研究者詳細 - 髙原　政宏

論文 - 髙原　政宏

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

Sugihara Y, Harada K, Oka S, Yasutomi E, Yamasaki Y, Inokuchi T, Kinugasa H, Takahara M, Hiraoka S, Otsuka F, Okada H

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

Cognitive decline due to ectopic primary hyperparathyroidism. 査読国際誌

Nishimura Y, Yamamoto A, Takahara M, Otsuka F

Clinical case reports 6 ( 12 ) 2513 - 2514 2018年12月

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

CAPの今後の課題、高齢者や妊娠患者などの特殊症例に対するCAPの有効性と安全性安全性の高いCAP療法をいかに使うか岡山大学病院の試み

井口俊博, 平岡佐規子, 安富絵里子, 岡昌平, 高原政宏, 岡田裕之

日本アフェレシス学会雑誌 37 ( Suppl. ) 61 - 61 2018年10月

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

Yamasaki Y, Harada K, Oka S, Takashima S, Inokuchi T, Sugihara Y, Takahara M, Hiraoka S, Okada H

Digestion 99 ( 4 ) 1 - 6 2018年9月

NUDT15 codon 139 is the best pharmacogenetic marker for predicting thiopurine-induced severe adverse events in Japanese patients with inflammatory bowel disease: a multicenter study. 査読

Yoichi Kakuta, Yosuke Kawai, Daisuke Okamoto, Tetsuya Takagawa, Kentaro Ikeya, Hirotake Sakuraba, Atsushi Nishida, Shoko Nakagawa, Miki Miura, Takahiko Toyonaga, Kei Onodera, Masaru Shinozaki, Yoh Ishiguro, Shinta Mizuno, Masahiro Takahara, Shunichi Yanai, Ryota Hokari, Tomoo Nakagawa, Hiroshi Araki, Satoshi Motoya, Takeo Naito, Rintaro Moroi, Hisashi Shiga, Katsuya Endo, Taku Kobayashi, Makoto Naganuma, Sakiko Hiraoka, Takayuki Matsumoto, Shiro Nakamura, Hiroshi Nakase, Tadakazu Hisamatsu, Makoto Sasaki, Hiroyuki Hanai, Akira Andoh, Masao Nagasaki, Yoshitaka Kinouchi, Tooru Shimosegawa, Atsushi Masamune, Yasuo Suzuki

Journal of gastroenterology 53 ( 9 ) 1065 - 1078 2018年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Despite NUDT15 variants showing significant association with thiopurine-induced adverse events (AEs) in Asians, it remains unclear which variants of NUDT15 or whether additional genetic variants should be tested to predict AEs. To clarify the best pharmacogenetic test to be used clinically, we performed association studies of NUDT15 variants and haplotypes with AEs, genome-wide association study (GWAS) to discover additional variants, and ROC analysis to select the model to predict severe AEs. METHODS: Overall, 2630 patients with inflammatory bowel disease (IBD) were enrolled and genotyped for NUDT15 codon 139; 1291 patients were treated with thiopurines. diplotypes were analyzed in 970 patients, and GWASs of AEs were performed with 1221 patients using population-optimized genotyping array and imputation. RESULTS: We confirmed the association of NUDT15 p.Arg139Cys with leukopenia and alopecia (p = 2.20E-63, 1.32E-69, OR = 6.59, 12.1, respectively), and found a novel association with digestive symptoms (p = 6.39E-04, OR = 1.89). Time to leukopenia was significantly shorter, and when leukopenia was diagnosed, thiopurine doses were significantly lower in Arg/Cys and Cys/Cys than in Arg/Arg. In GWASs, no additional variants were found to be associated with thiopurine-induced AEs. Despite strong correlation of leukopenia frequency with estimated enzyme activities based on the diplotypes (r2 = 0.926, p = 0.0087), there were no significant differences in the AUCs of diplotypes from those of codon 139 to predict severe AEs (AUC = 0.916, 0.921, for acute severe leukopenia, AUC = 0.990, 0.991, for severe alopecia, respectively). CONCLUSIONS: Genotyping of NUDT15 codon 139 was sufficient to predict acute severe leukopenia and alopecia in Japanese patients with IBD.

