研究者詳細 - 髙原　政宏

Th1/Th17-Mediated Interstitial Pneumonia in Chronic Colitis Mice Independent of Intestinal Microbiota 査読

Yasuhiro Nemoto, Takanori Kanai, Masahiro Takahara, Shigeru Oshima, Ryuichi Okamoto, Kiichiro Tsuchiya, Satoshi Matsumoto, Mamoru Watanabe

JOURNAL OF IMMUNOLOGY 190 ( 12 ) 6616 - 6625 2013年6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：AMER ASSOC IMMUNOLOGISTS

Although intestinal microbiota are essential for the development of T cell-mediated colitis, it remains undetermined whether they enhance or suppress the chronic extraintestinal inflammation that often complicates inflammatory bowel diseases. In this study, we investigate the role of intestinal microbiota in the development of colitis and extraintestinal manifestations in a mouse model in which colitis was induced in SCID mice by adoptive transfer of CD4(+) CD45RB(high) T cells. Under specific pathogen-free conditions, these mice developed both colitis and extraintestinal interstitial pneumonia, whereas mice given a mixture of antibiotics did not develop colitis, but, surprisingly, developed Th1/Th17-mediated IP. Irrespective of antibiotic treatment, cotransfer of CD4(+) CD25(+) regulatory T cells suppressed the development of pneumonitis and colitis, with all local CD4(+) CD45RB(high) T cell-derived cells converted to CD44(high) CD62L(-) IL-7R alpha(high) effector-memory T cells. Retransfer of CD4(+) effector-memory T cells from the lungs of antibiotic-treated mice with IP not only induced IP in both antibiotic-treated and -untreated recipients but also induced colitis in the untreated recipients. In summary, we have established a unique model of Th1/Th17-mediated IP in microbiota-free and antibiotic-treated mice. This model may be valuable in investigating the immunological mechanisms underlying extraintestinal disorders in patients with inflammatory bowel disease.

DOI： 10.4049/jimmunol.1202930

Peppermint Oil Solution Is Useful as an Antispasmodic Drug for Esophagogastroduodenoscopy, Especially for Elderly Patients 査読国際誌

Atsushi Imagawa, Hidenori Hata, Morihito Nakatsu, Yasunari Yoshida, Keiko Takeuchi, Toshihiro Inokuchi, Takayuki Imada, Yoshiyasu Kohno, Masahiro Takahara, Kazuyuki Matsumoto, Hirokazu Miyatake, Satoru Yagi, Masaharu Ando, Mamoru Hirohata, Shigeatsu Fujiki, Ryuta Takenaka

DIGESTIVE DISEASES AND SCIENCES 57 ( 9 ) 2379 - 2384 2012年9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：SPRINGER

Although hyoscine butyl bromide (HB) and glucagon (GL) are often used as antispasmodic drugs during esophagogastroduodenoscopy (EGD), these agents may cause adverse effects. Recently, it was reported that peppermint oil solution (PO) was very effective and had few side effects.
We clarified the efficacy and usefulness of PO as an antispasmodic during upper endoscopy, especially for elderly patients.
This study was a non-randomized prospective study. The antispasmodic score (1-5, where 5 represents no spasm) was defined according to the degree of spasms of the antrum and difficulty of biopsy. We compared the antispasmodic scores between non-elderly patients (younger than 70) and elderly patients (70 years old or older) according to the antispasmodic agent.
A total of 8,269 (Group PO: HB: GL: NO (no antispasmodic) = 1,893: 6,063: 157: 156) EGD procedures were performed. There was no significant difference in the antispasmodic score between Group PO (mean score +/- A standard deviation: 4.025 +/- A 0.925) and Group HB (4.063 +/- A 0.887). Among the non-elderly patients, those in Group PO (n = 599, 3.923 +/- A 0.935) had a worse antispasmodic score than those in Group HB (n = 4,583, 4.062 +/- A 0.876, P < 0.001). However, among the elderly patients, those in Group PO (n = 1,294, 4.073 +/- A 0.917) had similar scores to those in Group HB (n = 1,480, 4.064 +/- A 0.921, P = 0.83), and significantly better scores than those in Group GL (n = 69, 3.797 +/- A 0.933, P < 0.05).
Peppermint oil was useful as an antispasmodic during EGD, especially for elderly patients.

