研究者詳細 - 川野　誠司

論文 - 川野　誠司

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Clinical Features of Intestinal Behçet's Disease Associated with Myelodysplastic Syndrome and Trisomy 8.

Seiji Kawano, Sakiko Hiraoka, Hiroyuki Okada, Mitsuhiro Akita, Masaya Iwamuro, Kazuhide Yamamoto

Acta medica Okayama 69 ( 6 ) 365 - 9 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）

Several studies have identified a relationship between myelodysplastic syndrome and Behçet's disease (BD), especially intestinal BD, and trisomy 8 appears to play an important role in these disorders. Despite this, only few case reports or series have been reported in gastroenterology, meaning that endoscopic findings and characteristics of intestinal BD have not been clarified yet. In this report, we describe three cases of intestinal BD associated with myelodysplastic syndrome and trisomy 8, and discuss the clinical features and problems of these disorders from a gastroenterology perspective.

Morphological Changes in a Pyogenic Granuloma of the Esophagus Observed over Three Years.

Masaya Iwamuro, Hiroyuki Okada, Takehiro Tanaka, Keisuke Hori, Masahide Kita, Seiji Kawano, Yoshiro Kawahara, Kazuhide Yamamoto

Internal medicine (Tokyo, Japan) 54 ( 14 ) 1737 - 40 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）

A 78-year-old Japanese man underwent routine esophagogastroduodenoscopy, during which a reddish, flat elevated lesion was observed in the middle third of the esophagus. A bright red area of protrusion appeared in the center of the elevated lesion three months later, and the protruded nodule grew to be a blood blister six months after the initial endoscopy examination. The morphology of the lesion changed from a protruded nodule to a mass with two humps that subsequently returned to a single hump during the three-year observation period. A histological diagnosis of pyogenic granuloma was made based on a biopsy performed at six months. This report illustrates a rare case of an esophageal pyogenic granuloma presenting with a unique endoscopic appearance and morphologic changes. Endoscopic ultrasonography images are also presented.

DOI： 10.2169/internalmedicine.54.4265

Magnified endoscopic features of duodenal follicular lymphoma and other whitish lesions.

Masaya Iwamuro, Hiroyuki Okada, Katsuyoshi Takata, Yoshinari Kawai, Seiji Kawano, Junichiro Nasu, Yoshiro Kawahara, Takehiro Tanaka, Tadashi Yoshino, Kazuhide Yamamoto

Acta medica Okayama 69 ( 1 ) 37 - 44 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）

The sensitivity and specificity of magnified endoscopic features for differentiating follicular lymphoma from other diseases with duodenal whitish lesions have never been investigated. Here we compared the magnified endoscopic features of duodenal follicular lymphoma with those of other whitish lesions. We retrospectively reviewed the cases of patients with follicular lymphoma (n＝9), lymphangiectasia (n＝7), adenoma (n＝10), duodenitis (n＝4), erosion (n＝1), lymphangioma (n＝1), and hyperplastic polyp (n＝1). The magnified features of the nine follicular lymphomas included enlarged villi (n＝8), dilated microvessels (n＝5), and opaque white spots of various sizes (n＝9). The lymphangiectasias showed enlarged villi, dilated microvessels, and white spots, but the sizes of the white spots were relatively homogeneous and their margin was clear. Observation of the adenoma and duodenitis revealed only whitish villi. Although the lymphangioma was indistinguishable from the follicular lymphomas by magnified features, it was easily diagnosed based on the macroscopic morphology. In conclusion, magnified endoscopic features, in combination with macroscopic features, are useful for differentiating follicular lymphomas from other duodenal diseases presenting whitish lesions.

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

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

Intramucosal gastric mixed adenoneuroendocrine carcinoma completely resected with endoscopic submucosal dissection.

