Researchers Database

MIYATANI Hiroyuki

    ComprehensiveMedicine1 Professor
Last Updated :2021/10/17

Researcher Information

Degree

  • Doctor(Medicine)(Jichi Medical University)

J-Global ID

Research Interests

  • 乳頭機能不全症   胆道疾患   超音波内視鏡   

Research Areas

  • Life sciences / Gastroenterology
  • Life sciences / Internal medicine - General

Academic & Professional Experience

  • 2013 - Today  Jichi Medical University
  • 2004 - 2013  Jichi Medical University
  • 2001 - 2004  Saitama Medical University
  • 1996 - 2001  Jichi Medical University
  • 1996 - 2001  Jichi Medical School, Research Assistant

Education

  •        - 1987  Jichi Medical University  医学部  医学
  •        - 1987  Jichi Medical University  Faculty of Medicine

Association Memberships

  • 日本門脈圧亢進症学会   日本超音波医学会   日本膵臓学会   日本肝臓学会   日本胆道学会   日本消化器内視鏡学会   日本消化器病学会   日本内科学会   

Published Papers

  • Kenichi Yamanaka, Hiroyuki Miyatani, Yukio Yoshida, Shinichi Asabe, Toru Yoshida, Misaki Nakano, Shin Obara, Hidehiko Endo
    WORLD JOURNAL OF GASTROENTEROLOGY 19 (42) 7426 - 7432 1007-9327 2013/11 [Refereed][Not invited]
     
    AIM: To elucidate the characteristics of hemorrhagic gastric/duodenal ulcers in a post-earthquake period within one medical district. METHODS: Hemorrhagic gastric/duodenal ulcers in the Iwate Prefectural Kamaishi Hospital during the 6-mo period after the Great East Japan Earthquake Disaster were reviewed retrospectively. The subjects were 27 patients who visited our hospital with a chief complaint of hematemesis or hemorrhagic stool and were diagnosed as having hemorrhagic gastric/duodenal ulcers by upper gastrointestinal endoscopy during a 6-mo period starting on March 11, 2011. This period was divided into two phases: the acute stress phase, comprising the first month after the earthquake disaster, and the chronic stress phase, from the second through the sixth month. The following items were analyzed according to these phases: age, sex, sites and number of ulcers, peptic ulcer history, status of Helicobacter pylori (H. pylori) infection, intake of non-steroidal anti-inflammatory drugs, and degree of impact of the earthquake disaster. RESULTS: In the acute stress phase from 10 d to 1 mo after the disaster, the number of patients increased rapidly, with a nearly equal male-to-female ratio, and the rate of multiple ulcers was significantly higher than in the previous year (88.9% vs 25%, P < 0.005). In the chronic stress phase starting 1 mo after the earthquake disaster, the number of patients decreased to a level similar to that of the previous year. There were more male patients during this period, and many patients tended to have a solitary ulcer. All patients with duodenal ulcers found in the acute stress phase were negative for serum H. pylori antibodies, and this was significantly different from the previous year's positive rate of 75% (P < 0.05). CONCLUSION: Severe stress caused by an earthquake disaster may have affected the characteristics of hemorrhagic gastric/duodenal ulcers. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.
  • Satohiro Matsumoto, Hiroyuki Miyatani, Yukio Yoshida
    DIGESTIVE DISEASES AND SCIENCES 58 (5) 1306 - 1312 0163-2116 2013/05 [Refereed][Not invited]
     
    We examined the pathologies, treatment characteristics, and clinical course of elderly ulcerative colitis (UC) patients. Among 222 UC patients (127 men, 95 women; average age, 34 +/- A 16 years), we selected 109 with UC diagnosed between 20 and 39 years of age (young adult group) and 23 diagnosed at a parts per thousand yen60 years of age (elderly group). Moreover, 12 patients diagnosed between 60 and 64 years of age (late-onset group) and 6 patients aged a parts per thousand yen60 years diagnosed under 50 years old (long-standing group) were also extracted for sub-analysis. The clinical characteristics and course were compared among the groups. The average age at onset was 29 +/- A 6 years in the young adult group and 66 +/- A 5 years in the elderly group. The frequency of immunomodulator or steroid use did not differ between the two groups. The comorbidity rate was 14.7 % in the young adult group and 69.6 % in the elderly group (P < .0001). Seven patients (58.3 %) in the late-onset UC group and none of the patients in the long-standing UC group were on steroid treatment. None of the patients in the long-standing UC group required hospitalization/surgery for UC exacerbation, while 3 (25.0 %) and 2 patients (16.7 %) in the late-onset group required hospitalization and surgery, respectively. The comorbidity rate was significantly higher in the elderly group. Treatments did not differ significantly between the young adult and elderly groups. Therefore, it appears that the inflammation tends to subside with age in elderly patients with long-standing UC.
  • Yuji Shindo, Hiroyuki Miyatani, Takeshi Uehara, Takashi Ikeya, Kenichi Yamanaka, Masatoshi Ikeda, Kouichi Tokai, Shinya Ushimaru, Satohiro Matsumoto, Takeharu Asano, Toru Takamatsu, Masanori Fukunishi, Takaaki Iwaki, Yoshinori Sagihara, Shinichi Asabe, Yukio Yoshida
    Journal of Japanese Society of Gastroenterology 109 (7) 1243 - 1249 0446-6586 2012/07 [Refereed][Not invited]
     
    A 78-year-old man with hepatocellular carcinoma treated by chemoembolization and percutaneous ethanol injection was admitted to our hospital because of acute abdomen. The CT scan showed biliary fistula caused by hepatocellular carcinoma protruding from S3. Endoscopic retrograde cholangiopancreatography showed disruption of an intrahepatic duct and the main pancreatic duct, and contrast agent leaked into the peritoneal cavity from each duct Omental panniculitis with biliary fistula and pancreatic fistula was diagnosed. The symptoms improved by endoscopic nasobiliary drainage and endoscopic pancreatic stenting. On the 13th day after admission, we added endoscopic nasopancreatic drainage because his abdominal pain had been exacerbated by pancreatic juice leakage. Omental panniculitis by hepatocellular carcinoma complicated by biliary fistula and pancreatic fistula is extremely rare. Endoscopic transpapillary pancreaticobiliary drainage was effective for omental panniculitis in this case.
  • Koichi Tokai, Hiroyuki Miyatani, Yukio Yoshida, Shigeki Yamada
    WORLD JOURNAL OF GASTROENTEROLOGY 18 (28) 3770 - 3774 1007-9327 2012/07 [Refereed][Not invited]
     
    A 75-year old man had been diagnosed at 42 years of age as having polycythemia vera and had been monitored at another hospital. Progression of anemia had been recognized at about age 70, and the patient was thus referred to our center in 2008 where secondary myelofibrosis was diagnosed based on bone marrow biopsy findings. Hematemesis due to rupture of esophageal varices occurred in January and February of 2011. The bleeding was stopped by endoscopic variceal ligation. Furthermore, in March of the same year, hematemesis recurred and the patient was transported to our center. He was in irreversible hemorrhagic shock and died. The autopsy showed severe bone marrow fibrosis with mainly argyrophilic fibers, an observation consistent with myelofibrosis. The liver weighed 1856 g the spleen 1572 g, indicating marked hepatosplenomegaly. The liver and spleen both showed extramedullary hemopoiesis. Myelofibrosis is often complicated by portal hypertension and is occasionally associated with gastrointestinal hemorrhage due to esophageal varices. A patient diagnosed as having myelofibrosis needs to be screened for esophageal/gastric varices. Myelofibrosis has a poor prognosis. Therefore, it is necessary to carefully decide the therapeutic strategy in consideration of the patient's concomitant conditions, treatment invasiveness and quality of life. (C) 2012 Baishideng. All rights reserved.
  • Takaaki Iwaki, Hiroyuki Miyatani, Yukio Yoshida, Katsuhiko Matsuura, Yoshihisa Suminaga
    Clinical Journal of Gastroenterology 5 (2) 101 - 107 1865-7257 2012/04 [Refereed][Not invited]
     
