Researchers Database

sakamoto hirotsugu

    DepartmentofEndoscopicResearchandInternationalEducation(FundedbyFUJIFILMMedical) Assistant Professor
Last Updated :2021/12/04

Researcher Information

URL

J-Global ID

Research Interests

  • 食道   胃   十二指腸   トランスジェニックマウス   Cdx1   Cdx2   腸上皮化生   

Research Areas

  • Life sciences / Gastroenterology
  • Life sciences / Gastroenterology

Published Papers

  • Masafumi Kitamura, Yoshimasa Miura, Satoshi Shinozaki, Hirotsugu Sakamoto, Yoshikazu Hayashi, Mio Sakaguchi, Noriyoshi Fukushima, Alan Kawarai Lefor, Hironori Yamamoto
    Endoscopy international open 9 (7) E1062-E1069  2021/07 
    Background and study aims  Endoscopic submucosal dissection (ESD) of superficial gastric lesions involving the pyloric ring is difficult. The pocket-creation method (PCM) with a small-caliber-tip transparent hood can overcome this difficulty by compressing the pyloric sphincter applying both traction and counter-traction. The aim of this study is to clarify the usefulness of the PCM for ESD of superficial gastric neoplasms involving the pyloric ring compared to the conventional method (CM). Patients and methods  From October 2006 to August 2019, 66 gastric lesions requiring duodenal submucosal dissection beyond the pyloric ring in 66 patients were resected. The CM was mainly performed in the first period (CM group, n = 46) and the PCM in the second period (PCM group, n = 20). We retrospectively reviewed their medical records. Results  Although no significant differences were observed in en bloc resection rates between the two groups, the PCM group had a significantly higher R0 resection rate than the CM group ( P  = 0.047). There were no holes in resected specimens in the PCM group while three specimens in the CM group had a hole. The dissection speed in the PCM group tended to be higher than in the CM group, although it did not reach statistical significance ( P  = 0.148). No significant differences were observed for the incidence of adverse events. Conclusions  This is the first study reporting the advantages of the PCM over the CM for ESD of gastric lesions involving the pyloric ring. We believe that the PCM is an effective strategy to compress the pyloric sphincter and facilitates R0 resection.
  • Tomonori Yano, Takahito Takezawa, Kousei Hashimoto, Ayako Ohmori, Satoshi Shinozaki, Manabu Nagayama, Hirotsugu Sakamoto, Yoshimasa Miura, Yoshikazu Hayashi, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
    Endoscopy international open 9 (7) E1123-E1127  2021/07
  • Tsevelnorov Khurelbaatar, Hirotsugu Sakamoto, Tomonori Yano, Yuichi Sagara, Ulzii Dashnyam, Satoshi Shinozaki, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
    Endoscopy 53 (7) 744 - 748 2021/07 
    BACKGROUND: To decrease the risk of bleeding or perforation, ischemic polypectomy is performed using a detachable snare or endoclip with double-balloon endoscopy (DBE) for small-bowel polyps in patients with Peutz - Jeghers syndrome. The aim of this study was to determine the effectiveness and feasibility of ischemic polypectomy. METHODS: We retrospectively reviewed patients who underwent two or more sessions of ischemic polypectomy using DBE from July 2004 to August 2017. RESULTS: 67 therapeutic DBEs were performed in nine patients during the study period and 352 polyps were treated. The median observation period was 34 months (range 12 - 66). There was a declining trend over time in the median number of polyps > 15 mm treated per patient first DBE session 6, second 2, third 1.5, fourth 0.5, fifth 0.5; P = 0.11, Friedman test). No patient required laparotomy due to intussusception during the study period. One patient developed mild acute pancreatitis after the procedure. CONCLUSIONS: Ischemic polypectomy was feasible for the control of small-bowel polyps in patients with Peutz - Jeghers syndrome.
  • Hirotsugu Sakamoto, Makoto Nishimura, Alexei Teplov, Emine Cesmecioglu, Noboru Kawata, Jinru Shia, Yukako Yagi
    Endoscopy 2021/06
  • Mariko Sekiya, Hirotsugu Sakamoto, Tomonori Yano, Shoko Miyahara, Manabu Nagayama, Yasutoshi Kobayashi, Satoshi Shinozaki, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
    Endoscopy 53 (5) 517 - 521 2021/05 
    BACKGROUND : Many patients with familial adenomatous polyposis (FAP) have adenomatous polyps of the duodenum and the jejunum. We aimed to elucidate the long-term outcomes after double-balloon endoscopy (DBE)-assisted endoscopic resection of duodenal and jejunal polyps in patients with FAP. METHODS : We retrospectively reviewed patients who underwent more than two sessions of endoscopic resection using DBE from August 2004 to July 2018. RESULTS : A total of 72 DBEs were performed in eight patients (median age 30 years, range 12-53; 1.4 DBE procedures/patient-year) during the study period, and 1237 polyps were resected. The median observation period was 77.5 months (range 8-167). There were 11 adverse events, including seven delayed bleeds and four episodes of acute pancreatitis. No delayed bleeding occurred after cold polypectomy. Although, in one patient, one endoscopically resected duodenal polyp was diagnosed as being intramucosal carcinoma, none of the patients developed an advanced duodenal or jejunal cancer during the study period. CONCLUSIONS : Endoscopic resection of duodenal and jejunal polyposis using DBE in patients with FAP can be performed safely, efficiently, and effectively.
  • Satoshi Shinozaki, Yasutoshi Kobayashi, Hiroyuki Osawa, Hirotsugu Sakamoto, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto
    Digestion 102 (3) 319 - 325 2021 [Refereed][Not invited]
     
    BACKGROUND: A novel potassium-competitive acid blocker, vonoprazan (VPZ), improves first-line Helicobacter pylori eradication success. The aim of this systematic review is to clarify the effectiveness and safety of second-line H. pylori eradication therapy comparing VPZ and proton pump inhibitor (PPI)-based regimens. METHODS: Medline (PubMed), EMBASE, Web of Science, Cochrane Library, and the Japan Medical Abstract Society Database were searched. RESULTS: We selected 16 studies for quantitative review. Forest plot analysis showed significant superiority of VPZ over PPI-based regimens in overall second-line H. pylori eradication success (OR 1.51, 95% CI 1.27-1.81, p < 0.001). Forest plots from 2 studies with propensity score matched analysis showed significant superiority of VPZ over PPI-based regimens (OR 3.09, 95% CI 1.71-5.58, p < 0.001). The remaining 14 studies with per-protocol analysis and the full analysis set also showed significant superiority (OR 1.40, 95% CI 1.16-1.69, p < 0.001). Regarding adverse events, Forest plot analysis did not show a significant difference between the 2 regimens (OR 0.88, 95% CI 0.58-1.32, p = 0.53). CONCLUSIONS: A VPZ-based regimen has significant superiority over a PPI-based regimen for second-line H. pylori eradication therapy. A VPZ-based second-line H. pylori eradication regimen can be the first choice.
  • Manabu Nagayama, Tomonori Yano, Koji Atarashi, Takeshi Tanoue, Mariko Sekiya, Yasutoshi Kobayashi, Hirotsugu Sakamoto, Kouichi Miura, Keijiro Sunada, Takaaki Kawaguchi, Satoru Morita, Kayoko Sugita, Seiko Narushima, Nicolas Barnich, Jun Isayama, Yuko Kiridooshi, Atsushi Shiota, Wataru Suda, Masahira Hattori, Hironori Yamamoto, Kenya Honda
    Gut microbes 12 (1) 1788898 - 1788898 2020/11 
    Dysbiotic microbiota contributes to the pathogenesis of Crohn's disease (CD) by regulating the immune system. Although pro-inflammatory microbes are probably enriched in the small intestinal (SI) mucosa, most studies have focused on fecal microbiota. This study aimed to examine jejunal and ileal mucosal specimens from patients with CD via double-balloon enteroscopy. Comparative microbiome analysis revealed that the microbiota composition of CD SI mucosa differs from that of non-CD controls, with an increased population of several families, including Enterobacteriaceae, Ruminococcaceae, and Bacteroidaceae. Upon anaerobic culturing of the CD SI mucosa, 80 bacterial strains were isolated, from which 9 strains representing 9 distinct species (Escherichia coli, Ruminococcus gnavus, Klebsiella pneumoniae, Erysipelatoclostridium ramosum, Bacteroides dorei, B. fragilis, B. uniformis, Parabacteroides distasonis, and Streptococcus pasteurianus) were selected on the basis of their significant association with CD. The colonization of germ-free (GF) mice with the 9 strains enhanced the accumulation of TH1 cells and, to a lesser extent, TH17 cells in the intestine, among which an E. coli strain displayed high potential to induce TH1 cells and intestinal inflammation in a strain-specific manner. The present results indicate that the CD SI mucosa harbors unique pro-inflammatory microbiota, including TH1 cell-inducing E. coli, which could be a potential therapeutic target.
  • 山本 博徳, 阿部 孝, 石黒 信吾, 内田 恵一, 川崎 優子, 熊谷 秀規, 斉田 芳久, 佐野 寧, 竹内 洋司, 田近 正洋, 中島 健, 阪埜 浩司, 船坂 陽子, 堀 伸一郎, 山口 達郎, 吉田 輝彦, 坂本 博次, 石川 秀樹, 岩間 毅夫, 岡崎 康司, 斎藤 豊, 松浦 成昭, 武藤 倫弘, 冨田 尚裕, 秋山 卓士, 山本 敏樹, 石田 秀行, 中山 佳子
    遺伝性腫瘍 (一社)日本遺伝性腫瘍学会 20 (2) 59 - 78 2020/09
  • Satoshi Shinozaki, Yasutoshi Kobayashi, Yoshikazu Hayashi, Hirotsugu Sakamoto, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 32 (6) 874 - 881 2020/09 [Refereed][Not invited]
     
    BACKGROUND AND AIM: Linked color imaging (LCI) is a novel image-enhancing technology which enhances color differences between a colorectal lesion and surrounding mucosa with enough brightness to illuminate the wide colorectal lumen. The aim of this study is to compare colorectal polyp detection using LCI with that using white light imaging (WLI). METHODS: Randomized controlled trials and prospective studies comparing LCI with WLI for colorectal polyp detection were selected. Outcomes included overall polyp/adenoma detection and additional polyp detection at a second observation. Outcomes were documented by pooled risk ratios (RR) with 95% confidence interval (CI) using the Mantel-Haenszel random effect model. RESULTS: Seven studies were included. LCI showed significant superiority for polyp and adenoma detection compared with WLI (RR 1.16, 95% CI 1.09-1.25, P < 0.001 for polyp detection; RR 1.26, 95% CI 1.14-1.39 P < 0.001 for adenoma detection). LCI significantly increased the number of polyps detected per patient compared with WLI (mean difference 0.27, 95% CI 0.01-0.53, P = 0.040). LCI significantly increased the number of adenomas detected per patient compared with WLI (mean difference 0.22, 95% CI 0.08-0.36, P = 0.002). LCI significantly increased the number of flat polyps detected per patient compared with WLI (mean difference 0.14, 95% CI 0.01-0.27, P = 0.040). LCI had a significantly higher rate of additional polyp detection compared with WLI in the right colon (RR 2.68, 95% CI 1.71-4.19, P < 0.001). CONCLUSIONS: Linked color imaging has significantly greater polyp and adenoma detection rates and detection rate of previously missed polyps compared with WLI. We recommend the initial use of LCI for routine colonoscopy.
  • Takeshi Yamashina, Daiki Nemoto, Yoshikazu Hayashi, Hisashi Fukuda, Masahiro Okada, Takahito Takezawa, Masato Aizawa, Hirotsugu Sakamoto, Yoshimasa Miura, Keijiro Sunada, Alan Kawarai Lefor, Kazutomo Togashi, Hironori Yamamoto
    Gastrointestinal endoscopy 92 (2) 368 - 379 2020/08 
    BACKGROUND AND AIMS: Colorectal endoscopic submucosal dissection (ESD) is recognized as a challenging procedure. Previously, we reported that a new ESD strategy using the pocket-creation method (PCM) is useful for colorectal ESD, but no prospective randomized study has evaluated the efficacy of the PCM. The aim of this study was to evaluate the efficacy and safety of PCM for colorectal ESD compared with the conventional method (CM). METHODS: This was a prospective randomized controlled trial at 3 institutions in Japan. Patients with superficial colorectal neoplastic lesions >20 mm predicted to be intramucosal were randomly assigned to undergo ESD using the PCM or CM. Primary outcome was the ESD completion rate defined as completion of colorectal ESD with an en bloc resection using the assigned ESD method without changing to other methods or assisted by other devices. RESULTS: We analyzed 59 patients with 59 colorectal tumors in the PCM group and 55 in the CM group. The ESD completion rate was significantly higher in the PCM group compared with the CM group (93% [55/59] vs 73% [40/55]; P  = .01). En bloc resection rates, R0 resection rates, procedure time, and dissection speed were not significantly different between the 2 groups. The incidence of adverse events was similar in the 2 groups. CONCLUSIONS: Use of the PCM allows the endoscopist to complete the procedure with the intended method more often than the CM with similar clinical outcomes. (Clinical trial registration number: UMIN 000024394.).
  • Takeshi Yamashina, Yoshikazu Hayashi, Hisashi Fukuda, Masahiro Okada, Takahito Takezawa, Yasutoshi Kobayashi, Hirotsugu Sakamoto, Yoshimasa Miura, Satoshi Shinozaki, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
    Endoscopy international open 8 (8) E1021-E1030  2020/08 
    Background and study aims  Resecting large colorectal sessile tumors using endoscopic submucosal dissection (ESD) is challenging because of severe submucosal fibrosis. Previously, we reported that ESD strategy using the pocket-creation method (PCM) is useful for large colorectal sessile tumors, but there are no large studies reporting the effectiveness and safety of the PCM for resection of large colorectal sessile tumors. Patients and methods  This was a retrospective review of 90 large colorectal sessile tumors in 89 patients who underwent ESD in our institution. Large colorectal sessile tumors were defined as polypoid lesions 20 mm or more in diameter. We divided them into PCM (n = 40) and conventional method (CM) groups (n = 50). The primary outcome measure was en bloc resection. The inverse-probability-treatment weighting (IPTW) approach was used to adjust for selection bias. Results  Both PCM and CM achieved high en bloc resection (100 % vs. 94 %, non-adjusted P  = 0.25, IPTW-adjusted P  = 0.19) and R0 resection rates (88 % vs. 78 %, non-adjusted P  = 0.28, IPTW-adjusted P  = 0.27). When PCM was used, the rate of pathologically negative vertical margins was significantly greater than with the CM (IPTW-adjusted P  = 0.045). The dissection time was significantly shorter (IPTW-adjusted P  = 0.025) and dissection speed faster (IPTW-adjusted P  = 0.013) using the PCM than when the CM was used. There was no significant difference in the incidence of adverse events (intraprocedural perforation and delayed bleeding, IPTW-adjusted P  = 0.68). Conclusion  Although en bloc resection and R0 resection rates were similar, PCM significantly increased the rate of negative vertical margins with rapid dissection for treatment of large colorectal sessile tumors.
  • Makoto Naganuma, Taku Kobayashi, Masanao Nasuno, Satoshi Motoya, Shingo Kato, Katsuyoshi Matsuoka, Ryota Hokari, Chikako Watanabe, Hirotsugu Sakamoto, Hironori Yamamoto, Makoto Sasaki, Kenji Watanabe, Hideki Iijima, Yutaka Endo, Hitoshi Ichikawa, Keiji Ozeki, Satoshi Tanida, Nobuhiro Ueno, Mikihiro Fujiya, Minako Sako, Ken Takeuchi, Shinya Sugimoto, Takayuki Abe, Toshifumi Hibi, Yasuo Suzuki, Takanori Kanai
    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 18 (5) 1102 - 1111 2020/05 [Refereed][Not invited]
     
    BACKGROUND & AIMS: We compared the diagnostic accuracy of the fecal calprotectin (FCP) test vs the fecal immunochemical blood test (FIT) in determining the endoscopic severity and predicting outcomes of patients with ulcerative colitis (UC). METHODS: We performed a nationwide study of 879 patients with UC, enrolled at medical centers across Japan, from March 2015 to March 2017. We collected data on fecal biomarkers, endoscopic severities, and other clinical indices from Cohort 1 (n = 427) and assessed the diagnostic accuracy of FCP measurement and FIT results in determining clinical severity, based on Mayo score, and endoscopic remission, based on Mayo endoscopic sub-score (MES) or UC endoscopic index of severity. We also followed 452 patients in clinical remission from UC (Cohort 2) for 12 months and evaluated the associations of FCP levels and FIT results with clinical recurrence. RESULTS: The levels of FCP and FIT each correlated with the MES and UC endoscopic index of severity. There were no significant differences in the areas under the curve of FCP vs FIT in distinguishing patients with MES≤1 from those with MES≥2 (P = .394) or in distinguishing patients with MES=0 from those with MES≥1 (P = .178). Among 405 patients in clinical remission at baseline, 38 (9.4%) had UC recurrences within 3 months and 90 (22.2%) had recurrences within 12 months. FCP≥146 mg/kg (hazard ratio [HR], 4.83; 95% confidence interval [CI], 2.80-8.33) and FIT≥77 ng/mL (HR, 2.92; 95% CI, 1.76-4.83) were independently associated with clinical recurrence within 12 months. UC recurred within 12 months in 69% of patients with levels of FCP≥146 mg/kg and FIT ≥77 ng/mL; this value was significantly higher than the rate of recurrence in patients with levels of FCP≥146 mg/kg and FIT <77 ng/mL (31.5%, P < .001) or patients with levels of FCP<146 mg/kg and FIT ≥77 ng/mL (30.0%, P < .001). CONCLUSION: In a nationwide study of patients with UC in Japan, we found that the level of FCP and FIT could each identify patients with endoscopic markers of disease severity (MES≥2). The combination of FCP and FIT results can identify patients in remission who are at risk for disease recurrence. Clinical Trials Registry no: UMIN000017650 (http://www.umin.ac.jp/ctr/).
  • Satoshi Shinozaki, Hiroyuki Osawa, Hirotsugu Sakamoto, Yoshikazu Hayashi, Yasutoshi Kobayashi, Yoshimasa Miura, Alan Kawarai Lefor, Hironori Yamamoto
    Digestion 101 (4) 382 - 390 2020 [Refereed][Not invited]
     
    BACKGROUND/AIMS: The long-term outcomes of patients after cessation of acotiamide therapy in patients with functional dyspepsia remains unclear. The aim of this study is to investigate the timing and predictors of recurrence of dyspepsia symptoms after cessation of acotiamide therapy for functional dyspepsia. METHODS: Seventy patients treated with acotiamide for functional dyspepsia who then ceased treatment were enrolled. Changes in dyspepsia symptoms were evaluated using the Izumo scale, a self-reporting questionnaire of abdominal symptom-related quality of life. Patients were subclassified into epigastric pain, postprandial distress, and overlapped types. RESULTS: The mean follow-up after cessation of acotiamide was 1.9 years. After cessation of acotiamide, 39 patients (56%) had recurrence. Kaplan-Meier analysis revealed a recurrence-free rate of 51% at 1 year. Predictors of recurrence evaluated with a Cox proportional hazards model showed that overlapped-type dyspepsia and consultation with the treating physician before cessation were identified as significant positive and negative predictors, respectively (p < 0.05). The resumption of acotiamide significantly decreased the score for dyspepsia symptoms at 1 month. CONCLUSIONS: Dyspepsia symptoms recur about one year after cessation of acotiamide therapy. Patients with overlapped-type dyspepsia should be carefully followed after cessation. Patients should consult their treating physician before stopping acotiamide.
  • Shogo Magome, Hirotsugu Sakamoto, Satoshi Shinozaki, Masahiro Okada, Tomonori Yano, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
    Clinical endoscopy 53 (1) 101 - 105 2020/01 [Refereed][Not invited]
  • Masafumi Kitamura, Hirotsugu Sakamoto, Hironori Yamamoto
    Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 32 (1) 144 - 144 2020/01 [Refereed][Not invited]
  • Okada, Masahiro, Sakamoto, Hirotsugu, Hayashi, Yoshikazu, Yano, Tomonori, Shinozaki, Satoshi, Sunada, Keijiro, Lefor, Alan Kawarai, Yamamoto, Hironori
    Clinical journal of gastroenterology 12 (4) 320 - 324 1865-7257 2019 [Refereed][Not invited]
     
    A 67-year-old woman presented with symptoms of bowel obstruction. Radiographic and ultrasonographic findings suggested colo-colonic intussusception caused by a colonic lipoma. Colonoscopy with an endoscope tip balloon was performed for reduction. The intussusception was partially reduced by injecting dilute contrast media with a wedged inflated balloon at the endoscope tip. For definitive treatment of the polyp, ischemia was induced using a detachable snare. The abdominal pain well improved after endoscopic treatment. However, ultrasonography suggested a residual lesion. Another detachable snare was applied to the stalk on day 6. A large amount of dark-red necrotic tissue was passed per anus the following day. One month later, complete scarring of the site was confirmed colonoscopically. This is the first report of curative endoscopic treatment of an intussusception due to a giant colonic lipoma with detachable snares after the reduction with a wedged balloon of colonoscope tip.
  • Takezawa, Takahito, Hayashi, Yoshikazu, Shinozaki, Satoshi, Sagara, Yuichi, Okada, Masahiro, Kobayashi, Yasutoshi, Sakamoto, Hirotsugu, Miura, Yoshimasa, Sunada, Keijiro, Lefor, Alan Kawarai, Yamamoto, Hironori
    Gastrointestinal endoscopy 89 (5) 1045 - 1053 0016-5107 2019 [Refereed][Not invited]
     
