研究者詳細 - 山崎　泰史

論文 - 山崎　泰史

分割表示 139 件中 121 - 139 件目／全件表示 >>

First reports of esophageal adenocarcinoma with white globe appearance in Japanese and Caucasian patients. 国際誌

Yusuke Tonai, Ryu Ishihara, Yasushi Yamasaki, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Yasuhiko Tomita, Hiroyasu Iishi

Endoscopy international open 4 ( 10 ) E1075-E1077 2016年10月

記述言語：英語

Background and study aims: Better endoscopic diagnosis in case of Barrett's esophagus is still needed. White globe appearance (WGA) is a novel endoscopic marker for gastric adenocarcinoma, with high sensitivity for differentiating between gastric cancer/high-grade dysplasia and other lesions. We report 2 cases of esophageal adenocarcinoma with WGA. In Case 1, esophagogastroduodenoscopy (EGD) revealed a 10-mm esophageal adenocarcinoma in a 48-year-old Japanese woman with short-segment Barrett's esophagus. A small (< 1 mm) white globular lesion, typical of WGA, was observed under the epithelium by magnifying narrow-band imaging. A dilated neoplastic gland with eosinophilic material and necrotic epithelial fragments was identified at the site of the WGA by histologic examination. In Case 2, EGD revealed a 5-mm esophageal adenocarcinoma in a 60-year-old Caucasian man with long-segment Barrett's esophagus. A typical WGA was observed by magnifying narrow-band imaging and similar histologic findings were identified at the site of the WGA. WGA could be a reliable endoscopic finding for target biopsy in esophageal adenocarcinoma, if its specificity is as high as in gastric cancer. The clinical implications of WGA in patients with Barrett's esophagus should be investigated further.

Line-assisted complete closure of a large colorectal mucosal defect after endoscopic submucosal dissection. 国際誌

Minoru Kato, Yoji Takeuchi, Yasushi Yamasaki

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 28 ( 6 ) 686 - 686 2016年9月

Feasibility of Simple Traction Technique for Rectal Endoscopic Submucosal Dissection. 国際誌

Yasushi Yamasaki, Yoji Takeuchi, Noriya Uedo, Minoru Kato, Kenta Hamada, Yusuke Tonai, Noriko Matsuura, Takashi Kanesaka, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi

Digestive diseases and sciences 61 ( 7 ) 2127 - 31 2016年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIMS: Rectal endoscopic submucosal dissection (ESD) is a highly effective procedure that achieves high en bloc resection regardless of lesion size or location. However, rectal ESD has a higher risk of intraoperative and postoperative bleeding and still difficult for beginners. Therefore, we designed a novel traction technique "traction-assisted rectal ESD using a clip-with-line (TAREC)," and investigated its feasibility. METHODS: Between December 2014 and July 2015, ten patients with rectal neoplasms (median size 36 mm; range 20-125 mm) were treated using the TAREC technique. RESULTS: In all lesions, good visibility of the submucosal layer was obtained, and the submucosal layer was dissected easily under direct visualization. All lesions were removed en bloc, and there were no procedure-related adverse events including postoperative bleeding. In particular, we experienced no intraoperative bleeding, which may be difficult to stop in some circumstances. CONCLUSIONS: The TAREC technique is a simple and generally applicable procedure. This technique is feasible for rectal ESD.

DOI： 10.1007/s10620-016-4036-2

Endoscopic surveillance of head and neck cancer in patients with esophageal squamous cell carcinoma. 国際誌

Minoru Kato, Ryu Ishihara, Kenta Hamada, Yusuke Tonai, Yasushi Yamasaki, Noriko Matsuura, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Hiroyasu Iishi

