Faculty Profiles - KAWANO Seiji

Papers - KAWANO Seiji

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Reality of Gastric Cancer in Young Patients: The Importance and Difficulty of the Early Diagnosis, Prevention and Treatment.

Yoshiyasu Kono, Hiromitsu Kanzaki, Masaya Iwamuro, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada

Acta medica Okayama 74 ( 6 ) 461 - 466 2020.12

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

Gastric cancer usually arises in middle-aged to older patients, and is rarely found in younger patients. The clin-ical characteristics, etiology, prognosis, preventive methods and treatment of gastric cancer in young patients have not been fully investigated because of its low prevalence. In this review, we discuss the current under-standing and clinical problems associated with gastric cancer in young patients. Helicobacter pylori (H. pylori), which is a major cause of gastric cancer, especially in older populations, is closely associated with gastric cancer in young patients as well as in older patients. Gastric cancer in young patients tends to be diagnosed at an advanced stage with alarm symptoms. However, young patients with advanced gastric cancer tend to have a favorable general condition and organ function, so they can tolerate intensive systematic chemotherapy. Unfortunately, the prognosis of gastric cancer in young patients with an advanced stage is not favorable. We should not take this rare disease lightly, given its poor prognosis if patients are diagnosed at an unresectable stage. The evaluation of the H. pylori infection status and performance of H. pylori eradication therapy to prevent gastric cancer in young patients as well as the development of more intensive chemotherapy regimens for unre-sectable gastric cancer in young patients are warranted.

DOI： 10.18926/AMO/61204

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POEMが有効であったJackhammer esophagusの2例

榮浩行, 杉原雄策, 里見拓也, 岡上昇太郎, 濱田健太, 安部真, 河野吉泰, 神崎洋光, 岩室雅也, 川野誠司, 河原祥朗, 眞部紀明, 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 114 - 114 2020.11

びまん性大細胞型B細胞性リンパ腫の無治療経過観察中に胃病変の自然退縮が認められた1例

長岡寛和, 岩室雅也, 田中健大, 遠西大輔, 榮浩行, 安部真, 河野吉泰, 神崎洋光, 川野誠司, 河原祥朗, 岡田裕之

日本消化器病学会中国支部例会・日本消化器内視鏡学会中国支部例会プログラム・抄録集 114回・125回 92 - 92 2020.11

咽頭癌CRT後の局所再発病変に対してサルベージESDを施行した一例

織田崇志, 安部真, 濱田健太, 榮浩行, 河野吉泰, 神崎洋光, 岩室雅也, 川野誠司, 河原祥朗, 岡田裕之, 丸中秀格

日本消化器病学会中国支部例会プログラム・抄録集 114回 114 - 114 2020.11

胃癌術後11年目にKrukenberg腫瘍及び骨髄癌腫症を発症した一例

吉田遥, 川野誠司, 河原聡一郎, 岡上昇太郎, 里見拓也, 濱田健太, 榮浩行, 安部真, 河野吉泰, 神崎洋光, 岩室雅也, 河原祥朗, 岡田裕之

日本消化器病学会中国支部例会プログラム・抄録集 114回 55 - 55 2020.11

Ballvalve syndromeを契機に診断されたGAPPS (Gastric Adenocarcinoma and Proximal Polyposis of the Stomach)一例とその家系の検討

赤穂宗一郎, 川野誠司, 岡上昇太郎, 里見拓也, 岡本雄貴, 大林由佳, 馬場雄己, 濱田健太, 榮浩行, 安部真, 神崎洋光, 岩室雅也, 河原祥朗, 田中健太, 岡田裕之

Gastroenterological Endoscopy 62 ( Suppl.2 ) 2101 - 2101 2020.10

Ballvalve syndromeを契機に診断されたGAPPS (Gastric Adenocarcinoma and Proximal Polyposis of the Stomach)一例とその家系の検討

Gastroenterological Endoscopy 62 ( Suppl.2 ) 2101 - 2101 2020.10

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 2020.8

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

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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Gastric Adenocarcinoma and Proximal Polyposis of the Stomach Occurring With Ball Valve Syndrome. International journal

Soichiro Ako, Seiji Kawano, Hiroyuki Okada

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 20 ( 2 ) e12-e13 2020.7

Peutz-Jeghers症候群の14例における悪性腫瘍の合併に関する検討

里見拓也, 岩室雅也, 豊川達也, 森藤由記, 松枝和宏, 堀伸一郎, 吉岡正雄, 田中健大, 川野誠司, 岡田裕之

日本消化器病学会雑誌 117 ( 臨増総会 ) A275 - A275 2020.7

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 2020.6

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

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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Pattern of gastric lanthanum deposition based on the presence or absence of mucosal atrophy