    BACKGROUND AND AIMS: Colonic endoscopic submucosal dissection (ESD) is more difficult than rectal ESD because of poor maneuverability of the endoscope due to physiologic flexion, peristalsis, and respiratory movements. The aim of this study was to assess the usefulness of the pocket-creation method (PCM) for colonic ESD compared with the conventional method (CM) regardless of lesion shape or location. METHODS: A total of 887 colorectal lesions were treated by ESD. Of 887 lesions, 271 rectal lesions, 72 lesions smaller than 20 mm in diameter, and 1 non-neoplastic lesion were excluded. This is a retrospective chart review of the remaining 543 colon lesions in 512 patients. We divided them into the PCM group (n = 280) and the CM group (n = 263). The primary outcome was the en bloc resection rate. Secondary outcomes were R0 resection (en bloc resection with negative margin), adverse events, dissection time (in minutes), and dissection speed (in mm2/min). RESULTS: The PCM group achieved a significantly higher en bloc resection rate (PCM, 100% [280/280], vs CM, 96% [253/263]; P < .001) and R0 resection rate (91% [255/280] vs 85% [224/263], respectively; P = .033) than the CM group. Dissection time was similar (69.5 ± 44.4 vs 78.7 ± 62.6 minutes, P = .676). Dissection speed was significantly faster with the PCM than with the CM (23.5 ± 11.6 vs 20.9 ± 13.6 mm2/min, P < .001). The incidence of adverse events was similar (perforation, 2% vs 4% [P = .152], and delayed bleeding, 2% vs 1% [P = .361]). CONCLUSIONS: Colonic ESD using the PCM significantly improves the rates of en bloc resection and R0 resection and facilitates rapid dissection.
  • Miura Y, Yano T, Takezawa T, Sakamoto H, Osawa H, Lefor AK, Yamamoto H
    Endoscopy 50 (10) E294 - E295 0013-726X 2018/10 [Refereed][Not invited]
  • Iida M, Sakamoto H, Miura Y, Yano T, Hayashi Y, Lefor AK, Yamamoto H
    Endoscopy 50 (9) 931 - 932 0013-726X 2018/09 [Refereed][Not invited]
  • Tomonori Yano, Hirotsugu Sakamoto, Yasutoshi Kobayashi, Manabu Nagayama, Hiroko Tojo, Shoko Miyahara, Mariko Sekiya, Keijiro Sunada, Hironori Yamamoto
    Gastroenterological Endoscopy 60 (5) 1107 - 1115 0387-1207 2018/05 [Refereed][Not invited]
     
    Strictures of the small intestine are a significant complication in patients with Crohn’s disease. Their treatment remains a major challenge. Surgical resection cannot cure Crohn’s disease. Multiple resection of strictures may lead to short bowel syndrome. The development of balloon-assisted enteroscopy has enabled balloon dilation for strictures in the deep small bowel. Because balloon dilation can be repeatedly performed for recurrence of strictures, it may avoid or postpone the need for surgery. In this article, we introduce strategies and devices for endoscopic balloon dilation therapy for Crohn’s disease strictures.
  • Iwashita, Chihiro, Sakamoto, Hirotsugu, Miura, Yoshimasa, Shinozaki, Satoshi, Hayashi, Yoshikazu, Ino, Yuji, Osawa, Hiroyuki, Tamba, Mio, Morita, Kohei, Lefor, Alan Kawarai, Yamamoto, Hironori
    Minimally Invasive Therapy & Allied Technologies 27 (3) 171 - 176 1365-2931 2018 [Refereed][Not invited]
     
    Background/Aims: A submucosal cushion of sodium hyaluronate facilitates gastric and colorectal endoscopic submucosal dissection (ESD). However, few studies have evaluated the utility of sodium hyaluronate for ESD of esophageal lesions. The aim of this study is to evaluate the utility and safety of sodium hyaluronate for ESD of superficial esophageal squamous cell neoplasms (ESCN). Material and methods: We retrospectively reviewed 111 ESCN in 86 patients treated by ESD between September 2007 and April 2013. There were four double cancers, with 107 ESD procedures analyzed. Results: The en bloc resection rate was 99% (106/107). The R0 resection rate was 93% (99/107). Of 106 specimens resected en bloc, four specimens had a positive horizontal margin, two specimens had non-assessable horizontal margins and one specimen had non-assessable horizontal and vertical margins. One patient with a non-assessable horizontal margin developed local recurrence seven months later, treated by repeat ESD. Delayed bleeding occurred in two procedures (2%), and intra-procedural perforation occurred in four (4%). None required operative repair. Endoscopy trainees performed 33 of 107 (31%) ESD procedures. Post-ESD stenosis requiring dilation occurred following five procedures (5%). Conclusions: Sodium hyaluronate for ESD of ESCN achieves a high R0 resection rate with a low rate of adverse events.
  • Yamashina, Takeshi, Hayashi, Yoshikazu, Sakamoto, Hirotsugu, Yano, Tomonori, Miura, Yoshimasa, Shinozaki, Satoshi, Sunada, Keijiro, Lefor, Alan Kawarai, Yamamoto, Hironori
    Endoscopy 50 (8) 800 - 808 0013-726X 2018 [Refereed][Not invited]
     
    BACKGROUND: Colorectal endoscopic submucosal dissection (ESD) can be technically difficult in some situations, such as paradoxical movement of the proximal colon. The double-balloon endoscope provides stable endoscopic maneuvering, even in the small intestine. The aim of this study was to assess the outcomes of balloon-assisted endoscopic submucosal dissection (BAESD) of colonoscopically difficult superficial proximal colon tumors. METHODS: We retrospectively reviewed the records of patients who underwent BAESD of superficial proximal colon tumors where colonoscopic difficulties were encountered, from January 2011 to September 2016. Difficulties were defined as a previous incomplete colonoscopy using a conventional colonoscope or unstable endoscopic maneuverability around the tumor with a conventional colonoscope. A propensity score model was used as a secondary analysis to compare outcomes of the BAESD group with those of a non-BAESD group.  RESULTS:  BAESD was performed on 63 tumors in 63 patients. En bloc resection was achieved for 62 tumors (98 %) and an R0 resection was achieved for 55 tumors (87 %). Propensity score matching analysis created 59 matched pairs from the BAESD and non-BAESD groups. There were no statistically significant differences between the two groups in en bloc resection (100 % vs. 100 %; P > 0.99), R0 resection (90 % vs. 93 %; P = 0.74), perforation (0 % vs. 2 %; P > 0.99) or postoperative bleeding (3 % vs. 0 %; P = 0.50). CONCLUSION: Balloon-assisted endoscopy achieved safe and reliable ESD of colonoscopically difficult superficial proximal colon tumors.
  • Shinozaki, Satoshi, Kobayashi, Yasutoshi, Hayashi, Yoshikazu, Sakamoto, Hirotsugu, Lefor, Alan Kawarai, Yamamoto, Hironori
    Digestive Endoscopy 30 (5) 592 - 599 0915-5635 2018 [Refereed][Not invited]
     
    BACKGROUND AND AIM: Safety and effectiveness of cold snare polypectomy (CSP) compared with hot snare polypectomy (HSP) has been reported. The aim of the present study is to carry out a meta-analysis of the efficacy and safety of HSP and CSP. METHODS: Randomized controlled trials were reviewed to compare HSP with CSP for resecting small colorectal polyps. Outcomes reviewed include complete resection rate, polyp retrieval, delayed bleeding, perforation and procedure time. Outcomes were documented by pooled risk ratios (RR) with 95% confidence intervals (CI) using the Mantel-Haenszel random effect model. RESULTS: Eight studies were reviewed in this meta-analysis, including 1665 patients with 3195 polyps. Complete resection rate using HSP was similar to CSP (RR: 1.02, 95% CI: 0.98-1.07, P = 0.31). Polyp retrieval after HSP was similar to CSP (RR: 1.00, 95% CI: 1.00-1.01, P = 0.60). Delayed bleeding rate after HSP was higher than after CSP, although not significantly (patient basis: RR: 7.53, 95% CI: 0.94-60.24, P = 0.06; polyp basis: RR: 7.35, 95% CI: 0.91-59.33, P = 0.06). Perforation was not reported in all eight studies. Total colonoscopy time for HSP was significantly longer than CSP (mean difference 7.13 min, 95% CI: 5.32-8.94, P < 0.001). Specific polypectomy time for HSP was significantly longer than CSP (mean difference 30.92 s, 95% CI: 9.15-52.68, P = 0.005). CONCLUSION: This meta-analysis shows significantly shorter procedure time using CSP compared with HSP. CSP tends toward less delayed bleeding compared with HSP. We recommend CSP as the standard treatment for resecting small benign colorectal polyps.
  • Shinozaki, Satoshi, Osawa, Hiroyuki, Sakamoto, Hirotsugu, Hayashi, Yoshikazu, Kobayashi, Yasutoshi, Miura, Yoshimasa, Lefor, Alan Kawarai, Yamamoto, Hironori
    Kaohsiung Journal of Medical Sciences 34 (8) 456 - 460 1607-551X 2018 [Refereed][Not invited]
     
    Vonoprazan-based regimens have improved the rate of successful Helicobacter pylori (H. pylori) eradication, but it has not reached 100%. The aim of this study is to clarify significant predictors of successful H. pylori eradication using a vonoprazan-based regimen. In this retrospective cohort study, 174 patients who underwent primary H. pylori eradication therapy were included. All patients underwent esophagogastroduodenoscopy before treatment. The vonoprazan-based regimen includes amoxicillin 750 mg, clarithromycin 200 mg and vonoprazan 20 mg twice daily for one week. Pre-treatment with a proton pump inhibitor (PPI) was defined as continued PPI use for more than four weeks prior to eradication therapy. The rates of successful eradication were 83% (145/174) in intention-to-treat analysis and 85% (145/171) in per-protocol analysis. Predictors of successful eradication among 171 patients were evaluated in per-protocol analysis. In univariate analysis, male gender was a significant positive predictor of successful eradication (odds ratio [OR] 3.813, 95% confidence interval [CI] 1.363–10.663, p = 0.010) and pre-treatment with PPIs was a negative predictor (OR 0.193, 95%CI 0.076–0.485, p < 0.001). In multivariate analysis, male gender remained a positive predictor (OR 3.826, 95%CI 1.317–11.116, p = 0.013), and pre-treatment with PPIs (OR 0.232, 95%CI 0.087–0.615, p = 0.003) remained a negative predictor. In conclusion, pre-treatment with PPIs before eradication therapy decreases the rate of successful eradication. Therefore, it may be desirable to discontinue pre-treatment with PPIs prior to eradication therapy, because of the potential to improve the rate of successful eradication.
  • Shinozaki, Satoshi, Osawa, Hiroyuki, Kobayashi, Yasutoshi, Sakamoto, Hirotsugu, Hayashi, Yoshikazu, Miura, Yoshimasa, Lefor, Alan Kawarai, Yamamoto, Hironori
    Scandinavian Journal of Gastroenterology 53 (8) 897 - 904 0036-5521 2018 [Refereed][Not invited]
     
    OBJECTIVE: The novel potassium-competitive acid blocker, vonoprazan, provides rapid and effective acid suppression. The aim of this study is to evaluate the long-term outcomes of patients with symptomatic gastroesophageal reflux disease (GERD) treated with vonoprazan. METHODS: This retrospective cohort study included 55 patients with symptomatic GERD treated with vonoprazan who have been followed for more than one year. The effectiveness of vonoprazan on gastrointestinal symptoms was evaluated using the Izumo scale, a self-reported questionnaire reflecting quality of life related to various abdominal symptoms. RESULTS: These 55 patients with symptomatic GERD had non-erosive reflux disease (n = 30) or erosive esophagitis (n = 25). Vonoprazan (10 mg) for one month improved GERD symptoms in 89% (responders) and the improvement was maintained at one year in 82% without additional treatment. One-year maintenance therapy resulted in sustained resolution of GERD symptoms in 47%. Of the 49 responders, nine patients had relapse of GERD symptoms and dose escalation of vonoprazan improved the symptoms in six patients. Postprandial distress and the presence of erosive esophagitis before starting vonoprazan were identified as significant negative and positive predictors of sustained resolution of GERD symptoms for one year, respectively. Epigastric pain, postprandial distress, constipation and diarrhea were significantly improved at one-month and maintained at one year. After one-year of treatment, the endoscopic healing rate of erosive esophagitis was 95%. CONCLUSION: One-year treatment with vonoprazan significantly improves GERD symptoms and endoscopic healing of erosive esophagitis is satisfactory. The long-term use of vonoprazan is effective and useful to control GERD.
  • Satoshi Shinozaki, Hiroyuki Osawa, Yoshikazu Hayashi, Hirotsugu Sakamoto, Yoshimasa Miura, Alan Kawarai Lefor, Hironori Yamamoto
    KAOHSIUNG JOURNAL OF MEDICAL SCIENCES 33 (12) 616 - 622 1607-551X 2017/12 [Refereed][Not invited]
     
    The effects of vonoprazan, a new potassium-competitive acid blocker, on gastro-esophageal reflux disease (GERD) symptom are not fully elucidated. The aim of this study is to determine the effect of vonoprazan on GERD and associated gastrointestinal symptoms. We retrospectively reviewed 88 Helicobacter pylori negative patients with GERD treated with vonoprazan 10 mg daily. Symptoms were evaluated using the Izumo scale, which reflects quality of life related to various abdominal symptoms. The rates of improvement and resolution of GERD symptoms were 86% (76/88) and 57% (50/88), respectively. Improvement and resolution in patients with erosive esophagitis was higher than in those with non-erosive reflux disease (91% vs 83%, p = 0.260 and 71% vs 47%, p = 0.025, respectively). We attempted to identify factors which predict the effects of vonoprazan. Multivariate analysis identified advanced age (>= 60-year-old) (odds ratio [OR] 7.281, 95% confidence interval [Cl] 2.056-25.776, p = 0.002), obesity (BMI >= 24) (OR 3.342, 95%CI 1.124-9.940, p = 0.030) and erosive esophagitis (OR 4.368, 95%CI 1.281-14.895, p = 0.018) as positive predictors of resolution of GERD symptoms. Alcohol use (OR 0.131, 95%CI 0.027-0.632, p = 0.011 ) and history of H. pylori eradication (OR 0.171, 95%CI 0.041-0.718, p = 0.015) were identified as negative predictors. Vonoprazan also improved epigastric pain (73%), postprandial distress (60%), constipation (58%) and diarrhea (52%) in patients with GERD. In conclusion, vonoprazan 10 mg daily is effective in improving GERD symptoms. Advanced age, obesity, erosive esophagitis, alcohol use and history of H. pylori eradication influence the resolution of GERD symptoms. Treatment with vonoprazan favorably affects gastrointestinal symptoms in patients with GERD. Copyright (C) 2017, Kaohsiung Medical University. Published by Elsevier Taiwan LLC.
  • Satoshi Shinozaki, Hiroyuki Osawa, Hirotsugu Sakamoto, Yoshikazu Hayashi, Yoshimasa Miura, Alan Kawarai Lefor, Hironori Yamamoto
    JOURNAL OF GASTROINTESTINAL AND LIVER DISEASES 26 (4) 345 - 350 1841-8724 2017/12 [Refereed][Not invited]
     
    Background & Aims: Long-term outcomes in patients with functional dyspepsia remain elusive. Acotiamide, a prokinetic drug, has been available in Japan since 2013. The aim of this study was to assess long-term outcomes in patients with functional dyspepsia treated with acotiamide. Methods: We retrospectively reviewed 79 consecutive patients with functional dyspepsia whose symptoms improved with acotiamide therapy and who were followed for more than one year. All patients underwent esophagogastroduodenoscopy prior to acotiamide therapy. The mean follow-up was 1.9 (range, 1.0-3.3) years. We assessed the patients' symptom severity using the Izumo scale, which reflects changes in various abdominal symptoms. Results: At one year, dyspepsia symptoms recurred in 25% (20/79) of the patients. In multivariate analysis, severe dyspepsia was significantly associated with increased recurrence (odds ratio [OR] 15.04, 95% confidence interval [CI] 1.73-130.47, p=0.013). Continued use of acotiamide for one year diminished the recurrence of dyspepsia symptoms significantly (OR 0.16, 95% CI 0.04-0.61, p=0.006). The influence of these significant predictors on long-term outcomes was analyzed using the Kaplan-Meier method. Patients with severe dyspepsia before starting acotiamide had significantly more recurrences than those with mild symptoms (p=0.004, log-rank test). Patients who continued acotiamide therapy throughout the follow-up period had significantly fewer recurrences than those who stopped therapy (p<0.001). Conclusions: Over the long-term, patients with functional dyspepsia have a considerable rate of recurrence of dyspepsia. Severe dyspepsia before treatment increases the recurrence rates, while adherence to an acotiamide therapeutic regimen decreases recurrence rate.
  • Yuka Kagaya, Hirotsugu Sakamoto, Tomonori Yano, Keijiro Sunada, Alan Kawarai Lefor, Toshiro Niki, Hironori Yamamoto
    Clinical Journal of Gastroenterology 10 (3) 244 - 249 1865-7265 2017/06 [Refereed][Not invited]
     
    We describe a patient with Crohn’s disease (CD) concurrent with systemic lupus erythematosus (SLE). Continuous prednisolone and cyclosporine treatment resulted in no recurrent symptoms. However, diarrhea, vomiting, and fever occurred for approximately 3 months. A colonoscopy was then performed, which showed a discontinuous cobblestone appearance and longitudinal ulcers extending from the sigmoid colon to the descending colon and distal ileum. A biopsy revealed a noncaseating granulomatous lesion in the colonic mucosa. These findings led to a diagnosis of CD concurrent with SLE. We first attempted treatment with a full elemental diet, mesalazine, and azathioprine, in that order. However, as there was no improvement in inflammation, we started infliximab, a tumor necrosis factor-alpha inhibitor. Transanal double-balloon enteroscopy performed 4 months after starting infliximab showed mucosal healing, suggesting that infliximab was effective. There are few reports of treating patients with CD concurrent with SLE using a tumor necrosis factor-alpha inhibitor. We report our experience with a patient who had mucosal healing with infliximab and review the literature.
  • Hironori Yamamoto, Yoshimasa Miura, Satoshi Shinozaki, Yoshikazu Hayashi, Hirotsugu Sakamoto, Alan Kawarai Lefor
    Endoscopy 49 (4) 401  1438-8812 2017/04 [Refereed][Not invited]
  • Keijiro Sunada, Satoshi Shinozaki, Tomonori Yano, Yoshikazu Hayashi, Hirotsugu Sakamoto, Alan Kawarai Lefor, Hironori Yamamoto
    DIGESTIVE DISEASES AND SCIENCES 62 (4) 979 - 983 0163-2116 2017/04 [Refereed][Not invited]
     
    Cecal intubation using conventional colonoscopy (CC) requires substantial training. We hypothesized that double-balloon colonoscopy (DBC) facilitates cecal intubation by endoscopy na < ve operators. The aim of this study is to evaluate the cecal intubation rate and learning curve of DBC compared with CC. Eighteen endoscopy na < ve medical students were allocated to two groups and attempted cecal intubation within 20 min using a colon simulator. In group A, CC was performed ten times and then DBC ten times. In group B, the reverse was carried out. We evaluated the cecal intubation rate and learning curve. The overall success rate for cecal intubation using DBC was significantly superior to CC [132/180 (73%) vs. 12/180 (7%), p < 0.001]. To evaluate the success rate overtime, we divided the ten repetitions of the procedure into three time periods: first (1-3), second (4-6), and third (7-10). The success rate using CC is < 20%, even during the third time period, in both groups, and one perforation occurred. The success rate using DBC is over 30% in the first period and increased to nearly 80% in the third period in both groups. Finally, we evaluated the time needed for cecal intubation using DBC. The mean cecal intubation time in the first period is 14 min and decreased to 11 min in the third period. DBC has a higher cecal intubation rate than CC performed by endoscopy naive medical students using a colon simulator in this randomized-controlled, cross-over study.
  • Sakamoto H, Hayashi Y, Miura Y, Shinozaki S, Takahashi H, Fukuda H, Okada M, Ino Y, Takezawa T, Sunada K, Lefor AK, Yamamoto H
    Endoscopy international open 5 (2) E123 - E129 2364-3722 2017/02 [Refereed][Not invited]
     