Yasushi Yamasaki, Junichiro Nasu, Kou Miura, Yoshiyasu Kono, Hiromitsu Kanzaki, Keisuke Hori, Takehiro Tanaka, Masahide Kita, Takao Tsuzuki, Minoru Matsubara, Seiji Kawano, Yoshiro Kawahara, Masahiro Tabata, Hiroyuki Okada, Kazuhide Yamamoto

Internal medicine (Tokyo, Japan) 54 ( 8 ) 917 - 20 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）

Composite tumors in the stomach composed of adenocarcinoma and neuroendocrine carcinoma are rare. We herein report a case of intramucosal gastric mixed adenoneuroendocrine carcinoma (MANEC) that was treated with endoscopic submucosal dissection (ESD). A 77-year-old man who had previously received ESD for early gastric adenocarcinoma underwent esophagogastroduodenoscopy for screening, which showed a depressed lesion on the lesser curvature of the antrum. The tumor was removed en bloc via ESD and pathologically diagnosed as MANEC. The tumor was located within the mucosal layer, and no lymphovascular invasion was evident. Seven months after the ESD procedure, the patient is currently feeling well without recurrence or metastasis.

DOI： 10.2169/internalmedicine.54.3469

Ectopic pancreas in the stomach successfully resected by endoscopic submucosal dissection. 国際誌

Masaya Iwamuro, Takao Tsuzuki, Shogen Ohya, Hiroyuki Okada, Takehiro Tanaka, Keisuke Hori, Masahide Kita, Seiji Kawano, Yoshiro Kawahara, Kazuhide Yamamoto

Case reports in medicine 2015 147927 - 147927 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）

A 32-year-old Japanese man presented with a gastric submucosal tumor. Esophagogastroduodenoscopy showed a sessile submucosal tumor measuring approximately 10 mm in diameter on the greater curvature of the gastric antrum. Endoscopic ultrasonography examination revealed a solid tumor with a diameter of 11.8 mm, which was located in the deep mucosal and submucosal layers. The internal echogenicity was homogenous and hypoechoic. Biopsy examinations were performed twice but were not diagnostic since only the intact mucosal layer was obtained. The patient was subsequently diagnosed with ectopic pancreas in the stomach by endoscopic submucosal dissection (ESD). This case underscores the usefulness of the ESD technique for the pathological diagnosis of gastric submucosal tumors.

DOI： 10.1155/2015/147927

Recurrence after Radiotherapy for Gastric Mucosa-associated Lymphoid Tissue (MALT) Lymphoma with Trisomy 18 査読

Hisashi Ishikawa, Masaya Iwamuro, Hiroyuki Okada, Keisuke Hori, Masahide Kita, Seiji Kawano, Yoshiro Kawahara, Takehiro Tanaka, Eisei Kondo, Tadashi Yoshino, Kazuhide Yamamoto

INTERNAL MEDICINE 54 ( 8 ) 911 - 916 2015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：JAPAN SOC INTERNAL MEDICINE

A 36-year-old Japanese woman presented with extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) in the stomach. The gastric lesions only partially improved after eradication therapy for Helicobacter pylori. A fluorescence in situ hybridization analysis revealed no fusion genes of API2-MALT1, although trisomy of chromosome 18 was identified. Radiation therapy was initiated to treat the gastric lymphoma lesions, resulting in complete remission. However, MALT lymphoma recurred in the stomach 16 months later. This case indicates that intensive follow-up is required for MALT lymphoma associated with chromosomal aberrations in order to detect early relapse.

DOI： 10.2169/internalmedicine.54.3784

その他リンク： http://orcid.org/0000-0003-0995-9405

Chromoendoscopy of gastric adenoma using an acetic acid indigocarmine mixture. 国際誌

Yoshiyasu Kono, Ryuta Takenaka, Yoshiro Kawahara, Hiroyuki Okada, Keisuke Hori, Seiji Kawano, Yasushi Yamasaki, Koji Takemoto, Takayoshi Miyake, Shigeatsu Fujiki, Kazuhide Yamamoto

