimed to clarify the optimal surveillance interval after p-EMR for these neoplasias. METHODS: In this multicenter (15 participating institutions) prospective, randomized trial, 180 patients recruited over a 4-year period and were classified based on tumor location, tumor diameter, histological diagnosis, institution, and number of resected specimens. The patients underwent curative p-EMR followed by scheduled surveillance colonoscopy at 3, 6, 12, and 24 months after p-EMR (group A; n = 90) or at 6, 12, and 24 months after p-EMR (group B; n = 90). The primary endpoint was cumulative local recurrence at 6 months after p-EMR. Secondary endpoints included local recurrence and the cumulative surgical resection rate of recurrent tumors during the 24-month follow-up period. RESULTS: The median tumor diameter was 25 mm (IQR 20-30). Six months after p-EMR, 12 and 6 local recurrences were noted in groups A and B, which corresponded to 13 and 8 recurrences, respectively, during the 24-month surveillance period. The primary and secondary endpoints of recurrence were not significantly different between the groups on either intention-to-treat or per-protocol analysis; no surgery case was observed in group B when a strict surveillance protocol of 6-, 12-, and 24-month follow-up post-EMR was followed. CONCLUSIONS: For patients who underwent p-EMR for neoplastic lesions, additional postprocedural 3-month surveillance did not show superior results in detecting recurrence compared with a 6-month surveillance interval. CLINICAL TRIAL REGISTRATION: UMIN000015740.

    DOI: 10.1007/s00464-021-08311-6

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  • Liquid biopsy for patients with IBD-associated neoplasia. 国際誌

    Hideaki Kinugasa, Sakiko Hiraoka, Kazuhiro Nouso, Shumpei Yamamoto, Mami Hirai, Hiroyuki Terasawa, Eriko Yasutomi, Shohei Oka, Masayasu Ohmori, Yasushi Yamasaki, Toshihiro Inokuchi, Masahiro Takahara, Keita Harada, Takehiro Tanaka, Hiroyuki Okada

    BMC cancer   20 ( 1 )   1188 - 1188   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: It is often difficult to diagnose inflammatory bowel disease (IBD)-associated neoplasia endoscopically due to background inflammation. In addition, due to the absence of sensitive tumor biomarkers, countermeasures against IBD-associated neoplasia are crucial. The purpose of this study is to develop a new diagnostic method through the application of liquid biopsy. METHODS: Ten patients with IBD-associated cancers and high-grade dysplasia (HGD) with preserved tumor tissue and blood were included. Tumor and non-tumor tissues were analyzed for 48 cancer-related genes using next-generation sequencing. Simultaneously, circulating tumor DNA (ctDNA) was analyzed for mutations in the target genes using digital PCR. RESULTS: Out of 10 patients, seven had IBD-related cancer and three had IBD-related HGD. Two patients had carcinoma in situ; moreover, three had stageII and two had stage III. To avoid false positives, the mutation rate cutoff was set at 5% based on the control results; seven of 10 (70%) tumor tissue samples were mutation-positive. Mutation frequencies for each gene were as follows: TP53 (20.9%; R136H), TP53 (25.0%; C110W), TP53 (8.5%; H140Q), TP53 (31.1%; R150W), TP53 (12.8%; R141H), KRAS (40.0%; G12V), and PIK3CA (34.1%; R 88Q). The same mutations were detected in the blood of these seven patients. However, no mutations were detected in the blood of the remaining three patients with no tumor tissue mutations. The concordance rate between tumor tissue DNA and blood ctDNA was 100%. CONCLUSION: Blood liquid biopsy has the potential to be a new method for non-invasive diagnosis of IBD-associated neoplasia.

    DOI: 10.1186/s12885-020-07699-z

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  • Factors Predicting a Favorable Disease Course Without Anti-TNF Therapy in Crohn's Disease Patients.

    Toshihiro Inokuchi, Sakiko Hiraoka, Eriko Yasutomi, Shohei Oka, Yasushi Yamasaki, Hideaki Kinugasa, Masahiro Takahara, Seiji Kawano, Keita Harada, Hiroyuki Okada, Jun Kato

    Acta medica Okayama   74 ( 4 )   265 - 274   2020年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Determining factors that predict a favorable disease course without anti-tumor necrosis factor (TNF) agents would help establish a more cost-effective strategy for Crohn's disease (CD). A retrospective chart review was performed for CD patients with disease durations > 10 years who had not received anti-TNF agents as first-line therapy. Patients were divided into 2 groups: those who received neither anti-TNF agents nor bowel resection (G1), and those who had received an anti-TNF agent and/or bowel resection (G2). The patient backgrounds, therapies and clinical courses were compared between the groups. A total of 62 CD patients met the inclusion criteria (males: 71%; median duration of follow-up: 19 years). Six patients were included in G1; they were significantly less likely to have upper gastrointestinal lesions than G2 (p=0.007). A multivariate analysis revealed that the significant factors for avoidance of bowel resection without anti-TNF treatment were non-stricturing and non-penetrating behaviors, and absence of upper gastrointestinal lesions at the diagnosis (hazard ratios 0.41 and 0.52; p=0.004 and 0.04, respectively). In consideration of the long treatment course of CD, patients with non-stricturing and non-penetrating behaviors and no upper gastrointestinal lesions should not be treated with anti-TNF agents as first-line therapy.

    DOI: 10.18926/AMO/60363

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  • Blue laser imaging and linked color imaging improve the color difference value and visibility of colorectal polyps in underwater conditions. 国際誌

    Yasushi Yamasaki, Keita Harada, Shumpei Yamamoto, Eriko Yasutomi, Shotaro Okanoue, Mami Hirai, Shohei Oka, Yuka Obayashi, Hiroyuki Sakae, Kenta Hamada, Toshihiro Inokuchi, Hideaki Kinugasa, Yuusaku Sugihara, Masahiro Takahara, Takehiro Tanaka, Sakiko Hiraoka, Yoshiro Kawahara, Hiroyuki Okada

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   32 ( 5 )   791 - 800   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIM: Underwater endoscopic mucosal resection (UEMR) has become widespread for treating colorectal polyps. However, which observational mode is best suited for determining polyp margins underwater remains unclear. To determine the best mode, we analyzed three imaging modes: white light imaging (WLI), blue laser imaging (BLI) and linked color imaging (LCI). METHODS: Images of consecutive colorectal polyps previously examined by these three modes before UEMR were analyzed according to the degree of underwater turbidity (transparent or cloudy). Color differences between the polyps and their surroundings were calculated using the Commission Internationale d'Eclairage Lab color space in which 3-D color parameters were expressed. Eight evaluators, who were blinded to the histology, scored the visibility from one (undetectable) to four (easily detectable) in both underwater conditions. The color differences and visibility scores were compared. RESULTS: Seventy-three polyps were evaluated. Sixty-one polyps (44 adenomatous, 17 serrated) were observed under transparent conditions, and 12 polyps (seven adenomatous, five serrated) were observed under cloudy conditions. Under transparent conditions, color differences for the BLI (8.5) and LCI (7.9) were significantly higher than that of WLI (5.7; P < 0.001). Visibility scores for BLI (3.6) and LCI (3.4) were also higher than that of WLI (3.1; P < 0.0001). Under cloudy conditions, visibility scores for LCI (2.9) and WLI (2.7) were significantly higher than that of BLI (2.2; P < 0.0001 and P = 0.04, respectively). CONCLUSIONS: BLI and LCI were better observational modes in transparent water; however, BLI was unsuitable for cloudy conditions.

    DOI: 10.1111/den.13581

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  • Clinical Characteristics and Risk Factors for Rebleeding in Patients with Obscure Gastrointestinal Bleeding.

    Yuki Baba, Seiji Kawano, Yoshiyasu Kono, Toshihiro Inokuchi, Hiromitsu Kanzaki, Masaya Iwamuro, Keita Harada, Sakiko Hiraoka, Yoshiro Kawahara, Hiroyuki Okada

    Internal medicine (Tokyo, Japan)   59 ( 11 )   1345 - 1350   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective With the advent of capsule endoscopy (CE) and double-balloon endoscopy (DBE), the diagnosis and treatment of obscure gastrointestinal bleeding (OGIB) have markedly progressed. However, rebleeding sometimes occurs and is difficult to diagnose and treat. The aim of the present study was to investigate the clinical features of OGIB and risk factors for rebleeding in our hospital. Methods A total of 195 patients who underwent CE and/or DBE for OGIB in our hospital from January 2009 to July 2016 were included in the present study. We analyzed 168 cases of small intestinal OGIB, after excluding 27 cases of extra small intestinal bleeding. The clinical characteristics and risk factors related to rebleeding were retrospectively studied. Results Among the 168 patients who were included in the analysis, 95 patients (56.5%) were male. The mean age was 64.5 years (range, 8 to 87 years). Hypertension (31.0%) was the most frequent comorbidity, followed by chronic kidney disease (19.0%). The final diagnoses were ulcerative lesions (n=50, 29.8%), vascular lesions (n=30, 17.9%), tumors (n=7, 4.2%), and diverticula (n=2, 1.2%). The bleeding source was undetermined in the remaining 79 cases (47.0%). Rebleeding was confirmed in 29 cases (17.3%). In a univariate analysis, chronic kidney disease, vascular lesions, and overt previous bleeding were significantly associated with the risk of rebleeding. A multivariate analysis showed that chronic kidney disease, vascular lesion, and overt previous bleeding were significantly associated with the risk of rebleeding. Conclusion Patients with OGIB with overt previous bleeding, vascular lesions, and/or chronic kidney disease had a higher risk of rebleeding.

    DOI: 10.2169/internalmedicine.3628-19

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  • Observer agreement for the diagnosis of intestinal acute graft-vs.-host disease based on the presence of villous atrophy in the terminal ileum. 国際誌

    Yuusaku Sugihara, Sakiko Hiraoka, Eriko Yasutomi, Shohei Oka, Yasushi Yamasaki, Toshihiro Inokuchi, Hideaki Kinugasa, Masahiro Takahara, Yuki Morito, Sakuma Takahashi, Keita Harada, Takehiro Tanaka, Fumio Otsuka, Hiroyuki Okada

    Experimental and therapeutic medicine   19 ( 4 )   3076 - 3080   2020年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Intestinal graft-vs.-host disease (GVHD) is a serious complication of allo-hematopoietic stem cell transplantation (allo-HSCT). Villous atrophy in the terminal ileum is considered a useful diagnostic indicator for GVHD. However, the inter- and intra-observer agreement regarding the ileocolonoscopic findings indicative of acute intestinal GVHD, i.e., villous atrophy in the terminal ileum, are currently insufficient in multiple institutions. Thus, the present study aimed to investigate the incidence of villous atrophy in the terminal ileum to diagnose acute intestinal GVHD and determine the inter- and intra-observer agreement regarding this result for experienced endoscopists from multiple institutions. Consecutive patients who underwent allo-HSCT were referred to our institution between May 2008 and September 2015. A total of 54 patients underwent total ileocolonoscopy after allo-HSCT due to suspected intestinal acute GVHD. Subsequently, three observers from different institutions evaluated the cases for the presence of villous atrophy in the terminal ileum. In this study, the pathology results were a gold standard to evaluate the predictive value of ileocolonoscopy detection. Definitive pathological and non-pathological GVHD was diagnosed in 22 and 32 cases, respectively. The results of examining whether villous atrophy could predict GVHD were as follows. For three observers (A, B and C), the sensitivity of villous atrophy in the terminal ileum was 86.4, 77.3 and 79.2%, respectively, whereas the specificity was 62.5, 62.5 and 86.7%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of villous atrophy for GVHD were as follows: The PPV of appearance was 61.3, 58.6 and 82.6%, respectively, whereas the NPV was 87.0, 80.0 and 83.9%, respectively. Kappa coefficients for the inter-observer reliability were 0.85, 0.63 and 0.63 for observers A and B, A and C, and B and C, respectively. The intra-observer kappa coefficient was 0.88 for observer A, 0.73 for observer B and 0.75 for observer C. A substantial observer agreement was achieved for the analysis of villous atrophy in the terminal ileum and the agreement for the predictive histological diagnosis was also excellent. Based on the results of the present study, identification of villous atrophy in the terminal ileum was a clinically effective diagnostic parameter, even if different endoscopists were involved in the diagnosis at multiple institutions. The present study was registered as a trial with the University Hospital Medical Information Network (UMIN; registration no. UMIN000025390).

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  • Switching between Three Types of Mesalazine Formulation and Sulfasalazine in Patients with Active Ulcerative Colitis Who Have Already Received High-Dose Treatment with These Agents. 国際誌

    Eriko Yasutomi, Sakiko Hiraoka, Shumpei Yamamoto, Shohei Oka, Mami Hirai, Yasushi Yamasaki, Toshihiro Inokuchi, Hideaki Kinugasa, Masahiro Takahara, Keita Harada, Jun Kato, Hiroyuki Okada

    Journal of clinical medicine   8 ( 12 )   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIM: Oral mesalazine and sulfasalazine (SASP) are key drugs for treating ulcerative colitis (UC). The efficacy of switching from one of the several mesalazine formulations to another is largely unknown. This study assessed the efficacy of switching among three types of mesalazine formulation and SASP for UC therapy. METHODS: UC patients receiving high-dose mesalazine/SASP who switched to other formulations due to disease activity were considered eligible. Efficacy was evaluated 2, 6, and 12 months after switching. RESULTS: A total of 106 switches in 88 UC patients were analyzed. The efficacy at 2 months after switching was observed in 23/39 (59%) cases from any mesalazine formulation to SASP, in 18/55 (33%) cases from one mesalazine to another, and in 2/12 (17%) cases from SASP to any mesalazine formulation. Nine of 43 effective cases showed inefficacy or became intolerant post-switching. Delayed efficacy more than two months after switching was observed in four cases. Steroid-free remission was achieved in 42/106 (39%) cases-within 100 days in 35 of these cases (83%). CONCLUSIONS: Switching from mesalazine to SASP was effective in more than half of cases. The efficacy of switching between mesalazine formulations was lower but may be worth attempting in clinical practice from a safety perspective.

    DOI: 10.3390/jcm8122109

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  • A randomised controlled trial of a case management approach to encourage participation in colorectal cancer screening for people with schizophrenia in psychiatric outpatient clinics: study protocol for the J-SUPPORT 1901 (ACCESS) study. 国際誌

    Masaki Fujiwara, Masatoshi Inagaki, Taichi Shimazu, Masafumi Kodama, Ryuhei So, Takanori Matsushita, Yusaku Yoshimura, Shigeo Horii, Maiko Fujimori, Hirokazu Takahashi, Naoki Nakaya, Kyoko Kakeda, Tempei Miyaji, Shiro Hinotsu, Keita Harada, Hiroyuki Okada, Yosuke Uchitomi, Norihito Yamada

    BMJ open   9 ( 11 )   e032955   2019年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: One of the reasons for the high mortality rate from cancer in people with schizophrenia is delay in diagnosis. Many studies have shown lower cancer screening rates in people with schizophrenia; however, there are no interventions for people with schizophrenia to increase cancer screening. Therefore, we developed a case management (CM) intervention to encourage participation in cancer screening. The purpose of this study was to examine the efficacy of CM to encourage participation in cancer screening for people with schizophrenia, with particular focus on colorectal cancer screening by faecal occult blood testing, compared with usual intervention (UI), namely, municipal public education. METHODS AND ANALYSIS: This is an individually randomised, parallel group trial with blinded outcome assessments. The participants will be randomly allocated to either the CM plus UI group or UI alone group in a 1:1 ratio using a web-based program at a data management centre. The primary end point of the study is participation in colorectal cancer screening in the year of intervention, which will be assessed based on municipal records. ETHICS AND DISSEMINATION: This study is performed in accordance with Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan's Ministry of Education, Science, and Technology and the Ministry of Health, Labour, and Welfare and the modified Act on the Protection of Personal Information as well as the Declaration of Helsinki. This study was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences and Okayama University Hospital on 23 April 2019 (approval number: RIN1904-003). The findings of this trial will be submitted to an international peer-reviewed journal. TRIAL REGISTRATION NUMBER: UMIN000036017.

    DOI: 10.1136/bmjopen-2019-032955

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  • Berberine improved experimental chronic colitis by regulating interferon-γ- and IL-17A-producing lamina propria CD4+ T cells through AMPK activation. 国際誌

    Masahiro Takahara, Akinobu Takaki, Sakiko Hiraoka, Takuya Adachi, Yasuyuki Shimomura, Hiroshi Matsushita, Tien Thi Thuy Nguyen, Kazuko Koike, Airi Ikeda, Shiho Takashima, Yasushi Yamasaki, Toshihiro Inokuchi, Hideaki Kinugasa, Yusaku Sugihara, Keita Harada, Shingo Eikawa, Hidetoshi Morita, Heiichiro Udono, Hiroyuki Okada

    Scientific reports   9 ( 1 )   11934 - 11934   2019年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The herbal medicine berberine (BBR) has been recently shown to be an AMP-activated protein kinase (AMPK) productive activator with various properties that induce anti-inflammatory responses. We investigated the effects of BBR on the mechanisms of mucosal CD4+T cell activation in vitro and on the inflammatory responses in T cell transfer mouse models of inflammatory bowel disease (IBD). We examined the favorable effects of BBR in vitro, using lamina propria (LP) CD4+ T cells in T cell transfer IBD models in which SCID mice had been injected with CD4+CD45RBhigh T cells. BBR suppressed the frequency of IFN-γ- and Il-17A-producing LP CD4+ T cells. This effect was found to be regulated by AMPK activation possibly induced by oxidative phosphorylation inhibition. We then examined the effects of BBR on the same IBD models in vivo. BBR-fed mice showed AMPK activation in the LPCD4+ T cells and an improvement of colitis. Our study newly showed that the BBR-induced AMPK activation of mucosal CD4+ T cells resulted in an improvement of IBD and underscored the importance of AMPK activity in colonic inflammation.

    DOI: 10.1038/s41598-019-48331-w

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  • Eosinophilic Colitis Showing Multiple Submucosal Tumor-Like Protrusions. 国際誌

    Katsunori Matsueda, Keita Harada, Hiroyuki Okada

    The American journal of gastroenterology   114 ( 5 )   705 - 705   2019年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.14309/ajg.0000000000000065

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  • The novel latex agglutination turbidimetric immunoassay system for simultaneous measurements of calprotectin and hemoglobin in feces. 国際誌

    Sakiko Hiraoka, Shiho Takashima, Toshihiro Inokuchi, Asuka Nakarai, Masahiro Takahara, Keita Harada, Yasuhiro Seki, Katsunori Watanabe, Jun Kato, Hiroyuki Okada

    Intestinal research   17 ( 2 )   202 - 209   2019年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND/AIMS: Fecal calprotectin (Fcal) as well as the fecal immunochemical test (FIT) are useful biomarkers for detecting activity and mucosal healing in inflammatory bowel diseases. Here, we report the performance of simultaneous measurements of Fcal and FIT for ulcerative colitis (UC) patients using the newly-developed latex agglutination turbidimetric immunoassay (LATIA) system. METHODS: Fcal and hemoglobin were measured by the LATIA system in 152 UC patients who underwent colonoscopy. Fcal was also quantified with a conventional enzyme-linked immunosorbent assay (ELISA). Fecal markers were evaluated in conjunction with the mucosal status of UC, which was assessed via the Mayo endoscopic subscore (MES) classification. RESULTS: The LATIA system could quantify calprotectin and hemoglobin simultaneously with the same fecal samples within 10 minutes. The values of the Fcal-LATIA closely correlated with those of the Fcal-ELISA (Spearman rank correlation coefficient, r=0.84; P<0.0001). The values of Fcal for each assay and the FIT all significantly correlated with the MESs (Spearman rank correlation coefficient, Fcal-LATIA: r=0.58, Fcal-ELISA: r=0.55, and FIT: r=0.72). The mucosal healing predictability (determined by an MES of 0 alone) of the Fcal-LATIA, Fcal-ELISA, and FIT-LATIA with the cutoffs determined by receiver operating characteristic curve analysis was 0.79, 0.78, and 0.92 for sensitivity, respectively, and 0.78, 0.69, and 0.73 for specificity, respectively. CONCLUSIONS: The performance of the novel Fcal-LATIA was equivalent to that of the conventional Fcal assay. Simultaneous measurements with FITs would promote the clinical relevance of fecal biomarkers in UC.

    DOI: 10.5217/ir.2018.00086

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  • Comparison of Two Electrosurgical Modes for Endoscopic Submucosal Dissection of Superficial Colorectal Neoplasms: A Prospective Randomized Study.