    Background and study aims The pocket-creation method (PCM) is a novel strategy for endoscopic submucosal dissection (ESD). The aim of this study is to determine the efficacy of the PCM for colorectal laterally spreading tumors, non-granular type (LST-NG). Patients and methods The records of 126 consecutive patients with colorectal LST-NG who underwent ESD between April 2012 and July 2015 were retrospectively reviewed. Patients were divided into PCM (n = 73) and conventional method (CM) (n = 53) groups. Results The en bloc resection rate in the PCM group was significantly higher than in the CM group (100 % [73/73] vs. 92 % [49/53], P = 0.03). The en bloc resection rate with severe fibrosis was higher in the PCM group than in the CM group (100 % [3/3] vs. 60 % [3/5]). The R0 resection rate for the two groups was not statistically significantly different (93 % [68/73] vs. 91 % [48/53], P = 0.74). The perforation rate in the PCM group was lower than in the CM group although not statistically significantly less (0 % 0/73 vs. 4 % 2/53, P = 0.18). For lesions resected en bloc, dissection speed for the PCM group was significantly faster than for the CM group (median [IQR], 19 [13 -24] vs. 14 [10 - 22] mm2/min, P = 0.03). Conclusion ESD using PCM achieves a reliable and safe resection of colorectal LST-NG.
  • Satoshi Shinozaki, Hiroyuki Osawa, Yoshikazu Hayashi, Hirotsugu Sakamoto, Yasutoshi Kobayashi, Alan Kawarai Lefor, Hironori Yamamoto
    Biomedical Reports 7 (3) 231 - 235 2049-9442 2017 [Refereed][Not invited]
     
    Gastroesophageal reflux disease (GERD) is commonly treated by primary care physicians. Although proton pump inhibitors (PPI) have been the mainstay of GERD treatment for two decades, in some patients GERD is refractory to standard dose PPI for more than eight weeks and is referred to as PPI-resistant GERD. Vonoprazan, a novel competitive acid blocker, became available in Japan for the treatment of patients with GERD, and has greater acid inhibition than existing PPIs. The aim of the present study was to determine the effect of vonoprazan 10 mg daily on PPI-resistant GERD. We retrospectively reviewed 24 patients with PPI-resistant GERD treated with vonoprazan 10 mg daily. The Izumo scale was used to evaluate the effect of vonoprazan before and one month after treatment, which reflects quality of life related to gastrointestinal symptoms. The overall rates of improvement and resolution of GERD symptoms were 88% (21/24) and 42% (10/24), respectively, and the score was significantly decreased (before 5.8±1.7, at one month 1.9±1.9, P< 0.001). To evaluate the influence of esophageal erosions despite prior PPI treatment, the patients were divided into erosive (n=6) and non-erosive groups (n=18). Vonoprazan achieved 100% (6/6) improvement in the erosive group and 83% (15/18) in the non-erosive group. Patients in the erosive group had a significantly higher rate of resolution than in the non-erosive group [83% (5/6) vs 28% (5/18), P=0.017]. No adverse events occurred. Other GI symptoms in patients with PPI-resistant GERD were evaluated. The scores for epigastric pain, postprandial distress, constipation and diarrhea were unchanged during the treatment period. In conclusion, vonoprazan 10 mg daily is effective for the treatment of patients with PPI-resistant GERD. Vonoprazan resolves GERD symptoms in patients with erosions more than in those without erosions. This is the first report on the effect of vonoprazan 10 mg on PPI-resistant GERD.
  • Hirotsugu Sakamoto, Tomonori Yano, Keijiro Sunada
    Journal of Japanese Society of Gastroenterology 114 (3) 422 - 430 1349-7693 2017 [Refereed][Not invited]
  • Yoshimasa Miura, Satoshi Shinozaki, Yoshikazu Hayashi, Hirotsugu Sakamoto, Alan Kawarai Lefor, Hironori Yamamoto
    ENDOSCOPY 49 (1) 8 - 14 0013-726X 2017/01 [Refereed][Not invited]
     
    Background and study aims Duodenal endoscopic submucosal dissection (ESD) requires sophisticated endoscopic techniques because of a high rate of perforation. We introduced the pocket-creation method (PCM) of duodenal ESD to overcome difficulties. The aim of this study was to evaluate the safety and usefulness of ESD using the PCM for superficial tumors of the duodenum. Patients and methods We performed ESD of 17 non-ampullary duodenal lesions using the conventional method and of 28 lesions using the PCM from 2006 to 2015 and retrospectively reviewed the results, comparing the PCM and the conventional method. The median follow-up period was 35 months (range 2 - 97). Results There were more lesions at the duodenal angles in the PCM group compared with the conventional method group (54% [15/28] vs. 22% [4/17]; P = 0.048), and the resected specimen diameter was larger in the PCM than the conventional method group (median 37 mm [range 25 - 101] vs. 25mm [15 - 55]; P = 0.007). Dissection speed was faster in the PCM than the conventional method group (9.4mm(2)/min [3.0 - 15.7] vs. 6.5mm(2)/min [1.5 - 19.7]; P = 0.09). En bloc resection was more frequent in the PCM (100% [28/28]) than the conventional method group (88% [15/17]) (P = 0.07). Perforation was significantly less frequent in the PCM (7% [2/28]) than the conventional method group (29% [5/17]; P = 0.046). The one delayed perforation in the conventional method group required surgical repair, while other intraprocedural perforations were treated by clipping. There were no recurrences. Conclusions ESD of duodenal lesions can be safely performed using the PCM, which stabilizes the tip of the endoscope even in difficult locations.
  • Yuichi Sagara, Satoshi Shinozaki, Tomonori Yano, Hirotsugu Sakamoto, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto
    Clinical Journal of Gastroenterology 9 (6) 369 - 374 1865-7265 2016/12 [Refereed][Not invited]
     
    The over-the-scope clip (OTSC) system is a new technology that enables closure of fistulae which cannot be closed with a conventional clip. A 57-year-old woman had long-term hypoalbuminemia, edema and general malaise. Peroral double-balloon endoscopy (DBE) showed a jejuno-sigmoid fistula and blind loop syndrome of the jejunum and ileum, because ingested food bypassed the ileum through the fistula. She was advised to undergo surgical closure of the fistula, but she refused the procedure. For 7 years following DBE, repeat courses of antibiotics were required to treat bacterial overgrowth due to blind loop syndrome. The fistula was successfully closed using the OTSC system from the sigmoid colon side. The patient’s symptoms and quality of life improved. Two years after closure, hypoalbuminemia, edema and general malaise developed again due to dislocation of the OTSC. She then accepted surgical closure of the fistula, because she had experienced improvement after closure using the OTSC. Her quality of life improved again following surgery. OTSC application can demonstrate the improvement expected after surgical closure of a fistula, and may convince a patient of the benefits of surgical closure.
  • Hisashi Fukuda, Yoshikazu Hayashi, Yoshimasa Miura, Satoshi Shinozaki, Masahiro Okada, Hirotsugu Sakamoto, Keijiro Sunada, Noriyoshi Fukushima, Alan Kawarai Lefor, Hironori Yamamoto
    JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 31 316 - 316 0815-9319 2016/11 [Refereed][Not invited]
  • Satoshi Shinozaki, Hiroaki Nomoto, Yoshie Kondo, Hirotsugu Sakamoto, Yoshikazu Hayashi, Hironori Yamamoto, Alan Kawarai Lefor, Hiroyuki Osawa
    KAOHSIUNG JOURNAL OF MEDICAL SCIENCES 32 (5) 255 - 260 1607-551X 2016/05 [Refereed][Not invited]
     
    Alternative eradication therapies for Helicobacter pylori infection are needed because of an increasing failure rate over the past decade. The aim of this study was to determine if vonoprazan, a new potassium-competitive acid blocker, showed superiority to existing proton pump inhibitors for primary eradication of H. pylori in routine clinical practice. Data for 573 patients who underwent primary H. pylori eradication therapy were retrospectively reviewed. Regimens included clarithromycin 200 mg, amoxicillin 750 mg, and an acid-suppressing drug [ lansoprazole 30 mg (LAC), rabeprazole 10 mg (RAC), esomeprazole 20 mg (EAC), or vonoprazan 20 mg (VAC)] twice daily for 1 week. Eradication was successful in 73% (419/573) of patients using intention-to-treat (ITT) analysis and 76% (419/549) of patients in per-protocol (PP) analysis. The VAC group had a significantly superior eradication rate compared with the LAC and RAC groups in ITT (VAC 83%, LAC 66% and RAC 67%, p < 0.01) and PP analysis (VAC 85%, LAC 69% and RAC 70%, p < 0.01), and had a similarly high eradication rate to the EAC group (83% in ITT and 87% in PP). Although the eradication rate in the VAC and EAC groups was not significantly higher than in the LAC and RAC groups in patients with mild gastric atrophy with both ITT and PP analyses, it was significantly higher in patients with severe gastric atrophy (p < 0.01). The VAC group had a significantly higher H. pylori eradication rate than the LAC and RAC groups, and a > 80% eradication rate regardless of the degree of atrophy. Copyright (C) 2016, Kaohsiung Medical University. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license.
  • Masahiro Okada, Hirotsugu Sakamoto, Takahito Takezawa, Yoshikazu Hayashi, Keijiro Sunada, Alan K. Lefor, Hironori Yamamoto
    Clinical Endoscopy 49 (2) 207 - 208 2234-2443 2016/03 [Refereed][Not invited]
  • Keijiro Sunada, Satoshi Shinozaki, Manabu Nagayama, Tomonori Yano, Takahito Takezawa, Yuji Ino, Hirotsugu Sakamoto, Yoshimasa Miura, Yoshikazu Hayashi, Hiroyuki Sato, Alan Kawarai Lefor, Hironori Yamamoto
    INFLAMMATORY BOWEL DISEASES 22 (2) 380 - 386 1078-0998 2016/02 [Refereed][Not invited]
     
    Background:Crohn's disease (CD) strictures of the small intestine are a feared complication and difficult to treat because of difficulty gaining access to the stricture site. The development of double-balloon endoscopy (DBE) enabled access to the entire small intestine with interventional capabilities. The aim of this study was to assess the long-term outcomes in patients with small intestinal strictures secondary to CD after DBE-assisted endoscopic balloon dilation (EBD).Methods:In this retrospective cohort study, DBE-assisted EBD was performed in 85 consecutive patients with CD strictures of the small intestine from 2002 to 2014. Follow-up data were available for 85 patients for a mean of 41.9 months (range, 0-141), and clinical outcomes were assessed.Results:Overall, 321 DBE-assisted EBD sessions (473 procedures) were performed in 85 patients during the study period. Most CD strictures were de novo (97%). The surgery-free rate after initial DBE-assisted EBD was 87.3% at 1 year and 78.1% at 3 years. The presence of a fistula was significantly associated with the need for surgical intervention (hazard ratio = 5.50, 95% confidence interval: 2.16-14.0, P < 0.01). The surgery-free interval in patients with a fistula was significantly shorter than in patients without a fistula (P < 0.01, log-rank test).Conclusions:DBE-assisted EBD provides a favorable long-term outcome in patients with small intestinal CD-associated strictures. DBE-assisted EBD for CD strictures is a safe and effective treatment to avoid or postpone surgery over the long-term.
  • Satoshi Shinozaki, Hiroyuki Osawa, Hirotsugu Sakamoto, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto
    Journal of Medical Investigation 63 (3-4) 230 - 235 1349-6867 2016 [Refereed][Not invited]
     
    The effect of acotiamide on gastrointestinal symptoms is undefined. The aim of this study is to evaluate the effect of acotiamide on abdominal symptoms in patients with functional dyspepsia. We retrospectively reviewed 51 patients treated with acotiamide. We evaluated patient quality of life using the Izumo scale that detects changes in quality of life caused by abdominal symptoms. Acotiamide ameliorated the symptoms of functional dyspepsia at one and three months (improved: 61%vs80%, p=0.029 and resolved: 17% vs 33%, p=0.069). We then evaluated the effect of acotiamide on epigastric pain syndrome (EPS) (n=33) and postprandial distress syndrome (PDS) (n=41). Acotiamide treatment showed an early effect on rates of improvement (63%) and resolution (42%) of EPS symptoms at one month, maintained up to three months (69% and 39%, respectively). Both rates of improvement and resolution of PDS symptoms showed a significant increase from one month to three months (56% vs 78%, p=0.021 and 17% vs 46%, p=0.004, respectively). The severity of functional dyspepsia symptoms before treatment was significantly associated with failed resolution of functional dyspepsia symptoms (p=0.013). Acotiamide improves and resolves EPS symptoms as well as PDS symptoms. PDS symptoms take longer to resolve than EPS symptoms.
  • Satoshi Shinozaki, Tomonori Yano, Hirotsugu Sakamoto, Keijiro Sunada, Yoshikazu Hayashi, Hiroyuki Sato, Alan Kawarai Lefor, Hironori Yamamoto
    DIGESTIVE DISEASES AND SCIENCES 60 (12) 3691 - 3696 0163-2116 2015/12 [Refereed][Not invited]
     
    Background The long-term outcomes of patients after negative double-balloon endoscopy (DBE) for obscure gastrointestinal (GI) bleeding remain unclear. Aim The aim of this study was to assess the long-term outcomes of patients with negative DBE and clarify the effect of repeat endoscopic work-up. Methods A total of 42 patients with a negative DBE for overt obscure GI bleeding were enrolled, and their clinical data were retrospectively reviewed. The mean (+/- standard deviation) follow-up period is 5.4 (+/- 2.8) years. The outcome measurement was overt rebleeding witnessed by the patient after negative DBE. At the time of rebleeding, further endoscopic work-up and specific treatment were performed. Results Rebleeding occurred in 16 of 42 patients (38 %). At the time of rebleeding, further investigations were made in 14 of 16 patients (88 %), and the bleeding source was identified in 10 of 14 patients (71 %). These 10 patients received specific treatment (endoscopic in five, surgical in two, medical in two, and angiographic in one). The bleeding source was in the small intestine in seven of 10 patients (70 %). Blood transfusion before DBE and multiple bleeding episodes before DBE were significant predictive factors for rebleeding (odds ratio 5.056, 95 % confidence interval 1.158-22.059, p = 0.031 and odds ratio 8.167, 95 % confidence interval 1.537-43.392, p = 0.014, respectively). Conclusions The rebleeding rate after a negative DBE is considerable. Careful long-term follow-up and repeat endoscopic work-up at the time of overt rebleeding are important.
  • Satoshi Shinozaki, Hirotsugu Sakamoto, Yoshikazu Hayashi, Kenjiro Shinozaki, Alan Kawarai Lefor, Hironori Yamamoto
    Journal of Gastroenterology and Hepatology Research 4 (10) 1797 - 1800 2224-6509 2015 [Refereed][Not invited]
     
    AIM: To identify a predictor of successful primary Helicobacter pylori (H. pylori) eradication assessed in routine clinical practice. METHODS: From February 2013 to January 2015, 186 patients underwent primary eradication therapy. We retrospectively reviewed the medical records. All patients underwent EGD before eradication therapy and H. pylori infection was diagnosed by ≥10 U/mL serum anti-H. pylori IgG. We used standard triple therapy including a proton pump inhibitor (PPI) (rabeprazole 10 mg or lansoprazole 30 mg), clarithromycin 200 mg and amoxicillin 750 mg twice daily for seven days. To determine if eradication succeeded, a 13C-urea breath test was performed on all patients more than eight weeks after primary eradication. RESULTS: The overall success rate of H. pylori eradication therapy was 62% (116/186). We assessed potential predictors of successful primary H. pylori eradication therapy including gender, age, smoking habits, prior PPI intake, kind of PPI, serum IgG value and degree of atrophy. Univariate analysis showed that high serum IgG significantly predicts successful eradication (odds ratio (OR) 2.583, 95% confidence interval (CI) 1.285-5.191, p=0.008). The eradication rate was 77% (43/56) in the ≥45 U/mL group and 56% (73/130) in the < 45 U/ mL group, and significance was confirmed by multivariate analysis (OR 2.626, 95% CI 1.269-5.436, p=0.009). Multivariate analysis showed a trend that advanced age (≥70 year-old) increased the rate of successful eradication (OR 1.669, 95% CI 0.857-3.252, p=0.132). CONCLUSION: Elevated serum IgG significantly predicts successful primary H. pylori eradication.
  • Hakuei Shinhata, Hironori Yamamoto, Keijiro Sunada, Yuji Ino, Yoshikazu Hayashi, Hiroyuki Sato, Yoshimasa Miura, Hirotsugu Sakamoto, Aya Kitamura, Takahito Takezawa, Tomonori Yano, Takashi Sakatani, Kentaro Sugano
    ENDOSCOPY 47 E192 - E194 0013-726X 2015 [Refereed][Not invited]
  • Yuji Ino, Tomonori Yano, Hirotsugu Sakamoto, Yoshikazu Hayashi, Hiroyuki Osawa, Alan T. Lefor, Hironori Yamamoto
    ENDOSCOPY 47 E202 - E203 0013-726X 2015 [Refereed][Not invited]
  • Sakamoto H, Asahara T, Chonan O, Yuki N, Mutoh H, Hayashi S, Yamamoto H, Sugano K
    Intestinal research 1 13 39 - 49 1598-9100 2015/01 [Refereed][Not invited]
  • Hiroyuki Mutoh, Miho Sashikawa, Hirotsugu Sakamoto, Tomoko Tateno
    GUT AND LIVER 8 (5) 508 - 518 1976-2283 2014/09 [Refereed][Not invited]
     
    Background/Aims: Doublecortin and CaM kinase-like-1 (DCAMKL1) is a marker of stem cells expressed predominantly in the crypt base in the intestine. However, DCAMKL1-positive cells have been shown to be differentiated tuft cells rather than quiescent progenitors. Tuft cells are the only epithelial cells that express cyclooxygenase 2 (COX-2) in the normal intestinal epithelium. We previously generated Cdx2-transgenic mice as model mice for intestinal metaplasia and gastric carcinoma. In the current study, we investigated the association between COX-2 and DCAMKL1 in gastric carcinoma. Methods: We examined the association between COX-2 and DCAMKL1 expression in gastric carcinomas in clinical samples (early gastric well-differentiated adenocarcinoma) and Cdx2-transgenic mice; and the DCAMKL1-transgenic mouse stomach using immunohistochemistry and quantitative real-time polimerase chain reaction. Results: The COX-2-expressing cells were scattered, not diffusely expressed, in gastric carcinomas from humans and Cdx2-transgenic mice. DCAMKL1-positive cells were also scattered in the gastric carcinomas, indicating that tuft cells could still be present in gastric carcinoma. COX-2 was expressed in DCAMKL1-positive tuft cells in Cdx2- and DCAMKL1-transgenic mouse stomachs, whereas the Sox9 transcription factor was ubiquitously expressed in gastric carcinomas, including COX-2-positive cells. Conclusions: COX-2 is expressed in DCAMKL1-expressing quiescent tuft cells in gastric carcinoma.
  • Yoshikazu Hayashi, Hironori Yamamoto, Tomonori Yano, Aya Kitamura, Takahito Takezawa, Yuji Ino, Hirotsugu Sakamoto, Yoshimasa Miura, Hakuei Shinhata, Hiroyuki Sato, Keijiro Sunada, Kentaro Sugano
    ENDOSCOPY 45 E373 - E374 0013-726X 2013/12 [Refereed][Not invited]
  • Hirotsugu Sakamoto, Hiroyuki Mutoh, Yoshimasa Miura, Miho Sashikawa, Hironori Yamamoto, Kentaro Sugano
    Gut and Liver 7 (5) 513 - 518 1976-2283 2013/09 [Refereed][Not invited]
     
    Background/Aims: SOX9 is a marker for stem cells in the intestine, and overexpression of SOX9 is found in gastric and colon cancer however, the expression of SOX9 in nonampullary duodenal adenoma and adenocarcinoma has not yet been evaluated. This study aimed to investigate SOX9 expression in nonampullary duodenal adenoma and adenocarcinoma by immunohistochemistry. Methods: We evaluated SOX9 expression in 43 clinical samples (nonampullary duodenal adenoma in 22 lesions and nonampullary duodenal adenocarcinoma in 21 lesions) resected under endoscopic mucosal resection or endoscopic submucosal dissection. Results: SOX9 was expressed in part of the base of the normal duodenal mucosa surrounding adenomas and adenocarcinomas. In contrast, SOX9-positive cells were found in more than half of the crypts from the bottom part of the crypt in all of the 43 samples. Moreover, in 15 adenoma samples (68.2%) and 19 carcinoma samples (90.5%), SOX9 was expressed in more than three-quarters of the crypts from the bottom part of the crypt. Conclusions: SOX9 is overexpressed in nonampullary duodenal adenoma and adenocarcinoma in humans.
  • Hisashi Hatanaka, Hironori Yamamoto, Tomonori Yano, Jun Ushio, Takeshi Tomiyama, Shin-ichi Wada, Hirotsugu Sakamoto, Masahiro Okada, Kiichi Tamada, Kentaro Sugano
    DIGESTIVE ENDOSCOPY 24 (6) 479 - 479 0915-5635 2012/11 [Refereed][Not invited]
  • Yukihiro Sato, Hiroyuki Sato, Keisuke Naka, Satoshi Furuya, Haruhisa Tsukiji, Koji Kitagawa, Yoshihide Sonoda, Takanobu Usui, Hirotsugu Sakamoto, Sumi Yoshino, Yuko Shimizu, Masaharu Takahashi, Shigeo Nagashima, Jirintai, Tsutomu Nishizawa, Hiroaki Okamoto
    ARCHIVES OF VIROLOGY 156 (8) 1345 - 1358 0304-8608 2011/08 [Refereed][Not invited]
     