Endoscopy international open 4 ( 7 ) E752-5 2016年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND STUDY AIMS: Multiple squamous cell carcinomas (SCCs) frequently arise in the upper aerodigestive tract, referred to as the field cancerization phenomenon. The aim of this study was to elucidate the detailed clinical features of second primary head and neck (H&N) SCCs arising in patients with esophageal SCC. PATIENTS AND METHODS: A total of 818 patients underwent endoscopic resection for superficial esophageal cancer between January 2006 and December 2013. Of these, 439 patients met our inclusion criteria, and we retrospectively investigated the incidence, primary sites, and stages of second primary H&N SCCs in these patients. RESULTS: A total of 53 metachronous H&N SCCs developed in 40 patients after a median follow-up period of 46 months (range 9 - 109). The cumulative incidence rates of metachronous H&N SCCs at 3, 5, and 7 years were 5.3 %, 9.7 %, and 17.2 %, respectively. These lesions were frequently located at pyriform sinus or in the posterior wall of the pharynx (70 %, 37/53 lesions). Most of the lesions were detected at an early stage, though 4 lesions were associated with lymph node metastasis when their primary sites were detected (1 postcricoid area, 2 posterior wall of hypopharynx, and 1 lateral wall of oropharynx). CONCLUSIONS: Patients with esophageal SCC should undergo careful inspection of the pyriform sinus and posterior wall of the pharynx for detection of H&N SCCs. Methods to open the hypopharyngeal space, such as the Valsalva maneuver, should be included in the surveillance program.

DOI： 10.1055/s-0042-106720

Refractory strictures despite steroid injection after esophageal endoscopic resection. 国際誌

Noboru Hanaoka, Ryu Ishihara, Noriya Uedo, Yoji Takeuchi, Koji Higashino, Tomofumi Akasaka, Takashi Kanesaka, Noriko Matsuura, Yasushi Yamasaki, Kenta Hamada, Hiroyasu Iishi

Endoscopy international open 4 ( 3 ) E354-9 2016年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Although steroid injection prevents stricture after esophageal endoscopic submucosal dissection (ESD), some patients require repeated sessions of endoscopic balloon dilation (EBD). We investigated the risk for refractory stricture despite the administration of steroid injections to prevent stricture in patients undergoing esophageal ESD. Refractory stricture was defined as the requirement for more than three sessions of EBD to resolve the stricture. In addition, the safety of steroid injections was assessed based on the rate of complications. PATIENTS AND METHODS: We analyzed data from 127 consecutive patients who underwent esophageal ESD and had mucosal defects with a circumferential extent greater than three-quarters of the esophagus. To prevent stricture, steroid injection was performed. EBD was performed whenever a patient had symptoms of dysphagia. RESULTS: The percentage of patients with a tumor circumferential extent greater than 75 % was significantly higher in those with refractory stricture than in those without stricture (P = 0.001). Multivariate analysis adjusted for age, sex, history of radiation therapy, tumor location, and tumor diameter showed that a tumor circumferential extent greater than 75 % was an independent risk factor for refractory stricture (adjusted odds ratio [OR] 5.49 [95 %CI 1.91 - 15.84], P = 0.002). Major adverse events occurred in 3 patients (2.4 %): perforation during EBD in 2 patients and delayed perforation after EBD in 1 patient. The patient with delayed perforation underwent esophagectomy because of mediastinitis. CONCLUSIONS: A tumor circumferential extent greater than 75 % is an independent risk factor for refractory stricture despite steroid injections. The development of more extensive interventions is warranted to prevent refractory stricture.

DOI： 10.1055/s-0042-100903

Features of electrocoagulation syndrome after endoscopic submucosal dissection for colorectal neoplasm. 国際誌

Takeshi Yamashina, Yoji Takeuchi, Noriya Uedo, Kenta Hamada, Kenji Aoi, Yasushi Yamasaki, Noriko Matsuura, Takashi Kanesaka, Tomofumi Akasaka, Sachiko Yamamoto, Noboru Hanaoka, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi

Journal of gastroenterology and hepatology 31 ( 3 ) 615 - 20 2016年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) is a promising treatment for large gastrointestinal superficial neoplasms, although it is technically difficult, and perforation and delayed bleeding are well-known adverse events. However, there have been no large studies about electrocoagulation syndrome after colorectal ESD. The aim of this study was to evaluate the incidence and clinical significant risk factors of post-ESD coagulation syndrome (PECS). METHODS: This was a retrospective cohort study conducted in a referral cancer center. A total of 336 patients with colorectal neoplasms (143 adenomas or serrated lesions and 193 carcinomas) underwent ESD from January 2011 to June 2013. Incidence, outcome, and factors associated with occurrence of PECS were investigated. RESULTS: Occurred in 32 patients (9.5%). The median time until PECS was 15.5 h, and the median period of PECS was 32.5 h. Fever (≥37.6 °C) after ESD was found in 41% of the PECS group and 9% of the non-PECS group (P < 0.001). All PECS cases were managed conservatively. On multivariate analysis, female patients (odds ratio [OR] = 3.2, P = 0.002), lesion location at ascending colon and cecum (OR = 3.5, P = 0.001), and resected specimen ≥40 mm (OR = 2.1, P = 0.05) were independent risk factors for PECS. CONCLUSIONS: Occurred in 32 patients (9.5%) with colorectal ESD; however, all cases had a good outcome with conservative management. Female sex, tumor location at the ascending colon and cecum, and resected specimen ≥40 mm were independently significant risk factors for PECS.