Masaya Iwamuro, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Takehiro Tanaka, Hiroyuki Okada

Gastroenterological Endoscopy 62 ( 6 ) 684 - 690 2020.6

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Gastroenterological Endoscopy Society

Aim: This study aimed to investigate the relationship between the pattern of gastric lanthanum deposition and gastric mucosal atrophy. Methods: We retrospectively reviewed 4 patients with gastric lanthanum deposition who tested negative for Helicobacter pylori infection (non-atrophy group) and 10 patients with gastric lanthanum deposition with gastric atrophy (atrophy group). The endoscopic features of gastric lanthanum deposition were retrospectively analyzed in both groups. Results: Although gastric lanthanum deposition appears as white lesions, this presentation was not observed in 1 of the 4 patients in the non-atrophy group. The remaining 3 patients (75%) had diffuse white lesions in the gastric body that were predominantly distributed in the posterior wall and lesser curvature. In the atrophy group, white lesions were found in 9 of the 10 cases. In the areas with atrophic mucosa, white lesions were most frequently found in the gastric antrum (n = 5) and angle (n = 5). The white lesions appeared in an annular and/or granular pattern. White lesions were also found in the gastric body with mucosal atrophy and presented in an annular pattern (n = 1) or as diffuse whitish lesions (n = 1). Based on these findings, we speculate that in patients without gastric mucosal atrophy, gastric lanthanum deposition appears as diffuse white lesions in the posterior wall and lesser curvature of the gastric body. In the gastric mucosa with atrophy, lanthanum-related lesions likely appear as annular or granular white lesions. Moreover, these white lesions are probably more frequently observed in the gastric antrum and angle since atrophy begins at the lower part of the stomach. Conclusions: These findings suggest that the localization and macroscopic findings of gastric lanthanum deposition differ depending on the presence or absence of gastric atrophy.

DOI： 10.11280/gee.62.684

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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 2020.6

胃濾胞性リンパ腫に胃扁平上皮化生を合併した1例

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

日本消化器病学会中国支部例会プログラム・抄録集 113回 96 - 96 2020.5

Esophageal Papilloma Detected by Positron Emission Tomography.

Masaya Iwamuro, Yuki Okamoto, Seiji Kawano, Hiroyuki Okada

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

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

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

Gastrointestinal endoscopy 91 ( 4 ) 763 - 770 2020.4

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

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

DOI： 10.1016/j.gie.2019.10.022

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Primary localized amyloidosis of the stomach mimicking healing gastric ulcer. International journal

Katsunori Matsueda, Seiji Kawano, Hiroyuki Okada

Gastrointestinal endoscopy 91 ( 4 ) 947 - 948 2020.4

Efficacy and safety of scheduled early endoscopic ultrasonography-guided ethanol reinjection for patients with pancreatic neuroendocrine tumors: Prospective pilot study. International journal

Kazuyuki Matsumoto, Hironari Kato, Seiji Kawano, Hiroyasu Fujiwara, Kenji Nishida, Ryo Harada, Masakuni Fujii, Ryuichi Yoshida, Yuzo Umeda, Shiro Hinotsu, Takahito Yagi, Hiroyuki Okada

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 32 ( 3 ) 425 - 430 2020.3

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

Endoscopic ultrasonography (EUS)-guided ethanol injection was recently proposed for treatment of patients with small pancreatic neuroendocrine tumors (p-NET); however, tips on how to carry out safe and effective procedures are unclear. We launched a pilot study for scheduled early EUS-guided ethanol reinjection for small p-NET. Major eligibility criteria were presence of pathologically diagnosed grade (G) 1 or G2, tumor size ≤2 cm and being a poor or rejected candidate for surgery. For the treatment, we used a 25-gauge needle and pure ethanol. Contrast-enhanced computed tomography (CE-CT) was carried out on postoperative day 3, and if enhanced areas of the tumor were still apparent, an additional session was scheduled during the same hospitalization period. Primary endpoint was complete ablation rate at 1 month after treatment, and secondary endpoint was procedure-related adverse events. A total of five patients were treated. Median size of the tumor was 10 (range: 7-14) mm. Of the five patients, three underwent an additional session. Median volume of ethanol injection per session was 0.8 (range: 0.3-1.0) mL, and the total was 1.0 (0.9-1.8) mL. Complete ablation was achieved in four of the five tumors (80%) with no adverse events. During 1 year of follow up, none of the patients reported any procedure-related adverse events, and no recurrence of tumor. Scheduled early EUS-guided ethanol reinjection appears to be safe and effective for treating small p-NET (UMIN number: 000018834).

DOI： 10.1111/den.13552

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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 2020.1

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

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

Digestion 101 ( 6 ) 771 - 778 2020

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

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

DOI： 10.1159/000502573

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