    To investigate the nationwide prevalence of hepatitis E virus (HEV) infection and to characterize HEV genomes among Japanese wild boars (Sus scrofa leucomystax), 578 boars captured in 25 prefectures from 2003 to 2010 were studied. Anti-HEV IgG was detected in 8.1%, and HEV RNA in 3.3% of boars. Among the 19 boar HEV isolates obtained from infected boars, 14 isolates (74%) were classified as genotype 3, 4 isolates (21%) as genotype 4, and the remaining isolate (wbJOY_06) was distantly related to all known HEV isolates of genotypes 1-4, differing by 18.4-25.0% and 18.0-24.3% within the 412-nucleotide sequence of ORF1 and ORF2, respectively. A genotype 4 boar HEV isolate (wbJGF_08-1) obtained herein shared 98.6% identity over the entire genome with a human HEV isolate obtained from a patient who developed acute hepatitis after consuming undercooked wild boar meat, suggesting that wild boars are also reservoirs for genotype 4 HEV in humans.
  • Hirotsugu Sakamoto, Hironori Yamamoto, Yoshikazu Hayashi, Tomonori Yano, Tomohiko Miyata, Naoyuki Nishimura, Hakuei Shinhata, Hiroyuki Sato, Keijiro Sunada, Kentaro Sugano
    GASTROINTESTINAL ENDOSCOPY 74 (2) 328 - 333 0016-5107 2011/08 [Refereed][Not invited]
     
    Background: The major problem in the management of Peutz-Jeghers syndrome (PJS) is small-bowel polyps, which can cause intussusception and bleeding. Double-balloon endoscopy (DBE) enables endoscopic resection of small-bowel polyps. Objective: The aim of this study was to determine the efficacy and safety of endoscopic management of small-bowel polyps in PJS patients by using DBE. Design: Retrospective chart review. Setting: Single university hospital. Patients: Consecutive patients with PJS who underwent multiple sessions of DBE for evaluation or treatment of small-bowel polyps between September 2000 and April 2009. Interventions: Endoscopic resection of small-bowel polyps in PJS patients was performed by using DBE. Main Outcome Measurements: Efficacy, safety, and long-term laparotomy rate after the procedures were evaluated. Results: Fifteen patients (10 men, mean age 34.0 +/- 15.8 years) underwent DBE for a mean 3.0 +/- 1.0 sessions. The mean numbers of resected polyps larger than 20 mm significantly decreased as sessions advanced (first, 3.6; second, 1.3; third, 0.7; fourth, 0.4; and fifth, 1.0; P = .02). The mean maximum sizes of resected polyps also significantly decreased at each session: 33, 19, 12, 17, and 30 mm (P = .01). One patient had a perforation, but was managed conservatively. Other complications were pancreatitis (n = 2) and bleeding (n = 2). Only 1 patient underwent surgery for intussusception during the study period. Limitations: This was a small single-center retrospective study of short duration. Conclusions: Endoscopic management of small-bowel polyps in PJS patients by using DBE is safe and effective and avoids urgent laparotomy. (Gastrointest Endosc 2011;74:328-33.)
  • Hirotsugu Sakamoto, Hiroyuki Mutoh, Hiroko Hayakawa, Miho Sashikawa, Kentaro Sugano
    JOURNAL OF GASTROENTEROLOGY 46 (5) 620 - 628 0944-1174 2011/05 [Refereed][Not invited]
     
    Gene expression in the early stage of the transition to intestinal metaplasia in human gastric mucosa has not been determined. In this study, we investigated the temporal relationship between cell lineage changes and intestine-specific gene expression in the process leading to intestinal metaplasia, using Cdx2-transgenic mice. Cellular phenotypes were analyzed by immunohistochemistry and were compared with the gene expression profiles of cell lineage markers by real-time polymerase chain reaction. Up to postnatal day (PD) 20, the gastric mucosae of Cdx2-transgenic mice were histologically similar to those of their normal littermates. However, at approximately PD 20, we observed the sporadic appearance of glands in which all the epithelial cells expressed Cdx2 (Cdx2-diffuse positive glands). In the Cdx2-diffuse positive glands, parietal cells had disappeared, the proliferating zone had moved from the isthmus to the base, and absorptive cells and goblet cells were recognized. In contrast, the surrounding mucosa retained the phenotype of the gastric gland in which only some of the epithelial cells expressed Cdx2. During PDs 30 and 40, the entire fundic mucosa changed to transdifferentiated mucosa that was a composite of intestinal metaplasia and spasmolytic polypeptide-expressing metaplasia. An increase in the expression of intestine-specific genes, with a reciprocal decrease in gastric-specific gene expression, began much earlier than the emergence of Cdx2-diffuse positive glands. A dramatic increase in intestine-specific gene expression precedes the morphological appearance of intestinal metaplasia and spasmolytic polypeptide-expressing metaplasia.
  • Hirotsugu Sakamoto, Hiroyuki Mutoh, Kentaro Sugano
    SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY 45 (11) 1273 - 1280 0036-5521 2010/11 [Refereed][Not invited]
     
    Objective. Cdx2 is expressed in human intestinal metaplastic mucosa and induces intestinal metaplastic mucosa in Cdx2-transgenic mouse stomach. Claudin-2 is a structural component of tight junctions in the intestine and Cdx2 activates the Claudin-2 promoter in the human intestinal epithelial cell line Caco-2. Our aim is to evaluate the expression of Claudin-2 in intestinal metaplastic mucosa of Cdx2-transgenic mouse stomach. Material and methods. The Claudin-2 expression in the normal gastric mucosa and normal intestinal mucosa of wild type mice and the intestinal metaplastic mucosa of Cdx2-transgenic mice was analyzed by immunohistochemistry, Western blotting and quantitative real-time PCR (qRT-PCR). Results. Claudin-2 was expressed in the base of the glands in intestine and intestinal metaplasia while it was not expressed in the body of stomach. Claudin-2 expression was found in the antrum of stomach, while it was weaker than that in the intestine and the intestinal metaplasia. Claudin-2 was also detected in intestinal metaplasia, colon and ileum by both Western blotting and qRT-PCR while it was not detected in gastric body. Conclusion. These results suggest that Cdx2 plays an important role in the expression of Claudin-2 in vivo.
  • Hiroyuki Mutoh, Hiroko Hayakawa, Miho Sashikawa, Hirotsugu Sakamoto, Kentaro Sugano
    BIOCHEMICAL JOURNAL 427 423 - 434 0264-6021 2010/05 [Refereed][Not invited]
     
    Shh (Sonic Hedgehog) is a morphogen involved in gastric fundic gland differentiation in the adult. Shh expression is reduced in Helicobacter pylori-associated intestinal metaplastic change of the gastric epithelium and mice that lack Shh show intestinal transformation of the gastric mucosa. Similarly, in the stomach of Cdx2 (caudal-type homeobox 2)-transgenic mice, the gastric mucosa is replaced by intestinal metaplastic mucosa. The aim of the present study was to use Cdx2-transgenic mice to investigate: (i) Shh expression in the intestinal metaplastic mucosa of the Cdx2-transgenic mouse stomach; and (ii) the relationship between Shh and Cdx2. We determined that Shh mRNA levels were dramatically reduced in the intestinal metaplastic mucosa of the Cdx2-transgenic mouse stomach compared with the normal (wild-type) mouse stomach. This was not due to hypermethylation of the Shh promoter, but instead we showed that Cdx2 directly bound to the TATA box region of the Shh promoter. Cdx2 also down-regulated transcription of the Shh gene in the human gastric carcinoma cell lines AGS, MKN45 and MKN74. In conclusion, Cdx2 reduced Shh expression by binding to the unmethylated Shh promoter in the intestinal metaplastic mucosa of Cdx2-transgenic mouse stomach.
  • Hirotsugu Sakamoto, Hiroyuki Mutoh, Kenichi Ido, Shin Satoh, Machio Kumagai, Hiroko Hayakawa, Kiichi Tamada, Kentaro Sugano
    HUMAN PATHOLOGY 40 (12) 1762 - 1767 0046-8177 2009/12 [Refereed][Not invited]
     
    We reported previously that intestinal metaplasia in the gallbladder is strongly associated with expression of caudal-related homeobox transcription factor Cdx2. It has been documented that occult pancreatobiliary reflux, even in the absence of pancreaticobiliary maljunction, is associated with elevated risk of biliary malignancy. We ascertained the correlation between intestinal metaplasia in the gallbladder and occult pancreatobiliary reflux. In 196 patients with a normal pancreaticobiliary ductal arrangement who had undergone laparoscopic cholecystectomy, we performed intraoperative cholangiography and measured amylase levels in bile sampled from the gallbladder. The cutoff value for high cystic amylase was defined as a biliary amylase level higher than the normal upper limit of serum amylase (215 IU/L). We also retrospectively reviewed the cholecystectomized tissue specimens to investigate the presence of intestinal metaplasia and expression of Cdx2. Then, we explored the relationship between intestinal metaplasia in the gallbladder and occult choledocho-pancreatic reflux. Intestinal metaplasia was found in 16.8% (33/196) of the gallbladders. The prevalence of choledochopancreatic reflux revealed by intraoperative cholangiography was not significantly different between cases with intestinal metaplasia (5/33, 15.2%) and those without (25/163, 15.3%; P = .81). However, in cases with intestinal metaplasia, the rate of high cystic amylase (13/33, 39.4%) was significantly higher compared with cases without intestinal metaplasia (26/163, 16.0%, P = .005). In conclusion, intestinal metaplasia in the gallbladder is significantly correlated with high amylase levels in bile in patients with a morphologically normal pancreaticobiliary ductal arrangement. (C) 2009 Published by Elsevier Inc.
  • Hiroyuki Mutoh, Hiroko Hayakawa, Hirotsugu Sakamoto, Miho Sashikawa, Kentaro Sugano
    FEBS JOURNAL 276 (20) 5821 - 5831 1742-464X 2009/10 [Refereed][Not invited]
     
    Cdx1 and Cdx2, which are transcription factors regulating normal intestinal development, have been studied as potential key molecules in the pathogenesis of the precancerous intestinal metaplasia of the human stomach. However, the regulation of Cdx1 expression in the intestinal metaplasia is poorly understood. Cdx2-expressing gastric mucosa of Cdx2-transgenic mouse stomach was replaced by intestinal metaplastic mucosa. The aim of this study was to investigate the following: (a) Cdx1 expression in the intestinal metaplastic mucosa of the Cdx2-transgenic mouse stomach; and (b) the relationship between Cdx1 and Cdx2. A mouse model of intestinal metaplasia, the Cdx2-transgenic mouse, was used to investigate Cdx1 gene expression by RT-PCR. DNA methylation pro. le analysis was performed by bisulfite sequencing, and the interaction of Cdx2 with the Cdx1 promoter was examined by chromatin immunoprecipitation assay, electrophoretic mobility shift assay, and luciferase reporter assays. Cdx2 mRNA was expressed in the Cdx2-transgenic mouse stomach. However, endogenous Cdx2 mRNA was not expressed in the intestinal metaplasia of the Cdx2-transgenic mouse stomach. On the other hand, endogenous Cdx1 mRNA and protein were expressed in the intestinal metaplasia of the Cdx2-transgenic mouse stomach. The Cdx1 promoter was unmethylated in the intestinal metaplasia of the Cdx2-transgenic mouse stomach. Chromatin immunoprecipitation assay and electrophoretic mobility shift assay showed that Cdx2 was bound to the Cdx1 promoter region in the intestinal metaplasia and the normal intestine. Cdx2 upregulated and siRNA-Cdx2 downregulated the transcriptional activity of the Cdx1 gene in the human gastric carcinoma cell lines AGS, MKN45, and MKN74. In conclusion, transgenic Cdx2 induced endogenous Cdx1 through the binding of Cdx2 to the unmethylated Cdx1 promoter region in the intestinal metaplasia of the Cdx2-transgenic mouse stomach.
  • Hiroyuki Mutoh, Hiroko Hayakawa, Hirotsugu Sakamoto, Kentaro Sugano
    JOURNAL OF GASTROENTEROLOGY 42 (9) 719 - 729 0944-1174 2007/09 [Refereed][Not invited]
     
    Background. While cyclooxygenase-2 (COX-2) is not normally expressed by epithelial cells lining the human colon, COX-2 protein is aberrantly overexpressed in premalignant adenomatous polyps and carcinomas of the human colon. On the other hand, Cdx2 has been identified as a colonic tumor-suppressor gene, besides its role in cell differentiation. However, the relationship between CDX2 attenuation and COX-2 overexpression in colorectal carcinoma has not been established. Here, we investigated the mechanistic link between CDX2 downregulation and COX-2 upregulation. Methods. Gene expression was examined by immunoblotting, reverse transcription-polymerase chain reaction, and promoter analysis. Promoter transactivation was quantified by using a luciferase construct. DNA binding of nuclear factor-kappa B (NF-kappa B) was examined by electromobility shift analysis. Results. CDX2 decreased expression of COX-2 mRNA and protein at the transcriptional level in the human colon cancer Caco-2 cell line. Though p50/p65 NF-kappa B translocated into nucleus in the presence of CDX2, CDX2 interacted with p50/p65 NF-kappa B and impeded the formation of an NF-kappa B-DNA complex, required for promotion of Cox-2 transcription. Conclusion. The results indicate that CDX2 inhibits transcription of Cox-2 by interfering with the binding of NF-kappa B on the NF-kappa B binding site.
  • Hirotsugu Sakamoto, Hiroyuki Mutoh, Kenichi Ido, Kiichi Satoh, Hiroko Hayakawa, Kentaro Sugano
    HUMAN PATHOLOGY 38 (1) 66 - 71 0046-8177 2007/01 [Refereed][Not invited]
     
    We previously reported a case of a human gallbladder with cholelithiasis consisting of intestinal metaplasia with the expression of caudal-related homeobox transcription factor (Cdx2). However, it is unclear how often intestinal metaplasia and Cdx2 expression occur in human, nontumorous gallbladders with cholelithiasis. We studied the incidence of intestinal metaplasia and Cdx2 expression in human gallbladders with cholelithiasis. Gallbladders were resected under laparoscopy from 103 patients with cholelithiasis between September 2003 and March 2005. The mean age of the patients was 59.6 +/- 15.0 years (range, 22-92 years). We retrospectively reviewed these cases to look for the presence of intestinal metaplasia and the expression of Cdx2. In addition, the characteristics of intestinal metaplasia were examined by immunostaining for Muc2, chromogranin A, and serotonin. Intestinal metaplasia was found in 11.7% (12/103) of the gallbladders with cholelithiasis. The mean ages of patients with and without intestinal metaplasia were 60.8 +/- 15.4 and 59.4 +/- 14.9 years, respectively. Cdx2, Muc2, chromogranin A, and serotonin were expressed in 91.7% (11/12), 91.7% (11/12), 83.3% (10/12), and 50.0% (6/12) in intestinal metaplastic mucosa, respectively. Only one case (1.1%) that expressed Cdx2 without intestinal metaplasia did not express Muc2, chromogranin A, and serotonin. We found that 10.7% (11/103) of nontumorous gallbladders resected because of cholelithiasis under laparoscopy revealed intestinal metaplasia with Cdx2 expression. (c) 2007 Elsevier Inc. All rights reserved.
  • H Mutoh, H Sakamoto, H Hayakawa, Y Arao, K Satoh, M Nokubi, K Sugano
    DIFFERENTIATION 74 (6) 313 - 321 0301-4681 2006/07 [Refereed][Not invited]
     
    The basic helix-loop-helix transcription factor Math1, which is transiently expressed in proliferating neural precursors in multiple domains of the developing nervous system, is also related to the cell fate decision of enteroendocrine, goblet, and Paneth cells in the intestine. On the other hand, the transcription factor Cdx2, which is normally confined to intestinal epithelial cells, is related to the differentiation of these cells. Therefore, we investigated the relationship between Math1 and Cdx2 in intestinal epithelial cells. The Math1 and Cdx2 expressions in normal intestinal mucosa and intestinal metaplastic mucosa from mouse and human stomachs, as well as an intestinal crypt-derived cell line, were analyzed by immunohistochemistry, reverse transcription-polymerase chain reaction and Northern blotting, and Math1 enhancer element was analyzed by luciferase reporter assays. Math1-positive epithelial cells co-expressing Cdx2 were found in normal intestinal mucosa from humans and mice. Furthermore, Math1-producing epithelial cells that showed positive immunostaining for Cdx2 were also observed in intestinal metaplastic mucosa from human and Cdx2 transgenic mouse stomachs, although they were not detected in normal gastric mucosa of humans and mice. Expression of Cdx2 stimulated endogenous Math1 mRNA expression in the intestinal crypt-derived cell line IEC-6, corroborating observations in Cdx2-expressing intestinal metaplastic mucosa. Furthermore, expression of Cdx2 in IEC-6 cells conferred the ability to express a Math1 reporter gene containing a Math1 enhancer. Based on these results, we hypothesize that Cdx2 is involved in activating Math1 expression in intestinal epithelial cells.
  • T Nishizawa, M Takahashi, K Endo, S Fujiwara, N Sakuma, F Kawazuma, H Sakamoto, Y Sato, M Bando, H Okamoto
    JOURNAL OF GENERAL VIROLOGY 86 3321 - 3326 0022-1317 2005/12 [Refereed][Not invited]
     
    Two (2.3%) of 87 wild-caught boars in Japan had detectable hepatitis E virus (HEV) RNA. The two boar HEV isolates (wbJTS1 and wbJYG1) obtained in the present study and a previously reported isolate (wbJSGi) whose partial sequence had been determined were sequenced over the entire genome, The wbJSG1, wbJTS1 and wbJYG1 isolates comprised 7225 or 7226 nt, excluding the poly(A) tail, and segregated into genotype 3. They differed by 8.5-11.2 % from each other and by 8.6-18.4 % from 17 reported genotype 3 HEV isolates, including one boar isolate, in the full-length sequence. When compared with 191 reported genotype 3 HEV isolates whose partial sequences were known, these three boar isolates were closer to Japanese isolates than to isolates of non-Japanese origin (89.2 +/- 2.6 vs 85.9 +/- 2.2 %; P < 0.0001). A proportion of wild boars in Japan are infected with markedly heterogeneous HEV strains that are indigenous to Japan and may serve as reservoirs of HEV.
  • H Mutoh, K Satoh, H Kita, H Sakamoto, H Hayakawa, H Yamamoto, N Isoda, K Tamada, K Ido, K Sugano
    INTERNATIONAL JOURNAL OF DEVELOPMENTAL BIOLOGY 49 (7) 867 - 871 0214-6282 2005 [Refereed][Not invited]
     
    Many transcription factors are involved in the molecular control of intestinal epithelial cell differentiation. We report in this study that the transcription factor Cdx2 functions to define absorptive enterocytes during intestinal epithelial differentiation. Cdx2 is expressed in the villi of the normal small intestine. Intestinal metaplasia, which expresses Cdx2, occurs as a pathological condition in gastric mucosa. We have previously established Cdx2transgenic mice expressing Cdx2 exclusively in the gastric epithelium. In this study using Cdx2 transgenic mice, we show that Cdx2 plays a key role in the differentiation of intestinal absorptive enterocytes. The gastric mucosa of Cdx2 transgenic mice was morphologically completely changed into intestinal metaplastic mucosa. Absorptive enterocytes had microvilli which were observed by electron microscope. The intestinal metaplastic mucosa of Cdx2 transgenic mice expressed sucrase and peptide transporter PepT1. Disaccharidase and leucine aminopeptidase activities were observed in the intestinal metaplastic mucosa. Glucose and amino acids were absorbed from Cdx2 transgenic mouse stomach with intestinal metaplasia. Finally we generated mice whose intestine was extensively excised. Cdx2 transgenic mice with intestinal metaplasia survived even after extensive intestinal excision. We successfully demonstrated that Cdx2 induced not only morphological but also functional absorptive enterocytes in the intestinal metaplastic mucosa in vivo. Our results suggest that Cdx2 is necessary and sufficient by itself to specify the development of intestinal absorptive enterocytes, whereas other factors which are expressed in the small intestine are not always necessary for the differentiation of functional absorptive enterocytes.