DOI： 10.1007/s00535-018-1486-7

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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

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

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. 査読国際誌

Sugihara Y, Hiraoka S, Fujii N, Takashima S, Yamasaki Y, Inokuchi T, Takahara M, Kuwaki K, Harada K, Tanaka T, Okada H

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

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

Nakarai A, Kato J, Hiraoka S, Takashima S, Inokuchi T, Takahara M, Sugihara Y, Harada K, Okada H

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

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

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

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

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

Sugihara Y, Harada K, Kato R, Yamauchi K, Takashima S, Takei D, Yamasaki Y, Inokuchi T, Takahara M, Hiraoka S, Okada H

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

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

Kato R, Iwamuro M, Hiraoka S, Takashima S, Inokuchi T, Takahara M, Kondo Y, Tanaka T, Okada H

Acta medica Okayama 72 ( 2 ) 105 - 113 2018年4月

パテンシーカプセルが回腸に長期滞留したクローン病の1例

岩室雅也, 高嶋志保, 井口俊博, 高原政宏, 川野誠司, 平岡佐規子, 近藤喜太, 田中健大, 岡田裕之

日本消化器病学会雑誌 115 ( 2 ) 203 - 210 2018年2月

記述言語：日本語出版者・発行元：(一財)日本消化器病学会

40歳男性。21歳時にクローン病と診断され加療中。イレウス症状を繰り返すため当院紹介。CT検査では回腸狭窄および同部位に高吸収の人工物を認めた。ダブルバルーン内視鏡検査では回腸に多発狭窄を認め、小腸部分切除を施行したところ、狭窄部の近位側に異物を認めた。抽出した異物の解析により、30ヵ月前に嚥下したパテンシーカプセルの非溶解性コーティング膜の滞留と診断した。(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=20180223480008&doc_link_id=130006379165&url=https%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130006379165&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

Simultaneous measurements of faecal calprotectin and the faecal immunochemical test in quiescent ulcerative colitis patients can stratify risk of relapse 査読国際誌

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 and Colitis 12 ( 1 ) 71 - 76 2018年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Oxford University Press

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 &lt
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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Retention of patency capsule in a patient with Crohn's disease 査読

Masaya Iwamura, Shiho Takashima, Toshihiro Iguchi, Masahiro Takahara, Seiji Kawano, Satiko Hiraoka, Yuta Kondo, Takehi Tanaka, Hiroyuki Okada

Journal of Japanese Society of Gastroenterology 115 ( 2 ) 203 - 210 2018年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Japanese Society of Gastroenterology

A 40-year-old Japanese man with abdominal pain was referred to our hospital. The patient had been diagnosed with Crohn's disease at the age of 21 years and had since then received treatment with mesalazine and had been advocated an elemental diet. About 30 months before his visit to the hospital, he had swallowed a patency capsule, the retention of which in the ileum was subsequently detected on abdominal ultrasonography. The patient was advised to undergo the evaluation of stenosis, but he refused further investigation at that time. Computed tomography scanning performed at our institution revealed stenosis of the ileum and the presence of a high-density material in the proximal side of the stenosis. Double-balloon enteroscopy and enterography with contrast media revealed multiple stenoses of the ileum. The stenotic ileum was surgically resected, and a foreign body was removed. Electron microscopy analysis revealed that the foreign body was the cellophane wall of the PillCamTM patency capsule. Thus, the retention of the cellophane wall of a patency capsule after consumption was diagnosed for the current case on the basis of the study findings.

DOI： 10.11405/nisshoshi.115.203

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

Hiraoka S, Takashima S, Kondo Y, Inokuchi T, Sugihara Y, Takahara M, Kawano S, Harada K, Kato J, Okada H

Intestinal research 16 ( 1 ) 75 - 82 2018年

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 査読国際誌

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

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS

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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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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