DOI： 10.1007/s10620-012-2194-4

Partial Splenic Embolization Facilitates the Adherence to Peginterferon in Chronic Hepatitis C with Thrombocytopenia 査読

Masahiro Takahara, Yasuhiro Miyake, Hirokazu Miyatake, Atsushi Imagawa, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata, Kazuhide Yamamoto

INTERNAL MEDICINE 50 ( 22 ) 2731 - 2736 2011年

担当区分：筆頭著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：JAPAN SOC INTERNAL MEDICINE

Objective Platelet counts before starting the treatment affect the discontinuation and dose reduction of peginterferon in chronic hepatitis C. Thrombocytopenia leads to failure to achieve sustained virological response. This study was undertaken to evaluate the efficacy of partial splenic embolization (PSE) prior to starting peginterferon therapy combined with ribavirin in chronic hepatitis C patients showing thrombocytopenia.
Patients and Methods We compared the clinical features of 11 patients receiving PSE (PSE group) prior to starting the combined therapy with those of 13 patients not receiving PSE (non-PSE group). All of the patients showed platelet counts <= 12x10(4)/mm(3) and serum hepatitis C virus-RNA levels >= 100 KIU/mL at baseline. The end-point of PSE was a volume of splenic infarction over 75%. Peginterferon alpha-2b at a dose of 1.2 mu g/kg was administered by subcutaneous injection once a week. The dose of ribavirin was weight adjusted.
Results PSE was successfully performed without serious adverse events. The period from PSE to starting the combined therapy was 14 (6-27) days. After PSE, platelet counts were significantly increased. In PSE group, platelet counts during the combined therapy were maintained above those at baseline. In non-PSE group, platelet counts at the 2nd week after the start of the combined therapy significantly decreased to less than those at baseline. Overall, 80% adherence to expected peginterferon dose was not achieved in 5 patients (45%) of PSE group and in 11 (85%) of non-PSE group (p=0.043).
Conclusion Increased platelet counts after PSE facilitates the adherence to peginterferon therapy in chronic hepatitis C patients with thrombocytopenia.

DOI： 10.2169/internalmedicine.50.6143

Large Waist Circumference Is a Risk Factor for Reflux Esophagitis in Japanese Males 査読国際誌

Hisae Yasuhara, Yasuhiro Miyake, Tatsuya Toyokawa, Kazuyuki Matsumoto, Masahiro Takahara, Takayuki Imada, Satoru Yagi, Hirokazu Miyatake, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata

DIGESTION 81 ( 3 ) 181 - 187 2010年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：KARGER

Background/Aims: The prevalence of reflux esophagitis, which might lead to development of Barrett's esophagus and esophageal adenocarcinoma, has been increasing. The aim of this study was to assess risk factors for reflux esophagitis. Methods: We conducted a cross-sectional study of 1,495 Japanese subjects undergoing health checkups (822 males and 673 females; median age 50 years) at a tertiary care center. Results: One hundred and twenty-seven subjects (8%) had reflux esophagitis and hiatal hernia was observed in 292 subjects (20%). Reflux esophagitis (13 vs. 3%) and hiatal hernia (28 vs. 9%) were more frequent in males than females. Significant differences in clinical backgrounds were observed between females and males. Multivariate logistic regression analyses revealed that hiatal hernia (OR 6.63, 95% CI 2.47-17.8; p = 0.0002) was associated with reflux esophagitis in females. In males, age (per 1-year increment: OR 0.96, 95% CI 0.94-0.99; p = 0.007), hiatal hernia (OR 3.16, 95% CI 2.05-4.87; p < 0.0001) and waist circumference (per 1-cm increase: OR 1.09, 95% CI 1.02-1.15; p = 0.006) were associated with reflux esophagitis. Conclusions: Abdominal obesity may be an important risk factor for reflux esophagitis in males compared with females. Copyright (C) 2010 S. Karger AG, Basel

DOI： 10.1159/000235919

当院における胆嚢癌のまとめ

高原政宏, 豊川達也, 松本和幸, 今田貴之, 八木覚, 宮武宏和, 中津守人, 安東正晴, 廣畑衛

日本消化器病学会雑誌 106 ( 臨増大会 ) A910 - A910 2009年9月

H.pylori除菌療法は萎縮粘膜を改善し、特に萎縮の進んだ症例では早期に改善する長期間のprospective cohort studyの結果から

豊川達也, 高原政宏, 松本和幸, 今田貴之, 八木覚, 中津守人, 安東正晴

日本消化器病学会雑誌 106 ( 臨増大会 ) A771 - A771 2009年9月

A case of hepatic angiomyolipoma difficult to distinguish from hepatocellular carcinoma 査読国際誌

Masahiro Takahara, Yasuhiro Miyake, Kazuyuki Matsumoto, Daisuke Kawai, Eisuke Kaji, Tatsuya Toyokawa, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata

WORLD JOURNAL OF GASTROENTEROLOGY 15 ( 23 ) 2930 - 2932 2009年6月

担当区分：筆頭著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：W J G PRESS

We report a case of hepatic angiomyolipoma with uncommon clinical features. A 56-year-old man presented with a hepatic tumor in the caudate lobe. The tumor was hypoechoic on ultrasonography, showed early-phase hyperattenuation on enhanced computed tomography and did not absorb iron on superparamagnetic iron oxide-enhanced magnetic resonance imaging. Hepatocellular carcinoma was highly suspected, and the patient underwent hepatic resection. Histologically, the tumor was mainly composed of smooth muscle cells and contained small amounts of adipose cells and blood vessels. On immunohistochemical staining, the smooth muscle cells were positive for a melanocytic cell-specific monoclonal antibody. In cases with uncommon features of angiomyolipoma, it is quite difficult to distinguish angiomyolipoma from hepatocellular carcinoma. (C) 2009 The WJG Press and Baishideng. All rights reserved.