    Yuusaku Sugihara, Keita Harada, Shohei Oka, Eriko Yasutomi, Yasushi Yamasaki, Toshihiro Inokuchi, Hideaki Kinugasa, Masahiro Takahara, Sakiko Hiraoka, Fumio Otsuka, Hiroyuki Okada

    Acta medica Okayama   73 ( 1 )   81 - 84   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Endoscopic submucosal dissection (ESD) is reportedly one of the standard treatment strategies for large superficial colorectal neoplasms in Japan because of its high en bloc resection rate. A few technical issues regarding ESD should be considered, one of which is the selection of the Endo-cut I mode versus the Swift-coagulation mode as the electrosurgical unit mode setting during submucosal dissection. We seek to determine which of these two modes is more suitable for submucosal dissections of colorectal tumors with regard to procedure time and safety.

    DOI: 10.18926/AMO/56463

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  • Feasibility of Underwater Clip Closure for Large Mucosal Defects after Colorectal Endoscopic Submucosal Dissection. 国際誌

    Yasushi Yamasaki, Keita Harada, Shohei Oka, Shiho Takashima, Toshihiro Inokuchi, Yuusaku Sugihara, Masahiro Takahara, Sakiko Hiraoka, Hiroyuki Okada

    Digestion   99 ( 4 )   327 - 332   2019年

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    記述言語:英語  

    BACKGROUND/AIMS: Clip closure of mucosal defects after colorectal endoscopic submucosal dissection (C-ESD) may decrease the incidence of delayed adverse events. The size of the defect to be closed by conventional clip is limited, however, and we sometimes encounter incomplete closure when the defect is located at the flexure. As, theoretically, underwater clip closure (UCC) could achieve complete closure despite these difficult cases, we investigated its feasibility. METHODS: We retrospectively analyzed 21 patients who underwent UCC after C-ESD. The main outcome was the UCC success rate, defined as complete closure of the defect. Other outcomes were procedure time, number of clips, and the delayed adverse event rate. RESULTS: The median resected specimen size was 31 mm (range 18-47 mm). The UCC success rate was 100%. The median procedure time was only 11 min (range 6-21 min). The median number of clips was 9 (range 5-16). No delayed adverse event occurred. CONCLUSION: It is feasible to use UCC to close large mucosal defects, although further studies are warranted to assess its efficacy.

    DOI: 10.1159/000492815

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  • A Case of Diffuse Esophageal Spasm Treated with Peroral Endoscopic Myotomy.

    Yuusaku Sugihara, Keita Harada, Ryo Kato, Kenji Yamauchi, Hiroyuki Sakae, Seiji Kawano, Sakiko Hiraoka, Yoshiro Kawahara, Fumio Otsuka, Hiroyuki Okada

    Acta medica Okayama   72 ( 6 )   595 - 600   2018年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The indications for peroral endoscopic myotomy (POEM) have been expanded to include diffuse esophageal spasm (DES). A 67-year-old Japanese man presented with a 4-year history of dysphagia. Endoscopy and upper gastrography revealed abnormal peristaltic movements involving interruption of normal peristalsis, and a diverticulum located at the 2 o'clock esophageal position. High-resolution manometry indicated DES. POEM with a long (15 cm) myotomy was performed for the abnormal contractions, which subsequently disappeared along with dysphagia improvement. Our results suggest that esophageal motility disorders accompanying a diverticulum may be eliminated by POEM without treating the diverticulum itself. We speculate that POEM ameliorates esophageal diverticulum by reducing internal esophageal pressure.

    DOI: 10.18926/AMO/56378

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

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

    Internal medicine (Tokyo, Japan)   57 ( 17 )   2501 - 2504   2018年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    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

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  • Traction-assisted endoscopic submucosal dissection for a giant rectal tumor: Multiple clip-and-threads technique. 国際誌

    Yasushi Yamasaki, Keita Harada, Hiroyuki Okada

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   30 ( 5 )   697 - 699   2018年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/den.13204

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  • An Elevated Platelet Count Increases the Risk of Relapse in Ulcerative Colitis Patients with Mucosal Healing. 国際誌

    Asuka Nakarai, Jun Kato, Sakiko Hiraoka, Shiho Takashima, Toshihiro Inokuchi, Masahiro Takahara, Yuusaku Sugihara, Keita Harada, Hiroyuki Okada

    Gut and liver   12 ( 4 )   420 - 425   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background/Aims: Although mucosal healing (MH) has been considered a treatment goal for patients with ulcerative colitis (UC), the risk factors predictive of relapse in patients who achieve MH are unknown. Because the platelet count has been shown to be a marker of inflammation in inflammatory bowel diseases, this study aimed to assess whether the platelet count could predict relapse in UC patients with MH. Methods: A prospective observational study was performed. UC patients with MH were consecutively enrolled in the study and monitored for at least 2 years or until relapse. The correlation between the incidence of relapse and the platelet count at the time of study enrollment was examined. Results: In total, 43 patients were enrolled, and 14 patients (33%) relapsed. The median platelet count at the time of enrollment in the patients who relapsed significantly differed from that in the patients who did not relapse (27.2×10⁴/μL vs 23.8×10⁴/μL, respectively; p=0.016). A platelet count >25.0×10⁴/μL was a significant risk factor for relapse based on a multivariate analysis (hazard ratio, 4.85; 95% confidence interval, 1.07 to 25.28), and according to the Kaplan-Meier analysis, this cutoff could identify patients susceptible to relapse (p=0.041, log-rank test). Conclusions: The platelet count could be used as a predictor of relapse in UC patients with MH.

    DOI: 10.5009/gnl17236

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  • Villous atrophy in the terminal ileum is a specific endoscopic finding correlated with histological evidence and poor prognosis in acute graft-versus-host disease after allo-hematopoietic stem cell transplantation. 国際誌

    Yuusaku Sugihara, Sakiko Hiraoka, Nobuharu Fujii, Shiho Takashima, Yasushi Yamasaki, Toshihiro Inokuchi, Masahiro Takahara, Kenji Kuwaki, Keita Harada, Takehiro Tanaka, Hiroyuki Okada

    BMC gastroenterology   18 ( 1 )   111 - 111   2018年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Graft-versus-host disease (GVHD) is a common complication of allo-hematopoietic stem cell transplantation (allo-HSCT). Endoscopic biopsy can provide a definitive diagnosis, but the optimal endoscopic approach for diagnosis remains uncertain. This study evaluated whether ileocolonoscopic imaging can predict acute GVHD severity after allo-HSCT. METHODS: Consecutive patients who underwent allo-HSCT were referred to our institution, and those diagnosed with acute GVHD by pathology were included in this retrospective study. RESULTS: Fifty-one of 261 patients who underwent ileocolonoscopy were suspected to have acute intestinal GVHD. We performed univariate and multivariate conditional logistic regression with stepwise variable selection; villous atrophy in the terminal ileum remained a statistically significant predictor of GVHD severity (odds ratio, 4.69; 95% confidence interval, 1.07-20.60, P = 0.04). Patients were classified into three groups based on ileal endoscopic findings in the terminal ileum: group S, GVHD with severe villous atrophy; group M, mild atrophy; and group N, no atrophy. Compared with patients in groups M and N, those in group S had significant clinical GVHD at diagnosis (P = 0.03). In group S, three of four, compared with five of 13 patients in groups M and N, required the addition of second-line agents (P = 0.02). CONCLUSIONS: This study showed that severe atrophy of the terminal ileum predicts severe clinical GVHD that is likely to be refractory to steroid treatment. Thus, the severity of terminal ileum atrophy may serve as a tool in predicting clinically severe GVHD. TRIAL REGISTRATION: Trial Registration Number UMIN 000022805 , Registration date July 1, 2016.

    DOI: 10.1186/s12876-018-0829-4

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  • Ten Initial Cases of Peroral Endoscopic Myotomy for Treatment of Esophageal Motility Disorders at Okayama University Hospital.

    Yuusaku Sugihara, Keita Harada, Ryo Kato, Kenji Yamauchi, Shiho Takashima, Daisuke Takei, Yasushi Yamasaki, Toshihiro Inokuchi, Masahiro Takahara, Sakiko Hiraoka, Hiroyuki Okada

    Acta medica Okayama   72 ( 2 )   99 - 104   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Peroral endoscopic myotomy (POEM) for treatment of esophageal motility disorders has recently been reported to be highly effective and less invasive than other treatment. POEM was recently introduced in Okayama University Hospital under the supervision of a physician from a high-volume center. To verify the safety and efficacy of POEM during its introduction in our institution. We examined 10 cases in whom POEM was performed between January 2016 and April 2017. The patients included 7 men and 3 women, with a median age (range) of 49 years (17-74) and median symptom duration of 6 years (1-21). Seven patients had a straight esophagus, and the remaining 3 had a sigmoid esophagus. According to the Chicago classification, 6 patients were diagnosed with type I achalasia, 2 with type II achalasia, and 2 with distal esophagus spasm. Treatment outcomes and adverse events were evaluated. Treatment success was defined as a > 3 decrease in Eckardt score or a score of <3 at the time of discharge. The treatment success rate was 90%, with the average Eckardt score decreasing significantly, from 4.7 to 0.9 (p<0.05). No mucosal perforation, severe infection, mediastinitis, severe bleeding, or gastroesophageal reflux occurred intraoperatively or postoperatively. POEM was introduced to Okayama University Hospital, and the first 10 cases were accomplished safely and effectively under the supervision of an expert physician from a high-volume center.

    DOI: 10.18926/AMO/55849

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  • Fecal Immunochemical Test and Fecal Calprotectin Results Show Different Profiles in Disease Monitoring for Ulcerative Colitis. 国際誌

    Sakiko Hiraoka, Toshihiro Inokuchi, Asuka Nakarai, Shiho Takashima, Daisuke Takei, Yuusaku Sugihara, Masahiro Takahara, Keita Harada, Hiroyuki Okada, Jun Kato

    Gut and liver   12 ( 2 )   142 - 148   2018年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background/Aims: Both fecal immunochemical test (FIT) and fecal calprotectin (Fcal) results are useful biomarkers for ulcerative colitis (UC). However, the situations in which each marker should be used are largely unknown. Methods: A total of 110 colonoscopy intervals of UC patients were assessed, and correlations between changes in colonoscopic findings and changes in the two aforementioned fecal markers were examined. Results: Among patients with mucosal healing (MH) and negative FIT or Fcal results at the initial colonoscopy, FIT and Fcal findings exhibited accuracies of 93% (38/41) and 79% (26/33), respectively, for predicting the results of the subsequent examination. Among the 24 patients who showed endoscopic activity at the precedent colonoscopy and MH at the subsequent examination, positive-to-negative conversion of FIT and Fcal findings at the subsequent examination was observed in 92% (12/13) and 62% (8/13) of patients, respectively. Among the 43 patients who showed endoscopic activity at both the precedent and subsequent examinations, Fcal findings reflected the change in endoscopic activity better than FIT results (r=0.59, p<0.0001 vs r=0.30, p=0.054). Conclusions: The FIT is useful for confirming MH and the occurrence of relapse. In contrast, Fcal is useful for monitoring the mucosal status of patients with active inflammation.

    DOI: 10.5009/gnl17013

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  • Colonoscopy examination requires a longer time in patients with acromegaly than in other individuals.

    Masaya Iwamuro, Miho Yasuda, Kou Hasegawa, Satoshi Fujisawa, Kanako Ogura-Ochi, Yuusaku Sugihara, Keita Harada, Sakiko Hiraoka, Hiroyuki Okada, Fumio Otsuka

    Endocrine journal   65 ( 2 )   151 - 157   2018年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    This study aimed to determine the prevalence of colorectal neoplasms and to investigate the rate of and time required for cecal intubation in patients with acromegaly. A database search performed at our institution identified 29 patients with acromegaly who underwent colonoscopy. Data regarding the endoscopic, biological, and pathological examinations performed were retrospectively reviewed from the clinical records. Subsequently, the rate of and time required for cecal intubation were investigated in 23 patients with acromegaly and compared with the corresponding data of the control group. Control subjects were selected from a 2:1 matched historical control cohort, according to baseline characteristics. The mean age of the acromegaly group (17 female and 12 male) was 60.4 ± 12.6 years. Twelve patients had adenoma (41.4%), eight patients had hyperplastic polyps (27.6%), three patients had sessile serrated adenoma/polyps (10.3%), and three patients had colon cancer (10.3%). Successful cecal intubation was achieved in all patients in both groups. The difference in the time required for successful intubation between the acromegaly group (15.7 ± 9.8 minutes) and the control group (8.7 ± 6.0 minutes) was statistically significant. Linear regression analysis revealed that increased patient age was significantly related to longer colonoscope insertion times. In conclusion, although cecal intubation during colonoscopy was successful in all participants, it required a longer time in patients with acromegaly. Our results underscore the importance of and certain technical difficulties involved in colonoscopy procedures in patients with acromegaly, especially in older patients.

    DOI: 10.1507/endocrj.EJ17-0322

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  • Simultaneous Measurements of Faecal Calprotectin and the Faecal Immunochemical Test in Quiescent Ulcerative Colitis Patients Can Stratify Risk of Relapse. 国際誌

    Asuka Nakarai, Sakiko Hiraoka, Sakuma Takahashi, Tomoki Inaba, Reiji Higashi, Motowo Mizuno, Shiho Takashima, Toshihiro Inokuchi, Yuusaku Sugihara, Masahiro Takahara, Keita Harada, Jun Kato, Hiroyuki Okada

    Journal of Crohn's & colitis   12 ( 1 )   71 - 76   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Both faecal calprotectin [Fcal] and the faecal immunochemical test [FIT] are useful to predict clinical relapse of ulcerative colitis [UC]. However, the difference between Fcal and FIT in ability to predict relapse has scarcely been reported. Whether the combined use of these two faecal markers increases the predictability is also unknown. Methods: UC patients in clinical remission who underwent colonoscopy were enrolled prospectively, and the Fcal and FIT values were examined at enrolment. Their clinical course was observed for 2 years or until relapse. The correlation between the incidence of relapse and the values of the two markers was examined. Results: A total of 113 patients were enrolled, and 48 [42%] relapsed. Fcal ≥ 75 μg/g and FIT ≥ 110 ng/mL were defined as Fcal-positive and FIT-positive, respectively, according to the receiver operating characteristic curves. Both Fcal-positive and FIT-positive statuses were independent predictive factors of clinical relapse (hazard ratio [HR] 2.29; 95% confidence interval [CI], 1.23-4.49; p = 0.0086, and HR 2.91; 95% CI, 1.49-5.50; p = 0.0022, respectively). Categorisation of patients into three groups according to the faecal marker status [FIT-positive, FIT-negative and Fcal-positive, and both negative] can efficiently stratify the risk of relapse with graded increases in risk [FIT-negative and Fcal-positive: HR 2.05; 95% CI, 1.02-4.43; p = 0.0045, and FIT-positive: HR 5.43; 95% CI, 2.57-11.76; p < 0.0001, compared with both negative]. Conclusions: Fcal vs FIT showed distinct properties regarding the prediction of relapse in UC. A risk assessment using both faecal markers could increase the predictability for relapse.

    DOI: 10.1093/ecco-jcc/jjx118

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  • Efficacy of restarting anti-tumor necrosis factor α agents after surgery in patients with Crohn's disease. 国際誌

    Sakiko Hiraoka, Shiho Takashima, Yoshitaka Kondo, Toshihiro Inokuchi, Yuusaku Sugihara, Masahiro Takahara, Seiji Kawano, Keita Harada, Jun Kato, Hiroyuki Okada

    Intestinal research   16 ( 1 )   75 - 82   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background/Aims: The efficacy of anti-tumor necrosis factor α (anti-TNFα) antibodies for postoperative Crohn's disease (CD) in patients who were treated with these agents prior to surgery is largely unknown. Methods: CD patients who underwent intestinal resection and received anti-TNFα agents after surgery were divided into 2 groups according to the presence or absence of preoperative anti-TNFα treatment: anti-TNFα restart group or anti-TNFα naïve group. Endoscopic recurrence after surgery was examined according to the preoperative conditions, including administration of anti-TNFα agents before surgery. Results: Thirty-six patients received anti-TNFα antibody after surgery: 22 in the anti-TNFα restart group and 14 in the anti-TNFα naïve group. Endoscopic recurrence after surgery was more frequently observed in the anti-TNFα restart group than in the anti-TNFα naïve group (68% vs. 14%, P<0.001). Multivariate analysis revealed the following significant risk factors of endoscopic recurrence after surgery: anti-TNF restart group (odds ratio [OR], 28.10; 95% CI, 3.08-722.00), age at diagnosis <23 years (OR, 24.30; 95% CI, 1.67-1,312.00), serum albumin concentration at surgery <3.3 g/dL (OR, 34.10; 95% CI, 1.72-2,804.00), and presence of inflammation outside of the surgical site (OR, 21.40; 95% CI, 1.02-2,150.00). Treatment intensification for patients with endoscopic recurrence in the anti-TNFα restart group showed limited responses, with only 1 of 12 patients achieving endoscopic remission. Conclusions: The efficacy of restarting anti-TNFα antibody treatment after surgery was limited, and treatment intensification or a change to different classes of biologics should be considered for those patients.

    DOI: 10.5217/ir.2018.16.1.75

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  • Two Cases of Leiomyoma in the Colon Masquerading as Other Types of Colonic Pedunculated Polyps. 国際誌

    Ailee Ikeda, Masaya Iwamuro, Takehiro Tanaka, Toshihiro Inokuchi, Asuka Nakarai, Yuusaku Sugihara, Keita Harada, Sakiko Hiraoka, Yoshiro Kawahara, Hiroyuki Okada

    Case reports in gastrointestinal medicine   2018   8272313 - 8272313   2018年

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    記述言語:英語  

    We describe two cases of leiomyoma in the colon that were diagnosed histologically after endoscopic resection. The first case was a 79-year-old Japanese woman who presented with a pedunculated polyp of 14 mm length at the splenic flexure. Preoperative diagnosis suggested a colonic mucosubmucosal elongated polyp. The second case was a 29-year-old Japanese woman who presented with a pedunculated polyp of 40 mm length at the hepatic flexure and had an ulcer on top of the polyp. Preoperative diagnosis suggested an inflammatory fibroid polyp. A pathological diagnosis of colonic leiomyoma was made after endoscopic resection in both cases. Both tumors were confirmed to originate, not from the proper muscle layer, but from the muscularis mucosae. These cases underscore that although colonic involvement is infrequent, leiomyomas can display pedunculated morphology in the colon rather than the typical gross appearance of gastrointestinal submucosal tumors seen with sessile morphology.

    DOI: 10.1155/2018/8272313

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  • Metachronous Neoplasia and Local Recurrence after Colorectal Endoscopic Submucosal Dissection.

    Daisuke Takei, Keita Harada, Shiho Takashima, Toshihiro Inokuchi, Asuka Nakarai, Yusaku Sugihara, Masanobu Takahara, Sakiko Hiraoka, Hiroyuki Okada

    Acta medica Okayama   71 ( 6 )   475 - 483   2017年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Several reports discussed colonoscopic surveillance after polypectomy and endoscopic mucosal resection (EMR) for colorectal polyps, but only a few reports focused on prognostic analyses, and none involved metachronous neoplasia after colorectal endoscopic submucosal dissection (ESD). We conducted the present study to assess the risk of adenoma recurrence requiring endoscopic treatment, and to establish appropriate post-ESD colonoscopic surveillance. We enrolled 116 patients who had undergone colorectal ESD at Okayama University Hospital between February 2008 and July 2014 and had been followed-up >12 months. We retrospectively analyzed clinicopathological features of 101 lesions from 101 patients. Metachronous adenomas were detected in 21 cases (20.8%). We divided the patients into 2 groups according to the occurrence of metachronous adenomas. Our comparison of clinicopathological characteristics between these groups showed that in the metachronous adenomas group the number of synchronous adenomas at index colonoscopy was high and the rate of laterally spreading tumor-nongranular (LST-NG) was higher. A multivariate analysis indicated that the number of synchronous adenomas was significantly associated with metachronous adenomas (HR: 2.54, 95%CI: 1.04-6.52, p<0.05). The colonoscopic surveillance planning after colorectal ESD should be more meticulous for patients with more synchronous adenomas.

    DOI: 10.18926/AMO/55584

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  • Findings of Retrograde Contrast Study Through Double-balloon Enteroscopy Predict the Risk of Bowel Resections in Patients with Crohn's Disease with Small Bowel Stenosis. 国際誌

    Noriko Okazaki, Toshihiro Inokuchi, Sakiko Hiraoka, Masayasu Ohmori, Shiho Takashima, Daisuke Takei, Yuusaku Sugihara, Masahiro Takahara, Keita Harada, Seiji Kawano, Hiroyuki Okada, Jun Kato

    Inflammatory bowel diseases   23 ( 12 )   2097 - 2103   2017年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Patients with Crohn's disease (CD) with small bowel strictures are at risk of surgery. Double-balloon enteroscopy (DBE) can evaluate the status of the small intestine, and retrograde contrast through the scope enables the surgeon to obtain information beyond the reach of the scope. This study aimed to examine whether a retrograde contrast study through DBE could be used as a predictor of subsequent surgery in patients with CD with small intestinal strictures. METHODS: The findings of DBE with retrograde contrast in 48 patients CD with small bowel strictures were examined. RESULTS: Of the 48 patients, 14 (29%) underwent surgery for small intestinal strictures during a median observation period of 2.4 years (interquartile range: 1.4-3.7 yr). According to the results of the multivariate analysis, a maximum length of strictures ≥20 mm and the ratio of the maximum diameter of prestenotic dilations to the diameter of the normal small intestine ≥1.4 were independent risk factors of surgery for small intestinal strictures (risk ratio = 7.6 [95% confidence interval, 1.8-42.0], P = 0.006; and risk ratio = 52.0 [95% confidence interval, 3.5-2485.1], P = 0.002, respectively). The latter predicted subsequent surgery with 92% sensitivity and 88% specificity. Cumulative surgery-free rates were discriminated significantly according to the presence or absence of these 2 risk factors (log-rank test: P < 0.001). CONCLUSIONS: Findings of retrograde contrast through DBE are helpful to predict risk of surgery in patients with CD with small intestinal strictures.