    An intrahepatic arterioportal fistula is a rare cause of portal hypertension and variceal bleeding. We report on a patient with an intrahepatic arterioportal fistula following liver biopsy who was successfully treated by hepatectomy after unsuccessful arterial embolization. We also review the literature on symptomatic intrahepatic arterioportal fistulas after liver biopsy. A 48-year-old male with bleeding gastric varices and hepatitis B virus-associated liver cirrhosis was transferred to our hospital this patient previously underwent percutaneous liver biopsies 3 and 6 years ago. Abdominal examination revealed a bruit over the liver, tenderness in the right upper quadrant, and splenomegaly. Ultrasonographic examination, computed tomography, and angiography confirmed an arterioportal fistula between the right hepatic artery and the right portal vein with portal hypertension. After admission, the patient suffered a large hematemesis and developed shock. He was treated with emergency transarterial embolization using microcoils. Since some collateral vessels bypassed the obstructive coils and still fed the fistulous area, embolization was performed again. Despite the second embolization, the collateral vessels could not be completely controlled. Radical treatment involving resection of his right hepatic lobe was performed. For nearly 6 years postoperatively, this patient has had no further episodes of variceal bleeding. © Springer 2012.
  • Satohiro Matsumoto, Hiroyuki Miyatani, Yukio Yoshida, Mitsuhiro Nokubi
    GASTROINTESTINAL ENDOSCOPY 74 (5) 1152 - 1156 0016-5107 2011/11 [Refereed][Not invited]
  • Hiromu Inoue, Hiroyuki Miyatani, Yoshiyuki Nakashima, Noriyoshi Sagihara, Yukio Yoshida
    DIGESTIVE ENDOSCOPY 23 (4) 325 - 325 0915-5635 2011/10 [Refereed][Not invited]
  • Takuhiro Ugajin, Hiroyuki Miyatani, Satohiro Matsumoto, Tohru Takamatsu, Masanori Fukunishi, Yukio Yoshida, Yoh Dobashi
    DIGESTIVE ENDOSCOPY 23 (4) 328 - 328 0915-5635 2011/10 [Refereed][Not invited]
  • Satohiro Matsumoto, Hiroyuki Miyatani, Yukio Yoshida, Mitsuhiro Nokub
    GASTROINTESTINAL ENDOSCOPY 73 (6) 1309 - 1312 0016-5107 2011/06 [Refereed][Not invited]
  • Toru Takamatsu, Kouichi Toukai, Masatoshi Ikeda, Shinya Ushimaru, Takeharu Asano, Norihiro Matsumoto, Takaaki Iwaki, Masanori Fukunishi, Noriyoshi Sagihara, Hiroyuki Miyatani, Yukio Yoshida, Shigeki Yamada
    Journal of Japanese Society of Gastroenterology 108 (4) 658 - 664 0446-6586 2011/04 [Refereed][Not invited]
     
    Splenic tumors are very rare. In Japan only 42 cases of splenic angiosarcoma have been reported. We encountered a case of spontaneous rupture of a splenic angiosarcoma and liver metastasis. A 60-year-old woman who suddenly went into hemorrhagic shock presented at our hospital. Then acute spontaneously ruptured spleen and hepatic tumors were diagnosed by abdominal CT. After emergency TAE, the patient was hemodynamically stable, but died of liver failure 13 days after admission. The pathological diagnosis was primary splenic angiosarcoma with multiple organ metastasis on autopsy. Splenic angiosarcoma should be kept in mind in the differential diagnosis of splenomegaly or splenic tumor. TAE can be effective in primary hemostasis for angiosarcoma with intraperitoneal hemorrhage from multiple tumors.
  • Hideaki Honda, Hiroyuki Miyatani, Takashi Ikeya, Kenichi Yamanaka, Masatoshi Ikeda, Shinya Ushimaru, Toru Takamatsu, Takaaki Iwaki, Noriyoshi Sagihara, Yukio Yoshida
    Journal of Japanese Society of Gastroenterology 107 (9) 1497 - 1504 0446-6586 2010/09 [Refereed][Not invited]
     
    A 40-year-old man was admitted to our hospital because of epigastralgia and vomiting. His condition was diagnosed as acute pancreatitis with a pancreatic pseudocyst, obstructive jaundice, and duodenal stenosis. Because he had fever, abdominal pain, and elevated levels of C-reactive protein (CRP), endoscopic ultrasound-guided transmural cyst drainage (EUS-CD) was performed with a nasocystic tube on the 6th day. After the cyst was reduced and the patient recovered from the obstructive jaundice and duodenal stenosis, the nasal drainage tube was replaced with a plastic stent. Because a short extent of stenosis in the main pancreatic duct in the pancreatic head was found by endoscopic retrograde cholangiopancreatography (ERCP), a 5Fr pancreatic stent was placed to prevent pancreatitis. No recurrence of pancreatitis and the cyst occurred after removal of both stents 5 days later.
  • Hiroyuki Miyatani, Yukio Yoshida, Shinya Ushimaru, Noriyoshi Sagihara, Shigeki Yamada
    DIGESTIVE ENDOSCOPY 21 (4) 255 - 257 0915-5635 2009/10 [Refereed][Not invited]
     
    We report a rare case of flat-type primary malignant melanoma of the esophagus treated with endoscopic mucosal resection (EMR). A 64-year-old woman was referred for examination of a small pigmented lesion located in the mid esophagus. On endoscopy, the lesion exhibited almost no change in size over the year. Cap-assisted EMR was performed en bloc. The histopathological findings showed atypical melanocyte proliferation in the basal layer, spindle cells, and epithelioid cell proliferation with nuclear enlargement and a few mitotic figures. Histopathological examination confirmed the diagnosis of primary malignant melanoma. Immunostaining for S-100 protein and HMB-45 antibody were positive, and the Ki-67 index was low. The patient was discharged without additional surgical resection and/or chemotherapy. The patient had no symptoms and no signs of recurrence 20 months after EMR. There has been no report on a slow growing esophageal melanoma. It is difficult to estimate the malignant behavior of this case.
  • Miyatani H, Yoshida Y
    Therapeutics and clinical risk management 3 5 465 - 468 1176-6336 2009/06 [Refereed][Not invited]
  • Miyatani H, Yoshida Y, Kiyozaki H
    Therapeutics and clinical risk management 2 5 301 - 303 1176-6336 2009/04 [Refereed][Not invited]
  • Takuhiro Ugajin, Hiroyuki Miyatani, Toshio Demitsu, Takaaki Iwaki, Shinya Ushimaru, Yoshiyuki Nakashima, Yukio Yoshida
    INTERNAL MEDICINE 48 (9) 693 - 695 0918-2918 2009 [Refereed][Not invited]
     
    A 15-year-old, woman, Crohn's disease patient, who carried the TPMT *3C heterozygous mutant, complained of alopecia 3 days after starting 6-mercaptopurine (6-MP) and then developed severe myelosuppression 6 weeks after starting 6-MP. The alopecia involved scalp hair only (body hair preserved) and was dominant in the temporal region. Following these side effects, transient remission of Crohn's disease occurred. Myelosuppression due to 6-MP is a rare but life-threatening side effect that is difficult to predict despite continuous monitoring of complete blood cell counts. In the present case, 6-MP-induced alopecia preceded myelosuppression and progressed rapidly as the myelosuppression worsened.
  • Hiroyuki Miyatani, Yukio Yoshida, Masatoshi Ikeda, Noriyoshi Sagihara
    INTERNAL MEDICINE 47 (4) 321 - 322 0918-2918 2008 [Refereed][Not invited]
  • Takuhiro Ugajin, Hiroyuki Miyatani, Shin-ichi Momomura, Masamitsu Sanui, Yoshiyuki Nakashima, Yukio Yoshida
    INTERNAL MEDICINE 47 (7) 609 - 612 0918-2918 2008 [Refereed][Not invited]
     