World journal of gastroenterology 20 ( 17 ) 5092 - 7 2014年5月

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: To investigate the usefulness of chromoendoscopy, using an acetic acid indigocarmine mixture (AIM), for gastric adenoma diagnosed by forceps biopsy. METHODS: A total of 54 lesions in 45 patients diagnosed as gastric adenoma by forceps biopsy were prospectively enrolled in this study and treated by endoscopic submucosal dissection (ESD) between January 2011 and January 2012. AIM-chromoendoscopy (AIM-CE) was performed followed by ESD. AIM solution was sprinkled and images were recorded every 30 s for 3 min. Clinical characteristics such as tumor size (< 2 cm, ≥ 2 cm), surface color in white light endoscopy (WLE) (whitish, normochromic or reddish), macroscopic appearance (flat or elevated, depressed), and reddish change in AIM-CE were selected as valuables. RESULTS: En bloc resection was achieved in all 54 cases, with curative resection of fifty two lesions (96.3%). Twenty three lesions (42.6%) were diagnosed as well-differentiated adenocarcinoma and the remaining 31 lesions (57.4%) were gastric adenoma. All adenocarcinoma lesions were well-differentiated tubular adenocarcinomas and were restricted within the mucosal layer. The sensitivity of reddish color change in AIM-CE is significantly higher than that in WLE (vs tumor size ≥ 2 cm, P = 0.016, vs normochromic or reddish surface color, P = 0.046, vs depressed macroscopic type, P = 0.0030). On the other hand, no significant differences were found in the specificity and accuracy. In univariate analysis, normochromic or reddish surface color in WLE (OR = 3.7, 95%CI: 1.2-12, P = 0.022) and reddish change in AIM-CE (OR = 14, 95%CI: 3.8-70, P < 0.001) were significantly related to diagnosis of early gastric cancer (EGC). In multivariate analysis, only reddish change in AIM-CE (OR = 11, 95%CI: 2.3-66, P = 0.0022) was a significant factor associated with diagnosis of EGC. CONCLUSION: AIM-CE may have potential for screening EGC in patients initially diagnosed as gastric adenoma by forceps biopsy.

DOI： 10.3748/wjg.v20.i17.5092

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

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

Endoscopic submucosal dissection of esophageal cancer using the Mucosectom2 device: a feasibility study. 国際誌

Yoshiro Kawahara, Keisuke Hori, Ryuta Takenaka, Junichiro Nasu, Seiji Kawano, Masahide Kita, Takao Tsuzuki, Minoru Matsubara, Sayo Kobayashi, Hiroyuki Okada, Kazuhide Yamamoto

Endoscopy 45 ( 11 ) 869 - 75 2013年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) is being increasingly used for superficial esophageal cancers. However, esophageal ESD is technically difficult, time consuming, and less safe compared with endoscopic mucosal resection (EMR). To perform ESD safely and more efficiently, various types of knives have been developed. This study compared the efficacy of our newly developed device, Mucosectom2, with that of conventional devices for esophageal ESD. PATIENTS AND METHODS: Between May 2007 and February 2011, ESD was performed for 172 esophageal lesions. Of these, 120 lesions were treated by conventional devices only, whereas 52 lesions were treated by conventional devices and the Mucosectom2. Procedure time, en bloc and R0 resection rates, and adverse events were retrospectively compared between the conventional and Mucosectom2 groups. RESULTS: The median procedure time was 48.0 minutes in the conventional group and 21.5 minutes in the Mucosectom2 group; the procedure time was significantly shorter in the Mucosectom2 group than in the conventional group (P < 0.0001). The en bloc and R0 resection rates were lower in the conventional group than those in the Mucosectom2 group, although these differences were not significant. The rate of exposure of the muscle layer in the Mucosectom2 group was significantly lower than in the conventional group (P = 0.04). The rates of perforation and postoperative bleeding were not significantly different between the two groups. CONCLUSIONS: This feasibility study suggests that, compared with conventional ESD devices, the Mucosectom2 may decrease the time required for esophageal ESD. Although our groups appeared comparable, they were studied at different times. Endoscopic expertise and endoscope quality may have differed during these periods, thereby affecting the results of our study. A prospective trial is therefore required to confirm our results.