    DOI: 10.1097/MIB.0000000000001175

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  • Traction-assisted colorectal endoscopic submucosal dissection using the Mucosectom2 device. 国際誌

    Yasushi Yamasaki, Keita Harada, Hiroyuki Okada

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   29 ( 7 )   815 - 816   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1111/den.12919

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  • Two electrosurgical endo-knives for endoscopic submucosal dissection of colorectal superficial neoplasms: a prospective randomized study. 国際誌

    Yuusaku Sugihara, Keita Harada, Yoshiro Kawahara, Daisuke Takei, Shiho Takashima, Toshihiro Inokuchi, Asuka Nakarai, Masahiro Takahara, Kenji Kuwaki, Sakiko Hiraoka, Hiroyuki Okada

    Endoscopy international open   5 ( 8 )   E729-E735   2017年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND STUDY AIMS : Few studies have directly compared endo-knives for endoscopic submucosal dissection (ESD) in humans. We compared the performances of the Mucosectom2 and SB knife Jr. PATIENTS AND METHODS:  Two trainee endoscopists performed ESD of 36 lesions in this prospective, randomized controlled trial. Mucosal incision with a 1.5-mm Dual knife and submucosal dissection using the Mucosectom2 were performed in 1 group. Mucosal incision with a 1.5-mm Dual knife and submucosal dissection with a SB knife Jr. were performed in the other group. The primary outcome was the ESD procedure time. Secondary outcomes were total procedure time, self-completion rates, and adverse events. RESULTS : ESD time in Mucosectom2 patients was not significantly shorter than in SB knife Jr. patients (57 ± 32 min vs. 61 ± 44 min, respectively; P  = 0.94). Total procedure time in Mucosectom2 patients was not significantly shorter than in SB knife Jr. patients (81 ± 42 min vs. 82 ± 51 min, respectively; P =  0.85). The trainee self-completion rate was slightly higher in SB knife Jr. patients than in Mucosectom2 patients, although the difference was not significant (94 % vs. 100 %, respectively; P  = 0.959). Fewer hemostatic procedures using the Coagrasper were performed in Mucosectom2 patients than in SB knife Jr. patients, although the difference was not significant (0.62 vs. 0.7, respectively; P  = 0.432). CONCLUSIONS:  Mucosectom2 and SB knife Jr. did not significantly differ in performance for colorectal ESD to safely and reliably enhance ESD. Knife selection is not as important for learning colorectal ESD as patient- and lesion-related factors.

    DOI: 10.1055/s-0043-111792

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  • Two Cases of Rectal Xanthoma Presenting as Yellowish to Whitish Lesions during Colonoscopy. 国際誌

    Masaya Iwamuro, Takehiro Tanaka, Daisuke Takei, Yuusaku Sugihara, Keita Harada, Sakiko Hiraoka, Yoshiro Kawahara, Hiroyuki Okada

    Case reports in gastrointestinal medicine   2017   5975107 - 5975107   2017年

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    記述言語:英語  

    Two cases of rectal xanthomas are described. One case is that of a 56-year-old Japanese man in whom multiple yellowish spots measuring approximately 3 to 5 mm were observed in the rectum during colonoscopy. The other case is that of a 78-year-old Japanese man in whom colonoscopy showed a whitish plaque of 4 mm in diameter in the rectum. Biopsy examinations performed on both patients revealed the deposition of xanthoma cells within the rectal mucosa. Within the gastrointestinal tract, xanthomas most frequently arise in the stomach, whereas the colorectum is rarely affected. Despite this infrequency, the two cases indicate that xanthomas should be recalled when yellowish to whitish lesions are observed in the colorectum.

    DOI: 10.1155/2017/5975107

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  • Ulcerative colitis patients in clinical remission demonstrate correlations between fecal immunochemical test results, mucosal healing, and risk of relapse. 国際誌

    Asuka Nakarai, Jun Kato, Sakiko Hiraoka, Shiho Takashima, Daisuke Takei, Toshihiro Inokuchi, Yuusaku Sugihara, Masahiro Takahara, Keita Harada, Hiroyuki Okada

    World journal of gastroenterology   22 ( 21 )   5079 - 87   2016年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: To assess the risk of relapse in ulcerative colitis (UC) patients in clinical remission using mucosal status and fecal immunochemical test (FIT) results. METHODS: The clinical outcomes of 194 UC patients in clinical remission who underwent colonoscopy were based on evaluations of Mayo endoscopic subscores (MESs) and FIT results. RESULTS: Patients with an MES of 0 (n = 94, 48%) showed a ten-fold lower risk of relapse than those with an MES of 1-3 (n = 100, 52%) (HR = 0.10, 95%CI: 0.05-0.19). A negative FIT result (fecal hemoglobin concentrations ≤ 100 ng/mL) was predictive of patients with an MES of 0, with a sensitivity of 0.94 and a specific of 0.76. Moreover, patients with a negative FIT score had a six-fold lower risk of clinical relapse than those with a positive score (HR = 0.17, 95%CI: 0.10-0.28). Inclusion of the distinguishing parameter, sustaining clinical remission > 12 mo, resulted in an even stronger correlation between negative FIT results and an MES of 0 with respect to the risk of clinical relapse (HR = 0.11, 95%CI: 0.04-0.23). CONCLUSION: Negative FIT results one year or more after remission induction correlate with complete mucosal healing (MES 0) and better prognosis. Performing FIT one year after remission induction may be useful for evaluating relapse risk.

    DOI: 10.3748/wjg.v22.i21.5079

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  • Consecutive Measurements by Faecal Immunochemical Test in Quiescent Ulcerative Colitis Patients Can Detect Clinical Relapse. 国際誌

    Sakiko Hiraoka, Jun Kato, Asuka Nakarai, Shiho Takashima, Toshihiro Inokuchi, Daisuke Takei, Yuusaku Sugihara, Masahiro Takahara, Keita Harada, Hiroyuki Okada

    Journal of Crohn's & colitis   10 ( 6 )   687 - 94   2016年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: We have reported that results of the quantitative faecal immunochemical test (FIT; haemoglobin concentrations in faeces measured using an antibody for human haemoglobin) effectively reflect the mucosal status of ulcerative colitis (UC). The aim of this study was to evaluate the predictability of flare-up in quiescent UC patients by consecutive FIT evaluation. METHODS: Patients with UC who fulfilled the following criteria by index colonoscopy were enrolled: clinical remission; mucosal healing (Mayo endoscopic subscore 0); and negative FIT (less than 100ng/mL). These patients were followed up prospectively every 1-3 months by monitoring patient symptoms and FIT results between index and subsequent colonoscopies. RESULTS: The intervals between 2 colonoscopies (median 2.51 years) of 83 patients (49 males, median age at onset 34 years, median disease duration 9.74 years) were analysed. None of the 43 (52%) patients who maintained negative FIT throughout the observation period exhibited clinical relapse. On the other hand, 25/40 (63%) patients who showed positive conversion of FIT during the period experienced relapse. The cutoff FIT value of 450ng/mL could predict relapse with 73% positive predictive value and 96% negative predictive value. Moreover, positive conversion of FIT preceded occurrence of symptoms by 1 month or more in nearly one-third of patients with relapse. CONCLUSIONS: Consecutive measurements of FIT in quiescent UC patients who achieved mucosal healing with negative FIT would help identify patients with clinical relapse whose symptoms had not yet presented. Further investigations are required for more precise prediction of relapse with this modality.

    DOI: 10.1093/ecco-jcc/jjw025

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  • Fecal Immunochemical Test Versus Fecal Calprotectin for Prediction of Mucosal Healing in Crohn's Disease. 国際誌

    Toshihiro Inokuchi, Jun Kato, Sakiko Hiraoka, Shiho Takashima, Asuka Nakarai, Daisuke Takei, Yuusaku Sugihara, Masahiro Takahara, Seiji Kawano, Keita Harada, Hiroyuki Okada

    Inflammatory bowel diseases   22 ( 5 )   1078 - 85   2016年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Mucosal healing (MH) has been proposed as a treatment goal of inflammatory bowel disease patients. We reported recently that not only fecal calprotectin (Fcal) but also the fecal immunochemical test (FIT) can predict MH in ulcerative colitis. However, the predictive power of the fecal markers for MH in Crohn's disease (CD), particularly with small bowel lesions, has not been reported in detail. The aim of this study was to evaluate the predictability of FIT versus Fcal for MH in CD. METHODS: Consecutive CD patients underwent colonoscopy or balloon-assisted enteroscopy according to the disease location. FIT and Fcal were examined using stool samples collected the day before endoscopy. RESULTS: Seventy-one CD patients were analyzed, of whom 42 (59%) underwent balloon-assisted enteroscopy because of the presence of affected lesions in the small intestine. Both the Fcal and the FIT results were significantly correlated with endoscopic activity (r = 0.67 and 0.54, respectively). However, the FIT results did not correlate with the activity in patients with small bowel lesions alone, whereas Fcal did (r = 0.42 versus 0.78). Fcal predicted MH in CD with 87% sensitivity and 71% specificity, whereas the values for FIT were 96% and 48%, respectively. The specificity for MH among patients with small bowel lesions alone was low for FIT (40%) compared with Fcal (80%). CONCLUSIONS: Both FIT and Fcal were correlated with the mucosal status of CD. However, the specificity of FIT was not satisfactory, particularly for small bowel lesions.

    DOI: 10.1097/MIB.0000000000000728

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  • Evaluation of Mucosal Healing in Ulcerative Colitis by Fecal Calprotectin Vs. Fecal Immunochemical Test. 国際誌

    Shiho Takashima, Jun Kato, Sakiko Hiraoka, Asuka Nakarai, Daisuke Takei, Toshihiro Inokuchi, Yuusaku Sugihara, Masahiro Takahara, Keita Harada, Hiroyuki Okada, Takehiro Tanaka, Kazuhide Yamamoto

    The American journal of gastroenterology   110 ( 6 )   873 - 80   2015年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: We previously showed that a quantitative fecal immunochemical test (FIT) can predict mucosal healing (MH) in ulcerative colitis (UC). Fecal calprotectin (Fcal) has also been reported as an important biomarker of UC activity. The aim of this study was to compare the predictive ability of these two fecal markers for MH in UC. METHODS: FIT and Fcal were examined in stool samples from consecutive UC patients who underwent colonoscopy. Mucosal status was assessed via the Mayo endoscopic subscore (MES). RESULTS: In total, 105 colonoscopies in 92 UC patients were evaluated in conjunction with the FIT and Fcal results. Both FIT and Fcal results were significantly correlated with MES (Spearman's rank correlation coefficient: 0.61 and 0.58, respectively). The sensitivity and specificity of the FIT values (<100 ng/ml) for predicting MH (MES 0 alone) were 0.95 and 0.62, respectively, whereas those of Fcal (<250 μg/g) were 0.82 and 0.62, respectively. The sensitivities became similar when MH was defined as MES 0 or 1 (0.86 vs. 0.86). Although the predictability of MH evaluated by the area under the receiver operating characteristics curve was similar for the two fecal markers (FIT 0.83 vs. Fcal 0.82 for MES 0 alone), the FIT results were relatively robust regardless of the cutoff value selected. CONCLUSIONS: Both FIT and Fcal can efficiently predict MH in UC, but FIT appears to be more sensitive than Fcal for predicting MES 0 alone.

    DOI: 10.1038/ajg.2015.66

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  • Prospective evaluation of endoscopic criteria characteristic of sessile serrated adenomas/polyps.

    Toshio Uraoka, Reiji Higashi, Joichiro Horii, Keita Harada, Keisuke Hori, Hiroyuki Okada, Motowo Mizuno, Jun Tomoda, Nobuya Ohara, Takehiro Tanaka, Han-Mo Chiu, Naohisa Yahagi, Kazuhide Yamamoto

    Journal of gastroenterology   50 ( 5 )   555 - 63   2015年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Differentiating sessile serrated adenoma/polyp (SSA/P) from hyperplastic polyp (HP) is clinically important in determining the necessity of endoscopic resection or recommending appropriate surveillance. There are few reports of characterization of SSA/P using narrowband imaging and chromoendoscopy with and without magnification. We aimed to establish imaging criteria to aid real-time diagnosis of SSA/P. METHODS: Patients with pale sessile or flat lesions of 6 mm or greater were prospectively enrolled in this multicenter trial. Nine endoscopic criteria, determined in real time, were investigated for possible association with SSA/P. Endoscopic mucosal resection was performed; specimens were retrieved and analyzed by histopathological examination. RESULTS: In 63 patients, 89 lesions were detected, including 41 HP, 38 SSA/P, five mixed polyps, and five other lesions. Right-side colon location, lesion size of 10 mm or greater, excessive mucus, the presence of a varicose microvascular vessel (VMV) noted with high-magnification narrowband imaging, and type III(H) pit pattern were each commonly associated with SSA/P compared with HP. Multivariate analysis substantiated three independent endoscopic criteria for SSA/P: the presence of VMV (p = 0.001), lesion size of 10 mm or greater (p = 0.0017), and right-side location (p = 0.0041), with odds ratios of 8.2, 7.2, and 6.1, respectively. The presence of VMV had a significantly higher specificity (87.8%) than the other two independent endoscopic criteria (p = 0.0007 and p = 0.0008, respectively), but a lower sensitivity (57.9%), whereas a combination of the three criteria (two or more positive) increased the sensitivity significantly (89.5% and p = 0.0033) and had a higher degree of accuracy (82.3%). CONCLUSIONS: Three endoscopic criteria individually and in combination were effective in predicting a diagnosis of SSA/P without the need for chromoendoscopy.

    DOI: 10.1007/s00535-014-0999-y

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  • The earliest trough concentration predicts the dose of tacrolimus required for remission induction therapy in ulcerative colitis patients. 国際誌

    Sakiko Hiraoka, Jun Kato, Yuki Moritou, Daisuke Takei, Toshihiro Inokuchi, Asuka Nakarai, Sakuma Takahashi, Keita Harada, Hiroyuki Okada, Kazuhide Yamamoto

    BMC gastroenterology   15   53 - 53   2015年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Oral tacrolimus therapy is effective for refractory ulcerative colitis (UC), but dose adjustment according to the trough concentrations which varies largely among individuals, is required. This study aimed to identify factors to predict the tacrolimus dose required for achieving the target trough level for remission induction of UC. METHODS: Forty-seven consecutive UC patients who were treated with tacrolimus were retrospectively analyzed. Tacrolimus doses were adjusted every 2 or 3 days to achieve trough concentrations of 10-15 ng/mL. The dose required for reaching the target trough level was analyzed based on disease characteristics, course of trough concentrations, and gene polymorphism related to tacrolimus metabolism. RESULTS: Median daily dose of tacrolimus required for achieving the target trough level was 0.19 (0.07-0.42) mg/kg, and patients were divided into high or low dose group (< 0.2 mg/kg or > 0.2 mg/kg). The value of initial trough concentration/starting dose was higher in the low dose group than in the high dose group (1.35 ng/mL/mg vs. 0.78 ng/mL/mg, p < 0.0001). Although presence of CYP3A5 *1 was more frequently observed in the high dose group, initial trough concentration was the only significant factor for determining requirement of high dose of tacrolimus (OR = 28.0, 95% confidence interval 3.20 - 631). CONCLUSIONS: The most practical predictor of the dose required for achieving the target trough concentration was the trough concentration measured 2 or 3 days after starting tacrolimus therapy. Our findings would make tarcolimus administration for UC safer, easier and more effective.

    DOI: 10.1186/s12876-015-0285-3

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  • An effective and safe sedation technique combining target-controlled infusion pump with propofol, intravenous pentazocine, and bispectral index monitoring for peroral double-balloon endoscopy. 国際誌

    Seiji Kawano, Hiroyuki Okada, Masaya Iwamuro, Yoshiyasu Kouno, Kou Miura, Toshihiro Inokuchi, Hiromitsu Kanzaki, Keisuke Hori, Keita Harada, Sakiko Hiraoka, Yoshiro Kawahara, Kazuhide Yamamoto

    Digestion   91 ( 2 )   112 - 6   2015年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND/AIMS: Because peroral double-balloon endoscopy (DBE) is a time-consuming, painful procedure, sedation with analgesics, and/or anesthetics is generally required. The aim of this prospective study was to investigate the safety and efficacy of our sedation protocol for peroral DBE, which consisted of target-controlled infusion (TCI) anesthesia with propofol, an intravenous bolus of pentazocine, and bispectral index (BIS) monitoring. METHODS: A total of 34 consecutive patients who underwent DBE by the oral approach were enrolled. Patients were primarily sedated with a continuous infusion of propofol and adjusted in accordance with the BIS levels. The bolus infusion of pentazocine was performed when the propofol infusion was insufficient. The primary outcome measure of this study was to ensure the safety and efficacy of this sedation technique. The secondary purpose was to identify the characteristics of the patient who required the bolus infusion of pentazocine. RESULTS: Five patients (14.7%) required a reduction in the dose of propofol. However, no patient experienced any serious adverse events. All patients (100%) and 80.6% (25/31) of endoscopists answered that the sedation protocol was 'excellent' or 'enough' for peroral DBE. Eleven patients (32.3%) required a bolus injection of pentazocine. Age <60 years and a total procedure time of >70 min were significant risk-factors for pentazocine use. CONCLUSIONS: A combination of propofol via TCI pump, bolus injection of pentazocine as needed, and BIS monitoring was a safe and effective procedure for peroral DBE. Reasonable satisfaction indices were obtained from both patients and endoscopists. Pentazocine was required for young patients and in cases with longer procedure times.

    DOI: 10.1159/000369614

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  • Endoscopic radial incision and cutting method for refractory stricture of a rectal anastomosis after surgery. 国際誌

    Keita Harada, Seiji Kawano, Sakiko Hiraoka, Yoshiro Kawahara, Yoshitaka Kondo, Hiroyuki Okada

    Endoscopy   47 Suppl 1   E552-3   2015年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1055/s-0034-1392861

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  • Prognosis of ulcerative colitis differs between patients with complete and partial mucosal healing, which can be predicted from the platelet count. 国際誌

    Asuka Nakarai, Jun Kato, Sakiko Hiraoka, Toshihiro Inokuchi, Daisuke Takei, Yuki Moritou, Mitsuhiro Akita, Sakuma Takahashi, Keisuke Hori, Keita Harada, Hiroyuki Okada, Kazuhide Yamamoto

    World journal of gastroenterology   20 ( 48 )   18367 - 74   2014年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: To determine the difference in clinical outcome between ulcerative colitis (UC) patients with Mayo endoscopic subscore (MES) 0 and those with MES 1. METHODS: UC patients with sustained clinical remission of 6 mo or more at the time of colonoscopy were examined for clinical outcomes and the hazard ratios of clinical relapse according to MES. Parameters, including blood tests, to identify predictive factors for MES 0 and slight endoscopic recurrence in clinically stable patients were assessed. Moreover, a receiver operating characteristic curve was generated, and the area under the curve was calculated to indicate the utility of the parameters for the division between complete and partial mucosal healing. All P values were two-sided and considered significant when less than 0.05. RESULTS: A total of 183 patients with clinical remission were examined. Patients with MES 0 (complete mucosal healing: n = 80, 44%) were much less likely to relapse than those with MES 1 (partial mucosal healing: n = 89, 48%) (P < 0.0001, log-rank test), and the hazard ratio of risk of relapse in patients with MES 1 vs MES 0 was 8.17 (95%CI: 4.19-17.96, P < 0.0001). The platelet count (PLT) < 26 × 10(4)/μL was an independent predictive factor for complete mucosal healing (OR = 4.1, 95%CI: 2.15-7.99). Among patients with MES 0 at the initial colonoscopy, patients of whom colonoscopy findings shifted to MES 1 showed significant increases in PLT compared to those who maintained MES 0 (3.8 × 10(4)/μL vs -0.6 × 10(4)/μL, P < 0.0001). CONCLUSION: The relapse rate differed greatly between patients with complete and partial mucosal healing. A shift from complete to partial healing in clinically stable UC patients can be predicted by monitoring PLT.