    While ventricular premature contractions have been noted during colonoscopy (CS), ventricular fibrillation (VF) is rare. We recently had a patient who developed VF during CS and recovered without any sequelae despite severe complications after cardiopulmonary resuscitation (CPR). If electrocardiogram (ECG) monitoring had been done during CS, a direct current shock defibrillation could have been accomplished and prevented complications. CS in high-risk patients should be done with ECG monitoring.
  • Takuhiro Ugajin, Hiroyuki Miyatani, Yoshiaki Watanabe, Junji Nishida, Yukio Yoshida
    INTERNAL MEDICINE 47 (9) 879 - 880 0918-2918 2008 [Refereed][Not invited]
  • Hiromu Inoue, Yukihisa Sawada, Kaori Ochiai, Hideaki Honda, Junko Murayama, Yasutaka Kudo, Yoshiyuki Nakashima, Noriyoshi Sagihara, Hiroyuki Miyatani, Ikuo Nakamura, Yukio Yoshida
    INTERNAL MEDICINE 46 (12) 845 - 848 0918-2918 2007 [Refereed][Not invited]
     
    A 71-year-old man was admitted to our hospital with abdominal pain. Hepatocellular carcinoma (HCC) had been diagnosed 2 years earlier and he had undergone 7 courses of intra-hepato-arterial chemotherapy (IHAC). We performed gastrointestinal fiberscopy and identified a massive protrusion on the lesser curvature. Abdominal contrast-enhanced computed tomography revealed multiple hepatic masses and an extrahepatic enlarged mass with invasion to the pancreas and stomach. A specimen for endoscopic biopsy revealed adenocarcinoma that stained positive for alpha-fetoprotein. Gastrointestinal bleeding resulting from direct invasion of HCC is unusual.
  • Hiromu Inoue, Hiroyuki Miyatani, Yukihisa Sawada, Yukio Yoshida
    PANCREAS 33 (2) 208 - 209 0885-3177 2006/08 [Refereed][Not invited]
  • Yukihisa Sawada, Masakazu Kamihira, Satoshi Asano, Yoshiyuki Nakashima, Masanori Kihara, Kaori Ochiai, Takafumi Hyodo, Hiroyuki Miyatani, Toshifumi Fujiwara, Ryuichi Hirakawa, Ikuo Nakamura, Michio Imawari
    Japanese Journal of Gastroenterology 101 (2) 188 - 190 0446-6586 2004/02 [Refereed][Not invited]
  • Yoshida Y, Miyatani H, Tokuyama T, Hirakawa R
    Nihon rinsho. Japanese journal of clinical medicine 60 Suppl 2 583 - 586 0047-1852 2002/02 [Refereed][Not invited]

Books etc

MISC

  • Satohiro Matsumoto, Hiroyuki Miyatani, Yukio Yoshida  DIGESTIVE DISEASES AND SCIENCES  58-  (5)  1306  -1312  2013/05  [Not refereed][Not invited]
     
    We examined the pathologies, treatment characteristics, and clinical course of elderly ulcerative colitis (UC) patients. Among 222 UC patients (127 men, 95 women; average age, 34 +/- A 16 years), we selected 109 with UC diagnosed between 20 and 39 years of age (young adult group) and 23 diagnosed at a parts per thousand yen60 years of age (elderly group). Moreover, 12 patients diagnosed between 60 and 64 years of age (late-onset group) and 6 patients aged a parts per thousand yen60 years diagnosed under 50 years old (long-standing group) were also extracted for sub-analysis. The clinical characteristics and course were compared among the groups. The average age at onset was 29 +/- A 6 years in the young adult group and 66 +/- A 5 years in the elderly group. The frequency of immunomodulator or steroid use did not differ between the two groups. The comorbidity rate was 14.7 % in the young adult group and 69.6 % in the elderly group (P < .0001). Seven patients (58.3 %) in the late-onset UC group and none of the patients in the long-standing UC group were on steroid treatment. None of the patients in the long-standing UC group required hospitalization/surgery for UC exacerbation, while 3 (25.0 %) and 2 patients (16.7 %) in the late-onset group required hospitalization and surgery, respectively. The comorbidity rate was significantly higher in the elderly group. Treatments did not differ significantly between the young adult and elderly groups. Therefore, it appears that the inflammation tends to subside with age in elderly patients with long-standing UC.
  • 山中 健一, 宮谷 博幸, 吉田 行雄  月刊地域医学  26-  (11)  1054  -1057  2012/11  [Not refereed][Not invited]
  • TAKAMATSU Toru, OTAKE Haruka, UEHARA Takeshi, SHINDOU Yuji, IKEYA Takashi, TOUKAI Kouichi, IKEDA Masatoshi, USHIMARU Shinya, ASANO Takeharu, MATSUMOTO Satohiro, IWAKI Takaaki, FUKUNISHI Masanori, SAGIHARA Noriyoshi, ASABE Shinichi, MIYATANI Hiroyuki, YOSHIDA Yukio  膵臓 = The Journal of Japan Pancreas Society  27-  (5)  695  -700  2012/10  [Not refereed][Not invited]
  • SHINDO Yuji, MIYATANI Hiroyuki, UEHARA Takeshi, IKEYA Takashi, YAMANAKA Kenichi, IKEDA Masatoshi, TOKAI Kouichi, USHIMARU Shinya, MATSUMOTO Satohiro, ASANO Takeharu, TAKAMATSU Toru, FUKUNISHI Masanori, IWAKI Takaaki, SAGIHARA Yoshinori, ASABE Shinichi, YOSHIDA Yukio  Nippon Shokakibyo Gakkai Zasshi  109-  (7)  1243  -1249  2012/07  [Not refereed][Not invited]
     
    A 78-year-old man with hepatocellular carcinoma treated by chemoembolization and percutaneous ethanol injection was admitted to our hospital because of acute abdomen. The CT scan showed biliary fistula caused by hepatocellular carcinoma protruding from S3. Endoscopic retrograde cholangiopancreatography showed disruption of an intrahepatic duct and the main pancreatic duct, and contrast agent leaked into the peritoneal cavity from each duct. Omental panniculitis with biliary fistula and pancreatic fistula was diagnosed. The symptoms improved by endoscopic nasobiliary drainage and endoscopic pancreatic stenting. On the 13th day after admission, we added endoscopic nasopancreatic drainage because his abdominal pain had been exacerbated by pancreatic juice leakage. Omental panniculitis by hepatocellular carcinoma complicated by biliary fistula and pancreatic fistula is extremely rare. Endoscopic transpapillary pancreaticobiliary drainage was effective for omental panniculitis in this case.
  • TAKAMATSU TORU, OOTAKE HARUKA, UEHARA TAKESHI, SHINDOU YUJI, IKEYA TAKASHI, TOUKAI KOUICHI, IKEDA MASATOSHI, USHIMARU SHINYA, ASANO TAKEHARU, MATSUMOTO SATOHIRO, IWAKI TAKAAKI, FUKUNISHI MASANORI, SAGIHARA NORIYOSHI, ASABE SHINICHI, MIYATANI HIROYUKI, YOSHIDA YUKIO  自治医科大学紀要  34-  87  -95  2012/03  [Not refereed][Not invited]
  • Toru Takamatsu, Haruka Ootake, Takeshi Uehara, Yuji Shindou, Takashi Ikeya, Kouichi Toukai, Masatoshi Ikeda, Shinya Ushimaru, Takeharu Asano, Satohiro Matsumoto, Takaaki Iwaki, Masanori Fukunishi, Noriyoshi Sagihara, Shinichi Asabe, Hiroyuki Miyatani, Yukio Yoshida  Jichi Medical University journal  34-  87  -95  2012/03  [Not refereed][Not invited]
     