MISC

  • 小黒 邦彦, 矢野 智則, 永山 学, 坂本 博次, 山本 博徳  Progress of Digestive Endoscopy  99-  (Suppl.)  s85  -s85  2021/06
  • クローン病に対するCAST hoodを用いたhigh qualityなダブルバルーン内視鏡
    永山 学, 矢野 智則, 関谷 万理子, 矢野 慶太郎, 北村 昌史, 小黒 邦彦, Dashnyam Ulzii, Khurelbaatar Tsevelnorov, 坂本 博次, 林 芳和, 砂田 圭二郎, 山本 博徳  日本大腸検査学会雑誌  37-  (2)  102  -112  2021/04  
    慢性炎症性腸疾患の一つであるクローン病は主に小腸と大腸を侵す疾患であり、大腸内視鏡で到達困難な小腸にも病変が多い。バルーン小腸内視鏡は診断のみならず、狭窄に対する内視鏡的バルーン拡張術(endoscopic balloon dilation;EBD)を施行することができ、これにより外科的切除を回避もしくは遅らせることができる。CASThood(calibrated small-caliber-tip transparent hood)は腸管狭窄に対して開発されたバルーン内視鏡用フードで、狭窄内径の正確な測定が可能で、先端細径によるブジー効果や高い挿入効率が期待でき、効率的なEBDを可能にする。多数の小腸狭窄が存在する場合には連続的に多くの狭窄をEBDする必要があり、そのためには適切なデバイスとストラテジーを用いる必要がある。日本を含む東アジア諸国ではクローン病の症例は増加しており、小腸内視鏡の必要性はさらに高まると思われる。(著者抄録)
  • 苦痛のない大腸検査の工夫 ゴム栓を併用したwater exchange法による大腸内視鏡検査
    小黒 邦彦, 矢野 智則, 関谷 万理子, 北村 昌史, 宮原 晶子, 永山 学, 坂本 博次, 林 芳和, 砂田 圭二郎, 山本 博徳  日本大腸検査学会雑誌  37-  (2)  116  -116  2021/04
  • IBD診療における内視鏡の役割 クローン病に対するCAST hoodを用いたhigh quality内視鏡
    永山 学, 矢野 智則, 関谷 万理子, 小黒 邦彦, 北村 昌史, 坂本 博次, 林 芳和, 砂田 圭二郎, 山本 博徳  日本大腸検査学会雑誌  37-  (2)  118  -118  2021/04
  • 矢野 智則, 永山 学, 坂本 博次, 北村 昌史, 小黒 邦彦, 宮原 晶子, 砂田 圭二郎, 山本 博徳  消化器内視鏡  33-  (4)  728  -733  2021/04
  • Peutz-Jeghers症候群に対するダブルバルーン内視鏡、カプセル内視鏡とCT enterographyを用いた治療戦略
    小黒 邦彦, 矢野 智則, Khurelbaatar Tsevelnorov, Dashnyam Ulzii, 関谷 万理子, 北村 昌史, 宮原 晶子, 永山 学, 坂本 博次, 砂田 圭二郎, 山本 博徳  日本消化管学会雑誌  5-  (Suppl.)  130  -130  2021/01
  • 小黒 邦彦, 坂本 博次, 北村 昌史, 永山 学, 矢野 智則  Progress of Digestive Endoscopy  98-  (Suppl.)  s85  -s85  2020/12
  • 舌接触補助床および人工舌が口底癌術後患者の意欲改善、QOL向上につながった1例
    山川 道代, 高橋 浩二, 古内 三基子, 馬場 千恵子, 釜井 聡子, 長嶺 智重子, 茂木 さつき, 三輪田 哲郎, 坂本 博次, 倉科 憲太郎  学会誌JSPEN  2-  (Suppl.1)  1263  -1263  2020/11
  • 基礎から臨床へ:栄養、腸内細菌 クローン病の小腸細菌叢解析から同定されたクローン病関連大腸菌は腸炎誘導能を有する
    永山 学, 矢野 智則, 関谷 万理子, 坂本 博次, 三浦 光一, 砂田 圭二郎, 河口 貴昭, 森田 覚, 本田 賢也, 山本 博徳  日本小腸学会学術集会プログラム・抄録集  58回-  33  -33  2020/10
  • 矢野 智則, 坂本 博次, 永山 学, 宮原 晶子, 小黒 邦彦, 北村 昌史, 林 芳和, 砂田 圭二郎, 山本 博徳  Intestine  24-  (3)  208  -212  2020/08  
    <文献概要>キャストフードは,狭窄の内径を計測可能とする目盛りが側面に刻まれた先端細径フードである.これを使用することで,無送気でも視野確保が容易で,適切なサイズの拡張用バルーンを選択でき,ガイドワイヤの挿入も容易となり,バルーン拡張後のスコープ通過も容易となる.無送気での腸間膜付着側の病変観察も,透明なフード側面を透して容易に可能であり,有用である.
  • 砂田 圭二郎, Khurelbaatal Tsevelnorov, 坂本 博次, 矢野 智則, 山本 博徳  Intestine  24-  (3)  244  -247  2020/08  
    <文献概要>クローン病小腸狭窄性病変に対する内視鏡的バルーン拡張術(EBD)は,腸管を温存する有効な方法として,バルーン内視鏡の普及とともに徐々に広がりを見せている.EBD中およびEBD後の出血は,頻度が低いものの報告されている.予防のためには,狭窄部に深い潰瘍が存在する場合などのEBD除外基準を正しく守ることが必要である.出血を認めた際には,自然止血も期待できるが,持続する場合は内視鏡下のクリップ留置など止血術を考慮する必要がある.
  • 矢野 智則, 坂本 博次, 永山 学, 宮原 晶子, 小黒 邦彦, 北村 昌史, 林 芳和, 砂田 圭二郎, 山本 博徳  Intestine  24-  (3)  208  -212  2020/08  
    <文献概要>キャストフードは,狭窄の内径を計測可能とする目盛りが側面に刻まれた先端細径フードである.これを使用することで,無送気でも視野確保が容易で,適切なサイズの拡張用バルーンを選択でき,ガイドワイヤの挿入も容易となり,バルーン拡張後のスコープ通過も容易となる.無送気での腸間膜付着側の病変観察も,透明なフード側面を透して容易に可能であり,有用である.
  • 砂田 圭二郎, Khurelbaatal Tsevelnorov, 坂本 博次, 矢野 智則, 山本 博徳  Intestine  24-  (3)  244  -247  2020/08  
    <文献概要>クローン病小腸狭窄性病変に対する内視鏡的バルーン拡張術(EBD)は,腸管を温存する有効な方法として,バルーン内視鏡の普及とともに徐々に広がりを見せている.EBD中およびEBD後の出血は,頻度が低いものの報告されている.予防のためには,狭窄部に深い潰瘍が存在する場合などのEBD除外基準を正しく守ることが必要である.出血を認めた際には,自然止血も期待できるが,持続する場合は内視鏡下のクリップ留置など止血術を考慮する必要がある.
  • 小黒 邦彦, 坂本 博次, 三浦 義正, 矢野 智則, 山本 博徳  消化器内視鏡  32-  (7)  965  -970  2020/07  
    十二指腸水平部・上行部の内視鏡観察は、バルーン内視鏡(BAE)やカプセル内視鏡(CE)の開発によって、容易に行えるようになった。BAE、CEを用いなくても従来の上部消化管内視鏡で十二指腸水平部・上行部を観察することは可能であるが、それぞれの特徴をふまえ、目的や部位に応じて適切に検査の選択をする必要性がある。十二指腸は他の臓器に比較すると疾患の頻度が低く、水平部・上行部においては特に低いが、腫瘍性病変から非腫瘍性病変まで多彩な病変がみられる。近年十二指腸病変の症例数は徐々に増えてきていることから、スクリーニングでも、可能なかぎりこの部位も観察すべきである。特に留意すべき疾患として、十二指腸腺腫・癌、悪性リンパ腫、GIST(消化管間質腫瘍)、また全身疾患に伴う病変などがあげられる。十二指腸水平部・上行部の観察はルーチンでは行われないため、進行例で発見されることも多い。この部位をどう観察計断すべきであるか検討するため、今後さらに症例を集積する必要がある。(著者抄録)
  • 【十二指腸はこう診る】十二指腸への内視鏡挿入と観察の実際 十二指腸水平部・上行部の観察と診断
    小黒 邦彦, 坂本 博次, 三浦 義正, 矢野 智則, 山本 博徳  消化器内視鏡  32-  (7)  965  -970  2020/07  
    十二指腸水平部・上行部の内視鏡観察は、バルーン内視鏡(BAE)やカプセル内視鏡(CE)の開発によって、容易に行えるようになった。BAE、CEを用いなくても従来の上部消化管内視鏡で十二指腸水平部・上行部を観察することは可能であるが、それぞれの特徴をふまえ、目的や部位に応じて適切に検査の選択をする必要性がある。十二指腸は他の臓器に比較すると疾患の頻度が低く、水平部・上行部においては特に低いが、腫瘍性病変から非腫瘍性病変まで多彩な病変がみられる。近年十二指腸病変の症例数は徐々に増えてきていることから、スクリーニングでも、可能なかぎりこの部位も観察すべきである。特に留意すべき疾患として、十二指腸腺腫・癌、悪性リンパ腫、GIST(消化管間質腫瘍)、また全身疾患に伴う病変などがあげられる。十二指腸水平部・上行部の観察はルーチンでは行われないため、進行例で発見されることも多い。この部位をどう観察計断すべきであるか検討するため、今後さらに症例を集積する必要がある。(著者抄録)
  • 坂本 博次, 山本 博徳  救急医学  44-  (7)  876  -881  2020/06
  • 小黒 邦彦, 矢野 智則, 宮原 晶子, 坂本 博次, 山本 博徳  Progress of Digestive Endoscopy  97-  (Suppl.)  s81  -s81  2020/05
  • 宮原 晶子, 矢野 智則, 竹澤 敬人, 坂本 博次, 山本 博徳  Progress of Digestive Endoscopy  97-  (Suppl.)  s91  -s91  2020/05
  • フレルバータルツェベルノロフ, 小林 泰俊, 矢野 智則, 坂本 博次, 砂田 圭二郎, 木原 淳, 仁木 利郎, 新井 由季, 山本 博徳  Progress of Digestive Endoscopy  97-  (Suppl.)  s128  -s128  2020/05
  • 小腸腫瘍の診療の実際:診断から内視鏡治療、手術治療、化学療法まで 小腸GISTの診断におけるDynamic CTの有用性
    北村 昌史, 矢野 智則, 小林 泰俊, 坂本 博次, 砂田 圭二郎, 山本 博徳  日本消化管学会雑誌  4-  (Suppl.)  229  -229  2020/01
  • 三輪田 哲郎, 矢野 智則, 小林 泰俊, 坂本 博次, 山本 博徳  Progress of Digestive Endoscopy  96-  (Suppl.)  s75  -s75  2019/12
  • 胸腺腫を合併した自己免疫性腸炎による難治性下痢症が疑われた1例
    澁谷 優子, 小林 泰俊, 坂本 博次, 大森 彩子, 高橋 治夫, 三浦 義正, 林 芳和, 矢野 智則, 砂田 圭二郎, 山本 博徳  日本消化器病学会関東支部例会プログラム・抄録集  357回-  45  -45  2019/12
  • 櫻井 祐輔, 坂本 博次, 矢野 智則, 砂田 圭二郎, 山本 博徳  Progress of Digestive Endoscopy  95-  (1)  72  -74  2019/12  
    21歳男。発熱、腹痛を主訴とした。4ヵ月前より続く食思不振と腹痛、1ヵ月前より続く発熱にて近医を受診し、下部消化管内視鏡で回盲部中心に高度狭窄を伴う潰瘍を認めた。経肛門的ダブルバルーン内視鏡では回盲部に潰瘍を伴う開口部2ヵ所を認め、一方は約10cmの狭窄、もう一方は回腸末端に繋がる内瘻形成を伴っており、上行結腸粘膜からの生検で非乾酪性類上皮肉芽腫を認めた。疑診に該当するものの中等症のCrohn病として治療を開始し、栄養療法と生物学的製剤の併用により全身状態は安定していた。また、内視鏡的バルーン拡張術(EBD)を繰り返すことで腸閉塞症状なく狭窄部の粘膜治癒と内瘻閉鎖が得られ、初診から18ヵ月後には15mmまで拡張してスコープ通過可能なまでに改善した。以後腸閉塞所見なく寛解を維持しており、初回EBDから30ヵ月間手術を回避できている。
  • 消化管出血の診断・治療の進歩-現状と課題- 下部消化管出血に対するGel immersion endoscopyによる視野確保
    三輪田 哲郎, 矢野 智則, 小林 泰俊, 坂本 博次, 山本 博徳  Progress of Digestive Endoscopy  96-  (Suppl.)  s75  -s75  2019/12  [Not refereed][Not invited]
  • ダブルバルーン内視鏡にて診断した盲係蹄症候群の長期経過に関する検討
    上野 貴, 坂本 博次, 矢野 智則, 櫻井 祐輔, 関谷 万理子, 宮原 晶子, 小林 泰俊, Khurelbaatar Tsevelnorov, Dashyam Ulzii, 砂田 圭二郎, 山本 博徳  日本小腸学会学術集会プログラム・抄録集  57回-  47  -47  2019/11
  • 北村 昌史, 矢野 智則, 所 晋之助, 小林 泰俊, 坂本 博次, 砂田 圭二郎, 山本 博徳, 松原 大祐  日本消化器病学会雑誌  116-  (臨増大会)  A764  -A764  2019/11
  • 【消化管感染症のすべて】回盲部・大腸・肛門 細菌感染症 慢性感染症 腸管スピロヘータ症
    竹澤 敬人, 池田 恵理子, 坂本 博次  消化器内視鏡  31-  (増刊)  226  -229  2019/10
  • 【大腸腫瘍の内視鏡治療戦略-攻めるか、引くか?】腺腫の治療方針 腺腫でも2cm以上は一括切除が必要か? Yes
    竹澤 敬人, 林 芳和, 相良 裕一, 岡田 昌浩, 福田 久, 宇賀神 ららと, 坂本 博次, リー・ラルフ, 砂田 圭二郎, 山本 博徳  消化器内視鏡  31-  (10)  1518  -1522  2019/10  [Not refereed][Not invited]
  • 竹澤 敬人, 林 芳和, 相良 裕一, 岡田 昌浩, 福田 久, 宇賀神 ららと, 坂本 博次, リー・ラルフ, 砂田 圭二郎, 山本 博徳  消化器内視鏡  31-  (10)  1518  -1522  2019/10  [Not refereed][Not invited]
  • 【消化管感染症のすべて】回盲部・大腸・肛門 細菌感染症 慢性感染症 腸管スピロヘータ症
    竹澤 敬人, 池田 恵理子, 坂本 博次  消化器内視鏡  31-  (増刊)  226  -229  2019/10  [Not refereed][Not invited]
  • 三浦 義正, 竹澤 敬人, 坂本 博次, 林 芳和, 砂田 圭二郎, 山本 博徳  消化器内視鏡  31-  (7)  1061  -1063  2019/07  [Not refereed][Not invited]
  • 難治性潰瘍性大腸炎に漢方薬(含青黛)が著効した一例
    上野 航, 高橋 治夫, 平岡 友二, 福田 久, 角田 真人, 小林 泰俊, 坂本 博次, 砂田 圭二郎, 天野 國幹, 山本 博徳  日本消化器病学会関東支部例会プログラム・抄録集  355回-  40  -40  2019/07  [Not refereed][Not invited]
  • 森川 昇玲, 坂本 博次, 矢野 智則, 所 晋之助, 関谷 万理子, 相良 裕一, 船山 陽平, 関口 裕美, 山下 晋平, 上野 貴, 濱田 嵩史, Tsevelnorov Khurelbaatal, 砂田 圭二郎, 山本 博徳  Progress of Digestive Endoscopy  95-  (Suppl.)  s114  -s114  2019/06  [Not refereed][Not invited]
  • 篠崎 聡, 小林 泰俊, 林 芳和, 坂本 博次, アラン瓦井 レフォー, 山本 博徳  Gastroenterological Endoscopy  61-  (6)  1272  -1281  2019/06  [Not refereed][Not invited]
     
    【背景と目的】大腸ポリープに対する内視鏡的切除において、熱凝固を加えないでスネアで切除するコールドスネアポリペクトミー(CSP)と熱凝固を加えながらスネアで切除するホットスネアポリペクトミー(HSP)の比較研究がなされてきた。CSPとHSPの有効性と安全性をシステマティックレビューとメタ解析を用いて評価した。【方法】大腸ポリペクトミーに関してCSPとHSPを比較したランダム化比較研究(RCT)のみを解析の対象とした。評価項目は、完全切除率、ポリープ回収率、遅発性出血率、穿孔率および所要時間である。Mantel-Haenszel random effect modelを用いてpooled risk ratio(RR)と95%信頼区間(CI)を算出した。【結果】8つのRCT(症例数1,665名、切除ポリープ3,195個)に対しメタ解析を行った。完全切除率において、CSPとHSPは同程度であった(RR1.02、95% CI 0.98-1.07、p=0.31)。ポリープ回収率もCSPとHSPは同程度であった(RR1.00、95% CI 1.00-1.01、p=0.60)。遅発性出血率は、統計学的有意差を認めなかったもののHSPのほうがCSPより多い傾向にあった(症例単位:RR7.53、95% CI 0.94-60.24、p=0.06、ポリープ単位:RR7.35、95% CI 0.91-59.33、p=0.06)。すべてのRCTで穿孔は報告されなかった。大腸内視鏡時間はHSPでCSPより有意に長かった(平均差7.13分、95% CI 5.32-8.94、p<0.001)。ポリペクトミー時間もHSPでCSPより有意に長かった(平均差30.92秒、95% CI 9.15-52.68、p=0.005)。【結論】今回のメタ解析ではHSPと比較してCSPで所要時間が有意に短かった。また、遅発性出血率もHSPと比べてCSPで低い傾向にあった。したがって、小さな大腸ポリープに対するポリペクトミーにおいてCSPを標準的治療として推奨する。(著者抄録)
  • 原発性小腸癌30例の検討 ダブルバルーン内視鏡を活用してきた立場から
    根本 大樹, 矢野 智則, 坂本 博次, 小林 泰俊, 歌野 健一, 愛澤 正人, 五十畑 則之, 遠藤 俊吾, 冨樫 一智, 山本 博徳  日本大腸肛門病学会雑誌  72-  (5)  322  -322  2019/05  [Not refereed][Not invited]
  • 坂本 博次, 相良 裕一, 矢野 智則, 山本 博徳  臨床消化器内科  34-  (6)  640  -646  2019/05  [Not refereed][Not invited]
     
    <文献概要>Peutz-Jeghers症候群は,食道を除く消化管の過誤腫性ポリポーシス,口唇・口腔粘膜・指尖部を中心とする皮膚・粘膜の色素斑,常染色体優性遺伝を3主徴とする疾患である.原因遺伝子は癌抑制遺伝子のLKB1/STK11である.ポリープは粘膜上皮の過形成と粘膜筋板からの平滑筋線維束の樹枝状増生が特徴であり,小腸で増大したポリープにより腸重積をきたし,開腹手術が余儀なくされることが多い.近年ではバルーン内視鏡下でポリープに対する内視鏡的治療を定期的に行うことで手術を回避できるようになっているため,8歳までに消化管のサーベイランスを行うことが望ましい.消化器癌,乳癌,卵巣癌,子宮癌(最小偏倚腺癌),セルトリ細胞腫,肺癌等の悪性腫瘍合併発症リスクが高く,サーベイランスも重要である.
  • Linked color imaging(LCI)/Blue light imaging(BLI)で範囲/質的診断、Pocket-creation method(PCM)によるESDで一括切除しえたColitis-associated-cancer(CAC)の1例
    如水 慶嗣, 小林 泰俊, 林 芳和, 所 晋之助, 相良 裕一, 平岡 友二, 岩下 ちひろ, 角田 真人, 篠崎 聡, 竹澤 敬人, 坂本 博次, 岡田 昌浩, 矢野 智則, 砂田 圭二郎, 大澤 博之, 山本 博徳  日本消化器病学会関東支部例会プログラム・抄録集  354回-  31  -31  2019/04  [Not refereed][Not invited]
  • 宮原 晶子, 坂本 博次, 井野 裕治, 林 芳和, 矢野 智則, 宇賀神 ららと, 永山 学, 竹澤 敬人, 砂田 圭二郎, 山本 博徳  自治医科大学紀要  41-  47  -51  2019/03  [Not refereed][Not invited]
     