    DOI: 10.3748/wjg.v20.i48.18367

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  • Predictive factors for technically difficult endoscopic submucosal dissection in the colorectum. 国際誌

    Keisuke Hori, Toshio Uraoka, Keita Harada, Reiji Higashi, Yoshiro Kawahara, Hiroyuki Okada, Hemchand Ramberan, Naohisa Yahagi, Kazuhide Yamamoto

    Endoscopy   46 ( 10 )   862 - 70   2014年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND STUDY AIMS: Because of technical difficulty, colorectal endoscopic submucosal dissection (CR-ESD) is not widely performed. We aimed to determine risk factors for such technical difficulty as defined by long procedure duration (≥  150 min), perforation, and piecemeal resection. PATIENTS AND METHODS: Patients with consecutive colorectal tumors treated with ESD between April 2006 and December 2010 were enrolled in a prospective cohort study. For prediction of technical difficulty, three types of factor were investigated: tumor location, tumor type, and colonoscopy-related. Cases were subsequently categorized into earlier and later periods (April 2006 - August 2008, 123 lesions; September 2008 - December 2010, 124 lesions). Variables were analyzed using multiple logistic regression, with subgroup analyses for each period. RESULTS: 247 lesions were analyzed. Flexure location was an independent risk factor for technical difficulty as measured by longer procedure duration (odds ratio [OR] 4.1, 95 % confidence interval [95 %CI] 1.1 - 14.9), piecemeal resection (4.7, 1.1 - 17.2), or perforation (8.8, 1.1 - 56.8). Tumor with scarring or locally recurrent was a risk factor for longer procedure duration (4.7, 1.7 - 13.7), and for piecemeal resection (7.8, 2.4 - 25.0). Tumor of size  ≥  50 mm or spreading across ≥  2 folds was the strongest independent risk factor for longer duration (6.3, 2.8 - 15.4), and was an independent risk factor for longer duration in both time periods (earlier, 3.3, 1.1 - 10.4; later, 27.4, 7.4 - 138.0). Flexure location was an independent risk factor for perforation (13.9, 1.5 - 129.1) and for piecemeal resection (5.1, 0.9 - 25.2) in the earlier but not the later period. CONCLUSIONS: Factors predicting technical difficulty of CR-ESDs were clarified. Their importance was influenced by the increasing experience of the endoscopist.

    DOI: 10.1055/s-0034-1377205

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  • Long-term follow-up of ulcerative colitis patients treated on the basis of their cytomegalovirus antigen status. 国際誌

    Toshihiro Inokuchi, Jun Kato, Sakiko Hiraoka, Hideyuki Suzuki, Asuka Nakarai, Tomoko Hirakawa, Mitsuhiro Akita, Sakuma Takahashi, Keita Harada, Hiroyuki Okada, Kazuhide Yamamoto

    World journal of gastroenterology   20 ( 2 )   509 - 17   2014年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: To clarify the impact of cytomegalovirus (CMV) activation and antiviral therapy based on CMV antigen status on the long-term clinical course of ulcerative colitis (UC) patients. METHODS: UC patients with flare-up were divided into CMV-positive and -negative groups according to the CMV antigenemia assay. The main treatment strategy provided for the patients in the CMV-positive group comprised a dose reduction of corticosteroids and administration of ganciclovir. RESULTS: The median number of days to initial remission was significantly greater for the patients in the CMV-positive group (21 d vs 16 d, P = 0.009). However, the relapse rate after remission and colectomy rate during more than 30 mo of observation did not differ between the two groups. Multivariate analysis revealed that administration of ganciclovir was the only independent factor for avoiding colectomy in patients of the CMV-positive group. CONCLUSION: CMV antigen status did not significantly affect the long-term prognosis in UC patients under treatment with appropriate antiviral therapy.

    DOI: 10.3748/wjg.v20.i2.509

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  • Slight increases in the disease activity index and platelet count imply the presence of active intestinal lesions in C-reactive protein-negative Crohn's disease patients.

    Asuka Nakarai, Jun Kato, Sakiko Hiraoka, Toshihiro Inokuchi, Daisuke Takei, Yuki Morito, Mitsuhiro Akita, Sakuma Takahashi, Keisuke Hori, Keita Harada, Hiroyuki Okada, Kazuhide Yamamoto

    Internal medicine (Tokyo, Japan)   53 ( 17 )   1905 - 11   2014年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Although the serum C-reactive protein (CRP) level may, to some extent, predict the disease activity in patients with Crohn's disease (CD), it is not always elevated during periods of disease activity. This study aimed to identify factors predicting the presence of active intestinal lesions in CD patients without an elevated CRP level. METHODS: CD patients in whom the presence or absence of active intestinal lesions was evaluated using endoscopic and/or radiologic modalities were divided into two groups based on a negative (<3 mg/L) or positive (≥3 mg/L) CRP level. The correlations between the presence of active intestinal lesions and various clinical variables, including the Crohn's Disease Activity Index (CDAI), leukocyte and platelet counts and hemoglobin, serum albumin and CRP levels, were determined in the CRP-negative patients. RESULTS: Of the 128 patients examined, 70 had a negative CRP status, approximately half of whom had active intestinal lesions. The multivariate analysis revealed a CDAI of >100 and platelet count of >33×10(4)/μL to be significant predictive factors for the presence of active lesions in the CRP-negative patients [CDAI >100, odds ratio (OR) =5.55; 95% confidence interval (CI), 1.80-18.74, platelet count >33×10(4)/μL, OR =5.94; 95% CI, 1.34-28.87]. The sensitivity of fulfillment of either criterion for the presence of active intestinal lesions was 83%, while the specificity of fulfillment of both criteria was 94%. CONCLUSION: A relatively low CDAI and platelet count were identified as predictive markers of the presence of active intestinal lesions in CRP-negative CD patients. These results suggest that symptoms and laboratory data should be evaluated very carefully in such patients.

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  • Serum glycan markers for evaluation of disease activity and prediction of clinical course in patients with ulcerative colitis. 国際誌

    Koji Miyahara, Kazuhiro Nouso, Shunsuke Saito, Sakiko Hiraoka, Keita Harada, Sakuma Takahashi, Yuki Morimoto, Sayo Kobayashi, Fusao Ikeda, Yasuhiro Miyake, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Okada, Maho Amano, Kazuko Hirose, Shin-Ichiro Nishimura, Kazuhide Yamamoto

    PloS one   8 ( 10 )   e74861   2013年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The aims of this study were to determine the change of whole-serum N-glycan profile in ulcerative colitis (UC) patients and to investigate its clinical utility. METHODS: We collected serum from 75 UC patients at the time of admission and the same number of age/sex-matched healthy volunteers. Serum glycan profile was measured by comprehensive quantitative high-throughput glycome analysis and was compared with disease activity and prognosis. RESULTS: Out of 61 glycans detected, 24 were differentially expressed in UC patients. Pathway analysis demonstrated that highly sialylated multi-branched glycans and agalactosyl bi-antennary glycans were elevated in UC patients; in addition, the glycan ratio m/z 2378/1914, which also increased in UC, showed the highest Area under Receiver Operating Characteristic curve (0.923) for the diagnosis of UC. Highly sialylated multi-branched glycans and the glycan ratio m/z 2378/1914 were higher in the patients with total colitis, Clinical Activity Index >10, Mayo endoscopic score 3, or a steroid-refractory status. In particular, the glycan ratio m/z 2378/1914 (above median) was an independent prognostic factor for the need for an operation (hazard ratio, 2.67; 95% confidence interval, 1.04-7.84). CONCLUSIONS: Whole-serum glycan profiles revealed that the glycan ratio m/z 2378/1914 and highly sialylated multi-branched glycans increase in UC patients, and are correlated with disease activity. The glycan ratio m/z 2378/1914 was an independent predictive factor of the prognosis of UC.

    DOI: 10.1371/journal.pone.0074861

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  • Serum folate and homocysteine levels are associated with colon tumorigenesis in end-stage renal disease patients. 国際誌

    Eisuke Kaji, Jun Kato, Shunsuke Saito, Keita Harada, Kenji Kuwaki, Masashi Tatsukawa, Tamiya Morikawa, Sakiko Hiraoka, Hiroshi Matsushima, Kazuhide Yamamoto

    Nutrition and cancer   63 ( 2 )   202 - 11   2011年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The aim of this study was to evaluate the effect of folate and homocysteine on colon tumorigenesis by performing colonoscopy and examining serum folate and homocysteine levels in end-stage renal disease (ESRD) patients. We performed colonoscopy in 72 ESRD patients who were undergoing hemodialysis and also measured their serum folate and homocysteine levels. Serum folate and homocysteine concentrations of the 72 ESRD patients were 6.0±3.9 μg/l and 37.3±25.5 μmol/l, respectively. Colorectal neoplasia was detected in 47 (65%) of the patients. Compared to a control group, ESRD patients had significantly more and larger neoplasia (P=0.002 and 0.001, respectively). Multivariate analysis revealed that ESRD patients with lower levels of serum homocysteine had significantly more and larger neoplasia than those with higher levels (P=0.02 and 0.03, respectively). In addition, patients with a shorter duration of hemodialysis were likely to have larger neoplasia. ESRD patients had higher than normal serum homocysteine levels. Interestingly, patients with lower homocysteine levels were likely to carry more and larger colorectal neoplasia. These results suggest that suppression of folate metabolism and an elevated serum homocysteine concentration are inversely associated with colon tumorigenesis in ESRD patients.

    DOI: 10.1080/01635581.2011.523501

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  • Advantages of using thin endoscope-assisted endoscopic submucosal dissection technique for large colorectal tumors. 国際誌

    Toshio Uraoka, Shin Ishikawa, Jun Kato, Reiji Higashi, Hideyuki Suzuki, Eisuke Kaji, Motoaki Kuriyama, Shunsuke Saito, Mitsuhiro Akita, Keisuke Hori, Keita Harada, Shuhei Ishiyama, Junji Shiode, Yoshiro Kawahara, Kazuhide Yamamoto

    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society   22 ( 3 )   186 - 91   2010年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Our purpose was to evaluate the effectiveness of a newly developed non-invasive traction technique known as thin endoscope-assisted endoscopic submucosal dissection (TEA-ESD) procedure for the removal of colorectal laterally spreading tumors (LST). PATIENTS AND METHODS: A total of 37 LST located in the rectum and distal sigmoid colons of 37 patients were eligible for outcome analysis. Twenty-one LST were treated with TEA-ESD and were then retrospectively compared to 16 LST that had previously been treated with standard ESD. Tumor size, en bloc resection rate, procedure time, combined number of different electrical surgical knives used during each procedure and associated complications were evaluated in this case-control study. RESULTS: There was no statistically significant difference in tumor size between the TEA-ESD group and the ESD control group (43.6+/-16 mm and 42.4+/-14 mm, respectively). All LST were successfully resected en bloc in both groups. Procedure duration was shorter for the TEA-ESD group than the ESD control group, although the difference was not statistically significant (96+/-53 minutes vs 116+/-74 minutes; P=0.18). The percentage of cases in which only one electrical surgical knife was used during the entire procedure was significantly higher in the TEA-ESD group compared to the ESD control group (85.7% vs 31.3%; P=0.0005). There were no perforations in the TEA-ESD group while the ESD control group experienced one perforation. At the present time, TEA-ESD is limited to the rectum and distal sigmoid colon. CONCLUSION: It was technically easier, safer and more cost-effective to perform ESD for LST in the rectum and the distal sigmoid colon using the newly developed TEA-ESD traction technique.

    DOI: 10.1111/j.1443-1661.2010.00992.x

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  • Methylation status of normal background mucosa is correlated with occurrence and development of neoplasia in the distal colon. 国際誌

    Sakiko Hiraoka, Jun Kato, Joichiro Horii, Shunsuke Saito, Keita Harada, Hideyuki Fujita, Motoaki Kuriyama, Koji Takemoto, Toshio Uraoka, Kazuhide Yamamoto

    Human pathology   41 ( 1 )   38 - 47   2010年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The aim of this study is to evaluate the methylation status of normal colonic mucosa in relation to the stage of neoplasia arising from the mucosa. The methylation status of 2 age-related loci (ESR1 and MYOD1) and global methylation (the mean of Alu and Sat2) in the normal colonic mucosa of 156 patients with and without colorectal neoplasia were examined. The distal colon and proximal colon were analyzed separately because neoplasia is biologically and clinically different between these sites. The methylation status was determined by MethyLight using percentage of methylated reference (PMR). In the distal colon, methylation of the age-related loci decreased as the stage of neoplasia increased (patients with no neoplasia or with adenoma < or =9 mm versus patients with advanced adenoma or with invasive cancer: ESR1-PMR median, 21.0 versus 15.7; P = .015; MYOD1-PMR median, 5.35 versus 3.80; P = .0037, respectively). Interestingly, global methylation was inversely correlated with the stage of neoplasia (59.7 versus 61.5; P = .054). In contrast, the proximal colon showed no significant correlations. The methylation of MYOD1 in the normal mucosa was significantly correlated with K-ras mutation in neoplastic tissue arising from the mucosa. Specific epigenetic changes in normal colonic mucosa may be correlated with the occurrence and development of neoplasia in the distal colon.

    DOI: 10.1016/j.humpath.2009.06.002

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  • CO(2) insufflation for potentially difficult colonoscopies: efficacy when used by less experienced colonoscopists. 国際誌

    Toshio Uraoka, Jun Kato, Motoaki Kuriyama, Keisuke Hori, Shin Ishikawa, Keita Harada, Koji Takemoto, Sakiko Hiraoka, Hideyuki Fujita, Joichiro Horii, Yutaka Saito, Kazuhide Yamamoto

    World journal of gastroenterology   15 ( 41 )   5186 - 92   2009年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: To clarify the effectiveness of CO(2) insufflation in potentially difficult colonoscopy cases, particularly in relation to the experience level of colonoscopists. METHODS: One hundred twenty potentially difficult cases were included in this study, which involved females with a low body mass index and patients with earlier abdominal and/or pelvic open surgery or previously diagnosed left-side colon diverticulosis. Patients receiving colonoscopy examinations without sedation using a pediatric variable-stiffness colonoscope were divided into two groups based on either CO(2) or standard air insufflation. Both insufflation procedures were also evaluated according to the experience level of the respective colonoscopists who were divided into an experienced colonoscopist (EC) group and a less experienced colonoscopist (LEC) group. Study measurements included a 100-mm visual analogue scale (VAS) for patient pain during and after colonoscopy examinations, in addition to insertion to the cecum and withdrawal times. RESULTS: Examination times did not differ, however, VAS scores in the CO(2) group were significantly better than in the air group (P < 0.001, two-way ANOVA) from immediately after the procedure and up to 2 h later. There were no significant differences between either insufflation method in the EC group (P = 0.29), however, VAS scores for CO(2) insufflation were significantly better than air insufflation in the LEC group (P = 0.023) immediately after colonoscopies and up to 4 h afterwards. CONCLUSION: CO(2) insufflation reduced patient pain after colonoscopy in potentially difficult cases when performed by LECs.

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  • Methylation of estrogen receptor 1 in colorectal adenomas is not age-dependent, but is correlated with K-ras mutation. 国際誌

    Joichiro Horii, Sakiko Hiraoka, Jun Kato, Shunsuke Saito, Keita Harada, Hideyuki Fujita, Eisuke Kaji, Kazuhide Yamamoto

    Cancer science   100 ( 6 )   1005 - 11   2009年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The promoter region of estrogen receptor 1 (ESR1) has been shown to be methylated in normal colorectal mucosa in an age-dependent manner. However, the methylation of this region in colorectal tumors has not sufficiently been investigated. The methylation status of ESR1 in 105 colorectal adenoma tissues was examined by MethyLight and presented as the percentage of methylated references (PMR). Factors that affect the PMR of ESR1 in adenomas were determined using parameters including patient age, sex, past history of malignancy, family history of colorectal cancer, smoking and drinking habits, clinical characteristics of adenomas (location, size, macroscopic appearance, and histology), and K-ras mutation. Multiple linear regression revealed that the PMR was not correlated with patient age. K-ras mutation was significantly correlated with the higher methylation status of ESR1 in adenoma (t-value = 3.21, P = 0.0018), whereas alcohol exposure was significantly correlated with lower methylation status (t-value = -2.37, P = 0.02). Because methylation of O6-methylguanine DNA methyltransferase (MGMT) has been reported to be correlated with K-ras G-to-A transition, methylation of ESR1 was compared with that of MGMT with regard to K-ras mutation. Contrary to expectations, methylation of MGMT was not significantly correlated with K-ras G-to-A transition, but that of ESR1 was strongly correlated with K-ras G-to-A transition. Thus, the methylation status of ESR1 in adenomas was not correlated with patient age, but was associated with K-ras mutation, suggesting that methylation of ESR1 in tumors functions differently from that in normal colon mucosa.

    DOI: 10.1111/j.1349-7006.2009.01140.x

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  • [Case of small early cancer of sigmoid colon, which recurred with liver metastasis 18 months after surgical resection].

    Keita Harada, Jun Kato, Koji Takemoto, Toshio Uraoka, Sakiko Hiraoka, Hiroyuki Yanai, Kazuhide Yamamoto

    Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology   106 ( 5 )   660 - 7   2009年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 74-year-old man was referred to our hospital with positive fecal occult blood test. Colonoscopic examination revealed a 7-mm 0-Is type polyp in the sigmoid colon. Endoscopic mucosal resection for this lesion completely removed the lesion and the histologic diagnosis was well differentiated adenocarcinoma. Cancer cells invaded the submucosa to a depth of 900 microm, and vascular invasion was found. Therefore, the patient underwent additional surgical resection with lymph node dissection. During follow-up, however, serum CEA increased beyond the normal limit 18 months after surgical operation, and a 15-mm single liver metastasis was found through enhanced CT scan abdominal imaging, the FDG-PET scan, and ultrasonography. We have to pay attention to metachronous liver metastasis especially when the vascular invasion is suspected in the resected sample, even if the lesion is completely removed.

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  • Age-related methylation in normal colon mucosa differs between the proximal and distal colon in patients who underwent colonoscopy. 国際誌

    Joichiro Horii, Sakiko Hiraoka, Jun Kato, Keita Harada, Kenji Kuwaki, Hideyuki Fujita, Shinichi Toyooka, Kazuhide Yamamoto

    Clinical biochemistry   41 ( 18 )   1440 - 8   2008年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: To examine the difference in the methylation status in normal colon mucosa between the proximal and distal colon, in relation to the correlation between the methylation status of normal mucosa and characteristics of neoplasia. DESIGN AND METHODS: Paired biopsy specimens of normal mucosa from the proximal and distal colon of 82 patients who underwent colonoscopy were obtained. The methylation status of the promoter region of estrogen receptor 1 (ESR1) and myogenic differentiation 1 (MYOD1) was examined. RESULTS: Normal mucosa was more highly methylated in the distal than in the proximal colon in both ESR1 and MYOD1 loci (p<0.0001 and p=0.0009, respectively). Advanced characteristics of polyps in the distal colon were frequently observed in patients with lower methylation of ESR1 in the distal colon normal mucosa. CONCLUSIONS: Methylation levels in normal mucosa differ between the proximal and distal colon, and lower methylation of ESR1 in the distal colon normal mucosa may correlate with advanced features of neoplasia in the distal colon.

    DOI: 10.1016/j.clinbiochem.2008.08.089

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  • Genetic and epigenetic alterations of Ras signalling pathway in colorectal neoplasia: analysis based on tumour clinicopathological features. 国際誌

    K Harada, S Hiraoka, J Kato, J Horii, H Fujita, K Sakaguchi, Y Shiratori

    British journal of cancer   97 ( 10 )   1425 - 31   2007年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Activation of RAS signalling induced by K-ras/BRAF mutations is a hallmark of colorectal tumours. In addition, Ras association domain families 1 and 2 (RASSF1 and RASSF2), the negative regulators of K-ras, are often inactivated by methylation of the promoter region in those tumours. However, reports showing differences in the occurrence of these alterations on the basis of tumour characteristics have been scarce. We analysed K-ras/BRAF mutations and the methylation status of RASSF1 and RASSF2 promoter regions in 120 colorectal adenomas with respect to their clinicopathological features. K-ras/BRAF mutations and RASSF2 methylation were observed in 49 (41%) and 30 (25%) of the samples, respectively, while RASSF1 methylation was observed in only 3 (2.5%). Adenomas with RASSF2 methylation often carried K-ras/BRAF mutations simultaneously (22 out of 30, P<0.01). Multivariate analysis revealed that the concomitance of these alterations was frequently observed in serrated adenomas (odds ratio (OR) 11.11; 95% confidence interval (CI) 1.96-63.00), but rarely in adenomas located in the sigmoid or descending colon (OR 0.13; 95% CI 0.03-0.58). A comparison between adenomas and cancers showed a significantly higher prevalence of these alterations in cancers than in adenomas in the proximal colon (58 vs 27%, P=0.02). Frequency and the time point of the occurrence of Ras signalling disorders differ according to colorectal neoplasia's characteristics, particularly the location.