    While guidelines have been established for the treatment of esophageal and gastric varices, there is as yet no consensus with regard to the optimal method of treatment of ectopic varices. We report a case of ruptured duodenal varices treated successfully by endoscopic injection sclerotherapy (EIS) under radiographic guidance with a mixture of N-butyl-2-cyanoacrylate (NBCA)-lipiodol. A 73-year-old female patient with a history of liver cirrhosis was transferred to our hospital for the treatment of ruptured duodenal varices. Esophagogastroduodenoscopy (EGD) revealed distended duodenal varices with a mucosal erosion and a coagulum in the descending portion of the duodenum. Dynamic contrast-enhanced computed tomography (CT) of the abdomen revealed duodenal varices arising from the pancreaticoduodenal vein, being a branch of the superior mesenteric vein, the efferent vessel draining through the veins of Retzius. A total of 6 mL of an NBCA + lipiodol mixture (mixing ratio, 3:1) was injected into 3 sites of the duodenal varices via a 23-gauge disposable injection needle. Radiographic imaging during the EIS demonstrated that the NBCA + lipiodol mixture had reached the distended veins connected to the duodenal varices. At the follow-up CT conducted 6 days after the EIS, the duodenal varices with its collateral vessels were almost completely obliterated by the NBCA + lipiodol mixture. Even a single EIS session eradicated the varices almost completely without any complications. EIS under radiographic guidance using a mixture of NBCA-lipiodol (75%NBCA) is an effective method of treatment of duodenal varices in hemorrhagic or elective cases.
  • ASANO Takeharu, NAKAMURA Ikuo, OKAJIMA Mari, YAMANAKA Kenichi, ASABE Shinichi, MIYATANI Hiroyuki, MATSUURA Katsuhiko, YOSHIDA Yukio, IMAWARI Michio  Kanzo  53-  (1)  55  -63  2012/01  [Not refereed][Not invited]
     
    A 73-year-old man with chronic hepatitis C was diagnosed as hepatocellular carcinoma in segment 5 of the liver. Then anterior segmental liver resection was performed in 1999. He was checked by abdominal US or CT every 4-6 months after resection. In March 2009, abdominal CT showed a heterogeneous lesion with partially enhanced area at the right hepatic lobe after the resection. The lesion had enlarged with follow up CT in May 2009, and was diagnosed as pseudoaneurysm. Abdominal angiography showed a hepatic arterial pseudoaneurysm, 3 cm in diameter originating from the anterior segmental branch. The pseudoaneurysm was embolized using microcoils for prevention of rupture. The risk of rupture of pseudoaneurysm and mortality after rupture were very high. Therefore, earlier treatment might be preferable. Patients who have performed liver resection should be carefully followed up for not only detection of HCC recurrence but that of possible pseudoaneurysm as a late complication.
  • Hiromu Inoue, Hiroyuki Miyatani, Yoshiyuki Nakashima, Noriyoshi Sagihara, Yukio Yoshida  DIGESTIVE ENDOSCOPY  23-  (4)  325  -325  2011/10  [Not refereed][Not invited]
  • Takuhiro Ugajin, Hiroyuki Miyatani, Satohiro Matsumoto, Tohru Takamatsu, Masanori Fukunishi, Yukio Yoshida, Yoh Dobashi  DIGESTIVE ENDOSCOPY  23-  (4)  328  -328  2011/10  [Not refereed][Not invited]
  • TAKAMATSU Toru, TOUKAI Kouichi, USHIMARU Shinya, MATSUMOTO Satohiro, IWAKI Takaaki, FUKUNISHI Masanori, SAGIHARA Noriyoshi, MIYATANI Hiroyuki, YOSHIDA Yukio, YAMADA Shigeki  GASTROENTEROLOGICAL ENDOSCOPY  53-  (9)  3023  -3027  2011/09  [Not refereed][Not invited]
     
    Esophageal submucosal tumors (SMTs) are almost all benign in nature, and a malignant SMT is rare. Endoscopic ultrasound (EUS) can give useful information about the differentiation between benign and malignant SMTs, but it is sometimes difficult and occasionally impossible. Treatment policies for SMTs differ depending on the histological type, therefore diagnosis of an SMT requires histological and immunohistochemical confirmation. EUS-guided fine needle aspiration biopsy (EUS-FNAB) is an effective technique to obtain tissue samples of an SMT with minimal risk. We report on a case of an esophageal SMT diagnosed from a direct-observation biopsy by mucosal cutting. We think this method may be tried in convex type EUS-free facilities and, if not enough tissue could be collected with EUS-FNAB.
  • TAKAMATSU Toru, TOUKAI Kouichi, IKEDA Masatoshi, USHIMARU Shinya, ASANO Takeharu, MATSUMOTO Norihiro, IWAKI Takaaki, FUKUNISHI Masanori, SAGIHARA Noriyoshi, MIYATANI Hiroyuki, YOSHIDA Yukio, YAMADA Shigeki  Nippon Shokakibyo Gakkai Zasshi  108-  (4)  658  -664  2011/04  [Not refereed][Not invited]
     
    Splenic tumors are very rare. In Japan only 42 cases of splenic angiosarcoma have been reported. We encountered a case of spontaneous rupture of a splenic angiosarcoma and liver metastasis. A 60-year-old woman who suddenly went into hemorrhagic shock presented at our hospital. Then acute spontaneously ruptured spleen and hepatic tumors were diagnosed by abdominal CT. After emergency TAE, the patient was hemodynamically stable, but died of liver failure 13 days after admission. The pathological diagnosis was primary splenic angiosarcoma with multiple organ metastasis on autopsy. Splenic angiosarcoma should be kept in mind in the differential diagnosis of splenomegaly or splenic tumor. TAE can be effective in primary hemostasis for angiosarcoma with intraperitoneal hemorrhage from multiple tumors.
  • TAKAMATSU Toru, UEHARA Takeshi, IKEYA Takashi, TOUKAI Kouichi, IKEDA Masatoshi, USHIMARU Shinya, ASANO Takeharu, MATSUMOTO Satohiro, IWAKI Takaaki, FUKUNISHI Masanori, SAGIHARA Noriyoshi, ASABE Shinichi, MIYATANI Hiroyuki, YOSHIDA Yukio, NODA Hiroshi, DOBASHI You  膵臓 = The Journal of Japan Pancreas Society  25-  (5)  578  -584  2010/10  [Not refereed][Not invited]
  • HONDA Hideaki, MIYATANI Hiroyuki, IKEYA Takashi, YAMANAKA Kenichi, IKEDA Masatoshi, USHIMARU Shinya, TAKAMATSU Toru, IWAKI Takaaki, SAGIHARA Noriyoshi, YOSHIDA Yukio  Nippon Shokakibyo Gakkai Zasshi  107-  (9)  1497  -1504  2010/09  [Not refereed][Not invited]
     
    A 40-year-old man was admitted to our hospital because of epigastralgia and vomiting. His condition was diagnosed as acute pancreatitis with a pancreatic pseudocyst, obstructive jaundice, and duodenal stenosis. Because he had fever, abdominal pain, and elevated levels of C-reactive protein (CRP), endoscopic ultrasound-guided transmural cyst drainage (EUS-CD) was performed with a nasocystic tube on the 6th day. After the cyst was reduced and the patient recovered from the obstructive jaundice and duodenal stenosis, the nasal drainage tube was replaced with a plastic stent. Because a short extent of stenosis in the main pancreatic duct in the pancreatic head was found by endoscopic retrograde cholangiopancreatography (ERCP), a 5Fr pancreatic stent was placed to prevent pancreatitis. No recurrence of pancreatitis and the cyst occurred after removal of both stents 5 days later.
  • 宮谷 博幸, 吉田 行雄  月刊地域医学  24-  (6)  424  -430  2010/06  [Not refereed][Not invited]
  • IWAKI Takaaki, MIYATANI Hiroyuki, IKEYA Takashi, YAMANAKA Kenichi, IKEDA Masatoshi, USHIMARU Shinya, MATSUMOTO Satohiro, TAKAMATSU Toru, FUKUNISHI Masanori, SAGIHARA Noriyoshi, YOSHIDA Yukio  膵臓 = The Journal of Japan Pancreas Society  25-  (2)  132  -137  2010/04  [Not refereed][Not invited]
  • YOKOTA Kazuhisa, MIYATANI Hiroyuki, YOSHIDA Yukio  GASTROENTEROLOGICAL ENDOSCOPY  52-  (4)  1257  -1260  2010/04  [Not refereed][Not invited]
     