DOI： 10.1111/jgh.13052

Traction-assisted colonic endoscopic submucosal dissection using clip and line: a feasibility study. 国際誌

Yasushi Yamasaki, Yoji Takeuchi, Noriya Uedo, Minoru Kato, Kenta Hamada, Kenji Aoi, Yusuke Tonai, Noriko Matsuura, Takashi Kanesaka, Takeshi Yamashina, Tomofumi Akasaka, Noboru Hanaoka, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi

Endoscopy international open 4 ( 1 ) E51-5 2016年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND STUDY AIMS: Colonic endoscopic submucosal dissection (ESD) is a challenging procedure because it is often difficult to maintain good visualization of the submucosal layer. To facilitate colonic ESD, we designed a novel traction method, namely traction-assisted colonic ESD using clip and line (TAC), and investigated its feasibility. PATIENTS AND METHODS: We retrospectively analyzed 23 patients with large colonic superficial lesions who had undergone TAC. The main outcome was the procedural success rate of TAC, which we defined as successful, sustained application of clip and line to the lesion until the end of the procedure. RESULTS: The procedural success rate of TAC was 87 % (20/23). In all three unsuccessful cases, the lesions were in the proximal colon and the procedure times over 100 minutes. The overall mean procedure time was 61 min (95 % confidence interval, 18 - 172 min). We achieved en bloc resections of all lesions. There were no perforations or fatal adverse events. CONCLUSIONS: TAC is feasible and safe for colonic ESD and may improve the ease of performing this procedure.

DOI： 10.1055/s-0041-107779

"Take your polyp for a walk": endoscopic retrieval of multiple colon polyps using a clip and line. 国際誌

Tomofumi Akasaka, Yoji Takeuchi, Yasushi Yamasaki, Noboru Hanaoka, Noriya Uedo, Ryu Ishihara, Hiroyashu Iishi

Endoscopy 48 Suppl 1 E291-2 2016年

Endoscopic submucosal dissection as minimally invasive treatment for superficial pharyngeal cancer: a phase II study (with video). 国際誌

Noboru Hanaoka, Ryu Ishihara, Yoji Takeuchi, Motoyuki Suzuki, Shinji Otozai, Kota Kida, Tadashi Yoshii, Takashi Fujii, Kunitoshi Yoshino, Toshimitsu Sugawa, Koji Kitamura, Ryo Kanemura, Ryosuke Koike, Noriya Uedo, Koji Higashino, Tomofumi Akasaka, Takeshi Yamashina, Takashi Kanesaka, Noriko Matsuura, Kenji Aoi, Yasushi Yamasaki, Kenta Hamada, Hiroyasu Iishi, Yasuhiko Tomita

Gastrointestinal endoscopy 82 ( 6 ) 1002 - 8 2015年12月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIMS: Although endoscopic submucosal dissection (ESD) has been applied for superficial pharyngeal cancer, no prospective trials have been reported. To investigate the efficacy and safety of ESD for superficial pharyngeal cancer, we conducted a prospective phase II trial. METHODS: Fifty-four patients with 73 lesions were enrolled from September 2010 to August 2014, and ESD was performed. The primary endpoint was the complete resection rate. Secondary endpoints were safety, recurrence-free survival, overall survival, and incidence of metachronous pharyngeal cancer. RESULTS: Fifty-four patients had stage 0-III cancer: stage 0, n = 22; stage I, n = 14; stage II, n = 17; and stage III, n = 1. The en bloc resection rate was 100%, and the complete resection rate was 79.5% (58/73 lesions; 95% confidence interval, 68%-88%). No serious adverse events related to ESD were encountered. Four patients required nasogastric intubation and feeding. No patients required percutaneous endoscopic gastrostomy and tracheotomy. Swallowing, speech, and airway functions were preserved in all patients. One of the 54 patients died of an unrelated illness. Median follow-up was 27 months (range 6-55 months). Local cervical lymph node metastasis was observed in 1 patient, and the case was salvaged successfully with lymph node dissection. The 3-year overall and recurrence-free survival rates were 97.7% and 98.1%, respectively. Cumulative development of multiple cancers of the pharynx at 3 years was 18.4%. CONCLUSIONS: ESD appears to be a safe and effective minimally invasive treatment in patients with superficial pharyngeal cancer. ( CLINICAL TRIAL REGISTRATION NUMBER: UMIN000003623.).