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  • Decreased expression of hMLH1 correlates with reduced 5-fluorouracil-mediated apoptosis in colon cancer cells. 国際誌

    Hideyuki Fujita, Jun Kato, Joichiro Horii, Keita Harada, Sakiko Hiraoka, Hidenori Shiraha, Kohsaku Sakaguchi, Yasushi Shiratori

    Oncology reports   18 ( 5 )   1129 - 37   2007年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Patients with sporadic microsatellite instable colorectal cancers, in most of which the function of the hMLH1 mismatch repair gene is impaired, do not gain a survival benefit from 5-fluorouracil (5-FU)-based chemotherapy. However, the effect of hMLH1 on the cytotoxicity induced by 5-FU has not yet been sufficiently confirmed. In this study, we assessed the effect of hMLH1 on cytotoxicity and apoptosis induced by 5-FU using newly developed cell lines. We constructed two cell lines: SW480 (originally hMLH1-proficient), in which the expression of hMLH1 was reduced using a small interfering RNA (siRNA) technique, and HCT116 (originally hMLH1-deficient), in which the expression of hMLH1 can be regulated by doxycycline. Using these cell lines, a clonogenic survival assay, 4',6-diamidino-2-phenylindole (DAPI) staining and an Annexin-V assay were performed. Moreover, the incorporation of 5-FU into DNA was determined using tritium-labeled 5-FU. In both of our two cell lines, hMLH1-deficient cells exhibited approximately 2.4-fold clonal surviving fraction compared to hMLH1-proficient cells for 10 days after the administration of 5-FU. Additionally, hMLH1-deficient cells treated with 5-FU exhibited 34-45% less apoptosis than hMLH1-proficient cells according to the results of DAPI staining and Annexin-V assay. Furthermore, hMLH1-deficient cells treated with 5-FU exhibited an approximately 2-fold greater incorporation of 5-FU into DNA than control cells, suggesting that the recognition of 5-FU-incorporated DNA is impaired in hMLH1-deficient cells, resulting in reduced apoptosis. Our conclusions were that decreased expression of hMLH1 in colon cancer cells reduced the apoptosis induced by 5-FU, suggesting that hMLH1 is a key determinant of 5-FU chemosensitivity.

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  • Thin endoscope-assisted endoscopic submucosal dissection for large colorectal tumors (with videos). 国際誌

    Toshio Uraoka, Jun Kato, Shin Ishikawa, Keita Harada, Motoaki Kuriyama, Koji Takemoto, Yoshiro Kawahara, Yutaka Saito, Hiroyuki Okada

    Gastrointestinal endoscopy   66 ( 4 )   836 - 9   2007年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Endoscopic submucosal dissection (ESD) enables direct submucosal dissection so even large early stage GI tumors can be resected en bloc. Colorectal ESD is technically more difficult, however, and there is an increased risk of complications such as perforation and bleeding compared with gastric ESD. As a result, further refinements are required in this procedure. OBJECTIVE: Our purpose was to evaluate thin endoscope-assisted (TEA) ESD, a new traction system for improving submucosal cutting line visualization. DESIGN: Case series. SETTING: Okayama University Hospital. MAIN OUTCOME MEASUREMENTS: Efficacy and safety of the TEA-ESD procedure. RESULTS: Three cases of large, flat, elevated colorectal tumors (laterally spreading tumors) in the rectum and rectosigmoid colon were safely and successfully removed en bloc without complications. Total procedure times were 3 hours, 40 minutes, and 30 minutes with resected specimens measuring 70 x 68 mm, 38 x 35 mm, and 30 x 20 mm, respectively. LIMITATIONS: TEA-ESD was performed in only the rectum and rectosigmoid colon. CONCLUSIONS: This limited case series demonstrated that large laterally spreading tumors in the rectum and rectosigmoid colon could be safely resected en bloc with TEA-ESD.

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  • Laterally spreading type of colorectal adenoma exhibits a unique methylation phenotype and K-ras mutations. 国際誌

    Sakiko Hiraoka, Jun Kato, Masashi Tatsukawa, Keita Harada, Hideyuki Fujita, Tamiya Morikawa, Hidenori Shiraha, Yasushi Shiratori

    Gastroenterology   131 ( 2 )   379 - 89   2006年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND & AIMS: Laterally spreading tumors (LST), characterized by superficial extension along the colonic lumen, have recently been detected by colonoscopy. However, genetic and epigenetic characteristics of these tumors were scarcely reported. METHODS: A total of 205 sporadic colorectal adenoma tissues (157 protruded-type, 23 granular-type LST (G-LST), 12 flat-type LST (F-LST), and 13 flat-type smaller than 1 cm) were collected. CpG island methylator phenotype (CIMP) was determined by examination of methylation status at p16, methylated in tumor (MINT) 1, 2, 12, and 31 loci. K-ras codon 12 and 13 point mutations were also examined. The relationship between macroscopic appearance and CIMP status or K-ras mutations was analyzed. RESULTS: Among adenomas larger than 1 cm, CpG island methylation involving 2 or more loci (CIMP-high) was more likely to be observed in G-LST (14/23, 61%) than in protruded-type adenomas (18/73, 25%) (P = .002). The prevalence of K-ras mutations in G-LST (18/23, 78%) was significantly higher than that in protruded-type adenomas (18/73, 25%) (P < .0001). Moreover, the prevalence of CIMP-high and K-ras mutations in G-LST located in the proximal colon was much higher (11/13, 85%; and 12/13, 92%, respectively). In contrast, F-LST exhibited low prevalence of CIMP-high (1/12, 8%) and K-ras mutations (2/12, 16%). CONCLUSIONS: High prevalence of CIMP-high and K-ras mutations in G-LST, especially in the proximal colon, could strongly suggest that G-LST appearance is associated with a unique carcinogenic pathway.

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書籍等出版物

  • 下部消化管内視鏡診断アトラス

    松本, 主之( 担当: 共著)

    医学書院  2020年10月  ( ISBN:9784260041560

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    総ページ数:x, 244p   記述言語:日本語

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  • 1361専門家による私の治療

    猿田, 享男, 北村, 惣一郎( 担当: 共著)

    日本医事新報社  2019年7月  ( ISBN:9784784946518

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    総ページ数:1525p   記述言語:日本語

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  • 1336専門家による私の治療

    猿田, 享男, 北村, 惣一郎( 担当: 共著)

    日本医事新報社  2017年7月  ( ISBN:9784784946501

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    総ページ数:36, 1734p   記述言語:日本語

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MISC

  • 炎症性腸疾患患者における月経に関連する症状の変化および挙児希望に関わる検討

    安富 絵里子, 平岡 佐規子, 青山 祐樹, 井川 翔子, 山本 峻平, 大森 正泰, 山崎 泰史, 井口 俊博, 衣笠 秀明, 川野 誠司, 原田 馨太, 岡田 裕之

    日本高齢消化器病学会誌   24 ( 1 )   195 - 195   2021年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本高齢消化器病学会  

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  • CTコロノグラフィー検査が診断に有用であった盲腸子宮内膜症の2例

    小橋 真由, 岩室 雅也, 田中 健大, 杉原 雄策, 原田 馨太, 平岡 佐規子, 近藤 喜太, 岡田 裕之

    Gastroenterological Endoscopy   63 ( Suppl.1 )   966 - 966   2021年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 潰瘍性大腸炎診療におけるバイオマーカーの位置づけを考える 新規LRGも含め

    安富 絵里子, 平岡 佐規子, 竹井 健介, 井川 翔子, 山本 峻平, 大森 正泰, 岡 昌平, 山崎 泰史, 井口 俊博, 衣笠 秀明, 原田 馨太, 岡田 裕之

    日本消化器病学会雑誌   118 ( 臨増総会 )   A360 - A360   2021年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 治療法の再整理とアップデートのために 専門家による 私の治療 大腸ポリープ

    原田 馨太, 岡田 裕之

    日本医事新報   ( 5047 )   39 - 40   2021年1月

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    記述言語:日本語   出版者・発行元:(株)日本医事新報社  

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  • SAPHO症候群に対しイキセキズマブ投与後に腸炎を発症した1例

    森 悠記, 倉岡 紗樹子, 竹井 健介, 井川 翔子, 安富 絵里子, 山本 峻平, 大森 正泰, 岡 昌平, 山崎 泰史, 井口 俊博, 衣笠 秀明, 原田 馨太, 平岡 佐規子, 岡田 裕之

    日本消化管学会雑誌   5 ( Suppl. )   319 - 319   2021年1月

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    記述言語:日本語   出版者・発行元:(一社)日本消化管学会  

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  • 十二指腸・大腸腫瘍に対する内視鏡治療の最前線-cold snare polypectomyからunderwater EMR、ESDまで- 10-20mmの大腸腫瘍性病変に対する内視鏡的切除法の切除深度の検討 EMR、underwaterEMR、ESD、hybrid ESD/precutting EMRの比較

    大森 正泰, 山崎 泰史, 竹井 健介, 井川 翔子, 安富 絵里子, 山本 峻平, 岡 昌平, 井口 俊博, 衣笠 秀明, 原田 馨太, 平岡 佐規子, 岡田 裕之

    日本消化管学会雑誌   5 ( Suppl. )   208 - 208   2021年1月

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    記述言語:日本語   出版者・発行元:(一社)日本消化管学会  

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  • イキセキズマブ投与後に重症腸炎を発症したSAPHO症候群の1例

    倉岡 紗樹子, 竹井 健介, 井川 翔子, 安富 絵里子, 山本 峻平, 大森 正泰, 岡 昌平, 山崎 泰史, 井口 俊博, 衣笠 秀明, 原田 馨太, 平岡 佐規子, 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   114回   74 - 74   2020年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 潰瘍性大腸炎における経腹超音波検査の有用性

    高原 政宏, 平岡 佐規子, 大森 正泰, 安富 絵里子, 岡 昌平, 平井 麻美, 井口 俊博, 山本 峻平, 山崎 泰史, 衣笠 秀明, 原田 馨太, 大西 秀爾, 岡田 裕之

    日本消化器病学会雑誌   117 ( 臨増大会 )   A706 - A706   2020年10月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 難治性潰瘍性大腸炎患者における寛解導入治療後の便中マーカー推移の解析

    平岡 佐規子, 山本 俊平, 安富 絵里子, 大森 正泰, 岡 昌平, 平井 麻美, 山崎 康史, 井口 俊博, 衣笠 秀明, 原田 馨太, 岡田 裕之

    日本消化器病学会雑誌   117 ( 臨増大会 )   A779 - A779   2020年10月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 3-5mmの大腸微小ポリープに対する拡大観察を併用したCold Forceps Polypectomy

    山崎 泰史, 原田 馨太, 岡田 裕之, 山本 峻平, 安富 絵里子, 岡 昌平, 平井 麻美, 井口 俊博, 衣笠 秀明, 平岡 佐規子

    Gastroenterological Endoscopy   62 ( Suppl.1 )   1315 - 1315   2020年8月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • ベルベリンによる慢性腸炎マウスの腸内細菌叢の変化

    高原 政宏, 高木 章乃夫, 平岡 佐規子, 安富 絵里子, 山本 峻平, 岡 昌平, 平井 麻美, 山崎 泰史, 井口 俊博, 衣笠 秀明, 原田 馨太, 岡田 裕之

    日本消化器病学会雑誌   117 ( 臨増総会 )   A275 - A275   2020年7月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 悪性黒色腫の遅発性転移により小腸重積をきたした1例

    林 里美, 衣笠 秀明, 山本 峻平, 大森 正泰, 安富 絵里子, 岡 昌平, 山崎 泰史, 井口 俊博, 川野 誠司, 原田 馨太, 平岡 佐規子, 田中 健大, 寺石 文則, 山崎 修, 岡田 裕之

    日本消化器内視鏡学会中国支部例会   124回   41 - 41   2020年6月

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    記述言語:日本語   出版者・発行元:日本消化器内視鏡学会-中国支部  

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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-】空腸、回腸、盲腸、結腸、直腸(下) 腫瘍 大腸腫瘍 消化管ポリポーシス 大腸良性リンパ濾胞性ポリープ・ポリポーシス

    原田 馨太, 山崎 泰史, 平岡 佐規子, 岡田 裕之

    日本臨床   別冊 ( 消化管症候群IV )   165 - 168   2020年5月

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    記述言語:日本語   出版者・発行元:(株)日本臨床社  

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  • 大腸良性リンパ濾胞性ポリープ・ポリポーシス

    原田馨太

    日本臨牀 別冊 消化管症候群   2020年4月

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    担当区分:筆頭著者   記述言語:日本語   掲載種別:記事・総説・解説・論説等(商業誌、新聞、ウェブメディア)  

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  • レーザー内視鏡診療の現状と近未来 浸水下での大腸ポリープ境界診断におけるBLI/LCIの有効性を評価するための後ろ向き観察研究

    山崎 泰史, 原田 馨太, 安富 絵里子, 山本 峻平, 岡 昌平, 平井 麻美, 井口 俊博, 衣笠 秀明, 高原 政宏, 平岡 佐規子, 岡田 裕之

    日本消化管学会雑誌   4 ( Suppl. )   223 - 223   2020年1月

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    記述言語:日本語   出版者・発行元:(一社)日本消化管学会  

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  • 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年1月

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    記述言語:日本語   出版者・発行元:(一社)日本消化管学会  

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  • 【これ一冊でわかる 炎症性腸疾患診療のすべて】炎症性腸疾患のバイオマーカー

    平岡 佐規子, 安富 絵里子, 岡 昌平, 山崎 泰史, 井口 俊博, 高原 政宏, 衣笠 秀明, 原田 馨太, 近藤 喜太, 加藤 順, 岡田 裕之

    消化器外科   42 ( 12 )   1653 - 1662   2019年11月

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    記述言語:日本語   出版者・発行元:(株)へるす出版  

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  • 直腸顆粒細胞腫(Granular Cell Tumor)の1例

    深田 悠史, 衣笠 秀明, 山本 俊平, 平井 麻美, 安富 絵里子, 岡 昌平, 山崎 泰史, 井口 俊博, 高原 政宏, 原田 馨太, 平岡 佐規子, 田中 健大, 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   146 - 146   2019年11月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 浸水下での大腸ポリープ境界診断におけるLCI/BLIの有効性を評価するための遡及的研究

    山崎 泰史, 原田 馨太, 安富 絵里子, 岡 昌平, 平井 麻美, 井口 俊博, 衣笠 秀明, 高原 政宏, 平岡 佐規子, 岡田 裕之

    Gastroenterological Endoscopy   61 ( Suppl.2 )   2167 - 2167   2019年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • クローン病の内視鏡スコア変化予測には血清Alb値が有用である

    井口 俊博, 平岡 佐規子, 安富 絵里子, 平井 麻美, 岡 昌平, 山崎 泰史, 杉原 雄策, 衣笠 秀明, 高原 政宏, 原田 馨太, 川野 誠司, 岡田 裕之

    Gastroenterological Endoscopy   61 ( Suppl.2 )   2181 - 2181   2019年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 慢性便秘症と私

    原田 馨太

    現代産婦人科   68 ( Suppl. )   S41 - S41   2019年9月

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    記述言語:日本語   出版者・発行元:中国四国産科婦人科学会  

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  • 潰瘍性大腸炎に合併したMixed Neuroendocrine-Non-Neuroendocrine Neoplasmsの一例

    永原 崇甫, 衣笠 秀明, 岡 昌平, 安富 絵里子, 平井 麻美, 山本 俊平, 山崎 泰史, 井口 俊博, 杉原 雄策, 高原 政宏, 原田 馨太, 平岡 佐規子, 近藤 喜太, 田中 健大, 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   111回   72 - 72   2019年5月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 苦痛の少ない大腸内視鏡検査を実現するための患者選択の工夫

    岡 昌平, 原田 馨太, 岡田 裕之, 安富 絵里子, 平井 麻美, 山崎 泰史, 井口 俊博, 杉原 雄策, 高原 政宏, 衣笠 秀明, 平岡 佐規子

    Gastroenterological Endoscopy   61 ( Suppl.1 )   876 - 876   2019年5月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 超拡大内視鏡画像診断における「EC分類」はレクチャーにより初学者にも実行可能となるか

    杉原 雄策, 原田 馨太, 岡田 裕之, 安富 絵里子, 岡 昌平, 榮 浩行, 山崎 泰史, 井口 俊博, 衣笠 秀明, 高原 政宏, 平岡 佐規子, 河原 祥朗

    Gastroenterological Endoscopy   61 ( Suppl.1 )   871 - 871   2019年5月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 消化管ESD手技の最新の工夫(大腸) 大腸ESD後創部のクリップ完全縫縮は、術後経過の安定に寄与する

    平井 麻美, 原田 馨太, 岡田 裕之

    Gastroenterological Endoscopy   61 ( Suppl.1 )   815 - 815   2019年5月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 消化管狭窄に対する内視鏡治療の現況と課題 直腸腫瘍の術後吻合部狭窄に対するマネジメント

    原田 馨太, 平岡 佐規子, 岡田 裕之

    Gastroenterological Endoscopy   61 ( Suppl.1 )   755 - 755   2019年5月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 中毒性巨大結腸症を合併していた重症潰瘍性大腸炎の一例

    岡 昌平, 高原 政宏, 平岡 佐規子, 安富 絵里子, 井口 俊博, 平井 麻美, 山崎 泰史, 杉原 雄策, 衣笠 秀明, 原田 馨太, 高橋 一剛, 近藤 喜太, 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   111回   87 - 87   2019年5月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • インフリキシマブにより臨床的寛解を得たにも関わらず、突然に回腸腸間膜穿通をきたしたクローン病の一例

    安富 絵里子, 井口 俊博, 岡 昌平, 平井 麻美, 山崎 泰史, 衣笠 秀明, 高原 政宏, 川野 誠司, 原田 馨太, 平岡 佐規子, 岡田 裕之, 高橋 一剛, 近藤 善太, 田中 健大

    日本消化器病学会中国支部例会プログラム・抄録集   111回   86 - 86   2019年5月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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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年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 大腸ESDにおけるクリッピングは術後経過に寄与しているか

    原田 馨太, 平井 麻美, 安富 絵里子, 岡 昌平, 山崎 泰史, 井口 俊博, 杉原 雄策, 衣笠 秀明, 高原 政宏, 平岡 佐規子, 岡田 裕之

    日本消化器病学会雑誌   116 ( 臨増総会 )   A362 - A362   2019年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 重症/難治性潰瘍性大腸炎における当院の手術症例から内科と外科の連携を考える

    高原 政宏, 平岡 佐規子, 井口 俊博, 岡 昇平, 安富 絵里子, 山崎 泰史, 杉原 雄策, 衣笠 秀明, 原田 馨太, 近藤 喜太, 岡田 裕之

    日本消化器病学会雑誌   116 ( 臨増総会 )   A330 - A330   2019年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 急性消化管GVHDの診断における上部消化管内視鏡検査および大腸内視鏡検査の生検部位の比較検討

    杉原 雄策, 平岡 佐規子, 山崎 泰史, 井口 俊博, 衣笠 秀明, 高原 政宏, 原田 馨太, 小川 弘子, 岡田 裕之, 大塚 文男

    日本内科学会雑誌   108 ( Suppl. )   215 - 215   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本内科学会  

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  • 抗凝固薬服用者の大腸ポリープEMR 消化器内視鏡診療ガイドラインの検証

    小林 沙代, 原田 馨太, 内藤 修子, 平田 翔一郎, 織田 崇志, 根岸 慎, 河原 聡一郎, 藤澤 智雄, 名和 徹, 植木 亨, 坂口 孝作, 岡田 裕之

    日本消化管学会雑誌   3 ( Suppl. )   288 - 288   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本消化管学会  

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  • 消化管出血(静脈瘤破裂を除く)の予後不良症例の検討 急性消化管GVHDにおいて回腸末端の内視鏡所見は予後・重症度・治療反応性と関連するか?