    A 55-year-old man with a history of having undergone gastroduodenostomy (Billroth I method) for perforated duodenal ulcer was admitted to our hospital due to hematemesis that occurred 4 days after eating uncooked mackerel. Emergency gastroduodenoscopy revealed an A1 stage hemorrhagic ulcer with bleeding at the greater curvature of the mid-gastric body in the remnant stomach. An <I>Anisakis </I>simplex was found at the base of the ulcer, which was successfully removed by biopsy forceps. An endoscopic hemostasis procedure was performed on the visible vessels at the base of the ulcer to stop the bleeding. Thereafter, the patient was treated with proton pump inhibitors (PPI), and the ulcer had improved to H2 stage at 14 days after the hospital admission. We report a rare case of hemorrhagic gastric ulcer associated with anisakiasis.
  • 清崎 浩一, 周東 千緒, 斉藤 正昭, 千葉 文博, 高田 理, 吉田 卓義, 鈴木 浩一, 小西 文雄, 宮谷 博幸, 吉田 行雄  日本外科学会雑誌  111-  (2)  2010/03  [Not refereed][Not invited]
  • MIYATANI HIROYUKI, SAWADA YUKIHISA, NAKASHIMA YOSHIYUKI, ISHII AKIRA, SAGIHARA NORIYOSHI, IKEDA MASATOSHI, IWAKI TAKAAKI, YOSHIDA YUKIO  自治医科大学紀要  32-  103  -109  2010/03  [Not refereed][Not invited]
  • Hiroyuki Miyatani, Yukihisa Sawada, Yoshiyuki Nakashima, Akira Ishii, Noriyoshi Sagihara, Masatoshi Ikeda, Takaaki Iwaki, Yukio Yoshida  Jichi Medical University journal  32-  103  -109  2010/03  [Not refereed][Not invited]
     
    Agenesis of the duct of Wirsung is rarely encountered when pancreatography completely fails. We successfully treated a patient with pancreatic pain due to this unusual pancreas divisum by wire-assisted minor papillotomy using cap-attached front-view endoscopy. A 77-year-old man with a history of pancreatitis was admitted to our hospital due to epigastralgia. He had a partial gastrectomy with gastrojejunostomy (Billroth II). We performed ERCP with cap-attached front-view endoscopy to determine the cause of the abdominal pain. ERC revealed a mildly dilated common bile duct. However, ventral pancreatography was not obtained via the papilla of Vater. We attempted pancreatography via the minor papilla at the second ERCP. The minor papilla was difficult to find and approach because of its small size and obscure orifice. We inserted a thin metal tip cannula into the minor papilla and performed dorsal pancreatography. With a diagnosis of pancreas divisum, we performed wire-assisted minor precut papillotomy with a needle knife. A 5-Fr. single pig-tail plastic stent was successfully placed. There were no procedure-related complications and post-ERCP pancreatitis. The patient's epigastralgia was relieved, and the hyperamylasemia improved. Subsequently, though the epigastralgia relapsed, the serum amylase level remained almost normal.
  • 宮谷 博幸  月刊地域医学  24-  (2)  124  -128  2010/02  [Not refereed][Not invited]
  • FUKUDA Shigenobu, MIYATANI Hiroyuki, YAMANAKA Kenichi, USHIMARU Shinya, MATSUMOTO Satohiro, TAKAMATSU Tohru, IWAKI Takaaki, NAKASHIMA Yoshiyuki, SAGIHARA Noriyoshi, YOSHIDA Yukio  GASTROENTEROLOGICAL ENDOSCOPY  52-  (1)  58  -63  2010/01  [Not refereed][Not invited]
     
    Colonoscopy in a peritoneal dialysis patient can cause severe complications like peritonitis. Because dialysis technique has rapidly progressed, prognosis of dialysis patients has been improved. Therefore, we are going to have to perform colonoscopy for peritoneal dialysis patients more frequently. We have encountered two cases in peritoneal dialysis patients who underwent endoscopic mucosal resection. Case 1 developed a peritonitis following colonoscopy and made a full recovery fortunately. We could perform colonoscopy without complications in Case 2 by administering antibiotic agent and empting peritoneal cavity before colonoscopy.<BR>We report these cases with a review of the literature and call your attention to preventing complications of colonoscopy in a peritoneal dialysis.
  • Kenichi Yamanaka, Hiroyuki Miyatani, Yoshiyuki Nakashima, Takashi Ikeya, Masatoshi Ikeda, Shinya Ushimaru, Satohiro Matsumoto, Hideaki Honda, Toru Takamatsu, Takaaki Iwaki, Masanori Fukunishi, Noriyoshi Sagihara, Yukio Yoshida, Hiroshi Noda, Nobuyuki Tooyama, You Dobashi  Acta Hepatologica Japonica  51-  (7)  387  -393  2010  [Not refereed][Not invited]
     
    The patient was a 78-year-old male who had been found to have multiple hepatic cysts and renal cysts at 68 years of age. Because multiple hepatic cysts and a solid mass in some of the cysts were observed on a follow-up CT scan in December 2007, he was referred to our department for a thorough examination and treatment in March 2008. Abdominal ultrasonography showed multiple cysts in both lobes of the liver, and papillary protruding masses were observed in a cyst in S3 of the left lobe and a cyst in S7 of the right lobe. Abdominal CT showed a soft-tissue-density mass associated with weak contrast enhancement in the cyst at both sites. An FDG-PET study showed no abnormal accumulation in the liver. It was impossible to identify any communication between either of the two cysts and the bile duct by ERCP or MRCP. Cystic tumors were strongly suspected, and partial hepatectomy was performed. Histopathological examination revealed that the solid portion observed in part of a multilocular cystoma was vascular connective tissue that had the thickened cyst wall, while the portion that was thought to be a cystic protruding lesion was a thrombotic mass caused by intracystic hemorrhage, part of which had become organized, and there was no evidence of adenoma or cancer. Since cases of simultaneous multiple hepatic cysts with intracystic hemorrhage and a tendency to enlarge are extremely rare, we report here the case together with a brief discussion based on the literature. © 2010 The Japan Society of Hepatology.
  • SAGIHARA Noriyoshi, MIYATANI Hiroyuki, IKEDA Masatoshi, USHIMARU Shinya, HONDA Hideaki, TAKAMATSU Toru, IWAKI Takaaki, NAKAJIMA Yoshiyuki, YOSHIDA Yukio, YAMADA Shigeki  GASTROENTEROLOGICAL ENDOSCOPY  51-  (12)  3085  -3091  2009/12  [Not refereed][Not invited]
     
    We report a rare case of intramural hematoma of the papilla vater. The case is 64-year-old man. He had a history of diabetes and the deep-vein thrombosis. The steroid and Warfarin are administerd. He admitted to our hospital, due to epigastralgia with leucocytosis and liver dysfunction. Abdominal computed tomography revealed dilated intrahepatic bile duct and common bile duct. On ERCP, the duodenal papilla presented markedly swollen and colored shade red. Endoscopic sphincterotomy and endoscopic biliary drainage were performed because of insufficient decrease of serum total bilirubin and amylase level. Diagnosis of internal hematoma of the papilla was also made by intraductal ultrasonography. On the 31st day, he discharged without any symptoms. Duodenal intramural hematoma without any extrinsic causes is quite rare. The mechanism of this lesion was not clear, however, the diagnosis and treatment may be suggestive for same cases.
  • Hiroyuki Miyatani, Yukio Yoshida, Shinya Ushimaru, Noriyoshi Sagihara, Shigeki Yamada  DIGESTIVE ENDOSCOPY  21-  (4)  255  -257  2009/10  [Not refereed][Not invited]
     