DOI： 10.1016/j.gie.2015.06.021

A Randomized Trial of Monopolar Soft-mode Coagulation Versus Heater Probe Thermocoagulation for Peptic Ulcer Bleeding. 国際誌

Tomokazu Nunoue, Ryuta Takenaka, Keisuke Hori, Noriko Okazaki, Kenta Hamada, Yuki Baba, Yasushi Yamasaki, Yoshiyasu Kono, Hiroyuki Seki, Toshihiro Inokuchi, Koji Takemoto, Akihiko Taira, Hirofumi Tsugeno, Shigeatsu Fujiki, Yoshiro Kawahara, Hiroyuki Okada

Journal of clinical gastroenterology 49 ( 6 ) 472 - 6 2015年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIM: Endoscopic therapy has been demonstrated to be effective in achieving hemostasis for bleeding peptic ulcers. Thermal coagulation is one of the most commonly used methods, with a high success rate. Recently, endoscopic submucosal dissection for early gastric carcinoma was developed and hemostasis with soft coagulation using hemostatic forceps was introduced. The aim of this study was to compare the hemostatic efficacy of soft coagulation with heater probe thermocoagulation for peptic ulcer bleeding. METHODS: Patients who visited our hospital with hematemesis or melena underwent emergency endoscopy. Inclusion criteria were presentation with an actively bleeding ulcer, a nonbleeding visible vessel, or an adherent clot. Patients were excluded if they were unwilling to give written informed consent or had a bleeding gastric malignancy. Patients were randomized to receive endoscopic hemostasis with soft coagulation (Group S) or heater probe thermocoagulation (Group H). The primary endpoint was the primary hemostasis rate and secondary endpoints were rebleeding rate, complications, and the procedure time. RESULTS: Between May 2010 and February 2012, a total of 111 patients (89 gastric ulcers and 22 duodenal ulcers) were enrolled. Primary hemostasis was achieved in 54 patients (96%) in Group S and 37 (67%) in Group H (P<0.0001). Rebleeding occurred in 7 patients in Group H and none in Group S. Of these 7 patients, urgent surgery was performed in 1. Perforation occurred in 2 patients in Group H, which was managed conservatively. CONCLUSIONS: For patients with gastroduodenal ulcer bleeding, soft coagulation using monopolar hemostatic forceps is more effective than heater probe thermocoagulation for achieving hemostasis.

DOI： 10.1097/MCG.0000000000000190

Tolerability of magnifying narrow band imaging endoscopy for esophageal cancer screening. 国際誌

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

World journal of gastroenterology 21 ( 9 ) 2793 - 9 2015年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

AIM: To compare the tolerability of magnifying narrow band imaging endoscopy for esophageal cancer screening with that of lugol chromoendoscopy. METHODS: We prospectively enrolled and analyzed 51 patients who were at high risk for esophageal cancer. All patients were divided into two groups: a magnifying narrow band imaging group, and a lugol chromoendoscopy group, for comparison of adverse symptoms. Esophageal cancer screening was performed on withdrawal of the endoscope. The primary endpoint was a score on a visual analogue scale for heartburn after the examination. The secondary endpoints were scale scores for retrosternal pain and dyspnea after the examinations, change in vital signs, total procedure time, and esophageal observation time. RESULTS: The scores for heartburn and retrosternal pain in the magnifying narrow band imaging group were significantly better than those in the lugol chromoendoscopy group (P = 0.004, 0.024, respectively, ANOVA for repeated measures). The increase in heart rate after the procedure was significantly greater in the lugol chromoendoscopy group. There was no significant difference between the two groups with respect to other vital sign. The total procedure time and esophageal observation time in the magnifying narrow band imaging group were significantly shorter than those in the lugol chromoendoscopy group (450 ± 116 vs 565 ± 174, P = 0.004, 44 ± 26 vs 151 ± 72, P < 0.001, respectively). CONCLUSION: Magnifying narrow band imaging endoscopy reduced the adverse symptoms compared with lugol chromoendoscopy. Narrow band imaging endoscopy is useful and suitable for esophageal cancer screening periodically.