    杉原 雄策, 平岡 佐規子, 安富 絵里子, 岡 昌平, 山崎 泰史, 井口 俊博, 衣笠 秀明, 高原 政宏, 原田 馨太, 藤井 伸治, 田中 健大, 岡田 裕之

    日本消化管学会雑誌   3 ( Suppl. )   161 - 161   2019年2月

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    記述言語:日本語   出版者・発行元:(一社)日本消化管学会  

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  • 転移性大腸癌との鑑別に苦慮した大腸の肉芽性ポリープの1例

    山崎 辰洋, 岩室 雅也, 高原 政宏, 杉原 雄策, 原田 馨太, 平岡 佐規子, 近藤 喜太, 市原 英基, 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   110回   147 - 147   2018年12月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 高度狭窄により腸閉塞を発症したクローン病妊婦の一例

    岡 昌平, 高原 政宏, 平岡 佐規子, 安富 絵里子, 山崎 泰史, 井口 俊博, 杉原 雄策, 衣笠 秀明, 原田 馨太, 近藤 喜太, 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   110回   115 - 115   2018年12月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-中国支部  

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  • 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年12月

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    記述言語:日本語   出版者・発行元: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。

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  • 大腸ESD後創部に対する浸水下クリップ縫縮法 単施設実施可能性試験

    山崎 泰史, 原田 馨太, 岡 昌平, 高嶋 志保, 井口 俊博, 杉原 雄策, 高原 政宏, 平岡 佐規子, 岡田 裕之

    Gastroenterological Endoscopy   60 ( Suppl.2 )   2074 - 2074   2018年10月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 食道アカラシアバルーン拡張術およびHeller-Dor手術施行後の下部食道運動異常に対しPOEM(peroral endoscopic myotomy)が著効した1例

    杉原 雄策, 原田 馨太, 加藤 諒, 山内 健司, 高嶋 志保, 山崎 泰史, 井口 俊博, 高原 政宏, 川野 誠司, 平岡 佐規子, 眞部 紀明, 大塚 文男, 岡田 裕之

    岡山医学会雑誌   130 ( 2 )   67 - 71   2018年8月

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    記述言語:日本語   出版者・発行元:岡山医学会  

    症例は80歳代男性で、約60年前に嚥下障害を発症し、食道アカラシアと診断されていた。約15年前に症状が悪化し、食道アカラシアバルーン拡張術を2回施行された。一旦は症状が改善したが、5年前に再度悪化をきたし、Heller-Dor手術を施行された。症状は改善していたが、1年前より嚥下障害と嘔吐が出現した。アカラシアバルーン拡張術およびHeller-Dor手術を施行後、新たに発生した下部食道の運動異常と、それに伴う逆流が、症状再発の原因と診断し、経口内視鏡下筋層切開術(POEM)を施行した。下部食道の運動異常は消失し、バリウムの逆流も認めなかった。経過は良好で、術後4病日に退院となった。現在まで、症状の悪化や再発はきたしていない。

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J00175&link_issn=&doc_id=20180806220002&doc_link_id=10.4044%2Fjoma.130.67&url=https%3A%2F%2Fdoi.org%2F10.4044%2Fjoma.130.67&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • CTAPと出血シンチグラフィで診断し、経皮的硬化療法で止血し得た小腸静脈瘤出血の1例

    神尾 知宏, 川野 誠司, 大西 秀樹, 大林 由佳, 大山 淳史, 能祖 一裕, 原田 馨太, 岡田 裕之, 藤原 寛康, 金澤 右

    日本消化器病学会雑誌   115 ( 8 )   732 - 738   2018年8月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

    症例は55歳、男性。複数の腹部手術歴や、食道静脈瘤に対して内視鏡的治療歴あり。突然の血便を認め緊急入院。大腸内視鏡を施行するも出血源は同定できず、CT during arterial portography(CTAP)を施行したところ、上腸間膜静脈から流入し腹壁静脈へと排血する小腸静脈瘤を認めた。経皮的に腹壁静脈を直接穿刺することで硬化療法を施行し、良好な止血を得られ、侵襲の高い外科手術を回避することができた。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J01118&link_issn=&doc_id=20180817330007&doc_link_id=130007432101&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007432101&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

  • 【一歩先を行くクローン病診療】女性特有のイベントへの対応

    平岡 佐規子, 安富 絵里子, 岡 昌平, 山崎 泰史, 井口 俊博, 杉原 雄策, 高原 政宏, 原田 馨太, 川野 誠司, 近藤 喜太, 岡田 裕之

    消化器・肝臓内科   4 ( 2 )   113 - 119   2018年8月

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    記述言語:日本語   出版者・発行元:(有)科学評論社  

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  • MTF(male to female)性同一性障害患者に対する内視鏡医の関わり

    原田 馨太, 安富 絵里子, 岡 昌平, 山崎 康史, 杉原 雄策, 衣笠 秀明, 高原 政宏, 平岡 佐規子, 難波 祐三郎, 岡田 裕之

    日本高齢消化器病学会誌   21 ( 1 )   97 - 97   2018年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本高齢消化器病学会  

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  • 急性消化管GVHDの診断における上部消化管内視鏡検査と大腸内視鏡検査の比較

    杉原 雄策, 平岡 佐規子, 加藤 諒, 高嶋 志保, 山崎 泰史, 井口 俊博, 高原 政宏, 原田 馨太, 藤井 伸治, 田中 健大, 岡田 裕之

    Gastroenterological Endoscopy   60 ( Suppl.1 )   772 - 772   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 粘膜治癒を達成した潰瘍性大腸炎患者において血小板数は再燃予測マーカーとなる

    半井 明日香, 平岡 佐規子, 高嶋 志保, 岡 昌平, 山崎 泰史, 井口 俊博, 杉原 雄策, 高原 政宏, 原田 馨太, 加藤 順, 岡田 裕之

    Gastroenterological Endoscopy   60 ( Suppl.1 )   801 - 801   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 血漿中interleukin-1 receptor antagonistは潰瘍性大腸炎の内視鏡的活動性の予測に有用である

    高嶋 志保, 平岡 佐規子, 井口 俊博, 半井 明日香, 稲葉 知己, 吉岡 正雄, 竹本 浩二, 松枝 和宏, 高原 政宏, 原田 馨太, 岡田 裕之

    Gastroenterological Endoscopy   60 ( Suppl.1 )   801 - 801   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 食道アカラシアの診断と治療戦略 Peroral Endoscopic Myotomy(POEM、経口内視鏡的筋層切開術)の当院導入経緯と治療成績の検討

    杉原 雄策, 加藤 諒, 山内 健司, 原田 馨太, 高嶋 志保, 山崎 泰史, 井口 俊博, 高原 政宏, 川野 誠司, 平岡 佐規子, 河原 祥朗, 眞部 紀明, 岡田 裕之

    日本消化管学会雑誌   2 ( Suppl. )   136 - 136   2018年2月

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    記述言語:日本語   出版者・発行元:(一社)日本消化管学会  

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  • 【ここまでできるIEE】[大腸] 精密診断 量的診断(staging) NBIを中心に

    木下 聡, 浦岡 俊夫, 西澤 俊宏, 伴野 繁雄, 松下 美紗子, 森 英毅, 中里 圭宏, 原田 馨太, 東 玲治

    消化器内視鏡   29 ( 12 )   2209 - 2216   2017年12月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    早期大腸癌における内視鏡診断は、白色光、NBI非拡大・拡大、pit patternおよび超音波内視鏡(EUS)で行われている。Narrow band imaging(NBI)拡大内視鏡観察においては、The Japan NBI Expert Team(JNET)分類の登場にて質的・深達度診断のさらなる普及と精度向上を目指している。本稿では、現在実臨床で使用されている内視鏡診断におけるNBI分類の使用と当院における診断から治療に至るまでのストラテジーについて、NBI拡大診断を中心に詳説する。(著者抄録)

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  • 術前精査でSM癌と診断した大腸腫瘍の行く末

    原田 馨太, 赤穂 宗一郎, 榮 浩行, 高嶋 志保, 井口 俊博, 竹井 大介, 杉原 雄策, 高原 政宏, 平岡 佐規子, 河原 祥朗, 岡田 裕之

    Gastroenterological Endoscopy   59 ( Suppl.2 )   2174 - 2174   2017年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 大腸・小腸疾患に対する診断の進歩 ラテックス凝集法を用いた新規便中カルプロテクチン測定法における潰瘍性大腸炎患者の粘膜治癒検出能の検討

    平岡 佐規子, 井口 俊博, 半井 明日香, 高嶋 志保, 山崎 泰史, 杉原 雄策, 高原 政宏, 原田 馨太, 関 泰宏, 渡辺 勝紀, 岡田 裕之

    日本大腸肛門病学会雑誌   70 ( 抄録号 )   A68 - A68   2017年9月

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    記述言語:日本語   出版者・発行元:(一社)日本大腸肛門病学会  

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  • 大腸内視鏡を用いた急性GVHDの診断における「回腸末端の絨毛の萎縮」の臨床的意義 後方視的多施設共同研究

    杉原 雄策, 平岡 佐規子, 高嶋 志保, 竹井 大介, 井口 俊博, 高原 政宏, 森藤 由紀, 高橋 索真, 桑木 健志, 原田 馨太, 藤井 伸治, 田中 健大, 岡田 裕之

    Gastroenterological Endoscopy   59 ( Suppl.2 )   2238 - 2238   2017年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 家族性大腸腺腫症術後20年後に小腸癌を発症した1例

    杉原 雄策, 川野 誠司, 原田 馨太, 高嶋 志保, 竹井 大介, 井口 俊博, 高原 政宏, 平岡 佐規子, 母里 淑子, 岸本 浩行, 永坂 岳司, 岡田 裕之

    岡山医学会雑誌   129 ( 2 )   111 - 114   2017年8月

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    記述言語:日本語   出版者・発行元:岡山医学会  

    58歳男。20年前に予防的大腸亜全摘出術を受け、その後近医で経過観察されていた。今回、腹痛・嘔吐が突然出現し、腸閉塞を疑われ、当院に紹介された。大腸内視鏡検査の所見は残存直腸に5mm以下の腺腫性ポリープが数個残存するのみであった。経口ダブルバルーン小腸内視鏡検査でトライツ靱帯付近に全周性の狭窄を伴う隆起性病変を認めた。隆起表面は正常粘膜に覆われ、一部に発赤調の病変を認めた。上皮性腫瘍を疑い同部位から生検を施行したところ、病理診断はadenocarcinoma(Group5)であった。家族性大腸腺腫症に合併した小腸癌と診断し、腹腔鏡下小腸部分切除+周囲リンパ節郭清術を施行した。術後29日目のCTで肺転移を認め、52日目からFOLFOX+BV療法を開始し、140日目に肺転移巣に対して経皮的ラジオ波焼灼療法を施行した。現在、化学療法を継続中で、Performance Statusは0のままで推移している。

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00175&link_issn=&doc_id=20170817260004&doc_link_id=10.4044%2Fjoma.129.111&url=https%3A%2F%2Fdoi.org%2F10.4044%2Fjoma.129.111&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • POEM(Per-Oral Endoscopic Myotomy)を施行した食道アカラシアの1例

    杉原 雄策, 原田 馨太, 加藤 諒, 山内 健司, 高嶋 志保, 竹井 大介, 井口 俊博, 高原 政宏, 川野 誠司, 平岡 佐規子, 田辺 俊介, 野間 和宏, 白川 靖博, 眞部 紀明, 井上 晴洋, 岡田 裕之

    岡山医学会雑誌   129 ( 2 )   115 - 121   2017年8月

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    記述言語:日本語   出版者・発行元:岡山医学会  

    39歳男。食事摂取後の嚥下困難を主訴に近医受診し、上部消化管内視鏡検査で食道アカラシアと診断され、精査加療目的に当院紹介となった。食道X線造影検査(バリウム50ml内服)で食道内に5分間以上のバリウム停滞を認め、異常蠕動を認めた。高解像度食道内圧検査(嚥下試験)で下部食道の収縮圧は24mmHgであり、胃食道接合部の弛緩は認めなかった。これらの所見から、食道アカラシアのシカゴ分類type Iと診断し、POEMを施行した。翌日の食道X線造影検査でバリウムは速やかに胃内へ流入することが確認され、その後の経過も良好で、術後4日目に退院となり、1年後の現在まで症状の再燃は認めていない。

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00175&link_issn=&doc_id=20170817260005&doc_link_id=10.4044%2Fjoma.129.115&url=https%3A%2F%2Fdoi.org%2F10.4044%2Fjoma.129.115&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 当院における小児消化器内視鏡の現状と偶発症

    尾山 貴徳, 野田 卓男, 谷 守通, 納所 洋, 谷本 光隆, 川野 誠司, 原田 馨太, 加藤 博也, 岡田 裕之

    日本小児外科学会雑誌   53 ( 3 )   782 - 782   2017年5月

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    記述言語:日本語   出版者・発行元:(一社)日本小児外科学会  

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  • Mucosectom2とSB knife Jr.の大腸の粘膜下層剥離術における前向き無作為比較試験

    杉原 雄策, 原田 馨太, 河原 祥朗, 高嶋 志保, 竹井 大介, 井口 俊博, 高原 政宏, 桑木 健志, 平岡 佐規子, 岡田 裕之

    Gastroenterological Endoscopy   59 ( Suppl.1 )   944 - 944   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 大腸拡大JNET分類の有用性と今後の課題 JNET分類を難しくしているもの

    原田 馨太, 平岡 佐規子, 岡田 裕之

    Gastroenterological Endoscopy   59 ( Suppl.1 )   793 - 793   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • クローン病小腸狭窄病変に対するダブルバルーン小腸内視鏡逆行性造影の有用性の検討

    岡崎 倫子, 井口 俊博, 平岡 佐規子, 竹井 大介, 高嶋 志保, 原田 馨太, 川野 誠司, 岡田 裕之

    Gastroenterological Endoscopy   59 ( Suppl.1 )   1093 - 1093   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 【腸炎まるわかり】腸管Behcet病と単純性潰瘍

    平岡 佐規子, 井口 俊博, 川野 誠司, 原田 馨太, 岡田 裕之

    消化器内視鏡   29 ( 1 )   55 - 59   2017年1月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    腸管Behcet病および単純性潰瘍は、内視鏡像は酷似しているが、前者はBehcet徴候を有する全身性疾患で、後者は腸管に限局した疾患である。基本的には別の疾患と考えられるが、鑑別が難しい場合もある。両疾患の定型病変は回盲部の円形または類円形の深掘れ潰瘍である。その特徴的な形態から診断は容易なこともあるが、特に単純性潰瘍は他疾患との鑑別も必要である。(著者抄録)

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  • 3年間の内視鏡所見の変化を観察できた食道異所性皮脂腺の1例

    岩室 雅也, 岡田 裕之, 原田 馨太, 神崎 洋光, 堀 圭介, 喜多 雅英, 川野 誠司, 河原 祥朗, 田中 健大, 山本 和秀

    岡山医学会雑誌   128 ( 3 )   201 - 205   2016年12月

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    記述言語:日本語   出版者・発行元:岡山医学会  

    50歳女。43歳時に健診で胃病変を指摘され、上部消化管内視鏡検査で上部食道を中心に黄白色調の粒状病変を散在性に認め、生検で異所性皮脂腺と診断された。46歳時の内視鏡検査では下部食道にも淡い白色調の顆粒状集簇像がびまん性にみられた。3年間の経過観察中に下部食道病変は経時的に明瞭化したが、上部食道病変は肉眼的にほぼ不変であった。自験例では先天的に存在していた異所性皮脂腺の脂腺細胞が増殖した可能性、あるいは脂腺細胞の細胞質内に脂質滴が蓄積されて病変が明瞭化した可能性が示唆された。また、過去に食道異所性皮脂腺と診断された6例(男3例、女3例、平均年齢59.3歳)はいずれも上部消化管内視鏡検査で偶発的に発見されており、内視鏡所見は典型的な食道異所性皮脂腺の像であった。

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J00175&link_issn=&doc_id=20161216120004&doc_link_id=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F54616&url=http%3A%2F%2Fousar.lib.okayama-u.ac.jp%2F54616&type=%89%AA%8ER%91%E5%8Aw%81F%89%AA%8ER%91%E5%8Aw%8Aw%8Fp%90%AC%89%CA%83%8A%83%7C%83W%83g%83%8A&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F80034_3.gif

  • 増大傾向を示し術前診断が困難であった虫垂子宮内膜症の1例

    加藤 諒, 杉原 雄策, 原田 馨太, 高嶋 志保, 竹井 大介, 井口 俊博, 半井 明日香, 高原 政宏, 平岡 佐規子, 田中 健大, 岡田 裕之

    消化器の臨床   19 ( 3 )   258 - 262   2016年6月

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    記述言語:日本語   出版者・発行元:(株)ヴァンメディカル  

    49歳、女性。大腸内視鏡検査で虫垂開口部に増大する粘膜下腫瘍様隆起を指摘され、外科的切除を施行、虫垂子宮内膜症と診断した。術前診断に難渋した虫垂子宮内膜症を経験したので、文献的考察を含めて報告する。(著者抄録)

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  • EMR手技のスキルアップを目指して スネア先端を用いたprecutting EMRのススメ

    原田 馨太, 高嶋 志保, 竹井 大介, 井口 俊博, 半井 明日香, 杉原 雄策, 高原 政宏, 平岡 佐規子, 河原 祥朗, 岡田 裕之

    日本大腸検査学会雑誌   32 ( 2 )   127 - 127   2016年3月

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    記述言語:日本語   出版者・発行元:日本大腸検査学会  

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  • 原発性小腸癌34例の治療成績

    秋元 悠, 那須 淳一郎, 岩室 雅也, 神崎 洋光, 堤 康一郎, 喜多 雅英, 川野 誠司, 原田 馨太, 加藤 博也, 平岡 佐規子, 河原 祥朗, 八木 孝仁, 大塚 文男, 岡田 裕之

    日本病院総合診療医学会雑誌   9 ( 1 )   23 - 29   2015年10月

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    記述言語:日本語   出版者・発行元:(一社)日本病院総合診療医学会  

    当院の原発性小腸癌患者34例の治療成績を解析した。原発部位は十二指腸29例、空腸3例、回腸1例、空腸または回腸1例、臨床病期はStage I 11例、Stage II 5例、Stage III 6例、Stage IV 12例。治療内容は、Stage Iでは内視鏡的切除5例と手術6例、Stage II/Stage IIIでは全例手術、Stage IVでは化学療法のみが3例、化学療法+原発巣切除が3例、原発巣切除+転移巣切除が4例、緩和治療が2例で、5年生存率はStage I/IIが80%、Stage IIIが33%、Stage IVが39%であった。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J05937&link_issn=&doc_id=20160609410004&doc_link_id=%2Ffg3byoin%2F2015%2F000901%2F004%2F0023-0029%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Ffg3byoin%2F2015%2F000901%2F004%2F0023-0029%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 同種造血幹細胞移植施行後GVHD症例の重症度・治療反応性は、回腸末端の内視鏡所見より予測できるか?