    We report a rare case of flat-type primary malignant melanoma of the esophagus treated with endoscopic mucosal resection (EMR). A 64-year-old woman was referred for examination of a small pigmented lesion located in the mid esophagus. On endoscopy, the lesion exhibited almost no change in size over the year. Cap-assisted EMR was performed en bloc. The histopathological findings showed atypical melanocyte proliferation in the basal layer, spindle cells, and epithelioid cell proliferation with nuclear enlargement and a few mitotic figures. Histopathological examination confirmed the diagnosis of primary malignant melanoma. Immunostaining for S-100 protein and HMB-45 antibody were positive, and the Ki-67 index was low. The patient was discharged without additional surgical resection and/or chemotherapy. The patient had no symptoms and no signs of recurrence 20 months after EMR. There has been no report on a slow growing esophageal melanoma. It is difficult to estimate the malignant behavior of this case.
  • Hiroyuki Miyatani, Yukio Yoshida, Shinya Ushimaru, Noriyoshi Sagihara, Shigeki Yamada  DIGESTIVE ENDOSCOPY  21-  (4)  255  -257  2009/10  [Not refereed][Not invited]
     
    We report a rare case of flat-type primary malignant melanoma of the esophagus treated with endoscopic mucosal resection (EMR). A 64-year-old woman was referred for examination of a small pigmented lesion located in the mid esophagus. On endoscopy, the lesion exhibited almost no change in size over the year. Cap-assisted EMR was performed en bloc. The histopathological findings showed atypical melanocyte proliferation in the basal layer, spindle cells, and epithelioid cell proliferation with nuclear enlargement and a few mitotic figures. Histopathological examination confirmed the diagnosis of primary malignant melanoma. Immunostaining for S-100 protein and HMB-45 antibody were positive, and the Ki-67 index was low. The patient was discharged without additional surgical resection and/or chemotherapy. The patient had no symptoms and no signs of recurrence 20 months after EMR. There has been no report on a slow growing esophageal melanoma. It is difficult to estimate the malignant behavior of this case.
  • MIYATANI Hiroyuki, YOSHIDA Yukio  膵臓 = The Journal of Japan Pancreas Society  24-  (4)  532  -536  2009/08  [Not refereed][Not invited]
  • TAKAMATSU Toru, MIYATANI Hiroyuki, USHIMARU Shinya, HONDA Hideaki, IWAKI Takaaki, FUKUNISHI Masanori, UGAGIN Takuhiro, NAKASHIMA Yoshiyuki, SAGIHARA Noriyoshi, YOSHIDA Yukio  GASTROENTEROLOGICAL ENDOSCOPY  51-  (2)  237  -241  2009/02  [Not refereed][Not invited]
     
    A 46-year-old male with alcoholic chronic pancreatitis and pancreatic head pseudocyst developed an infection in the pancreatic head pseudocyst. The first endoscopic retrograde pancreatography (ERP) did not show the pancreatic pseudocyst communicating with the main pancreatic duct. However, after percutaneous pseudocyst drainage, the second ERP showed that the pancreatic pseudocyst communicated with the main pancreatic duct. Transpapillary cystic drainage was successfully performed using 5Fr tube stent.
  • Takuhiro Ugajin, Hiroyuki Miyatani, Toshio Demitsu, Takaaki Iwaki, Shinya Ushimaru, Yoshiyuki Nakashima, Yukio Yoshida  INTERNAL MEDICINE  48-  (9)  693  -695  2009  [Not refereed][Not invited]
     
    A 15-year-old, woman, Crohn's disease patient, who carried the TPMT *3C heterozygous mutant, complained of alopecia 3 days after starting 6-mercaptopurine (6-MP) and then developed severe myelosuppression 6 weeks after starting 6-MP. The alopecia involved scalp hair only (body hair preserved) and was dominant in the temporal region. Following these side effects, transient remission of Crohn's disease occurred. Myelosuppression due to 6-MP is a rare but life-threatening side effect that is difficult to predict despite continuous monitoring of complete blood cell counts. In the present case, 6-MP-induced alopecia preceded myelosuppression and progressed rapidly as the myelosuppression worsened.
  • 宮谷 博幸, 中島 嘉之, 岩城 孝明  月刊地域医学  22-  (11)  1136  -1141  2008/11  [Not refereed][Not invited]
  • ORIHASHI Kazumasa, MIYATANI Hiroyuki  Journal of medical ultrasonics : official journal of the Japan Society of Ultrasonics in Medicine  35-  (3)  147  -148  2008/09  [Not refereed][Not invited]
  • FUKUDA Shigenobu, MIYATANI Hiroyuki, HONDA Hideaki, TAKAMATSU Tohru, FUKUNISHI Masanori, IWAKI Takaaki, UGAJIN Takuhiro, NAKASHIMA Yoshiyuki, SAGIHARA Noriyoshi, YOSHIDA Yukio  膵臓 = The Journal of Japan Pancreas Society  23-  (4)  533  -540  2008/08  [Not refereed][Not invited]
  • 鷺原 規喜, 宮谷 博幸, 吉田 行雄  日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy  50-  (5)  1338  -1339  2008/05  [Not refereed][Not invited]
  • Hiroyuki Miyatani, Yukio Yoshida, Masatoshi Ikeda, Noriyoshi Sagihara  47-  (4)  2008  [Not refereed][Not invited]
  • Biliopancreatic fistula with portal vein thrombosis caused by a pancreatic pseudocyst
    Hiroyuki Miyatani, Noriyoshi Sagihara, Yukio Yoshida, Yoshihisa Suminaga  Clinical J Gastroenterol  1-  (59)  63  2008  [Not refereed][Not invited]
  • Takuhiro Ugajin, Hiroyuki Miyatani, Shin-ichi Momomura, Masamitsu Sanui, Yoshiyuki Nakashima, Yukio Yoshida  INTERNAL MEDICINE  47-  (7)  609  -612  2008  [Not refereed][Not invited]
     
    While ventricular premature contractions have been noted during colonoscopy (CS), ventricular fibrillation (VF) is rare. We recently had a patient who developed VF during CS and recovered without any sequelae despite severe complications after cardiopulmonary resuscitation (CPR). If electrocardiogram (ECG) monitoring had been done during CS, a direct current shock defibrillation could have been accomplished and prevented complications. CS in high-risk patients should be done with ECG monitoring.
  • Hiroyuki Miyatani, Yukio Yoshida, Masatoshi Ikeda, Noriyoshi Sagihara  INTERNAL MEDICINE  47-  (4)  321  -322  2008  [Not refereed][Not invited]
  • Takuhiro Ugajin, Hiroyuki Miyatani, Yoshiaki Watanabe, Junji Nishida, Yukio Yoshida  INTERNAL MEDICINE  47-  (9)  879  -880  2008  [Not refereed][Not invited]
  • MURAYAMA Junko, MIYATANI Hiroyuki, USHIMARU Shinya, HONDA Hideaki, SAWADA Yukihisa, NAKAJIMA Yoshiyuki, UGAJIN Takuhiro, SAGIHARA Noriyoshi, YOSHIDA Yukio, YOSHIDA Takayoshi  日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy  49-  (12)  2972  -2977  2007/12  [Not refereed][Not invited]
  • MIYATANI HIROYUKI, YOSHIDA YUKIO, USHIMARU SHINYA, IKEDA MASATOSHI, HONDA HIDEAKI, SAWADA YUKIHISA, NAKASHIMA YOSHIYUKI, UGAJIN TAKUHIRO, OCHIAI KAORI, SAGIHARA NORIYOSHI, KAWAMURA YUTAKA J  自治医科大学紀要  30-  155  -158  2007/12  [Not refereed][Not invited]
  • Hiroyuki Miyatani, Yukio Yoshida  Journal of Medical Ultrasonics  34-  (4)  205  -207  2007/12  [Not refereed][Not invited]
     