DOI： 10.1055/s-0033-1344229

マントル細胞リンパ腫における十二指腸病変の内視鏡像の検討

岩室雅也, 岡田裕之, 守都敏晃, 川野誠司, 那須淳一郎, 河原祥朗, 高田尚良, 吉野正, 山本和秀

日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 55 ( 8 ) "2167 - 74" 2013年8月

記述言語：日本語出版者・発行元：Japan Gastroenterological Endoscopy Society

【背景・目的】マントル細胞リンパ腫はしばしば消化管に浸潤し，多発性のポリープ状隆起を形成するが，十二指腸病変の肉眼型について詳細に検討した報告はない．今回われわれはマントル細胞リンパ腫における十二指腸病変について検討した．<BR>【方法】十二指腸浸潤を伴うマントル細胞リンパ腫の11例を対象とし，臨床背景および内視鏡像について検討した．<BR>【結果】十二指腸病変はいずれも隆起性病変を呈し，うち6例ではmultiple lymphomatous polyposisを形成していた．また隆起性病変の形態を細分すると，小ポリープ集簇3例，疣状3例，疣状病変と小ポリープ集簇病変の両者の混在2例，粘膜下腫瘍様3例であり，小ポリープ集簇病変ではいずれもびらんを認めなかったが，粘膜下腫瘍様隆起病変および疣状病変は1例を除く全症例でびらんを伴っていた．<BR>【結論】上記の病変を十二指腸に認めた場合には，マントル細胞リンパ腫の可能性を念頭に置き，生検診断を行うべきであると考えられた．

DOI： 10.11280/gee.55.2167

その他リンク： http://search.jamas.or.jp/link/ui/2013373163

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

Primary intestinal follicular lymphoma: How to identify follicular lymphoma by routine endoscopy. 国際誌

Masaya Iwamuro, Yoshinari Kawai, Katsuyoshi Takata, Seiji Kawano, Tadashi Yoshino, Hiroyuki Okada, Kazuhide Yamamoto

World journal of gastrointestinal endoscopy 5 ( 1 ) 34 - 8 2013年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

A 69-year-old Japanese female was diagnosed with primary intestinal follicular lymphoma. Esophagogastroduodenoscopy with high-definition imaging revealed not only the typical feature of whitish polyps of up to 2 mm in diameter in the duodenal second and third portions, but also more detailed morphology, such as enlarged whitish villi and tiny whitish depositions. These findings appeared to reflect the pathological structures; infiltration of lymphoma cells into the villi were probably seen as enlargement of the villi, and the formation of lymphoid follicles were shown as opaque white spots or tiny white depositions. Thus, the above features might contribute to the distinct diagnosis of intestinal follicular lymphoma. This case indicates that routine esophagogastroduodenoscopy can visualize microsurface structures, which can be pathognomonic and help to diagnose intestinal follicular lymphoma, even without magnifying endoscopy.

DOI： 10.4253/wjge.v5.i1.34

Clinicopathological characteristics of human epidermal growth factor receptor 2-positive Barrett's adenocarcinoma. 国際誌

Takehiro Tanaka, Atsushi Fujimura, Koichi Ichimura, Hiroyuki Yanai, Yasuharu Sato, Katsuyohi Takata, Hiroyuki Okada, Seiji Kawano, Shunsuke Tanabe, Tadashi Yoshino

World journal of gastroenterology 18 ( 43 ) 6263 - 8 2012年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: To compare the clinicopathological characteristics of human epidermal growth factor receptor 2 (HER2)-positive and HER2-negative Barrett's adenocarcinoma in Japan. METHODS: We performed immunohistochemical analysis of HER2 in 30 samples taken from patients with Barrett's adenocarcinoma and dual color in situ hybridization in cases showing 2+ reactions. We compared the clinicopathological characteristics of HER2-positive and HER2-negative patients. RESULTS: HER2 positivity was identified in 8 (27%) carcinoma samples. We found that HER2 expression was associated with p53 overexpression (100% vs 52.6% in pT1 tumor; 100% vs 54.5% in all stage tumor, P < 0.05) and protruding lesions at the early disease stage. There was no association between the mucin phenotype of the carcinomas and prognosis. HER2 expression and low clinical stage were unexpectedly different between Barrett's adenocarcinoma patients and gastric cancer patients, but the macroscopic features may be associated with earlier diagnosis in these patients. CONCLUSION: Our results suggest that HER2-positive Barrett's adenocarcinomas are associated with p53 overexpression and lesion protrusion at the early disease stage.