    杉原 雄策, 平岡 佐規子, 高嶋 志保, 竹井 大介, 半井 明日香, 高原 政宏, 原田 馨太, 岡田 裕之, 山本 和秀, 田中 健大

    Gastroenterological Endoscopy   57 ( Suppl.2 )   2132 - 2132   2015年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 内視鏡的粘膜下層剥離術(ESD)が施行された大腸T1(SM)癌の治療成績と予後の検討

    榮 浩行, 原田 馨太, 浦岡 俊夫, 高嶋 志保, 井口 俊博, 竹井 大介, 杉原 雄策, 半井 明日香, 高原 政宏, 小林 沙代, 高橋 索真, 齊藤 俊介, 堀井 城一朗, 東 玲治, 平岡 佐規子, 岡田 裕之, 山本 和秀

    Gastroenterological Endoscopy   57 ( Suppl.1 )   804 - 804   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 直腸肛門部腫瘍の術後吻合部狭窄に対する、内視鏡的新規治療RIC法応用の試み

    原田 馨太, 岡田 裕之, 高嶋 志保, 竹井 大介, 井口 俊博, 半井 明日香, 杉原 雄策, 高原 政宏, 川野 誠司, 平岡 佐規子, 河原 祥朗, 近藤 喜太, 山本 和秀

    Gastroenterological Endoscopy   57 ( Suppl.1 )   927 - 927   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 大腸LSTの病態生理と診断・治療戦略 大腸ESD後の異時性多発及び局所再発に関する検討

    竹井 大介, 原田 馨太, 岡田 裕之

    日本消化器病学会雑誌   112 ( 臨増総会 )   A130 - A130   2015年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 潰瘍性大腸炎患者における大腸腫瘍性病変の内視鏡治療 当院の現況

    原田 馨太, 平岡 佐規子, 高嶋 志保, 竹井 大介, 井口 俊博, 半井 明日香, 杉原 雄策, 高原 政宏, 衣笠 秀明, 川野 誠司, 河原 祥朗, 岡田 裕之, 山本 和秀

    日本消化器病学会雑誌   112 ( 臨増総会 )   A496 - A496   2015年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • CD長期罹患例を検討し、抗TNFα抗体治療の不要なCD症例を探る

    井口 俊博, 平岡 佐規子, 加藤 順, 竹井 大介, 半井 明日香, 原田 馨太, 岡田 裕之, 山本 和秀

    日本消化器病学会雑誌   111 ( 臨増大会 )   A881 - A881   2014年9月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 当院におけるパテンシーカプセルの使用経験

    森藤 由記, 川野 誠司, 平岡 佐規子, 井口 俊博, 竹井 大介, 半井 明日香, 高橋 索真, 秋田 光洋, 原田 馨太, 岡田 裕之, 山本 和秀

    Gastroenterological Endoscopy   56 ( Suppl.1 )   1167 - 1167   2014年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 大腸sessile serrated adenoma/poylpとhyperplastic polypのIEEを用いた内視鏡診断基準の確立

    浦岡 俊夫, 東 玲治, 堀井 城一朗, 原田 馨太, 堀 圭介, 水野 元夫, 友田 純, 大原 信哉, 田中 健大, 矢作 直久, 山本 和秀

    Gastroenterological Endoscopy   56 ( Suppl.1 )   1359 - 1359   2014年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 当院における消化管神経内分泌腫瘍(NET)の治療成績

    筑木 隆雄, 岡田 裕之, 山本 和秀, 河原 祥朗, 那須 淳一郎, 平岡 佐規子, 原田 馨太, 松原 稔, 喜多 雅英, 堀 圭介, 秋田 光洋, 高橋 索真, 神崎 洋光, 井口 俊博, 三浦 公, 河野 吉泰, 半井 明日香, 森藤 由記, 竹井 大介

    Gastroenterological Endoscopy   56 ( Suppl.1 )   1339 - 1339   2014年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 当院における原発性小腸癌34例の検討

    秋元 悠, 那須 淳一郎, 神崎 洋光, 堤 康一郎, 松原 稔, 筑木 隆雄, 喜多 雅英, 川野 誠司, 原田 馨太, 加藤 博也, 平岡 佐規子, 河原 祥朗, 岡田 裕之, 八木 孝仁, 山本 和秀

    日本消化器病学会雑誌   111 ( 臨増総会 )   A347 - A347   2014年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • Ras/ERK系と大腸粘膜治癒 Ras/ERK系の阻害因子Spred-2の解析を通じて

    高橋 索真, 平岡 佐規子, 伏見 聡一郎, 伊藤 利洋, 板倉 淳哉, 木村 亮二朗, 楊 旭, 篠倉 美理, 中川 裕貴, 住居 優一, 竹井 大介, 井口 俊博, 半井 明日香, 森藤 由記, 秋田 光洋, 原田 馨太, 岡田 裕之, 松川 昭博, 山本 和秀

    消化器と免疫   ( 50 )   66 - 68   2014年3月

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    記述言語:日本語   出版者・発行元:日本消化器免疫学会  

    【目的】Ras/ERK系を抑制するSpred-2のIBDへの関与を検討する。【方法】Spred-2 KOマウスおよびWTマウスにDSS腸炎を誘導し、症状変化・組織像・大腸粘膜の細胞増殖を評価した。【結果】Spred-2 KOマウスではWTマウスより腸炎の症状が軽く、腸管上皮の再生が速やかであった。また、腸管上皮中のBrdU陽性細胞の比率が有意に高かった。【結論】Spred-2はIBDにおける粘膜治癒を抑制している可能性がある。(著者抄録)

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  • 【小腸粘膜傷害の診断と治療の最前線】小腸粘膜傷害の診断に対する小腸内視鏡の有用性と限界

    川野 誠司, 岡田 裕之, 井口 俊博, 秋田 光洋, 喜多 雅英, 原田 馨太, 平岡 佐規子, 那須 淳一郎, 河原 祥朗, 山本 和秀

    消化管の臨床   19   17 - 21   2014年3月

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    記述言語:日本語   出版者・発行元:うず潮フォーラム事務局  

    小腸粘膜傷害を認めた非腫瘍性疾患のうち、慢性疾患を中心に内視鏡像から(1)縦走潰瘍、(2)小病変(びらん、アフタ)、(3)輪状潰瘍に分類し、小腸内視鏡の有用性と限界について検討した。クローン病とNSAIDs起因性小腸粘膜傷害は、(1)〜(3)すべての像を呈する場合があり、常に鑑別診断として念頭に置いておく必要がある。一方で、輪状潰瘍を呈する疾患では確定診断不能な症例を経験した。今後、このような症例を重ねて検討を追加していくと同時に、各疾患の病態や治療についてもさらなる検討を必要とすると考えられた。(著者抄録)

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  • 【大腸側方発育型腫瘍(LST)-新たな時代へ】LSTの遺伝子学的特徴 大腸癌の発癌機序からみたLSTの位置づけ

    平岡 佐規子, 原田 馨太, 加藤 順

    Intestine   18 ( 1 )   53 - 60   2014年1月

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    記述言語:日本語   出版者・発行元:(株)日本メディカルセンター  

    側方に発育する大腸腫瘍であるLST-G,LST-NG,sessile serrated adenoma/polyp(SSA/P)は,分子生物学的にも違いがあり,それぞれ異なった発癌過程を反映する形態変化と考えられる.形態により違いのみられるおもな遺伝子変化は,RAS/RAF/MAPK系シグナルの遺伝子変異(K-ras,BRAF変異)とDNAメチル化の頻度(CIMP)であり,LST-GはK-ras変異,CIMP-low,LST-NGはCIMP-negative,SSA/PはBRAF変異,CIMP-highがそれぞれ特徴的である.(著者抄録)

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  • 免疫学的便潜血定量法による潰瘍性大腸炎の粘膜治癒評価

    半井 明日香, 加藤 順, 平岡 佐規子, 栗山 宗彰, 井口 俊博, 竹井 大介, 森藤 由記, 秋田 光洋, 高橋 索真, 原田 馨太, 岡田 裕之, 山本 和秀

    岡山医学会雑誌   125 ( 3 )   221 - 223   2013年12月

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    記述言語:日本語   出版者・発行元:岡山医学会  

    大腸内視鏡検査と免疫学的便潜血定量法(FIT)をほぼ同時に行った潰瘍性大腸炎(UC)患者152人(男性77人、女性75人、年齢中央値31歳)を対象に、便中ヘモグロビン(Hb)濃度と内視鏡所見を比較し、FITによる粘膜治癒評価の有用性について検討した。病型は全大腸炎型98、左側結腸炎型31、直腸炎型23であった。便中Hb濃度と大腸粘膜所見のMayo endoscopic scoreとの間に有意な相関を認め(Spearman順位相関係数=0.549)、FIT陰性例(Hb濃度<100ng/ml)はscore 0で92%、score 1で47%、score 2で13%、score 3で12%を占め、scoreが小さいほど陰性例の割合が有意に多かった。FIT陰性例の粘膜治癒予測能はscore 0で感度0.92、特異度0.71、正診率0.74、score 0、1で各々0.60、0.87、0.72であり、FIT陽性例(Hb濃度≧100ng/ml)ではscore 2、3で各々0.87、0.60、0.72であった。FITはUCにおける粘膜状態を良く反映し、特にFIT陰性は粘膜治癒と強く相関した。

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J00175&link_issn=&doc_id=20131206280006&doc_link_id=10.4044%2Fjoma.125.221&url=https%3A%2F%2Fdoi.org%2F10.4044%2Fjoma.125.221&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • CRPの上昇がみられないクローン病患者における粘膜治癒の指標

    半井 明日香, 平岡 佐規子, 加藤 順, 井口 俊博, 平川 智子, 高橋 索真, 秋田 光洋, 堀 圭介, 原田 馨太, 岡田 裕之, 山本 和秀

    Gastroenterological Endoscopy   55 ( Suppl.1 )   1043 - 1043   2013年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 潰瘍性大腸炎の活動性・予後予測における血清糖鎖マーカーの有用性

    宮原 孝治, 能祖 一裕, 平岡 佐規子, 森元 裕貴, 高橋 索真, 小林 沙代, 斎藤 俊介, 原田 馨太, 山本 和秀, 天野 麻穂, 西村 紳一郎

    日本臨床分子医学会学術総会プログラム・抄録集   50回   76 - 76   2013年4月

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    記述言語:日本語   出版者・発行元:日本臨床分子医学会  

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  • 若年女性が喫煙後に急性呼吸不全を呈した症例

    山下 貴弘, 高尾 和志, 三谷 玲雄, 三谷 納, 原田 馨太, 浪越 為八, 名和 徹, 幡 英典, 濱本 博美, 藪下 和久, 下江 俊成, 坂口 孝作, 浮田 實

    福山医学   ( 19 )   114 - 114   2013年3月

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    記述言語:日本語   出版者・発行元:福山市医師会  

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  • アロプリノールによる薬剤性間質性肺炎の1例

    三谷 納, 高尾 和志, 三谷 玲雄, 山下 貴弘, 原田 馨太, 浪越 為八, 名和 徹, 幡 英典, 濱本 博美, 藪下 和久, 下江 俊成, 坂口 孝作, 浮田 實

    福山医学   ( 19 )   114 - 115   2013年3月

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    記述言語:日本語   出版者・発行元:福山市医師会  

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  • 腹腔動脈限局解離を来たし、Segmental Arterial Mediolysisが考えられた1例

    榮 浩行, 濱本 博美, 三浦 公, 辰川 匡史, 原田 馨太, 名和 徹, 植木 亨, 藪下 和久, 下江 俊成, 坂口 孝作, 遠藤 久之

    福山医学   ( 20 )   103 - 103   2013年3月

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    記述言語:日本語   出版者・発行元:福山市医師会  

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  • 内視鏡検査にて診断された小腸原発悪性リンパ腫の検討

    川野 誠司, 岡田 裕之, 井口 俊博, 秋田 光洋, 喜多 雅英, 原田 馨太, 平岡 佐規子, 那須 淳一郎, 河原 祥朗, 吉野 正, 山本 和秀

    日本消化器病学会雑誌   110 ( 臨増総会 )   A263 - A263   2013年2月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • Ras/Raf/ERKの抑制因子Spred-2は、マウス炎症性腸疾患モデルにおいて、腸管再生抑制に関与している

    高橋 索真, 平岡 佐規子, 井口 俊博, 半井 明日香, 平川 智子, 秋田 光洋, 原田 馨太, 岡田 裕之, 山本 和秀

    日本消化器病学会雑誌   110 ( 臨増総会 )   A224 - A224   2013年2月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • サイトメガロウイルス抗原陽性及び陰性UC症例の内科的治療法と長期手術率

    井口 俊博, 平岡 佐規子, 加藤 順, 半井 明日香, 鈴木 英之, 秋田 光洋, 高橋 索真, 原田 馨太, 岡田 裕之, 山本 和秀

    日本消化器病学会雑誌   110 ( 臨増総会 )   A202 - A202   2013年2月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 【大腸ESDの適応と実際】線維化からみた大腸ESDの適応と実際 EMR後局所遺残・再発病変への対応も含めて

    浦岡 俊夫, 堀井 城一朗, 石居 公之, 後藤 修, 原田 馨太, 岡田 裕之, 矢作 直久

    胃と腸   48 ( 2 )   155 - 163   2013年2月

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    記述言語:日本語   出版者・発行元:(株)医学書院  

    大腸の粘膜下層の線維化の成因には,(1)癌の粘膜下層への浸潤,(2)人為的要因(術前生検,局注の既往,EMR後局所遺残・再発),(3)腸管の蠕動運動,(4)慢性炎症(炎症性腸疾患など)が挙げられる.大腸ESDは,このようなEMRでは切除困難もしくは不可能な病変に対して,技術的に困難ではあるものの,一括切除が期待できる手技である.しかし,穿孔の危険性がより高く,長時間の手技となることがある粘膜下層の線維化を有する病変に対するESDには,高い技術と経験が必要である.大腸ESDを安全かつ確実に完遂するには,病変の困難性を術前に予測したうえで,術者は技量および経験とのバランスを図る必要がある.(著者抄録)

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  • 大腸ESDにおける穿孔例の検討

    原田 馨太, 平岡 佐規子, 岡田 裕之, 井口 俊博, 半井 明日香, 平川 智子, 秋田 光洋, 喜多 雅英, 松原 稔, 川野 誠司, 那須 淳一郎, 河原 祥朗, 山本 和秀

    日本消化器病学会雑誌   110 ( 臨増総会 )   A290 - A290   2013年2月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 【安全かつ効率的な大腸ESDを目指して】大腸ESDを安全かつ確実に行うために 線維化症例に対するコツと対策

    堀井 城一朗, 浦岡 俊夫, 石居 公之, 後藤 修, 原田 馨太, 岡田 裕之, 矢作 直久

    Intestine   17 ( 1 )   35 - 42   2013年1月

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    記述言語:日本語   出版者・発行元:(株)日本メディカルセンター  

    ESDは,EMRでは切除困難もしくは不可能な粘膜下層に線維化を伴う病変に対しても,一括切除が期待できる手技である.しかし,線維化症例に対するESDは,難易度や,穿孔の危険性がより高く,長時間の手技となることがあり,高い技術と経験が必要とされる.このような難易度の高い大腸ESDを安全かつ確実に完遂するには,治療の困難性を術前に評価することが必要であり,十分な技量をもった術者のみが治療に当たるべきである.(著者抄録)

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  • 【直腸LSTの診断と治療】直腸ESDに対する手技的困難病変とその対応

    浦岡 俊夫, 堀井 城一朗, 石居 公之, 後藤 修, 原田 馨太, 矢作 直久

    消化器内科   55 ( 6 )   749 - 754   2012年12月

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    記述言語:日本語   出版者・発行元:(有)科学評論社  

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  • 難治性潰瘍性大腸炎におけるインフリキシマブ治療効果と前治療の有効性との関係

    平川 智子, 平岡 佐規子, 高橋 索真, 秋田 光洋, 原田 馨太, 加藤 順, 岡田 裕之, 山本 和秀

    日本消化器病学会雑誌   109 ( 臨増大会 )   A834 - A834   2012年9月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 比較的大型の大腸腫瘍に対するEMRの有用性について

    原田 馨太, 平岡 佐規子, 高橋 索真, 平川 智子, 秋田 光洋, 加地 英輔, 那須 淳一郎, 河原 祥朗, 岡田 裕之, 山本 和秀

    Gastroenterological Endoscopy   54 ( Suppl.2 )   2921 - 2921   2012年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 他臓器癌の併存または既往は大腸腫瘍のリスクとなるか?(Is Presence or History of Extracolonic Primary Malignancy a Risk for Colorectal Neoplasia?)

    秋田 光洋, 平岡 佐規子, 平川 智子, 原田 馨太, 山本 和秀, 加藤 順

    日本癌学会総会記事   71回   172 - 173   2012年8月

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    記述言語:英語   出版者・発行元:(一社)日本癌学会  

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  • 【知ってますか!SSA/Pとその癌化】LHP(large hyperplastic polyp)とSSA/Pは同じか 通常観察から(色素内視鏡、拡大内視鏡を中心に)

    浦岡 俊夫, 堀井 城一朗, 原田 馨太, 東 玲治, 堀 圭介, 加地 英輔, 平川 智子, 友田 純, 岡田 裕之, 大江 啓常, 水野 元夫, 山本 和秀, 大原 信哉, 矢作 直久

    消化器内視鏡   24 ( 7 )   1129 - 1137   2012年7月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    Sessile serrated adenoma/polyp(SSA/P)は、大腸癌のなかで一定の頻度で認められるマイクロサテライト不安定性が高度なMSI-H癌の前駆病変として近年注目されている。一方、癌化のリスクが極めて低いと考えられてきたHPは、癌化例が症例報告されるようになり、その多くは10mmを超えることから、臨床においてlarge hyperplastic polyp(LHP)という用語が便宜上用いられている。今回の検討によると、内視鏡的に発見されたLHPは、病理組織学的にはHPとSSA/Pに区別されることが示され、SSA/Pを内視鏡診断するうえで、右側、病変表面の強い粘液付着が有意な所見であった。また、シダ状のIIIH型pit patternとNBI拡大観察での拡張・蛇行した血管varicose microvascular vessel(VMV)も有意な所見であり、特異度が高かった。10mm以上のHPとSSA/Pの取り扱いを区別する意義は、今後の鋸歯状病変自体のterminologyの確立、本病変を正確に診断するための内視鏡技術と分子生物学的な側面からのアプローチによる病変の解明によって明らかになると考えられる。(著者抄録)

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  • 膵尾部の小病変に対するEUS-FNAにおいて、呼吸性変動軽減を目的とした、腹部用手圧迫法施行例の検討

    植木 亨, 三浦 公, 榮 浩行, 名和 徹, 原田 馨太, 辰川 匡史, 濱本 博美, 藪下 和久, 遠藤 久之, 下江 俊成, 坂口 孝作

    Gastroenterological Endoscopy   54 ( Suppl.1 )   1270 - 1270   2012年4月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 胃静脈瘤出血に対する治療法の検討

    原田 馨太, 植木 亨, 名和 徹, 三浦 公, 榮 浩行, 辰川 匡史, 藪下 和久, 遠藤 久之, 下江 俊成, 坂口 孝作

    Gastroenterological Endoscopy   53 ( Suppl.2 )   2623 - 2623   2011年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 総胆管結石に対するEST併用ラージバルーン法(ESLBD)による採石術の検討

    榮 浩行, 植木 亨, 三浦 公, 辰川 匡史, 原田 馨太, 名和 徹, 濱本 博美, 藪下 和久, 下江 俊成, 坂口 孝作, 遠藤 久之

    Gastroenterological Endoscopy   53 ( Suppl.2 )   2758 - 2758   2011年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 内視鏡的止血困難例に対し、大動脈遮断バルーンカテーテルを用い出血死を回避できた2例

    三浦 公, 植木 亨, 榮 浩行, 原田 馨太, 辰川 匡史, 名和 徹, 濱本 博美, 藪下 和久, 下江 俊成, 坂口 孝作, 遠藤 久之, 宮庄 浩司

    Gastroenterological Endoscopy   53 ( Suppl.2 )   2677 - 2677   2011年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 最近当科入院した急性ウイルス性肝炎の9例

    山田 大介, 佐藤 麻夕子, 原田 馨太, 幡 英典, 名和 徹, 三谷 玲雄, 高尾 和志, 濱本 博美, 藪下 和久, 遠藤 久之, 坂口 孝作, 下江 俊成, 守本 洋一, 浮田 實

    福山医学   ( 18 )   97 - 97   2011年8月

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    記述言語:日本語   出版者・発行元:福山市医師会  

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  • 胃瘻造設後に腸壁嚢胞状気腫(Pneumatosis Cystoides Intestinalis;PCI)を認めた一例

    佐藤 麻夕子, 高尾 和志, 幡 英典, 山田 大介, 名和 徹, 原田 馨太, 三谷 玲雄, 濱本 博美, 藪下 和久, 遠藤 久之, 坂口 孝作, 下江 俊成, 守本 洋一, 浮田 實

    福山医学   ( 18 )   97 - 97   2011年8月

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    記述言語:日本語   出版者・発行元:福山市医師会  

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  • 【細径スコープを使いこなす-2011】[下部消化管:治療] 細径内視鏡併用によるESD

    浦岡 俊夫, 石川 信, 東 玲治, 原田 馨太, 鈴木 英之, 堀 圭介, 河原 祥朗, 岡田 裕之, 山本 和秀, 石居 公之, 矢作 直久

    消化器内視鏡   23 ( 6 )   1117 - 1123   2011年6月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    大腸ESD(endoscopic submucosal dissection)は、その先進施設においては、安全に施行されるようになってきたが、長時間の施行時間や各種デバイスなどに対するコストがかかるなどの問題が残されている。筆者らは、より安全・確実にESDを施行するためには、更なる工夫による問題点の克服が必要だと考え、直腸および遠位S状結腸の病変を対象とした細径内視鏡補助下ESD(thin endoscope assisted-ESD:TEA-ESD)を考案した。本法では、上部消化管用細径内視鏡がカンタートラクションとしての役割を担う。周囲切開と少しの剥離後に病変辺縁にクリップを掛け、同時に挿入した上部消化管用細径スコープにてクリップを把持し、スコープのアングル操作にてカンタートラクションをかける。もう1本の通常の上部消化管用内視鏡を介したナイフにて粘膜下層を剥離することによって、病変を一括切除する方法である。剥離したい部位の粘膜下層を自由かつ十分に展開できるため、安全な一括切除が可能となる。(著者抄録)

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  • 【進むべきか引くべきか胃と大腸のSM癌-ESD時代の術前診断と治療戦略】[大腸SM癌の診断と治療] 切除後にSM癌と判明した場合の対応

    浦岡 俊夫, 平川 智子, 鈴木 英之, 東 玲治, 原田 馨太, 河原 祥朗, 岡田 裕之, 緒方 晴彦, 矢作 直久, 山本 和秀

    消化器内視鏡   23 ( 5 )   967 - 975   2011年5月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    大腸SM癌は、約10〜15%の症例でリンパ節転移を認められる一方で、85〜90%の症例にはリンパ節転移がない。リンパ節郭清を行わない内視鏡的切除で根治が得られる病変を効果的に抽出することが、より多くの患者をより低侵襲な治療法の選択へと導く。ESDの大腸への導入にて、従来は切除できなかった大型病変やnon lifting sign陽性病変が切除されるようになった現状において、切除標本の病理組織学的検索による根治度判定は、ますます重要になってきていると考えられる。明確かつ適切な追加腸切除の適応を決定するためには、今後も、より確証の高いエビデンスを構築していく必要がある。また、臨床医においては、正確な術前内視鏡診断能、十分な病理組織学的検索を行うための内視鏡的切除の技術、そして、病理医と十分なディスカッションが行えるための病理組織学的知識を身につけておく必要がある。(著者抄録)