    症例は65歳女性。30歳頃から鼻出血を繰り返し、近医にて鉄欠乏性貧血に対して鉄剤投与されていた。貧血が悪化したため当科入院となった。小腸カプセル内視鏡にて空腸粘膜に矢野・山本分類type 1b相当のangioectasiaが多発し、血性腸液を認めた。手指に毛細血管拡張病変も認め、遺伝性出血性末梢血管拡張症と診断した。経口ダブルバルーン内視鏡下にangioectasiaに対するアルゴンプラズマ凝固術を施行したところ、貧血の改善を認めた。その後、6ヵ月から1年程度の間隔でカプセル内視鏡を施行している。Angioectasiaの数が明らかに増加し、貧血の進行を伴う際には、カプセル内視鏡で確認されたangioectasiaが多発している領域に集中して内視鏡的治療を行っている。遺伝性出血性末梢血管拡張症では内視鏡的治療を行った後もangioectasiaが再発するが、病変数と分布を把握するためのサーベイランスとしてカプセル内視鏡検査を行うことで、より侵襲の高い内視鏡的治療を行う回数と処置時間を低減できる可能性が示唆される。(著者抄録)
  • 矢野智則, 竹澤敬人, 橋元幸星, 大森彩子, 坂本博次, 砂田圭二郎, 山本博徳  日本消化管学会雑誌  3-  (Suppl.)  167  -167  2019/02  [Not refereed][Not invited]
  • 三浦義正, 矢野智則, 坂口美織, 井野裕治, 角田真人, TSEVELNOROV Khurelbaatar, 小林泰俊, 坂本博次, 林芳和, 砂田圭二郎, 大澤博之, 福嶋敬宜, 山本博徳  胃と腸  53-  (13)  1747‐1755  2018/12  [Not refereed][Not invited]
  • 小林 泰俊, 矢野 智則, 坂本 博次, 砂田 圭二郎, 山本 博徳  Progress of Digestive Endoscopy  94-  (Suppl.)  s72  -s72  2018/12  [Not refereed][Not invited]
  • 篠崎 聡, 大澤 博之, 小林 泰俊, 坂本 博次, 砂田 圭二郎  Progress of Digestive Endoscopy  94-  (Suppl.)  s74  -s74  2018/12  [Not refereed][Not invited]
  • 相良 裕一, 矢野 智則, 坂本 博次, 砂田 圭二郎, 山本 博徳  Progress of Digestive Endoscopy  94-  (Suppl.)  s80  -s80  2018/12  [Not refereed][Not invited]
  • 櫻井 祐輔, 坂本 博次, 船山 陽平, 関谷 万理子, 森川 昇玲, 上野 貴, 山下 晋平, 相良 裕一, 宮原 晶子, 平岡 友二, 所 晋之助, 東條 浩子, 小林 泰俊, 矢野 智則, 砂田 圭二郎, 山本 博徳  Progress of Digestive Endoscopy  94-  (Suppl.)  s114  -s114  2018/12  [Not refereed][Not invited]
  • 岡田 昌浩, 林 芳和, 坂本 博次, 竹澤 敬人, 矢野 智則, 砂田 圭二郎, 山本 博徳  Progress of Digestive Endoscopy  94-  (Suppl.)  s137  -s137  2018/12  [Not refereed][Not invited]
  • 砂田圭二郎, 篠崎聡, 竹澤敬人, 小林泰俊, 坂本博次, 林芳和, 矢野智則, 山本博徳  Intestine  22-  (6)  570‐575  2018/11  [Not refereed][Not invited]
  • 河合繁夫, 相良裕一, 坂本博次  日本病理学会会誌  107-  (2)  109  2018/10  [Not refereed][Not invited]
  • 腸管スピロヘータ症に治療は必要か?
    大和田 潤, 竹澤 敬人, 宮原 晶子, 平岡 友二, 福田 久, 岡田 昌浩, 井野 裕治, 坂本 博次, 三浦 義正, 林 芳和, 矢野 智則, 砂田 圭二郎, 大澤 博之, 山本 博徳  日本消化器病学会雑誌  115-  (臨増大会)  A727  -A727  2018/10  [Not refereed][Not invited]
  • RAに対しEtanerceptで加療中に発症したUCの1症例
    平出 敏知, 相良 裕一, 砂田 富美子, 岩下 ちひろ, 坂本 博次, 廣澤 拓也, 小川 和紀, 中元 明裕, 倉田 秀一, 岩本 雅弘  日本内科学会関東地方会  644回-  37  -37  2018/09  [Not refereed][Not invited]
  • 【知っておこう!遺伝性消化器疾患】 遺伝性消化器疾患診療における内視鏡の役割
    坂本 博次, 山本 博徳  消化器内視鏡  30-  (8)  983  -994  2018/08  [Not refereed][Not invited]
     
    遺伝性消化器疾患の診療において内視鏡の果たす役割は多岐にわたる。その役割は大きく以下の4つ、(1)診断、(2)血縁者に対するスクリーニング、(3)サーベイランス、(4)治療、に大別することができる。遺伝性消化器疾患はいずれも稀な疾患であるものの、特徴的な内視鏡所見が診断契機になることも稀ではないため、それぞれの疾患の特徴を理解しておくことが肝要である。血縁者に対するスクリーニングには遺伝子変異の検索が重要であるが、保険診療で認められていない疾患がほとんどであるため、遺伝性ポリポーシス症候群では特徴的な内視鏡所見の有無により診断されることも多い。また遺伝性消化器疾患の多くで一般人口と比較して発癌リスクが高いため、適切な間隔で内視鏡等を用いたサーベイランスを行う必要がある。内視鏡治療も開腹手術を避けるために、疾患特異的な病変の治療に対して行われている。(著者抄録)
  • 【知っておこう!遺伝性消化器疾患】 遺伝性出血性末梢血管拡張症
    井野 裕治, 矢野 智則, 宮原 晶子, 坂本 博次, 山本 博徳  消化器内視鏡  30-  (8)  1020  -1025  2018/08  [Not refereed][Not invited]
     
    遺伝性出血性末梢血管拡張症(HHT)は家族性、遺伝性に皮膚粘膜や内臓の末梢血管に異常拡張をきたし、反復する鼻出血や消化管出血を主徴とする疾患である。血管内皮細胞上に存在するTGF-βファミリーシグナル系のI型受容体であるactivin A receptor like type 1(ACVRL1)、同じくIII型受容体であるエンドグリン(ENG)、細胞内に存在するSMAD4の3遺伝子が、原因遺伝子として同定されている。これらに異常をきたすと血管内皮細胞および血管平滑筋細胞の血管新生と血管安定化のバランスが崩れ、HHTが発症すると考えられている。全消化管に毛細血管拡張症が起こりうるが、大腸よりも胃や十二指腸のほうが多いといわれている。毛細血管拡張は皮膚にみられるものと大きさや形状はほぼ同じである。鉄剤の内服でコントロールできない貧血を伴う消化管出血をきたした場合は、アルゴンプラズマ凝固法による焼灼術などの姑息的治療が行われている。また近年ではベバシズマブの投与が有効であったとの報告があり、今後の臨床応用が期待されている。(著者抄録)
  • 【高リスク患者の内視鏡】 小腸(空腸・回腸) 活動性小腸出血患者に対する緊急バルーン小腸内視鏡の注意点
    矢野 智則, 坂本 博次, 小林 泰俊, 宮原 晶子, 東條 浩子, 関谷 万里子, 砂田 圭二郎, 山本 博徳  消化器内視鏡  30-  (7)  886  -891  2018/07  [Not refereed][Not invited]
     
    活動性小腸出血では、病歴や背景疾患、便の色と排便頻度、胸腹部ダイナミックCT、バイタルサインなどの情報から出血源の病変種類と部位を推測し、緊急バルーン小腸内視鏡の適応を判断する。その挿入ルートは、視野確保が容易で血性腸液を出血部位同定の手がかりにできる経口ルートが基本である。しかし、CT等で下部回腸出血と判明している場合は経肛門ルートを選択する。スコープは鉗子口径が大きなものを選択し、先端アタッチメントと、BioShield irrigatorを併用する。小腸はランドマークがないため、経口ルートで血性腸液を認めたらマーキングクリップを留置し、それを基点にして出血源を探す。小腸は内腔が狭く、血性腸液で内腔が埋まって止血術中の視野確保が困難になりやすいが、水の代わりに透明なgelを注入して視野を確保する方法が役に立つ。(著者抄録)
  • Gel immersion endoscopyによる視野確保は急性出血性直腸潰瘍において特に有効である
    大森 彩子, 矢野 智則, 岡田 昌浩, 高岡 良成, 坂本 博次  Progress of Digestive Endoscopy  93-  (Suppl.)  s116  -s116  2018/06  [Not refereed][Not invited]
  • 矢野智則, 坂本博次, 小林泰俊, 永山学, 宮原晶子, 東條浩子, 山本博徳  胃と腸  53-  (6)  801  -807  2018/05  [Not refereed][Not invited]
     
    <文献概要>小腸出血では,年齢層や背景疾患などによって出血源となる病変の頻度が異なる.また,小腸出血に対する検査方法もさまざまだが,それぞれに長所と短所がある.適切な検査方法を選択して診断するためには,病変頻度と各検査の特徴を理解しておく必要がある.小腸内視鏡診療ガイドラインではOGIBに対する診断アルゴリズムが示されており,胸腹部造影CTを最初に行う検査として位置づけている.CTで有意所見があればバルーン内視鏡だが,有意所見がなければカプセル内視鏡を行って,その結果に応じてバルーン内視鏡などの検査を追加するか判断する.ただし,若年者ではCrohn病とMeckel憩室が比較的多いことから,当施設ではカプセル内視鏡よりも先に経肛門バルーン内視鏡を行っている.また,視野確保が困難なほど持続出血する血管性病変に対してはgel immersion endoscopyが視野確保に有用である.
  • 手技の解説 クローン病小腸狭窄に対する内視鏡的バルーン拡張術(動画付き)
    矢野 智則, 坂本 博次, 小林 泰俊, 永山 学, 東條 浩子, 宮原 晶子, 関谷 万里子, 砂田 圭二郎, 山本 博徳  Gastroenterological Endoscopy  60-  (5)  1107  -1115  2018/05  [Not refereed][Not invited]
     
    クローン病患者において、小腸狭窄は重要な合併症であり、その治療については未だ課題が多い。外科的切除で治療しても、クローン病を完治させることはできない。再燃して生じた狭窄に対して外科的切除を繰り返せば、短腸症候群になってしまう。バルーン内視鏡の登場により、深部小腸の狭窄に対する内視鏡的バルーン拡張術も可能となった。バルーン拡張術後に再狭窄することもあるが、繰り返し治療することが可能で、外科的治療を長期にわたって回避できる。本稿では、クローン病小腸狭窄に対する内視鏡的バルーン拡張術について、多数例の治療経験から編み出された戦略や工夫について紹介する。(著者抄録)
  • 坂本博次, 山本博徳  日本臨床  76-  625‐629  2018/04  [Not refereed][Not invited]
  • 【ここまできた胃・十二指腸ESD-現状と今後の展望】 非乳頭部十二指腸上皮性腫瘍に対する低侵襲治療 十二指腸ESDを安全に行うための手技の工夫
    三浦 義正, 井野 裕治, 岩下 ちひろ, 岡田 昌浩, 福田 久, 高橋 治夫, 篠崎 聡, 坂本 博次, 林 芳和, 砂田 圭二郎, 山本 博徳  消化器内視鏡  30-  (4)  502  -508  2018/04  [Not refereed][Not invited]
     
    十二指腸内視鏡的粘膜下層剥離術(ESD)は術中穿孔のみならず、術後の遅発窩孔へのケアを行う必要がある。筆者らの考案したpocket-creation methodは、この十二指腸ESDの困難性を克服するのに非常に理にかなった方法である。その最大の利点は安定性であり、細かな内視鏡操作、ナイフ操作により筋層へのダメージを極力回避するだけでなく、剥離深度の調整により意図的に粘膜下層組織を筋層上に残すことで遅発穿孔予防も行えると考えている。Pocket-creation methodの導入で、筆者らは術中穿孔率が有意に減少したことを報告した。しかしながら、その難しさはほかの消化管のESDより群を抜いており、リスク・ベネフィットを考慮した適切な症例選択も重要となる。また、外科のバックアップはいうまでもないが、偶発症に対する十分な経験・知識・準備のある内視鏡医が施行すべきで、安易に行うべきではないことは肝に銘じておくべきである。(著者抄録)
  • バルーン内視鏡診断と治療の現況と将来 家族性大腸腺腫症の十二指腸・小腸腺腫に対する内視鏡的治療の有用性
    関谷 万理子, 坂本 博次, 矢野 智則  Gastroenterological Endoscopy  60-  (Suppl.1)  641  -641  2018/04  [Not refereed][Not invited]
  • SNADETに対するUnderwater polypectomy/EMRの治療成績
    三浦 義正, 井野 裕治, 岩下 ちひろ, 岡田 昌浩, 坂本 博次, 林 芳和, 矢野 智則, 砂田 圭二郎, 山本 博徳  Gastroenterological Endoscopy  60-  (Suppl.1)  863  -863  2018/04  [Not refereed][Not invited]
  • 原因不明消化管出血の治療戦略と予後 ダブルバルーン内視鏡のスコープ先端バルーンを用いたGel immersion endoscopy効果倍増の工夫
    矢野 智則, 坂本 博次, 小林 泰俊  日本消化器病学会雑誌  115-  (臨増総会)  A146  -A146  2018/04  [Not refereed][Not invited]
  • SNADETに対するUnderwater polypectomy/EMRの治療成績
    三浦 義正, 井野 裕治, 岩下 ちひろ, 岡田 昌浩, 坂本 博次, 林 芳和, 矢野 智則, 砂田 圭二郎, 山本 博徳  Gastroenterological Endoscopy  60-  (Suppl.1)  863  -863  2018/04  [Not refereed][Not invited]
  • 【ここまできた胃・十二指腸ESD-現状と今後の展望】 非乳頭部十二指腸上皮性腫瘍に対する低侵襲治療 十二指腸ESDを安全に行うための手技の工夫
    三浦 義正, 井野 裕治, 岩下 ちひろ, 岡田 昌浩, 福田 久, 高橋 治夫, 篠崎 聡, 坂本 博次, 林 芳和, 砂田 圭二郎, 山本 博徳  消化器内視鏡  30-  (4)  502  -508  2018/04  [Not refereed][Not invited]
     
    十二指腸内視鏡的粘膜下層剥離術(ESD)は術中穿孔のみならず、術後の遅発窩孔へのケアを行う必要がある。筆者らの考案したpocket-creation methodは、この十二指腸ESDの困難性を克服するのに非常に理にかなった方法である。その最大の利点は安定性であり、細かな内視鏡操作、ナイフ操作により筋層へのダメージを極力回避するだけでなく、剥離深度の調整により意図的に粘膜下層組織を筋層上に残すことで遅発穿孔予防も行えると考えている。Pocket-creation methodの導入で、筆者らは術中穿孔率が有意に減少したことを報告した。しかしながら、その難しさはほかの消化管のESDより群を抜いており、リスク・ベネフィットを考慮した適切な症例選択も重要となる。また、外科のバックアップはいうまでもないが、偶発症に対する十分な経験・知識・準備のある内視鏡医が施行すべきで、安易に行うべきではないことは肝に銘じておくべきである。(著者抄録)
  • 消化器内視鏡領域における医工学診療の最近の進歩 ダブルバルーン内視鏡を用いたGel immersion endoscopy
    矢野 智則, 小林 泰俊, 坂本 博次, 宮原 晶子, 砂田 圭二郎, 山本 博徳  医工学治療  30-  (Suppl.)  96  -96  2018/03  [Not refereed][Not invited]
  • 大腸ESDのこれまでとこれから Balloon-assisted ESDの右側結腸内視鏡困難症例に対する有用性についての検討
    山階 武, 林 芳和, 坂本 博次, 三浦 義正, 矢野 智則, 砂田 圭二郎, 山本 博徳  日本消化管学会雑誌  2-  (Suppl.)  123  -123  2018/02  [Not refereed][Not invited]
  • 家族性大腸腺腫症の空腸腺腫に対してバルーン内視鏡とPocket-creation methodを併用しESDを施行し得た1例
    飯田 瑞穂, 坂本 博次, 三浦 義正, 矢野 智則, 平岡 友二, 福田 久, 岡田 昌浩, 井野 裕治, 竹澤 敬人, 小林 泰俊, 林 芳和, 砂田 圭二郎, 大澤 博之, 山本 博徳  日本消化管学会雑誌  2-  (Suppl.)  328  -328  2018/02  [Not refereed][Not invited]
  • 大腸ESDのこれまでとこれから Balloon-assisted ESDの右側結腸内視鏡困難症例に対する有用性についての検討
    山階 武, 林 芳和, 坂本 博次, 三浦 義正, 矢野 智則, 砂田 圭二郎, 山本 博徳  日本消化管学会雑誌  2-  (Suppl.)  123  -123  2018/02  [Not refereed][Not invited]
  • 家族性大腸腺腫症の空腸腺腫に対してバルーン内視鏡とPocket-creation methodを併用しESDを施行し得た1例
    飯田 瑞穂, 坂本 博次, 三浦 義正, 矢野 智則, 平岡 友二, 福田 久, 岡田 昌浩, 井野 裕治, 竹澤 敬人, 小林 泰俊, 林 芳和, 砂田 圭二郎, 大澤 博之, 山本 博徳  日本消化管学会雑誌  2-  (Suppl.)  328  -328  2018/02  [Not refereed][Not invited]
  • 経皮内視鏡的胃管瘻を造設して栄養管理を行った声門上癌再発の1例
    渡辺 春菜, 中村 めぐみ, 椎名 美知子, 佐藤 敏子, 坂本 博次, 古内 三基子, 亀田 尚香, 高橋 さとか, 山川 道代, 倉科 憲太郎, 西野 宏  日本病態栄養学会誌  21-  (Suppl.)  S  -104  2018/01  [Not refereed][Not invited]
  • 【内視鏡安全学-偶発症の予防と発生時の対応】 小腸 小腸バルーン内視鏡における偶発症の予防と発生時の対応
    矢野 智則, 坂本 博次, 小林 泰俊, 宮原 晶子, 東條 浩子, 永山 学, 砂田 圭二郎, 山本 博徳  消化器内視鏡  29-  (11)  2022  -2025  2017/11  [Not refereed][Not invited]
     
    小腸はその解剖学的特徴から、内視鏡での深部挿入が困難であった。今世紀に入って登場したバルーン小腸内視鏡は、バルーン付きオーバーチューブを用いることで深部挿入を可能にした。バルーン小腸内視鏡検査では、その構造的特徴と小腸の解剖学的特徴から、誤嚥性肺炎、急性膵炎、穿孔などの偶発症に注意が必要である。特にCrohn病症例では全層性炎症によって腸間膜が短縮した部分に力が集中し、穿孔が起こりやすい。バルーン小腸内視鏡は深部小腸においても操作性がよく、小腸における内視鏡治療も可能にした。しかし小腸は、ほかの消化管に比べて腸壁が薄く、内腔が狭いため、注意が必要である。ポリープ治療では穿孔と出血、バルーン拡張術では穿孔、止血術では高周波装置や止血クリップによる穿孔に注意が必要である。これらの偶発症について、その発生原理を理解し、適切な予防策をとることが、安全な検査・治療のために重要である。(著者抄録)
  • 永山 学, 矢野 智則, 坂本 博次, 砂田 圭二郎, 山本 博徳  Intestine  21-  (6)  526  -530  2017/11  [Not refereed][Not invited]
     
    Cryptogenic multifocal ulcerous stenosing enteritis(CMUSE)は小腸に中心性狭窄が多発する原因不明の慢性稀少疾患である。腸管病変はNSAIDsの膜様狭窄に類似しており、おもに腸管閉塞症状をきたす。治療に関してはステロイド感受性が高いとされるが、ステロイド依存性も示し、また術後の再燃も問題となる。近年、本疾患の病態にプロスタグランジン(PG)が関与していることが示唆されているが結論はついていない。本邦からの報告例はこれまでにないが、東アジアからの報告例もみられてきており、注目すべき疾患の一つである。(著者抄録)
  • 永山 学, 矢野 智則, 坂本 博次, 砂田 圭二郎, 山本 博徳  胃と腸  52-  (11)  1458  -1466  2017/10  [Not refereed][Not invited]
     
    CMUSE(cryptogenic multifocal ulcerous stenosing enteritis)は空腸,回腸に境界明瞭な浅い潰瘍と多発性再発性狭窄を来す原因不明の慢性希少疾患である.本邦からの報告はこれまでに認めていない.腸管病変は短い求心性狭窄が主体で,粘膜下層までの線維化にとどまり,これにより慢性/再発性の腸管閉塞症状を来す.治療には主にステロイドや手術が選択され,内視鏡的バルーン拡張術も選択肢の一つである.近年,本疾患の病態にプロスタグランジン(PG)が関与していることが示唆されているが結論はついておらず,今後の症例蓄積が必要である.(著者抄録)
  • 永山 学, 矢野 智則, 坂本 博次, 砂田 圭二郎, 山本 博徳  胃と腸  52-  (11)  1458  -1466  2017/10  [Not refereed][Not invited]
     