DOI： 10.3748/wjg.15.2930

当院における食道癌化学放射線療法の検討

松本和幸, 豊川達也, 高原政宏, 今田貴之, 八木覚, 宮武宏和, 中津守人, 安東正晴, 廣畑衛

香川県内科医会誌 45 36 - 40 2009年6月

記述言語：日本語出版者・発行元：香川県内科医会

2000年1月から2007年12月までに当院にて治療をした食道癌患者44例を対象とし、化学放射線療法(chemoradiotherapy:CRT)を施行した26例(CRT群)ならびに手術療法を施行した18例(手術群)に層別化しretrospectiveに比較検討した。年齢は45歳から86歳で中央値69歳であった。患者背景として、年齢、腫瘍占拠部位、臨床病期、PSを比較した結果、手術群で臨床病期が早期であった(p<0.01)。CRT群の奏効率は73%であり、CRT群の生存期間は2年生存率38%、4年生存率25%であった。また、根治術可能な臨床病期0〜IIIまででCRT群と手術群の生存期間を比較した結果、2年生存率はCRT群で46%、手術群で53%であり、両群間の生存期間に差異は認めなかった。食道癌に対するCRTは手術療法と比較し遜色ない治療法であった。(著者抄録)

当院におけるGIST症例の検討

河野吉泰, 豊川達也, 松本和幸, 高原政宏, 今田貴之, 八木覚, 宮武宏和, 中津守人, 安東正晴, 廣畑衛

香川県内科医会誌 45 47 - 52 2009年6月

記述言語：日本語出版者・発行元：香川県内科医会

Gastrointestinal stromal tumor(以下GIST)は全消化管切除腫瘍の0.5〜1.0%程度を占める稀な腫瘍である。今回我々は当院において病理組織学的にGISTと診断された19例を対象とし、その臨床的および病理学的特徴について検討した。発生部位は胃が14例と最多で、全体的に無症状で発見される例が多かった。手術標本の病理組織で診断されたものが13例と大部分を占めていた。腫瘍の大きさ・核分裂指数により評価した臨床的悪性度に基づきリスク分類を行った。転移・再発に関しては全て高リスク例であり、よく相関していた。予後に関しては、高リスク6例のうち死亡転帰は2例であり、リスク分類のみで予後を推測することは困難であった。予後不良因子として腹膜病変が示唆された。術前・術後化学療法の有効性や術後の適切な経過観察期間など、GISTに関して未だに臨床研究段階の項目は多く、今後さらなる症例数の集積が望まれる。(著者抄録)

ALK陰性直腸原発anaplastic large cell lymphomaの1例

高原政宏, 豊川達也, 脇正人, 小西順, 松本和幸, 今田貴之, 八木覚, 宮武宏和, 中津守人, 安東正晴, 廣畑衛

Gastroenterological Endoscopy 51 ( Suppl.1 ) 947 - 947 2009年4月

A combination treatment of entecavir and early-phase corticosteroid in severe exacerbation of chronic hepatitis B 査読国際誌

Kazuyuki Matsumoto, Yasuhiro Miyake, Hirokazu Miyatake, Masahiro Takahara, Takayuki Imada, Satoru Yagi, Tatsuya Toyokawa, Morihito Nakatsu, Masaharu Ando, Mamoru Hirohata

WORLD JOURNAL OF GASTROENTEROLOGY 15 ( 13 ) 1650 - 1652 2009年4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：W J G PRESS

Of patients with severe exacerbation of chronic hepatitis B accompanied by jaundice and coagulopathy, 20%-30% have a fatal outcome. In this report, we describe 2 cases of severe exacerbation of chronic hepatitis B with jaundice and coagulopathy who were successfully treated with a combination of entecavir and corticosteroid. In both cases, rapid reductions in serum hepatitis B virus (HBV)-DNA levels were observed, and corticosteroid was stopped after serum HBV-DNA levels became undetectable. Entecavir treatment was continued. Generally, entecavir treatment reduced serum HBV-DNA levels rapidly, although the improvement in liver function was delayed by a few weeks. During this time lag, liver cell injury continued and the disease progressed. Corticosteroid suppressed the excessive host immune response and was useful for stopping progressive deterioration. A combination of entecavir and early-phase corticosteroid may be a useful treatment in severe exacerbation of chronic hepatitis B. (C) 2009 The WJG Press and Baishideng. All rights reserved.

DOI： 10.3748/wjg.15.1650