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  • 腫瘤形成性自己免疫性膵炎(AIP)の外科的切除後の残膵にAIPが再燃した2例

    植木 亨, 榮 浩行, 名和 徹, 原田 馨太, 三浦 公, 辰川 匡史, 濱本 博美, 藪下 和久, 遠藤 久之, 下江 俊成, 坂口 孝作

    日本消化器病学会雑誌   108 ( 臨増総会 )   A216 - A216   2011年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 後腹膜線維症を合併した自己免疫性膵炎の2例

    榮 浩行, 植木 亨, 三浦 公, 辰川 匡史, 原田 馨太, 濱本 博美, 名和 徹, 藪下 和久, 下江 俊成, 坂口 孝作, 遠藤 久之

    日本消化器病学会雑誌   108 ( 臨増総会 )   A372 - A372   2011年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • ASVSにて特異な反応を示したインスリノーマの一例

    濱本 博美, 辰川 匡史, 原田 馨太, 浪越 為八, 三谷 玲雄, 名和 徹, 末次 慶収, 高尾 和志, 植木 亨, 藪下 和久, 下江 俊成, 坂口 孝作

    日本内分泌学会雑誌   86 ( 3 )   707 - 707   2010年12月

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    記述言語:日本語   出版者・発行元:(一社)日本内分泌学会  

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  • Nutcracker esophagusの一例

    原田 馨太, 名和 徹, 幡 英典, 藪下 和久, 遠藤 久之, 下江 俊成, 坂口 孝作

    日本消化器病学会雑誌   107 ( 臨増大会 )   A766 - A766   2010年9月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 当院でのPEG造設術クリニカルパス導入の試み

    小林 友美, 妹尾 梨絵, 小林 明日香, 平 佳代子, 森本 和美, 内田 朋子, 藤本 理美, 川崎 未来, 高下 仁美, 河村 美保, 井谷 史嗣, 原田 馨太, 名和 徹

    静脈経腸栄養   25 ( 1 )   435 - 435   2010年1月

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    記述言語:日本語   出版者・発行元:(株)ジェフコーポレーション  

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  • 【消化管癌の自然史】大腸腫瘍の自然史におけるRasシグナル異常 腫瘍局在による異常パターンの違いについて

    原田 馨太, 平岡 佐規子, 加藤 順, 山本 和秀

    消化器科   49 ( 2 )   166 - 172   2009年8月

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    記述言語:日本語   出版者・発行元:(有)科学評論社  

    大腸腫瘍の自然史におけるRasシグナル異常について検討した。対象は大腸ポリープ切除を受けた97人(年齢中央値67歳)からの120検体であった。1)腫瘍存在部位は近位結腸48(40%)、遠位結腸49(41%)、直腸23(19%)で、病理では管状腺腫72(60%)、管状絨毛腺腫40(33)、鋸歯状腺腫8(7%)であった。2)49検体(41%)にK-ras/BRAF変異が認められ、近位結腸・直腸で多く、遠位結腸で少ない傾向であった。3)30検体(25%)にRASSF2のメチル化がみられ、近位結腸・直腸で多く、遠位結腸で少ない傾向であった。4)RASSF2メチル化を有する腺腫の73%にK-ras/BRAF変異を有しており、多変量解析では鋸歯状腺腫が有意に関連し(OR 11.11)、遠位結腸で有意に関連が少なかった(OR 0.13)。5)大腸癌切除標本からの65検体ではK-ras/BRAF変異とRASSF2メチル化の両方を認めたのは近位結腸・直腸で多く、遠位結腸で少なかったが、癌では腺腫に比べ近位結腸での頻度が有意に高かった。

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  • 腎不全患者における葉酸・ホモシステインの大腸腫瘍発生に与える影響(Effect of Mate and homocysteine on colon tumorgenesis in end-stage renal disease patients)

    加地 英輔, 加藤 順, 齊藤 俊介, 堀井 城一朗, 原田 馨太, 平岡 佐規子, 山本 和秀

    日本癌学会総会記事   68回   306 - 306   2009年8月

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    記述言語:英語   出版者・発行元:(一社)日本癌学会  

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  • 切除18ヵ月後に肝転移をきたした径7mmのS状結腸早期癌の1例

    原田 馨太, 加藤 順, 竹本 浩二, 浦岡 俊夫, 平岡 佐規子, 柳井 広之, 山本 和秀

    日本消化器病学会雑誌   106 ( 5 )   660 - 667   2009年5月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

    症例は74歳男性。便潜血陽性に対する精査目的の大腸内視鏡検査にて、S状結腸に径7mm大のO-Is型腫瘍を指摘され、内視鏡的粘膜切除術を施行した。切除標本の病理組織学的診断は高分化腺癌で、粘膜下浸潤と脈管侵襲が認められたため、追加切除を行った。しかし術後18ヵ月目にCEAの上昇を認め、腹部造影CT、FDG-PET、超音波エコー検査にて15mmの単発肝転移による異時性再発を診断された。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J01118&link_issn=&doc_id=20090518090006&doc_link_id=10024850990&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F10024850990&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

  • 大腸内視鏡検査のトレーニングシステムには、CO2送気の導入が望まれる

    浦岡 俊夫, 加藤 順, 栗山 宗彰, 原田 馨太, 石川 信, 竹本 浩二, 平岡 佐規子, 堀井 城一朗, 藤田 英行, 鈴木 英之, 堀 圭介, 山本 和秀

    日本消化器病学会雑誌   106 ( 臨増総会 )   A255 - A255   2009年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 過形成性ポリープから発生したと考えられた大腸SM癌の1例

    浦岡 俊夫, 加藤 順, 平岡 佐規子, 原田 馨太, 石川 信, 栗山 宗彰, 鈴木 英之, 齊藤 俊介, 堀井 城一朗, 大原 信哉, 山本 和秀

    早期大腸癌   12 ( 5 )   501 - 508   2008年9月

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    記述言語:日本語   出版者・発行元:(株)日本メディカルセンター  

    症例は51歳男性で便潜血陽性精査にて近医を受診、大腸内視鏡検査で下行結腸の脾彎曲よりに平坦・隆起性病変を指摘され、精査加療目的で紹介来院となった。大腸内視鏡所見では下行結腸彎曲よりに通常観察では10mm大のやや発赤した平坦な隆起性病変を認め、肛門側はややそぞうな粘膜で血管透見性が低下しており、病変の連続性が疑われた。インジゴカルミン散布により病変の境界は明瞭となり18mmの二段隆起を有する平坦・隆起性病変と判断した。口側の発赤隆起部はその中央部で僅かに陥凹しており、腫瘍性病変が考えられた。クリスタルバイオレット染色下拡大観察では口側隆起部にはV1軽度不整pitを認め、肛門側は白色調で粘液を有しII型pitが認められたことから過形成ポリープ(HP)と考えられた。以上の所見から、HPから発生した深達度SM1までの早期大腸癌と術前診断して内視鏡的粘膜下層剥離術(ESD)にて病変を一括切除した。病理組織学的所見にてwell differentiated adenocarcinoma in HP,pSM(250μm)・ly0・v0・LM(-)・VM(-)と診断、口側の発赤平坦・隆起部に一致して高分化腺癌が認められ、その中央部では粘膜下層への微小浸潤が認められた。遺伝子学的検索により本症例はHPからserrated neoplastic pathwayを介し、浸潤癌へと発育進展した病変であることが示唆された。

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  • 左側結腸において正常粘膜のDNAメチル化と大腸腫瘍発生・進展とは関連する(Methylation of background normal mucosa is correlated with occurrence and development of neoplasia in the distal colon)

    平岡 佐規子, 加藤 順, 堀井 城一朗, 斉藤 俊介, 加地 英輔, 原田 馨太, 藤田 英行, 山本 和秀

    日本癌学会総会記事   67回   208 - 208   2008年9月

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    記述言語:英語   出版者・発行元:(一社)日本癌学会  

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  • 大腸ポリープにおけるK-rasのG to A変異はMGMTのメチル化よりもESR1のメチル化と関連する(K-ras G to A transition in colorectal adenomas is not correlated with methylation of MGMT, but with that of ESR1)

    堀井 城一朗, 平岡 佐規子, 加藤 順, 斉藤 俊介, 加地 英輔, 原田 馨太, 藤田 英行, 山本 和秀

    日本癌学会総会記事   67回   171 - 171   2008年9月

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    記述言語:英語   出版者・発行元:(一社)日本癌学会  

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  • 【NBI/FICEとpit pattern】NBIによるpit pattern観察 NBI観察が深達度診断に有用であった早期大腸癌の1例

    浦岡 俊夫, 加藤 順, 原田 馨太, 平岡 佐規子, 石川 信, 大原 信哉, 山本 和秀

    早期大腸癌   12 ( 4 )   404 - 405   2008年7月

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    記述言語:日本語   出版者・発行元:(株)日本メディカルセンター  

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  • 過形成性ポリープから発生したと考えられた大腸SM癌の一例

    浦岡 俊夫, 加藤 順, 平岡 佐規子, 原田 馨太, 石川 信, 大原 信哉

    早期大腸癌   12 ( 3 )   330 - 331   2008年5月

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    記述言語:日本語   出版者・発行元:(株)日本メディカルセンター  

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  • 【大腸疾患の実地診療 増加する大腸癌と炎症性腸疾患への対応】大腸疾患の実地診療・セミナー 大腸癌の現状と実地診断の実際 大腸癌診断へのプロセス どのような症状・検査所見から大腸癌を疑い、検査を組み立てるか

    原田 馨太, 加藤 順

    Medical Practice   25 ( 4 )   619 - 623   2008年4月

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    記述言語:日本語   出版者・発行元:(株)文光堂  

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  • 消化管癌の自然史を見直す 大腸腫瘍の自然史におけるRasシグナル異常 腫瘍局在による異常パターンの違いについて

    原田 馨太, 平岡 佐規子, 山本 和秀

    日本消化器病学会雑誌   105 ( 臨増総会 )   A142 - A142   2008年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 低用量アスピリン内服患者における便潜血検査の意義

    石川 信, 加藤 順, 山本 和秀, 浦岡 俊夫, 平岡 佐規子, 竹本 浩二, 栗山 宗彰, 藤田 英行, 原田 馨太, 堀井 城一朗, 秋田 光洋, 斉藤 俊介, 鈴木 英之

    日本消化器病学会雑誌   105 ( 臨増総会 )   A197 - A197   2008年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 【大腸EMR、ESDの進歩】ESD デバイスの工夫・改良 Bナイフ

    浦岡 俊夫, 斎藤 豊, 中島 健, 原田 馨太, 加藤 順, 松田 尚久

    早期大腸癌   11 ( 6 )   511 - 515   2007年11月

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    記述言語:日本語   出版者・発行元:(株)日本メディカルセンター  

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  • K-ras/BRAF変異及びRASSF2メチル化を保持する大腸腺腫の特徴(Characteristics of colorectal adenomas carrying K-ras/BRAF mutation and RASSF2 methylation)

    原田 馨太, 平岡 佐規子, 加藤 順, 堀井 城一朗, 藤田 英行, 坂口 孝作

    日本癌学会総会記事   66回   84 - 84   2007年8月

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    記述言語:英語   出版者・発行元:(一社)日本癌学会  

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  • 正常結腸粘膜の広範的及び局所的なメチル化状態と進行性大腸癌のリスク(Global and locus specific methylation status of normal colon mucosa and risk of advanced colorectal neoplasia)

    平岡 佐規子, 加藤 順, 堀井 城一朗, 原田 馨太, 藤田 英行, 坂口 孝作, 白鳥 康史

    日本癌学会総会記事   66回   551 - 551   2007年8月

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    記述言語:英語   出版者・発行元:(一社)日本癌学会  

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  • 結腸癌細胞においてhMLH1の発現減少は5-フルオロウラシル介在性アポトーシスの減少に関連する(Decreased expression of hMLH1 correlates with reduced 5-fluorouracil-mediated apoptosis in colon cancer cells)

    藤田 英行, 加藤 順, 堀井 城一朗, 原田 馨太, 平岡 佐規子, 白羽 英則, 坂口 孝作, 白鳥 康史

    日本癌学会総会記事   66回   488 - 488   2007年8月

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    記述言語:英語   出版者・発行元:(一社)日本癌学会  

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  • 大腸ポリープにおけるESR1のメチル化とK-ras mutationの関連(Methylation of estrogen receptor 1 in colorectal adenomas is not age-dependent but correlated with K-ras mutation)

    堀井 城一朗, 平岡 佐規子, 加藤 順, 原田 馨太, 藤田 英行, 坂口 孝作

    日本癌学会総会記事   66回   319 - 319   2007年8月

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    記述言語:英語   出版者・発行元:(一社)日本癌学会  

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  • 大腸正常粘膜における加齢関連領域のメチル化と大腸発癌危険因子との関連

    堀井 城一朗, 平岡 佐規子, 加藤 順, 原田 馨太, 藤田 英行, 桑木 健志, 白鳥 康史

    日本消化器病学会雑誌   103 ( 臨増大会 )   A880 - A880   2006年9月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 大腸腺腫におけるCpG islandのメチル化はその肉眼形態と発生部位により異なる

    平岡 佐規子, 加藤 順, 原田 馨太, 藤田 英行, 森本 尚史, 栗山 宗彰, 竹本 浩二, 黒目 学, 森川 民也, 河本 博文, 岡田 裕之, 白鳥 康史

    日本消化器病学会雑誌   102 ( 臨増総会 )   A241 - A241   2005年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • 再発性多発軟骨炎の1例

    渡邉 徹心, 井上 禎規, 宮本 亨, 高山 典子, 原田 馨太, 小野田 友男

    西日本皮膚科   65 ( 4 )   396 - 396   2003年8月

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    記述言語:日本語   出版者・発行元:日本皮膚科学会-西部支部  

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  • 微小胃悪性リンパ腫の2例

    河原 祥朗, 吉野 正, 平良 明彦, 八木 覚, 原田 馨太, 上川 滋, 松本 誠司, 小橋 春彦, 藤木 茂篤

    Gastroenterological Endoscopy   44 ( Suppl.2 )   1536 - 1536   2002年9月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器内視鏡学会  

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  • 腹腔鏡により診断しえた結核性腹膜炎の2例

    松本 誠司, 小橋 春彦, 八木 覚, 高山 典子, 原田 馨太, 上川 滋, 河原 祥朗, 俣野 茂, 熊代 博文, 吉野 智亮, 渡邊 一彦, 柴山 卓夫, 藤木 茂篤, 北田 信吾

    津山中央病院医学雑誌   16 ( 1 )   85 - 90   2002年8月

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    記述言語:日本語   出版者・発行元:(一財)津山慈風会津山中央病院  

    症例1:74歳男.原因不明の高熱,体重減少,腹水のため紹介した.症例2:74歳女.下腹部膨満と倦怠感,少量の腹水貯留のため紹介した.腹腔鏡所見では症例1,2とも混濁した腹水が貯留し,壁側・臓側腹膜面に直径0.5〜1.0mmの白色結節をび漫性に認めた.白色結節から目標生検を行ったところ,2例とも多核巨細胞を含む類上皮肉芽腫を認め,症例1では抗酸菌染色陽性の菌体を検出,症例2では腹水の結核菌PCR法陽性であった.以上より2例とも結核性腹膜炎と診断し,いずれも抗結核療法により軽快した

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  • 再発性多発軟骨炎の一例

    渡邉 徹心, 宮本 亨, 高山 典子, 原田 馨太, 小野田 友男

    津山中央病院医学雑誌   16 ( 1 )   129 - 132   2002年8月

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    記述言語:日本語   出版者・発行元:(一財)津山慈風会津山中央病院  

    84歳男.不明熱の精査目的で左耳介の発赤,腫脹,疼痛を認め皮膚科を受診した.抗核抗体は陽性で皮膚病理組織所見では軟骨の壊死像を認め,再発性多発軟骨炎と診断した.ステロイド内服治療を施行して発熱,炎症所見ともに軽快した

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  • 内視鏡的に食道異所性皮脂腺と診断された一例

    原田 馨太, 河原 祥朗, 平良 明彦, 藤木 茂篤, 寺元 典弘, 吉野 正

    津山中央病院医学雑誌   16 ( 1 )   97 - 100   2002年8月

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    記述言語:日本語   出版者・発行元:(一財)津山慈風会津山中央病院  

    54歳女.内視鏡的に食道上皮内に多発する黄色調微細顆粒状病変を認め,生検病理組織より食道異所性皮脂腺と確定診断された.本症例は辺縁に典型的な花弁状分葉を呈した5mm以上の病変が多発しており,Large typeが中心で一部他のtypeが混在したものとすることができる.腹痛自体は胃病変によるものとされ,制酸剤などを用いて軽快した

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  • 初診時に胸部陰影を呈さず,低酸素血症で発症したp-ANCA陽性びまん性肺胞出血の一例

    八木 覚, 柴山 卓夫, 上川 滋, 原田 馨太, 高山 典子, 吉野 智亮, 平良 明彦, 渡辺 一彦, 俣野 茂, 熊代 博文, 河原 祥朗, 松本 誠司, 小橋 春彦, 藤木 茂篤, 北田 信吾

    津山中央病院医学雑誌   16 ( 1 )   91 - 95   2002年8月

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    記述言語:日本語   出版者・発行元:(一財)津山慈風会津山中央病院  

    77歳女.意識障害を伴う低酸素血症をきたして救急搬送された.来院時の胸部X線・CTでは異常陰影を認めなかったが,第4病日の胸部CTで両側び漫性にスリガラス影が出現し,呼吸状態が悪化して人工呼吸管理となった.気管支肺胞洗浄で血性BALFが回収され,血清p-ANCA陽性よりp-ANCA陽性び漫性肺胞出血と診断した.ステロイドパルス療法が奏効し,人工呼吸管理よりの離脱が可能であり,気管支鏡による迅速な診断が救命に繋がったと考えられた

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  • 当院におけるMALTリンパ腫に対するHelicobacter pylori除菌療法の検討

    河原 祥朗, 藤木 茂篤, 吉野 正, 平良 明彦, 小橋 春彦, 松本 誠司, 八木 覚, 高山 典子, 原田 馨太, 上川 滋, 北田 信吾

    日本消化器病学会雑誌   99 ( 臨増総会 )   A214 - A214   2002年3月

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    記述言語:日本語   出版者・発行元:(一財)日本消化器病学会  

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  • B型慢性肝炎に対するインターフェロン少量間欠長期投与

    小橋 春彦, 松本 誠司, 若林 肇, 八木 覚, 高山 典子, 原田 馨太, 上川 滋, 河原 祥朗, 俣野 茂, 熊代 博文, 吉野 智亮, 柴山 卓夫, 藤木 茂篤, 北田 信吾

    津山中央病院医学雑誌   15 ( 1 )   3 - 8   2001年6月

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    記述言語:日本語   出版者・発行元:(一財)津山慈風会津山中央病院  

    HBs抗原陽性,HBV-DNA陽性で,1年間以上肝機能異常を示し組織学的に慢性肝炎と診断された8例(男7:女1)を対象とし,インターフェロン(IFN)を少量,週3回,長期間投与する方法により,有効性が向上するか否かを検討した.IFN-α300万単位(〜600万単位;100万単位を1MUとする)を1〜2週間連日,その後週3回で計7〜24週間,総量165〜312MU投与した.その結果,治療終了6ヵ月後,肝機能正常化率は8例中6例(75%),HBV-DNA(プローブ法)陰性化率は治療終了6ヵ月後で8例中5例(62.5%),治療前HBe抗原陽性であった6例のセロコンバージョン率は治療終了6ヵ月で6例中2例(33.3%)であった.一般的な4週間連日投与に比し高い有効率を認めた.治療終了後の肝機能の反跳や肝不全等の重大な副作用は認められなかった

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受賞

  • 教育奨励賞

    2021年6月   岡山医学会  

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  • 教育功労賞

    2021年1月   岡山大学大学院医歯薬学総合研究科  

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  • 第121回日本内科学会中国地方会指導医賞

    2019年10月   日本内科学会中国支部  

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共同研究・競争的資金等の研究

  • 大腸内視鏡挿入支援を実現する空圧駆動高柔軟ラバーアクチュエータの開発

    研究課題/領域番号:21K12727  2021年04月 - 2026年03月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    原田 馨太, 脇元 修一

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    配分額:4160000円 ( 直接経費:3200000円 、 間接経費:960000円 )

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担当授業科目

  • 消化器・肝臓内科学(基本臨床実習) (2021年度) 特別  - その他

  • 消化器系(臓器・系別統合講義) (2021年度) 特別  - その他

  • 選択制臨床実習(消化器・肝臓内科学) (2021年度) 特別  - その他

  • 消化器・肝臓内科学(基本臨床実習) (2020年度) 特別  - その他

  • 消化器系(臓器・系別統合講義) (2020年度) 特別  - その他

  • 選択制臨床実習(消化器・肝臓内科学) (2020年度) 特別  - その他

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