    CMUSE(cryptogenic multifocal ulcerous stenosing enteritis)は空腸,回腸に境界明瞭な浅い潰瘍と多発性再発性狭窄を来す原因不明の慢性希少疾患である.本邦からの報告はこれまでに認めていない.腸管病変は短い求心性狭窄が主体で,粘膜下層までの線維化にとどまり,これにより慢性/再発性の腸管閉塞症状を来す.治療には主にステロイドや手術が選択され,内視鏡的バルーン拡張術も選択肢の一つである.近年,本疾患の病態にプロスタグランジン(PG)が関与していることが示唆されているが結論はついておらず,今後の症例蓄積が必要である.(著者抄録)
  • 悪性リンパ腫に関連した小腸狭窄に対する内視鏡的バルーン拡張術は有用である
    馬込 省吾, 坂本 博次, 矢野 智則, 岡田 昌浩, 福田 久, 高橋 治夫, 竹澤 敬人, 井野 祐治, 三浦 義正, 林 芳和, 砂田 圭二郎, 大澤 博之, 山本 博徳  Gastroenterological Endoscopy  59-  (Suppl.2)  2161  -2161  2017/09  [Not refereed][Not invited]
  • 右側結腸における内視鏡困難症例に対するバルーン内視鏡使用下ESDについての検討
    山階 武, 林 芳和, 坂本 博次, 三浦 義正, 砂田 圭二郎, 山本 博徳  Gastroenterological Endoscopy  59-  (Suppl.2)  2206  -2206  2017/09  [Not refereed][Not invited]
  • 悪性リンパ腫に関連した小腸狭窄に対する内視鏡的バルーン拡張術は有用である
    馬込 省吾, 坂本 博次, 矢野 智則, 岡田 昌浩, 福田 久, 高橋 治夫, 竹澤 敬人, 井野 祐治, 三浦 義正, 林 芳和, 砂田 圭二郎, 大澤 博之, 山本 博徳  Gastroenterological Endoscopy  59-  (Suppl.2)  2161  -2161  2017/09  [Not refereed][Not invited]
  • 右側結腸における内視鏡困難症例に対するバルーン内視鏡使用下ESDについての検討
    山階 武, 林 芳和, 坂本 博次, 三浦 義正, 砂田 圭二郎, 山本 博徳  Gastroenterological Endoscopy  59-  (Suppl.2)  2206  -2206  2017/09  [Not refereed][Not invited]
  • アサコール投与中に心膜炎を発症した全結腸型潰瘍性大腸炎の1例
    木蜜 徹, 砂田 富美子, 倉田 秀一, 岩下 ちひろ, 海老澤 勝人, 鳥海 進一, 坂本 博次, 大森 彩子, 渡邉 裕昭  日本内科学会関東地方会  634回-  31  -31  2017/07  [Not refereed][Not invited]
  • S状結腸に滞留したPress through pack(PTP)シートをダブルバルーン内視鏡(DBE)内に引き込んで安全に回収しえた一例
    小林 泰俊, 矢野 智則, 坂本 博次, 長井 洋樹, 馬込 省吾, 岡田 昌浩, 福田 久, 高橋 治夫, 井野 裕治, 竹澤 敬人, 三浦 義正, 林 芳和, 砂田 圭二郎, 大澤 博之, 山本 博徳  Progress of Digestive Endoscopy  91-  (Suppl.)  s118  -s118  2017/06  [Not refereed][Not invited]
  • 砂田 富美子, 坂本 博次, 津久井 舞未子, 倉田 秀一  Progress of Digestive Endoscopy  90-  (1)  124  -125  2017/06  [Not refereed][Not invited]
     
    73歳男性。腹部膨満感を主訴に受診となった。腹部CTでは異常所見を認めず、大腸内視鏡にてS状結腸に多発する憩室と正常粘膜を呈する8mm大のポリープを認め、経過観察とした。14ヵ月後の大腸内視鏡でも前回と同様の所見で、粘膜変化や増大傾向は認めなかったが、患者の希望により内視鏡的粘膜切除術を施行した。病理組織学的に大腸mucosal polypの診断とされた。
  • EBウイルスVCA-IgM(FA法)陰性でアンピシリン疹を認めた伝染性単核球症の1例
    平山 果歩, 神田 直樹, 坂本 博次, 隈部 綾子, 山本 祐, 畠山 修司, 松村 正巳  栃木県医学会々誌  47-  70  -72  2017/06  [Not refereed][Not invited]
  • Hironori Yamamoto, Yoshimasa Miura, Satoshi Shinozaki, Yoshikazu Hayashi, Hirotsugu Sakamoto, Alan Kawarai Lefor  ENDOSCOPY  49-  (4)  401  -401  2017/04  [Not refereed][Not invited]
  • STフードを用いたESDポケット法によるトラクション・カウンタートラクション
    高橋 治夫, 林 芳和, 坂本 博次  Gastroenterological Endoscopy  59-  (Suppl.1)  946  -946  2017/04  [Not refereed][Not invited]
  • 大腸ESDにおいて剥離速度の遅延を来たした症例の予測因子の検討
    山階 武, 林 芳和, 坂本 博次, 三浦 義正, 砂田 圭二郎, 山本 博徳  Gastroenterological Endoscopy  59-  (Suppl.1)  946  -946  2017/04  [Not refereed][Not invited]
  • 小腸内視鏡 近年の進歩と課題 Peutz-Jeghers症候群の小腸ポリープに対する阻血治療の有用性と手技の工夫
    相良 裕一, 坂本 博次, 矢野 智則  Gastroenterological Endoscopy  59-  (Suppl.1)  904  -904  2017/04  [Not refereed][Not invited]
  • 非乳頭部十二指腸腫瘍に対する内視鏡治療の変遷と現状 Pocket-creation methodを用いたESD
    三浦 義正, 井野 裕治, 岩下 ちひろ, 岡田 昌浩, 福田 久, 高橋 治夫, 坂本 博次, 林 芳和, 矢野 智則, 砂田 圭二郎, 大澤 博之, 山本 博徳  Gastroenterological Endoscopy  59-  (Suppl.1)  1171  -1171  2017/04  [Not refereed][Not invited]
  • 消化管感染症における内視鏡の役割 大腸内視鏡を機に診断し得た腸管スピロヘータ症41例の検討 治療方針を含めて
    竹澤 敬人, 高橋 治夫, 坂本 博次  Gastroenterological Endoscopy  59-  (Suppl.1)  757  -757  2017/04  [Not refereed][Not invited]
  • 小腸内視鏡 近年の進歩と課題 Peutz-Jeghers症候群の小腸ポリープに対する阻血治療の有用性と手技の工夫
    相良 裕一, 坂本 博次, 矢野 智則  Gastroenterological Endoscopy  59-  (Suppl.1)  904  -904  2017/04  [Not refereed][Not invited]
  • STフードを用いたESDポケット法によるトラクション・カウンタートラクション
    高橋 治夫, 林 芳和, 坂本 博次  Gastroenterological Endoscopy  59-  (Suppl.1)  946  -946  2017/04  [Not refereed][Not invited]
  • 大腸ESDにおいて剥離速度の遅延を来たした症例の予測因子の検討
    山階 武, 林 芳和, 坂本 博次, 三浦 義正, 砂田 圭二郎, 山本 博徳  Gastroenterological Endoscopy  59-  (Suppl.1)  946  -946  2017/04  [Not refereed][Not invited]
  • 非乳頭部十二指腸腫瘍に対する内視鏡治療の変遷と現状 Pocket-creation methodを用いたESD
    三浦 義正, 井野 裕治, 岩下 ちひろ, 岡田 昌浩, 福田 久, 高橋 治夫, 坂本 博次, 林 芳和, 矢野 智則, 砂田 圭二郎, 大澤 博之, 山本 博徳  Gastroenterological Endoscopy  59-  (Suppl.1)  1171  -1171  2017/04  [Not refereed][Not invited]
  • 【消化管ポリポーシスの最前線】 過誤腫性ポリポーシス
    坂本 博次, 矢野 智則, 砂田 圭二郎  日本消化器病学会雑誌  114-  (3)  422  -430  2017/03  [Not refereed][Not invited]
     
    Peutz-Jeghers症候群、若年性ポリポーシス症候群、PTEN過誤腫症候群は、いずれも過誤腫性ポリポーシスをきたす常染色体優性遺伝の疾患である。発症頻度はそれほど高くない疾患であるが、ポリープ増大に対する治療と悪性腫瘍の高リスク群としてのサーベイランスの両方を適切に行っていく必要がある疾患であり、診断や治療の遅れにつながることのないよう、各疾患の特徴を理解しておく必要がある。本稿では、各疾患の臨床的特徴、原因遺伝子、ポリポーシスに対する治療、発癌リスクとサーベイランス方法について解説する。(著者抄録)
  • 新たなモダリティーが解明した小腸疾患の診断と治療 Peutz-Jeghers症候群のポリポーシスに対する治療戦略
    坂本 博次, 相良 裕一, 矢野 智則  日本消化器病学会雑誌  114-  (臨増総会)  A101  -A101  2017/03  [Not refereed][Not invited]
  • 山階武, 山階武, 林芳和, 坂本博次, 三浦義正, 砂田圭二郎, 山本博徳  Gastroenterological Endoscopy (Web)  59-  (Supplement1)  2017
  • 【腸炎まるわかり】 血流障害 虚血性小腸炎
    坂本 博次, 長井 洋樹, 矢野 智則  消化器内視鏡  29-  (1)  103  -107  2017/01  [Not refereed][Not invited]
     
    虚血性小腸炎は一過性の血流障害に起因した虚血により発症し、60歳前後の男性に好発する。腹痛、下痢、嘔吐にて発症し、症状改善後に経口摂取を再開すると、症状が再燃しやすい。好発部位は回腸であり、内視鏡所見は区域性の絨毛脱落、発赤浮腫、びらん、潰瘍を認め、狭窄型では慢性期に管状狭窄を呈する。狭窄に対しては手術が必要になることが多いが、短い狭窄であれば内視鏡的バルーン拡張術による治療も可能である。(著者抄録)
  • 【小腸出血-診断・治療の最前線-】 小腸出血に対する診断・治療戦略
    矢野 智則, 坂本 博次, 永山 学, 砂田 圭二郎, 山本 博徳  消化器・肝臓内科  1-  (1)  1  -6  2017/01  [Not refereed][Not invited]
  • 【術前内視鏡】 小腸悪性腫瘍の術前内視鏡の実際
    坂本 博次, 矢野 智則  消化器内視鏡  28-  (12)  1986  -1991  2016/12  [Not refereed][Not invited]
     
    カプセル内視鏡(CE)とバルーン内視鏡(BAE)の開発により、小腸悪性腫瘍の診断は以前よりも容易になり、ガイドラインでも積極的な活用が推奨されている。特にBAEにより、生検による質的診断を行うことが可能となり、その質的診断を踏まえて、最適な治療方針を検討することができるようになった。また、BAEによりマーキングを行うことで、より低侵襲な手術を選択できるようになった。早期の悪性腫瘍に対しては、内視鏡治療を行うことも可能である。しかし、小腸悪性腫瘍に対する標準的な治療法は確立されておらず、質の高いエビデンスの集積により、新しい診断・治療体系の構築が求められている。(著者抄録)
  • 自治医科大学附属病院における胃瘻栄養管理体制と管理栄養士の役割
    椎名 美知子, 佐藤 敏子, 古内 めぐみ, 古内 三基子, 馬場 千恵子, 亀田 尚香, 坂本 博次, 倉科 憲太郎  日本病態栄養学会誌  20-  (Suppl.)  S  -88  2016/12  [Not refereed][Not invited]
  • Yoshie Kondo, Satoshi Shinozaki, Hirotsugu Sakamoto, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto, Hiroyuki Osawa  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  31-  118  -118  2016/11  [Not refereed][Not invited]
  • Hiroaki Nomoto, Satoshi Sinozaki, Yoshie Kondo, Hirotsugu Sakamoto, Yoshikazu Hayashi, Hironori Yamamoto, Alan Kawarai Lefor, Hiroyuki Osawa  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  31-  65  -65  2016/11  [Not refereed][Not invited]
  • Yosimasa Miura, Satoshi Shinozaki, Yoshikazu Hayashi, Hirotsugu Sakamoto, Alan Kawarai Lefor, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  31-  290  -290  2016/11  [Not refereed][Not invited]
  • 消化管リンパ増殖性疾患の内視鏡像の特徴 小腸悪性リンパ腫44例の内視鏡所見と生検部位に関する検討
    岡田 昌浩, 坂本 博次, 三登 久美子  日本消化器病学会雑誌  113-  (臨増大会)  A602  -A602  2016/09  [Not refereed][Not invited]
  • 保存的加療を行った非閉塞性腸管虚血症に対しカプセル内視鏡検査を行い小腸虚血後の変化を観察できた一例
    山口 将太, 坂本 博次, 宮原 晶子, 林 芳和, 永山 学, 矢野 智則, 砂田 圭二郎, 山本 博徳  Progress of Digestive Endoscopy  89-  (Suppl.)  s123  -s123  2016/06  [Not refereed][Not invited]
  • 診療の秘訣 持続する下痢の鑑別 薬剤性を中心に
    坂本 博次  Modern Physician  36-  (6)  598  -598  2016/06  [Not refereed][Not invited]
  • 保存的加療を行った非閉塞性腸管虚血症に対しカプセル内視鏡検査を行い小腸虚血後の変化を観察できた一例
    山口 将太, 坂本 博次, 宮原 晶子, 林 芳和, 永山 学, 矢野 智則, 砂田 圭二郎, 山本 博徳  Progress of Digestive Endoscopy  89-  (Suppl.)  s123  -s123  2016/06  [Not refereed][Not invited]
  • 【転移性消化管腫瘍】 小腸(空腸・回腸) 転移性小腸腫瘍と鑑別が必要な小腸病変 PET-CTとバルーン内視鏡で診断された原発性小腸癌腹膜播種
    深谷 幸祐, 坂本 博次, 山本 博徳  消化器内視鏡  28-  (6)  892  -893  2016/06  [Not refereed][Not invited]
  • Manabu Nagayama, Tomonori Yano, Yoshikazu Hayashi, Chihiro Iwashita, Hisashi Fukuda, Masahiro Okada, Yuji Ino, Takahito Takezawa, Hirotsugu Sakamoto, Yoshimasa Miura, Keijiro Sunada, Alan K. Lefor, Hironori Yamamoto  GASTROINTESTINAL ENDOSCOPY  83-  (5)  AB500  -AB500  2016/05  [Not refereed][Not invited]
  • Tomonori Yano, Masahiro Okada, Hisashi Fukuda, Hirotsugu Sakamoto, Manabu Nagayama, Alan K. Lefor, Hironori Yamamoto  GASTROINTESTINAL ENDOSCOPY  83-  (5)  AB638  -AB639  2016/05  [Not refereed][Not invited]
  • Hirotsugu Sakamoto, Yoshikazu Hayashi, Yoshimasa Miura, Haruo Takahashi, Hisashi Fukuda, Masahiro Okada, Chihiro Iwashita, Manabu Nagayama, Takahito Takezawa, Tomonori Yano, Keijiro Sunada, Alan K. Lefor, Hironori Yamamoto  GASTROINTESTINAL ENDOSCOPY  83-  (5)  AB374  -AB375  2016/05  [Not refereed][Not invited]
  • 【希少がんの病理と診療】 小腸癌
    加賀谷 結華, 坂本 博次, 山本 博徳  癌と化学療法  43-  (5)  509  -512  2016/05  [Not refereed][Not invited]
     
    カプセル内視鏡とバルーン内視鏡の開発により、小腸癌の診断は以前よりも容易になった。特にバルーン内視鏡は、これまで観察不可能であった小腸全域の観察が可能であるのみならず、生検による組織診断や内視鏡治療も行うことができる。内視鏡診断が予後の改善に寄与することが示されてはいるが、依然として一般的に小腸癌の予後は悪い。治療は大腸癌に準じた手術・化学療法が行われているが、特に化学療法の奏効率は現在のところ高くはない。小腸内視鏡を用いた早期発見や分子標的薬による治療などの新しい診断・治療体系の構築が求められている。(著者抄録)
  • 坂本 博次, 矢野 智則  Intestine  20-  (3)  307  -312  2016/05  [Not refereed][Not invited]
     
    小腸の消化管ポリポーシスに対する内視鏡的治療は,おもに(1)発癌の予防,(2)腸重積や出血など,ポリープ増大による症状を予防する,という二つの観点から行われる.Peutz-Jeghers症候群の小腸ポリポーシスはポリープ増大による腸重積や出血などの症状が問題になるため,これらの合併症や開腹手術の予防のために小腸内視鏡による内視鏡的治療が行われている.家族性大腸腺腫症では大腸だけでなく,十二指腸・小腸にも腺腫を認めることがあり,症例によっては多発する.十二指腸・小腸腺腫に対し,発癌リスク軽減を期待して内視鏡的治療が試みられている.(著者抄録)
  • 【希少がんの病理と診療】 小腸癌
    加賀谷 結華, 坂本 博次, 山本 博徳  癌と化学療法  43-  (5)  509  -512  2016/05  [Not refereed][Not invited]
     
    カプセル内視鏡とバルーン内視鏡の開発により、小腸癌の診断は以前よりも容易になった。特にバルーン内視鏡は、これまで観察不可能であった小腸全域の観察が可能であるのみならず、生検による組織診断や内視鏡治療も行うことができる。内視鏡診断が予後の改善に寄与することが示されてはいるが、依然として一般的に小腸癌の予後は悪い。治療は大腸癌に準じた手術・化学療法が行われているが、特に化学療法の奏効率は現在のところ高くはない。小腸内視鏡を用いた早期発見や分子標的薬による治療などの新しい診断・治療体系の構築が求められている。(著者抄録)
  • 大腸LSTの内視鏡治療 進歩と限界 大腸LST-NGのESDにおけるポケット法の有用性
    坂本 博次, 林 芳和, 三浦 義正  Gastroenterological Endoscopy  58-  (Suppl.1)  484  -484  2016/04  [Not refereed][Not invited]
  • 【大腸内視鏡挿入法-永遠のテーマ】 ダブルバルーン内視鏡を用いた大腸内視鏡挿入法
    高橋 治夫, 竹澤 敬人, 井野 祐治, 坂本 博次, 三浦 義正, 林 芳和, 矢野 智則, 砂田 圭二郎, 山本 博徳  消化器内視鏡  28-  (4)  632  -638  2016/04  [Not refereed][Not invited]
     
    近年、大腸内視鏡による大腸癌スクリーニングの重要性が増すなか、挿入困難例の対応について問題となることも多い。ダブルバルーン大腸内視鏡(DBC)は腹部手術・放射線治療・過去の炎症などによって生じた癒着のため、または腸管過伸展となるために挿入困難となっている症例に対して有効であることが多く、当科ではそのような症例に対しては、基本的にDBCでの挿入を行っている。オーバーチューブの働きによりループの進展を防ぎ、スコープ先端に力が加わりやすくなるために、挿入がスムーズになる。ループが解除できなくても、無理にループや屈曲を解除せずに挿入を進めることがコツである。DBCは比較的経験の浅い内視鏡医でも、一定の研修を行えば習得することが可能であり、安全性も高い。小腸の観察・治療のみならず、大腸内視鏡においてもダブルバルーン内視鏡が活躍する場面がさらに増えてくるものと思われる。(著者抄録)
  • 大腸LSTの内視鏡治療 進歩と限界 大腸LST-NGのESDにおけるポケット法の有用性
    坂本 博次, 林 芳和, 三浦 義正  Gastroenterological Endoscopy  58-  (Suppl.1)  484  -484  2016/04  [Not refereed][Not invited]
  • 【粘膜下腫瘍のすべて】 空腸・回腸の粘膜下腫瘍の診断と治療
    矢野 智則, 坂本 博次, 永山 学, 岡田 昌浩, 砂田 圭二郎, 山本 博徳  消化器内視鏡  28-  (2)  276  -282  2016/02  [Not refereed][Not invited]
     
    空腸・回腸の粘膜下腫瘍や粘膜下腫瘍様病変には、さまざまなものがあるが、無症状に経過するものも珍しくなく、正確な頻度は不明である。消化管出血や、狭窄症状、腹痛、腸重積、腹部腫瘤触知を契機として診断されるほか、無症状で他疾患に対する検査で偶然見つかる場合もある。表面を正常粘膜が覆っているため、内視鏡単独で診断せず、CTや腹部超音波、ミニプローブを用いたEUSなどの情報も考慮して総合的に診断する。内視鏡的生検は、正診率の割に生検後出血の危険が高いものがあり、施行するかどうか慎重に判断する。外科的切除が必要な場合には、点墨などのマーキングを行っておけば、腹腔鏡補助下小腸部分切除術を行う際に役に立つ。(著者抄録)
  • Kunihiko Oguro, Yoshimasa Miura, Yuji Ino, Chihiro Iwashita, Masahiro Okada, Hisashi Fukuda, Haruo Takahashi, Manabu Nagayama, Takahitotakezawa, Hirotsugu Sakamoto, Yoshikazu Hayashi, Hiroyuki Sato, Tomonori Yano, Keijiro Sunada, Hiroyuki Osawa, Alan K. Lefor, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  30-  290  -290  2015/12  [Not refereed][Not invited]
  • Hisashi Fukuda, Yoshikazu Hayashi, Masahiro Okada, Chihiro Iwashita, Haruo Takahashi, Manabu Nagayama, Takahito Takezawa, Yuji Ino, Yoshimasamiura, Hirotsugu Sakamoto, Hiroyukisato, Tomonori Yano, Keijiro Sunada, Hiroyuki Osawa, Alan K. Lefor, Hironoriyamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  30-  175  -175  2015/12  [Not refereed][Not invited]
  • Rarato Ugajin, Hirotsugu Sakamoto, Tomonori Yano, Yuji Ino, Yoshikazu Hayashi, Chihiro Iwashita, Masahiro Okada, Hisashi Fukuda, Manabu Nagayama, Takahito Takezawa, Hiroyuki Sato, Keijiro Sunada, Alan K. Lefor, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  30-  219  -220  2015/12  [Not refereed][Not invited]
  • Kawasaki Yuki, Takahito Takezawa, Shunji Hayashi, Masahiro Okada, Hisashi Fukuda, Manabu Nagayama, Haruo Takahashi, Yuji Ino, Hirotsugu Sakamoto, Yoshimasa Miura, Yoshikazu Hayashi, Hiroyuki Sato, Tomonori Yano, Keijiro Sunada, Hiroyuki Osawa, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  30-  180  -181  2015/12  [Not refereed][Not invited]
  • Kozue Murayama, Keijiro Sunada, Yoshikazu Hayashi, Hisashi Fukuda, Masahiro Okada, Haruo Takahashi, Manabu Nagayama, Takahito Takezawa, Hirotsugu Sakamoto, Ino Yuji, Yoshimasa Miura, Tomonori Yano, Hiroyuki Sato, Hiroyuki Osawa, Alan K. Lefor, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  30-  178  -178  2015/12  [Not refereed][Not invited]
  • 誤飲したPTPシートが小腸狭窄に滞留し発症したサブイレウスの1例
    崎尾 亮太郎, 岩下 ちひろ, 坂本 博次, 矢野 智則, 砂田 圭二郎, 山本 博徳  日本内科学会関東地方会  619回-  31  -31  2015/11  [Not refereed][Not invited]
  • アコチアミドは上腹部症状だけでなく胸焼けおよび便秘を改善させる
    篠崎 聡, 坂本 博次, 山本 博徳  日本消化器病学会雑誌  112-  (臨増大会)  A833  -A833  2015/09  [Not refereed][Not invited]
  • 【家族性腫瘍学-家族性腫瘍の最新研究動向-】 原因遺伝子 LKB1/STK11
    坂本 博次  日本臨床  73-  (増刊6 家族性腫瘍学)  380  -384  2015/08  [Not refereed][Not invited]
  • 【処置具を使いこなす】 消化管出血治療 小腸出血 小腸止血手技の種類と使い分けのコツ 総論と処置具を使いこなすコツ
    坂本 博次, 矢野 智則  消化器内視鏡  27-  (8)  1242  -1245  2015/08  [Not refereed][Not invited]
  • 永山 学, 砂田 圭二郎, 矢野 智則, 小野 公平, 根本 大樹, 宮田 康史, 井野 裕治, 竹澤 敬人, 坂本 博次, 新畑 博英, 三浦 義正, 林 芳和, 佐藤 博之, 山本 博徳  日本消化器病学会雑誌  112-  (7)  1270  -1280  2015/07  [Not refereed][Not invited]
     