DOI： 10.3748/wjg.v21.i9.2793

Endoscopic mucosal resection of early stage colon neuroendocrine carcinoma. 国際誌

Yasushi Yamasaki, Noriya Uedo, Ryu Ishihara, Yasuhiko Tomita

BMJ case reports 2015 2015年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

Early stage colorectal neuroendocrine carcinoma is rare. A small colon tumour was found in a 56-year-old man during diagnostic colonoscopy performed after a positive faecal occult blood test, and he was referred for treatment. A slightly reddish superficial elevated lesion with a shallow depression 10 mm in size was found in the transverse colon. Magnifying narrow-band imaging revealed disrupted irregular microvessels and the absence of a surface pattern in the depressed area. En bloc endoscopic mucosal resection (EMR) of the tumour was undertaken. The tumour was positive for chromogranin A and synaptophysin, and had a mitotic rate of >20/10 high-power fields and a Ki-67 proliferative index of >50%; it was diagnosed as a neuroendocrine carcinoma. The tumour minimally invaded the submucosa (300 μm) without lymphovascular involvement. The patient was followed up carefully, and at 1 year after EMR, no recurrence was found using colonoscopy and CT scans.

DOI： 10.1136/bcr-2014-208148

Use of non-invasive serum glycan markers to distinguish non-alcoholic steatohepatitis from simple steatosis. 国際誌

Yasushi Yamasaki, Kazuhiro Nouso, Koji Miyahara, Nozomu Wada, Chihiro Dohi, Yuki Morimoto, Hideaki Kinugasa, Yasuto Takeuchi, Tetsuya Yasunaka, Kenji Kuwaki, Hideki Onishi, Fusao Ikeda, Yasuhiro Miyake, Shinichiro Nakamura, Hidenori Shiraha, Akinobu Takaki, Yoshiaki Iwasaki, Maho Amano, Shin-Ichiro Nishimura, Kazuhide Yamamoto

Journal of gastroenterology and hepatology 30 ( 3 ) 528 - 34 2015年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND AND AIMS: Serum glycans have been reported to be promising diagnostic markers for many inflammatory diseases and cancers. The aims of this study were to investigate whole glycan expression in patients with non-alcoholic fatty liver diseases and to evaluate the potential use of glycan profiles as new clinical biomarkers to distinguish non-alcoholic steatohepatitis (NASH) from simple steatosis (SS). METHODS: We collected sera from 42 histologically proven NASH and 15 SS patients prior to treatment. Serum glycan profiles were measured by comprehensive, quantitative, high-throughput glycome analysis, and diagnostic values of serum glycans for NASH prediction were examined. RESULTS: Among the 41 serum glycans examined, the expression levels of 8 glycans in NASH were significantly higher than those of SS. Out of these eight glycans, three glycans (m/z 1955, 2032, and 2584) showed high areas under the receiver operating characteristic curve (0.833, 0.863, and 0.866, respectively) for distinguishing NASH from SS. In multivariate analyses with clinical parameters and serum glycans, these three glycans were significant predictive factors for distinguishing NASH from SS. The odds ratio of m/z 1955, 2032, and 2584 were 48.5, 6.46, and 11.8, respectively. These glycans also correlated significantly with lobular inflammation, ballooning, and fibrosis, but not with steatosis. CONCLUSION: We clearly demonstrated whole-serum glycan profiles in NASH patients, and the feasibility of serum glycans (m/z 1955, 2032, and 2584) as new noninvasive biomarkers for distinguishing NASH from SS.