    Aortoesophageal fistula (AEF) is very rare and is associated with a high mortality rate. AEF manifests with massive gastrointestinal bleeding and is difficult to diagnose from endoscopic findings and clinical features. We encountered a patient with an AEF that was promptly diagnosed by endoscopic ultrasonography (EUS) using a microprobe. A 58-year-old man was admitted to our hospital because of hematemesis. Endoscopic examination revealed a submucosal tumor (SMT)-like lesion 2 cm in diameter 25 cm from the dental arch. EUS with a 20-MHz microprobe revealed a blood vessel-like structure with hypoechoic flowing contents and a high echoic area suggestive of a thrombus protruding into the esophageal lumen. AEF resulting from a ruptured thoracic aortic aneurysm was suggested from the EUS findings and was definitely diagnosed by computed tomography. Graft replacement of the descending aorta was successfully performed. The patient is now in good health 6 years after the first admission. This is the first report of a case of AEF diagnosed by EUS with a microprobe. © 2007 The Japan Society of Ultrasonics in Medicine.
  • UGAJIN Takuhiro, MIYATANI Hiroyuki, SAITA Kazuo, IIJIMA Yuhki, YOSHIDA Yukio  Jichi Medical University journal  30-  115  -121  2007/12  [Not refereed][Not invited]
     
    An 80 year old man with type C liver cirrhosis presented with a high grade fever and lumbago. He was suspected of having sepsis and admitted to the hospital. Citrobacter diversus was cultured from the blood. Laboratory tests were consistent with pre-septic DIC. An MRI was performed to identify the origin of lumbago and infection. Consequently he was diagnosed as having pyogenic spondylitis and an iliopsoas abscess. The patient was started on intravenous antibiotics but responded inadequately. Thorough anterior debridement was performed because low grade fever with a positive CRP (6mg/dl) continued. Liver cirrhosis is an immunocompromising disease and a risk factor for spinal osteomyelitis. We must be aware of pyogenic spondylitis in the clinical practice of chronic liver diseases.
  • Miyatani Hiroyuki, Yoshida Yukio, Ushimaru Shinya, Ikeda Masatoshi, Honda Hideaki, Sawada Yukihisa, Nakashima Yoshiyuki, Ugajin Takuhiro, Ochiai Kaori, Sagihara Noriyoshi, Kawamura Yutaka J  Jichi Medical University journal  30-  156  -158  2007/12  [Not refereed][Not invited]
     
    In a patient in whom it was initially difficult to pass the duodenojejunal junction, a long decompression tube was easily inserted using double balloon endoscopy. The patient was a 16-year-old male with bowel obstruction who had undergone proctocolectomy for ulcerative colitis. A double balloon endoscope was inserted into the jejunum about 50 cm from the ligament of Treitz. A stiff hydrophilic-coated guidewire, 350 cm in length, was inserted into the deep jejunum through the accessory channel of the endoscope. A long 16Fr silicon tube was easily inserted over the guidewire into the deep jejunum through the nose. The obstruction was successfully decompressed without laparotomy. This technique is a useful method that can be used in patients in whom other techniques of decompression tube insertion fail; it allows the possibility of directly diagnosing the cause of the bowel obstruction without prior decompression.
  • FUKUMOTO Kenji, MIYATANI Hiroyuki, YOSIDA Yukio, USIMARU Sinya, KUDO Yasutaka, HONDA Hideaki, SAWADA Yukihisa, UGAJIN Takahiro, NAKASHIMA Yoshiyuki, SAGIHARA Noriyoshi  日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy  49-  (8)  1839  -1843  2007/08  [Not refereed][Not invited]
  • H. Miyatani, Y. Yoshida  ENDOSCOPY  39-  E246  -E246  2007/02  [Not refereed][Not invited]
  • Decompression tube insertion using double balloon endoscopy in a case following initial difficulty in passing the duodenojejunal junction. 30: 155-158. 2007.
    Hiroyuki Miyatani, Yukio Yoshida, Shinya Ushimaru, Masatoshi Ikeda, Hideaki Honda, Yukihisa Sawada, Yoshiyuki Nakashima, Takuhiro Ugajin, Kaori Ochiai, Noriyoshi Sagihara, Yutaka J. Kawamura  Jichi Medical University Journal  30-  155  -158  2007  [Not refereed][Not invited]
  • 十二指腸腫瘍の内視鏡治療.埼玉県医学会雑誌,42:377-380, 2007.
    宮谷博幸,吉田行雄,牛丸信也,池田正俊,本田英明,増井利治,澤田幸久,中島嘉之,宇賀神卓広,落合香織,鷺原規喜  42-  377  -380  2007  [Not refereed][Not invited]
  • Hiroyuki Miyatani, Yukio Yoshida  JOURNAL OF MEDICAL ULTRASONICS  34-  (4)  205  -207  2007  [Not refereed][Not invited]
     
    Aortoesophageal fistula (AEF) is very rare and is associated with a high mortality rate. AEF manifests with massive gastrointestinal bleeding and is difficult to diagnose from endoscopic findings and clinical features. We encountered a patient with an AEF that was promptly diagnosed by endoscopic ultrasonography (EUS) using a microprobe. A 58-year-old man was admitted to our hospital because of hematemesis. Endoscopic examination revealed a submucosal tumor (SMT)-like lesion 2 cm in diameter 25 cm from the dental arch. EUS with a 20-MHz microprobe revealed a blood vessel-like structure with hypoechoic flowing contents and a high echoic area suggestive of a thrombus protruding into the esophageal lumen. AEF resulting from a ruptured thoracic aortic aneurysm was suggested from the EUS findings and was definitely diagnosed by computed tomography. Graft replacement of the descending aorta was successfully performed. The patient is now in good health 6 years after the first admission. This is the first report of a case of AEF diagnosed by EUS with a microprobe.
  • Hiromu Inoue, Yukihisa Sawada, Kaori Ochiai, Hideaki Honda, Junko Murayama, Yasutaka Kudo, Yoshiyuki Nakashima, Noriyoshi Sagihara, Hiroyuki Miyatani, Ikuo Nakamura, Yukio Yoshida  INTERNAL MEDICINE  46-  (12)  845  -848  2007  [Not refereed][Not invited]
     
    A 71-year-old man was admitted to our hospital with abdominal pain. Hepatocellular carcinoma (HCC) had been diagnosed 2 years earlier and he had undergone 7 courses of intra-hepato-arterial chemotherapy (IHAC). We performed gastrointestinal fiberscopy and identified a massive protrusion on the lesser curvature. Abdominal contrast-enhanced computed tomography revealed multiple hepatic masses and an extrahepatic enlarged mass with invasion to the pancreas and stomach. A specimen for endoscopic biopsy revealed adenocarcinoma that stained positive for alpha-fetoprotein. Gastrointestinal bleeding resulting from direct invasion of HCC is unusual.
  • Hiroyuki Miyatani, Yukio Yoshida  JOURNAL OF MEDICAL ULTRASONICS  34-  (4)  205  -207  2007  [Not refereed][Not invited]
     