DOI： 10.3748/wjg.v18.i43.6263

Primary follicular lymphoma of the duodenum relapsing 11 years after resection.

Masaya Iwamuro, Hiroyuki Okada, Katsuyoshi Takata, Seiji Kawano, Yoshiro Kawahara, Junichiro Nasu, Katsuji Shinagawa, Tadashi Yoshino, Kazuhide Yamamoto

Internal medicine (Tokyo, Japan) 51 ( 9 ) 1031 - 5 2012年

記述言語：英語掲載種別：研究論文（学術雑誌）

A 52-year-old Japanese woman was diagnosed with primary follicular lymphoma of the duodenum that was curatively resected by pancreatoduodenectomy. She remained in complete remission until 11 years after the surgery, when multiple enlarged intra-abdominal lymph nodes were demonstrated by computed tomography scans and positron emission tomography scans. Two years later, jejunal lesions were detected by endoscopy, and biopsy samples confirmed a recurrence of follicular lymphoma. This case indicates that primary gastrointestinal follicular lymphoma has a potential of relapse after an extended period of time, and thus patients must be followed up for over 10 years after complete remission.

A prospective analysis of efficacy and long-term outcome of radiation therapy for gastric mucosa-associated lymphoid tissue lymphoma. 国際誌

Hiroyuki Okada, Mitshuhiro Takemoto, Yoshiro Kawahara, Junichiro Nasu, Ryuta Takenaka, Seiji Kawano, Masafumi Inoue, Koichi Ichimura, Takehiro Tanaka, Katsushi Shinagawa, Tadashi Yoshino, Kazuhide Yamamoto

Digestion 86 ( 3 ) 179 - 86 2012年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIMS: Few studies exist on the efficacy and long-term outcome of radiation therapy (RT) for gastric mucosa-associated lymphoid tissue (MALT) lymphoma. METHODS: Twenty-two patients with stage I or stage II(1) disease were prospectively evaluated, including 14 patients without Helicobacter pylori(H. pylori) infection and 8 patients with persistent lymphoma after H. pylori eradication. RT dose was 30 Gy in daily fractions of 1.5 Gy. All patients underwent endoscopic and histological follow-up regularly. RESULTS: The study included 22 patients with a mean age of 63 years. The t(11;18)(q21;q21) translocation occurred in 8 of the 22 cases. All patients showed complete remission without any serious toxicity. At a median follow-up evaluation 74 months (range 27-159) after completion of RT, the overall and relapse-free survival rates after 5 years were 91 and 84%, respectively. Although no patient showed local recurrence of lymphoma, distant recurrence was detected in 3 patients, all of whom were H. pylori negative; MALT lymphoma relapsed in two patients with the t(11;18)(q21;q21) translocation, and diffuse large-cell lymphoma developed in one patient without the translocation. CONCLUSION: RT provides excellent local control of the gastric MALT lymphoma. However, continuous follow-up is mandatory as relapse may occur in other sites.

DOI： 10.1159/000339497

Usefulness and Problems of Endoscopic Ultrasonography in Prediction of the Depth of Tumor Invasion in Early Gastric Cancer

Tsuzuki Takao, Okada Hiroyuki, Nasu Junichiro, Takenaka Ryuta, Inoue Masafumi, Kawano Seiji, Kita Masahide, Hori Keisuke, Yamamoto Kazuhide