DOI： 10.1111/jgh.12726

A novel traction method using an endoclip attached to a nylon string during colonic endoscopic submucosal dissection. 国際誌

Yasushi Yamasaki, Yoji Takeuchi, Noboru Hanaoka, Koji Higashino, Noriya Uedo, Ryu Ishihara, Hiroyasu Iishi

Endoscopy 47 Suppl 1 UCTN E238-9 2015年

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

Monopolar Soft-Mode Coagulation Using Hemostatic Forceps for Peptic Ulcer Bleeding

Yasushi Yamasaki, Ryuta Takenaka, Tomokazu Nunoue, Yoshiyasu Kono, Koji Takemoto, Akihiko Taira, Hirofumi Tsugeno, Shigeatsu Fujiki

HEPATO-GASTROENTEROLOGY 61 ( 136 ) 2272 - 2276 2014年11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：H G E UPDATE MEDICAL PUBLISHING S A

Background/Aims: Upper gastrointestinal hemorrhage from bleeding peptic ulcer is sometimes difficult to treat by conventional endoscopic methods. Recently, monopolar electrocoagulation using a soft-coagulation system and hemostatic forceps (soft coagulation) has been used to prevent bleeding during endoscopic submucosal dissection. The aim of this study was to assess the safety and efficacy of soft coagulation in the treatment of bleeding peptic ulcer. Methodology: A total of 39 patients with peptic ulcers were treated using soft coagulation at our hospital between January 2005 and March 2010. Emergency treatment employed an ERBE soft-mode coagulation system using hemostatic forceps. Second-look endoscopy was performed to evaluate the efficacy of prior therapy. Initial hemostasis was defined as accomplished by soft coagulation, with or without other endoscopic therapy prior to soft coagulation. The rate of initial hemostasis, rebleeding, and ultimate hemostasis were retrospectively analyzed. Results: The study subjects were 31 men and 8 women with a mean age of 68.3 +/- 13.7 years, with 29 gastric ulcers and 10 duodenal ulcers. Initial hemostasis was achieved in 37 patients (95%). During follow-up, bleeding recurred in two patients, who were retreated with soft coagulation. Conclusions: The monopolar soft coagulation is feasible and safe for treating bleeding peptic ulcers.

DOI： 10.5754/hge13780

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

[The impact of guidelines for the management of acute cholecystitis in a rural area of Japan].

Yasushi Yamasaki, Ryuta Takenaka, Noriko Okazaki, Yuki Baba, Kenta Hamada, Hiroki Takayama, Koji Takemoto, Akihiko Taira, Hirofumi Tsugeno, Yasuhiro Kubota, Doufu Hayashi, Shigeatsu Fujiki

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 110 ( 10 ) 1774 - 82 2013年10月

記述言語：日本語掲載種別：研究論文（学術雑誌）

We monitored the management of acute cholecystitis in a rural area of Japan to determine the effectiveness of new guidelines for the management of acute cholecystitis and cholangitis. Between January 2000 and September 2011, 366 patients were treated for acute cholecystitis. Of these, 59 had common bile duct stones (CBDS) and 307 did not. Patients in both groups were further subdivided into two groups: a before guidelines group (BGG; n=153) and an after guideline group (AGG; n=154). Among the patients without CBDS, early cholecystectomy was more common in the AGG group (n=53) than in the BGG group. Furthermore, the length of hospital stay was four days shorter in the AGG group than in the BGG group (n=23). Among the patients with CBDS, the timing of cholecystectomy after endoscopic retrograde cholangiography was seven days earlier in the AGG group than in the BGG group. Even in a rural area of Japan, early cholecystectomy appears safe and can decrease the length of hospital stay.

Wernicke's Encephalopathy in a Patient with Peptic Ulcer Disease. 国際誌

Akinori Uruha, Toshio Shimizu, Tomoji Katoh, Yasushi Yamasaki, Shiro Matsubara

Case reports in medicine 2011 156104 - 156104 2011年

記述言語：英語

We report a 74-year-old man with Wernicke's encephalopathy (WE) whose only prior illness was peptic ulcer disease. Upper gastrointestinal endoscopy demonstrated gastric ulcer scars accompanied by marked deformity, without pathologic evidence of malignancy. WE due to peptic ulcer disease in previous reports was substantially associated with thiamine deficiency due to recurrent vomiting or surgical procedures. In our case, however, there was no history of vomiting or gastrointestinal surgery. Besides, we thoroughly ruled out other known clinical settings related to WE. There is the possibility that peptic ulcer disease itself provoked thiamine deficiency due to malabsorption.

DOI： 10.1155/2011/156104

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