    Aortoesophageal fistula (AEF) is very rare and is associated with a high mortality rate. AEF manifests with massive gastrointestinal bleeding and is difficult to diagnose from endoscopic findings and clinical features. We encountered a patient with an AEF that was promptly diagnosed by endoscopic ultrasonography (EUS) using a microprobe. A 58-year-old man was admitted to our hospital because of hematemesis. Endoscopic examination revealed a submucosal tumor (SMT)-like lesion 2 cm in diameter 25 cm from the dental arch. EUS with a 20-MHz microprobe revealed a blood vessel-like structure with hypoechoic flowing contents and a high echoic area suggestive of a thrombus protruding into the esophageal lumen. AEF resulting from a ruptured thoracic aortic aneurysm was suggested from the EUS findings and was definitely diagnosed by computed tomography. Graft replacement of the descending aorta was successfully performed. The patient is now in good health 6 years after the first admission. This is the first report of a case of AEF diagnosed by EUS with a microprobe.
  • OGI MAOKO, KAWAMURA YUTAKA J, KONISHI FUMIO, MIYATANI HIROYUKI, YAMADA SIGEKI  自治医科大学紀要  29-  217  -221  2006/12  [Not refereed][Not invited]
  • MIYATANI HIROYUKI, YOSHIDA YUKIO, USHIMARU SHINYA, KUDO YASUTAKA, HONDA HIDEAKI, MURAYAMA JUNKO, SAWADA YUKIHISA, NAKASHIMA YOSHIYUKI, UGAJIN TAKUHIRO, OCHIAI KAORI, SAGIHARA NORIYOSHI, NAKAMURA IKUO  自治医科大学紀要  29-  193  -200  2006/12  [Not refereed][Not invited]
  • Miyatani Hiroyuki, Yoshida Yukio, Ushimaru Shinya, Kudo Yasutaka, Honda Hideaki, Murayama Junko, Sawada Yukihisa, Nakashima Yoshiyuki, Ugajin Takuhiro, Ochiai Kaori, Sagihara Noriyoshi, Nakamura Ikuo  Jichi Medical University journal  29-  193  -200  2006/12  [Not refereed][Not invited]
     
    Obstructive jaundice caused solely by a pancreatic pseudocyst is rare. We report a case of a pancreatic pseudocyst complicated by obstructive jaundice successfully treated by EUS-guided drainage. A 48-year-old man was admitted to our hospital due to jaundice and abdominal distention. He had undergone necrosectomy of the pancreatic head for acute non-alcoholic pancreatitis about 1 year before the current admission. Following a diagnosis of obstructive jaundice due to compression by a pancreatic pseudocyst, EUS-guided drainage was performed with a 6F nasocystic catheter. Two weeks later, the pancreatic pseudocyst had decreased in size, and a 7F double pig-tail biliary stent was placed to drain the cavity. The patient responded well to treatment, and his laboratory values normalized. A follow-up CT scan 2 months later showed that the pancreatic pseudocyst had disappeared. The patient had an uncomplicated recovery and has been asymptomatic for 11 months. There have been no previous reports of successful drainage under EUS-guidance in cases of obstructive jaundice caused solely by a pancreatic pseudocyst without biliary drainage.
  • Ogi Maoko, Kawamura Yutaka J, Konishi Fumio, Miyatani Hiroyuki, Yamada Sigeki  Jichi Medical University journal  29-  217  -221  2006/12  [Not refereed][Not invited]
     
    We present an unusual case of appendiceal hemorrhage which was diagnosed at emergency colonoscopy and successfully treated surgically. A44-year-old man presented with repeated hematochezia. Emergency colonoscopy revealed continuous bleeding from the orifice of the appendix. The origin of the hemorrhage was the appendix. Emergency appendectomy was performed. Histopathological examination revealed a hematoma in the tip of the appendix and mesoappendix. Appendiceal hemorrhage is extremely rare. For the diagnosis of appendiceal hemorrhage, meticulous colonoscopic examination of the appendiceal orifice, including repeated irrigation and careful observation of the orifice, is essential. Emergency appendectomy is thought to be the treatment of choice.
  • KAMIHIRA M, YOSHIDA Y, MIYATANI Y  Nippon Daicho Komonbyo Gakkai Zasshi  59-  (2)  101  -105  2006/02  [Not refereed][Not invited]
     
    In this study, we attempted to clarify the rate of recurrence of ischemic colitis (IC) and the clinical features of recurrent IC. Sixty-five patients diagnosed with IC at Omiya Medical Center, Jichi Medical School, from November 1991 to October 2001 were retrospectively reviewed. We sent the patients a questionnaire to ascertain whether they had experienced recurrences in their IC in the years following their treatment at our institution. We reviewed data on 58 patients who replied to the questionnaire.<BR>Ten (17.2%) of the 58 IC patients who replied to the questionnaire had experienced recurrence. The mean age of patients with recurrence was 49.2 years, and that of patients without recurrence was 62.1 years. Eight (88.9%) of 9 patients in the recurrence group and 17 (45.9%) of the 37 patients in the non-recurrence group had experienced constipation.<BR>Many of the patients in the recurrence group were without basic disorders. Furthermore, the recurrences were recognized at almost the same location. All lesions in the recurrence group were the transient type.<BR>In this retrospective study, patients with recurrent IC were younger than patients without it (p<0.05) and tended to experience constipation (p<0.05).
  • SAWADA Yukihisa, KAMIHIRA Masakazu, ASANO Satoshi, NAKASHIMA Yoshiyuki, KIHARA Masanori, OCHIAI Kaori, HYODO Takafumi, MIYATANI Hiroyuki, FUJIWARA Toshifumi, HIRAKAWA Ryuichi, NAKAMURA Ikuo, IMAWARI Michio  Nippon Shokakibyo Gakkai Zasshi  101-  (2)  188  -190  2004/02  [Not refereed][Not invited]
  • MIYATANI Hiroyuki, YAMANAKA Takeo  胆道 = Journal of Japan Biliary Association  15-  (4)  283  -287  2001/10  [Not refereed][Not invited]
  • MIYATANI Hiroyuki, YAMANAKA Takeo  胆道 = Journal of Japan Biliary Association  15-  (4)  301  -305  2001/10  [Not refereed][Not invited]
  • 胆道  15(4), 283-287-  2001  [Not refereed][Not invited]
  • SAWADA Akihiro, MATSUURA Katsuhiko, HAMADA Kenji, KOBAYASHI Yasuyuki, TANAKA Osamu, MIYATANI Hiroyuki, YAMANAKA Takeo, YAMADA Shigeki  日本画像医学雑誌 = Japanese journal of medical imaging  18-  (3)  144  -150  1999/09  [Not refereed][Not invited]
  • SUNADA K, YAMANAKA T, TAJIMI M, MIYATANI H, HYODO T, FUTAMURA M, YOSHIDA Y, IMAWARI M  Journal of medical ultrasonics = 超音波医学  26-  (4)  1999/04  [Not refereed][Not invited]
  • KAMIHIRA Masakazu, YOSHIDA Yukio, KOIKE Masaki, SATO Yoshihiro, HYOUDOU Takashi, MIYATANI Hiroyuki, MIZOOKA Masafumi, OSAWA Hiroyuki, FUTAMURA Mistugi, HIRAKAWA Ryuuichi, OISHI Takashi, YAMANAKA Takeo  Gastroenterol Endosc  41-  (1)  36  -41  1999/01  [Not refereed][Not invited]
  • ERBD施行例の検討
    日本消化器内視鏡学会埼玉部会で発表  1999  [Not refereed][Not invited]
  • 新開発穿刺用超音波内視鏡の使用経験-胃粘膜下腫瘍の診断-
    消化器内視鏡  11-  1591  -1595  1999  [Not refereed][Not invited]
  • M OHARA, M HIROHATA, T TOSHIMORI, H MIYATANI, R OKAMOTO, S HIRASAKI, H KUMASHIRO, H MORITANI, Y TOMINAGA, M IMAI  INTERNAL MEDICINE  31-  (3)  397  -399  1992/03  [Not refereed][Not invited]
     
    A-39-year-old man was admitted to our hospital because of a markedly decreased level of serum cholinesterase found incidentally by a blood test. Detailed examination did not reveal severe liver disease, malignant tumor, infection or organophosphate compound poisoning. Investigation of three generations of his family revealed two homozygous and five heterozygous family members with the cholinesterase deficiency gene E1s indicating familial serum cholinesterase deficiency.

Research Grants & Projects

  • 十二指腸乳頭機能不全の診断と治療
  • 胆道ステントに関する研究
  • 超音波内視鏡による診断と治療
  • Study on treatment of gastric and esophageal varices
  • Study on biliary stent
  • Study on EUS-FNA


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