Acta Medica Okayama 65 ( 2 ) 105 - 112 2011年4月

記述言語：英語出版者・発行元：Okayama University Medical School

The objectives of this study were to evaluate the accuracy of endoscopic ultrasonography (EUS) in local and regional staging of early gastric cancer, to analyze the factors influencing the accuracy of EUS, and to reveal the usefulness and problems of EUS in pre-treatment staging of gastric cancer. We examined 105 lesions in 104 patients with histologically confirmed gastric cancer and retrospectively evaluated them with EUS. The diagnostic accuracy, sensitivity, and specificity of EUS were determined by comparing the pre-treatment EUS with the postoperative histopathological findings. The overall diagnostic accuracy of EUS for the depth of cancer invasion was 86%. The overall sensitivity and specificity were 60% and 96%, respectively. The accuracy significantly declined in lesions located in the upper-third of the stomach (70%). Type 0-I lesions tended to be over-staged (12&), and the upper-third lesions tended to be under-staged (23%). The accuracy significantly declined in differentiated adenocarcinoma with massive submucosal invasion (56.5%). EUS is useful for evaluating the depth of gastric cancer invasion which determines the feasibility of endoscopic treatment. However, it is noteworthy that the diagnostic accuracy of the invasion depth diminished for lesions in the upper third of the stomach.

DOI： 10.18926/AMO/45269

その他リンク： http://search.jamas.or.jp/link/ui/2012046218

Proton pump inhibitor dose-related healing rate of artificial ulcers after endoscopic submucosal dissection: a prospective randomized controlled trial. 国際誌

Seiji Kawano, Hiroyuki Okada, Yoshiro Kawahara, Keisuke Hori, Daisuke Tanioka, Takao Tsuzuki, Masafumi Inoue, Satoru Yagi, Ryuta Takenaka, Kazuhide Yamamoto

Digestion 84 ( 1 ) 46 - 53 2011年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIMS: Two studies have reported on the superiority of a proton pump inhibitor (PPI) compared with a histamine-2-receptor antagonist for the treatment of artificial ulcers after endoscopic submucosal dissection (ESD), but the optimal dose of PPI remains to be defined. The aim of this study was to evaluate the possibility of reducing the dose of PPI. The authors thus compared 30 mg (standard-dose) and 15 mg (half-dose) lansoprazole in terms of ulcer healing, prevention of bleeding and quality of life. METHODS: 91 patients with gastric mucosal neoplasm were enrolled. All patients who underwent ESD were administered lansoprazole 30 mg daily during the first week, after which they were randomly assigned to either the standard-dose or half-dose group. RESULTS: One patient in each group developed hematemesis. The stage of ulcers, ulcer reduction ratios and scores on the Gastrointestinal Symptom Rating Scale did not differ at 28 and 56 days. The costs of PPI for the half-dose group and standard-dose group were 7,326.5 and 11,698.4 JPY, respectively, i.e. a difference of 471.9 JPY. CONCLUSIONS: A reduced dose of PPI after 1 week of ESD was equivalent in treatment performance to the standard dose and cheaper.

DOI： 10.1159/000321660

Does pretreatment with lansoprazole influence Helicobacter pylori eradication rate and quality of life? 国際誌

Masafumi Inoue, Hiroyuki Okada, Shinichiro Hori, Yoshiro Kawahara, Seiji Kawano, Ryuta Takenaka, Tatsuya Toyokawa, Yasuhiro Onishi, Yasushi Shiratori, Kazuhide Yamamoto

Digestion 81 ( 4 ) 218 - 22 2010年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND/AIMS: It is controversial whether pretreatment with a proton pump inhibitor (PPI) before Helicobacter pylori eradication treatment decreases the eradication rate. To determine the effects of pretreatment with lansoprazole alone, followed by an H. pylori eradication regimen (lansoprazole 30 mg, amoxicillin 750 mg and clarithromycin 200 mg twice daily for 1 week), on the eradication rate and quality of life (QoL) of the patient. METHODS: Patients with H. pylori-positive peptic ulcer were randomly assigned to two groups. The patients received either lansoprazole (30 mg) once daily for 6-8 weeks before H. pylori eradication (group A), or eradication treatment and then lansoprazole (30 mg) for 6-8 weeks (group B). To assess the QoL of the patients, the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire was evaluated. RESULTS: A total of 116 patients were enrolled. The cure rates were 78.9% in group A and 78.0% in group B. In both groups, GSRS analysis showed a significant improvement of the overall GSRS score at the assessment of eradication efficacy, compared to baseline; there was no difference between the groups. CONCLUSION: With this H. pylori eradication regimen, there was no difference in the cure rates and QoL associated with PPI pretreatment.

DOI： 10.1159/000260416

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