    クローン病(CD)の診療では内視鏡の果たす役割が大きい。ダブルバルーン内視鏡(DBE)はEGDやCSで到達できない小腸の評価に用いられる。DBEは疑診例における確定診断や、病型診断、病勢の評価に有用であるとともに、小腸狭窄の評価や内視鏡的バルーン拡張術(EBD)などが可能である。今後の課題として粘膜治癒の評価やEBD後のフォローアップ、小腸癌サーベイランスなどが挙げられるが、これらについてのエビデンスはまだ乏しい。CDの小腸病変はこれまで認識されてきた以上に多く、今後はCDと確定診断された症例であってもDBEなどで小腸病変を積極的に検索することが必要と思われる。(著者抄録)
  • 【十二指腸腫瘍をどうする】 全身性疾患に伴う十二指腸腫瘍(消化管ポリポーシス、von Recklinghausen病、ZEなど)
    坂本 博次, 宮田 康史, 山本 博徳  消化器内視鏡  27-  (7)  1184  -1186  2015/07  [Not refereed][Not invited]
  • 内視鏡を活用したあらたな診療展開 十二指腸、小腸 ダブルバルーン内視鏡まで施行しても原因不明であった消化管出血の長期予後の検討
    篠崎 聡, 矢野 智則, 坂本 博次, 砂田 圭二郎, 林 芳和, 佐藤 博之, 山本 博徳  Progress of Digestive Endoscopy  87-  (Suppl.)  s93  -s93  2015/06  [Not refereed][Not invited]
  • 坂本 典孝, 小野 公平, 永山 学, 吉田 友直, 根本 大樹, 宮田 康史, 井野 裕治, 竹澤 敬人, 坂本 博次, 新畑 博英, 三浦 義正, 林 芳和, 佐藤 博之, 砂田 圭二郎, 矢野 智則, 大澤 博之, 山本 博徳  Progress of Digestive Endoscopy  87-  (Suppl.)  s104  -s104  2015/06  [Not refereed][Not invited]
  • SAKAMOTO HIROTSUGU  モダンフィジシャン  35-  (5)  666  2015/05  [Not refereed][Not invited]
  • ONO KOHEI, MIURA YOSHIMASA, NAGAYAMA MANABU, NEMOTO TAIKI, MIYATA YASUSHI, INO YUJI, TAKEZAWA TAKAHITO, SATO HIROYUKI, SAKAMOTO HIROTSUGU, NIIHATA HIROHIDE, HAYASHI YOSHIKAZU, YANO TOMONORI, SUNADA KEIJIRO, OSAWA HIROYUKI, HOSOYA YOSHINORI, YAMAMOTO HIRONORI  Gastroenterol Endosc  57-  (Supplement 1)  749  -749  2015/04  [Not refereed][Not invited]
  • NEMOTO TAIKI, HAYASHI YOSHIKAZU, ONO KOHEI, NAGAYAMA MANABU, INO YUJI, WATANABE SHUNJI, MIURA YOSHIMASA, TAKEZAWA TAKAHITO, SATO HIROYUKI, SAKAMOTO HIROTSUGU, YANO TOMONORI, SUNADA KEIJIRO, OSAWA HIROYUKI, YAMAMOTO HIRONORI  Gastroenterol Endosc  57-  (Supplement 1)  902  -902  2015/04  [Not refereed][Not invited]
  • UGAJIN RARATO, SAKAMOTO HIROTSUGU, YANO TOMONORI, INO YUJI, HAYASHI YOSHIKAZU, NAGAYAMA MANABU, TAKEZAWA TAKAHITO, NIIHATA HIROHIDE, SATO HIROYUKI, SUNADA KEIJIRO, YAMAMOTO HIRONORI  Gastroenterol Endosc  57-  (Supplement 1)  883  -883  2015/04  [Not refereed][Not invited]
  • HAYASHI YOSHIKAZU, TAKAHASHI HARUO, NAGAYAMA MANABU, INO YUJI, MIURA YOSHIMASA, TAKEZAWA TAKAHITO, SATO HIROYUKI, NIIHATA HIROHIDE, SAKAMOTO HIROTSUGU, YANO TOMONORI, SUNADA KEIJIRO, OSAWA HIROYUKI, YAMAMOTO HIRONORI  Gastroenterol Endosc  57-  (Supplement 1)  955  -955  2015/04  [Not refereed][Not invited]
  • SAKAMOTO HIROTSUGU, YAMAMOTO HIRONORI  成人病と生活習慣病  45-  (3)  361  -367  2015/03  [Not refereed][Not invited]
     
    バルーンがつけられたオーバーチューブで腸管を内側から把持し、腸管を伸展しにくくすることで深部挿入を可能とした内視鏡である。持続出血例では緊急で前処置なしの経口バルーン内視鏡を行う。出血からできるだけ早いタイミングで検査を行うことが診断率向上につながる。angioectasiaからの出血に対してはargon plasma coagulation、Dieulafoy's lesionからの出血に対してはクリッピングによる止血術を行う。生検を行うことで正確な組織学的診断をつけ、適切な治療に結びつけることが可能になった。ポリペクトミーや内視鏡的粘膜切除術が可能となった。Peutz-Jeghers症候群の過誤腫性ポリープに対しては留置スネアやクリップによる阻血治療も試みられている。術後再建腸管に対するERCPや操作が安定しない部位での内視鏡的粘膜下層剥離術も可能となった。(著者抄録)
  • 小野公平, 坂本博次, 竹澤敬人, 三浦義正, 新畑博英, 林芳和, 佐藤博之, 砂田圭二郎, 大澤博之, 山本博徳  日本消化管学会総会学術集会プログラム・抄録集  11th-  277  2015  [Not refereed][Not invited]
  • Takahito Takezawa, Teppei Sasahara, Shunji Hayashi, Manabu Nagayama, Yuji Ino, Hirotsugu Sakamoto, Hakuei Shinhata, Yoshimasa Miura, Yoshikazu Hayashi, Hiroyuki Satou, Tomonori Yano, Keijiro Sunada, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  29-  239  -240  2014/11  [Not refereed][Not invited]
  • Hakuei Shinhata, Yoshikazu Hayashi, Daiki Nemoto, Kohei Ono, Masahiro Okada, Yasushi Miyata, Manabu Nagayama, Yuji Ino, Takahito Takezawa, Yoshimasa Miura, Hiroyuki Sato, Hirotsugu Sakamoto, Tomonori Yano, Keijiro Sunada, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  29-  300  -300  2014/11  [Not refereed][Not invited]
  • Yuji Ino, Tomonori Yano, Yoshikazu Hayashi, Hirotsugu Sakamoto, Hiroyuki Osawa, Keijiro Sunada, Hiroyuki Sato, Yoshimasa Miura, Hakuei Shinhata, Takahito Takezawa, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  29-  79  -79  2014/11  [Not refereed][Not invited]
  • Yoshikazu Hayashi, Keijiro Sunada, Hakuei Shinhata, Daiki Nemoto, Kohei Ono, Yasushi Miyata, Manabu Nagayama, Takahito Takezawa, Yuji Ino, Yoshimasa Miura, Hiroyuki Sato, Hirotsugu Sakamoto, Tomonori Yano, Hiroyuki Osawa, Alan Lefor, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  29-  283  -283  2014/11  [Not refereed][Not invited]
  • Keijiro Sunada, Yoshikazu Hayashi, Hakuei Shinhata, Manabu Nagayama, Takahito Takezawa, Hirotsugu Sakamoto, Yuji Ino, Yoshimasa Miura, Tomonori Yano, Hiroyuki Sato, Alan T. Lefor, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  29-  301  -301  2014/11  [Not refereed][Not invited]
  • Yoshimasa Miura, Yuji Ino, Yoshikazu Hayashi, Wataru Sasao, Haruo Takashita, Manabu Nagayama, Takahito Takezawa, Hirotsugu Sakamoto, Hakuei Shinhata, Hiroyuki Sato, Tomonori Yano, Keijiro Sunada, Hiroyuki Osawa, Alan T. Lefor, Hironori Yamamoto  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  29-  296  -296  2014/11  [Not refereed][Not invited]
  • 永山学, 矢野智則, 佐藤博之, 永田博之, 宮田康史, 北村絢, 井野裕治, 竹澤敬人, 坂本博次, 新畑博英, 三浦義正, 林芳和, 砂田圭二郎, 山本博徳, 菅野健太郎  Gastroenterol Endosc  56-  (Supplement 2)  3173  2014/09  [Not refereed][Not invited]
  • 相良裕一, 坂本博次, 矢野智則, 永山学, 竹澤敬人, 新畑博英, 井野裕治, 三浦義正, 林芳和, 佐藤博之, 砂田圭二郎, 大澤博之, 山本博徳  Gastroenterol Endosc  56-  (Supplement 2)  3180  2014/09  [Not refereed][Not invited]
  • 腸管スピロヘータ症11症例の検討
    竹澤 敬人, 林 俊治, 永山 学, 井野 佑治, 坂本 博次, 新畑 博英, 三浦 義正, 林 芳和, 佐藤 博之, 矢野 智則, 砂田 圭二郎, 足立 吉數, 山本 博徳  日本消化器病学会雑誌  111-  (臨増大会)  A900  -A900  2014/09  [Not refereed][Not invited]
  • YANO TOMONORI, SUNADA KEIJIRO, SATO HIROYUKI, HAYASHI YOSHIKAZU, MIURA YOSHIMASA, SHINHATA HAKUEI, SAKAMOTO HIROTSUGU, INO YUJI, TAKEZAWA TAKAHITO, NAGAYAMA MANABU, OSAWA HIROYUKI, YAMAMOTO HIRONORI  胃と腸  49-  (9)  1283  -1291  2014/08  [Not refereed][Not invited]
  • SAKAMOTO HIROTSUGU, KITAMURA AYA, TAKEZAWA TAKAHITO, SHINHATA HAKUEI, HAYASHI YOSHIKAZU, SATO HIROYUKI, YANO TOMONORI, SUNADA KEIJIRO, YAMAMOTO HIRONORI  Intestine  18-  (4)  397  -402  2014/07  [Not refereed][Not invited]
  • 坂本博次, 矢野智則  モダンフィジシャン  34-  (5)  568  -571  2014/05  [Not refereed][Not invited]
  • 坂本博次, 矢野智則, 井野裕治, 林芳和, 北村絢, 竹澤敬人, 新畑博英, 三浦義正, 佐藤博之, 砂田圭二郎, 山本博徳, 菅野健太郎  Gastroenterol Endosc  56-  (Supplement 1)  1075  2014/04  [Not refereed][Not invited]
  • 相良裕一, 矢野智則, 北村絢, 高橋治夫, 宮田なつ美, 竹澤敬人, 坂本博次, 新畑博英, 井野裕治, 林芳和, 佐藤博之, 砂田圭二郎, 山本博徳, 菅野健太郎  Gastroenterol Endosc  56-  (Supplement 1)  1275  2014/04  [Not refereed][Not invited]
  • 竹澤敬人, 高橋治夫, 北村絢, 井野佑治, 坂本博次, 新畑博英, 三浦義正, 林芳和, 佐藤博之, 矢野智則, 砂田圭二郎, 山本博徳  消化器内視鏡  26-  (3)  445  -453  2014/03  [Not refereed][Not invited]
  • 内視鏡的切除標本による十二指腸球部上皮性腫瘍の免疫組織学的検討
    永田 博之, 武藤 弘行, 坂本 博次, 三浦 義正, 宮田 康史, 永山 学, 高橋 治夫, 北村 絢, 井野 裕治, 新畑 博英, 竹澤 敬人, 林 芳和, 佐藤 博之, 矢野 智則, 砂田 圭二郎, 大澤 博之, 佐藤 貴一, 山本 博徳, 菅野 健太郎  日本消化器病学会雑誌  111-  (臨増総会)  A344  -A344  2014/03  [Not refereed][Not invited]
  • 永山学, 矢野智則, 林芳和, 沼尾規且, 北村絢, 井野裕治, 竹澤敬人, 新畑博英, 三浦義正, 佐藤博之, 坂本博次, 砂田圭二郎, 山本博徳, 菅野健太郎  栄養-評価と治療  31-  (1)  75  2014/02  [Not refereed][Not invited]
  • 佐藤雅史, 根本大樹, 吉田友直, 村山梢, 林芳和, 竹澤敬人, 井野裕治, 三浦義正, 新畑博英, 佐藤博之, 坂本博次, 矢野智則, 砂田圭二郎, 大澤博之, 山本博徳  Prog Dig Endosc  86-  (Supplement)  S130  2014  [Not refereed][Not invited]
  • 竹澤敬人, 林俊治, 笹原鉄平, 永山学, 井野佑治, 坂本博次, 新畑博英, 三浦義正, 林芳和, 佐藤博之, 矢野智則, 砂田圭二郎, 平井義一, 山本博徳  日本ブラキスピラ学会学術集会抄録集  6th-  15  2014  [Not refereed][Not invited]
  • 根本大樹, 林芳和, 小野公平, 宮田康史, 横山健介, 村山梢, 永山学, 竹澤敬人, 井野裕治, 三浦義正, 新畑博英, 佐藤博之, 坂本博次, 矢野智則, 砂田圭二郎, 大澤博之, 山本博徳  Prog Dig Endosc  86-  (Supplement)  S92  2014  [Not refereed][Not invited]
  • 宮田康史, 矢野智則, 永山学, 井野裕治, 竹澤敬人, 坂本博次, 新畑博英, 三浦義正, 林芳和, 佐藤博之, 砂田圭二郎, 大澤博之, 山本博徳  Prog Dig Endosc  85-  (Supplement)  S95  2014  [Not refereed][Not invited]
  • Yoshikazu Hayashi, Hironori Yamamoto, Hakuei Shinhata, Aya Kitamura, Haruo Takahashi, Yoshimasa Miura, Takahito Takezawa, Hiroyuki Sato, Hirotsugu Sakamoto, Tomonori Yano, Keijiro Sunada, Kentaro Sugano  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  28-  557  -557  2013/10  [Not refereed][Not invited]
  • 矢野智則, 林芳和, 井野裕治, 坂本博次  消化器内視鏡  25-  (9)  1397  -1400  2013/09  [Not refereed][Not invited]
  • 矢野智則, 砂田圭二郎, 林芳和, 佐藤博之, 三浦義正, 新畑博英, 坂本博次, 井野裕治, 北村絢, 山本博徳  IBD Res  7-  (3)  215  -220  2013/09  [Not refereed][Not invited]
  • 砂田圭二郎, 林芳和, 新畑博英, 北村絢, 坂本博次, 井野裕治, 三浦義正, 佐藤博之, 山本博徳  消化器内視鏡  25-  (8)  1254  -1261  2013/08  [Not refereed][Not invited]
  • 坂本博次, 矢野智則, 山本博徳  消化器内視鏡  25-  (7)  1034  -1035  2013/07  [Not refereed][Not invited]
  • 砂田圭二郎, 林芳和, 井野裕治, 坂本博次, 竹澤敬人, 新畑博英, 三浦義正, 佐藤博之, 矢野智則, 山本博徳  消化器内視鏡  25-  (5)  743  -749  2013/05  [Not refereed][Not invited]
  • 坂本博次  自治医科大学紀要  35-  135  2013/03  [Not refereed][Not invited]
  • 井野裕治, 矢野智則, 林芳和, 坂本博次, 佐藤博之, 砂田圭二郎, 三浦義正, 北村絢, 新畑博英, 高橋治夫, 山本博徳, 菅野健太郎  Prog Dig Endosc  83-  (Supplement)  S78  2013  [Not refereed][Not invited]
  • 新畑博英, 林芳和, 砂田圭二郎, 佐藤博之, 竹澤敬人, 三浦義正, 井野裕治, 北村絢, 坂本博次, 矢野智則, 山本博徳, 菅野健太郎  Prog Dig Endosc  84-  (Supplement)  S64  2013  [Not refereed][Not invited]
  • 三浦義正, 井野裕治, 林芳和, 佐藤博之, 新畑博英, 北村絢, 坂本博次, 竹澤敬人, 佐々尾航, 高橋治夫, 矢野智則, 砂田圭二郎, 大澤博之, 佐藤貴一, 山本博徳, 菅野健太郎  Prog Dig Endosc  84-  (Supplement)  S74  2013  [Not refereed][Not invited]
  • 高橋治夫, 矢野智則, 林芳和, 砂田圭二郎, 佐藤博之, 新畑博英, 竹澤敬人, 坂本博次, 北村絢, 山本博徳  Prog Dig Endosc  84-  (Supplement)  S82  2013  [Not refereed][Not invited]
  • Hirotsugu Sakamoto, Hiroyuki Mutoh, Yoshimasa Miura, Hironori Yamamoto, Kentaro Sugano  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  27-  388  -389  2012/12  [Not refereed][Not invited]
  • 坂本博次, 山本博徳  Front Gastroenterol  17-  (2)  105  -113  2012/04  [Not refereed][Not invited]
  • 竹澤敬人, 岩下ちひろ, 村山梢, 坂本博次, 新畑博英, 西村直之, 三浦義正, 林芳和, 佐藤博之, 矢野智則, 宮田知彦, 砂田圭二郎, 山本博徳, 菅野健太郎  栄養-評価と治療  29-  (1)  94  2012/02  [Not refereed][Not invited]
  • 坂本博次, 矢野智則, 山本博徳  Gastroenterol Endosc  53-  (Supplement 2)  2571  2011/09  [Not refereed][Not invited]
  • 岩下ちひろ, 竹澤敬人, 村山梢, 廣澤拓也, 野口地塩, 牛尾純, 坂本博次, 新畑博英, 西村直之, 三浦義正, 佐藤博之, 矢野智則, 宮田知彦, 砂田圭二郎, 山本博徳, 菅野健太郎  日本消化器病学会雑誌  108-  A835  2011/09  [Not refereed][Not invited]
  • 新畑博英, 山本博徳, 西村直之, 三浦義正, 佐藤博之, 林芳和, 坂本博次, 矢野智則, 砂田圭二郎  月刊消化器内科  53-  (1)  35  -41  2011/07  [Not refereed][Not invited]
  • 矢野智則, 西村直之, 砂田圭二郎, 佐藤博之, 新畑博英, 三浦義正, 坂本博次, 林芳和, 宮田知彦, 山本博徳  Intestine  15-  (2)  123  -128  2011/03  [Not refereed][Not invited]
  • 鈴木忠広, 小形幸代, 荒井康之, 中塚俊博, 間中一至, 坂本博次, 高山愼吾, 杉山照幸, 伊東紘一  茨城県臨床医学雑誌  (46)  9  2011/02  [Not refereed][Not invited]
  • 荒井康之, 坂本博次, 中塚俊博, 杉山照幸  茨城県臨床医学雑誌  (46)  1  2011/02  [Not refereed][Not invited]
  • 横山健介, 坂本博次, 竹澤敬人, 青木崇, 矢野智則, 宮田知彦, 砂田圭二郎, 山本博徳, 佐渡和也, 村岡新, 大木伸一, 三澤吉雄, 坂谷貴司, 菅野健太郎  Prog Dig Endosc  80-  (1)  98  2011  [Not refereed][Not invited]
  • 武藤弘行, 指川未歩, 坂本博次  Helicobacter Res  14-  (6)  468  -474  2010/12  [Not refereed][Not invited]
  • 坂本博次, 矢野智則, 佐藤博之, 西村直之, 新畑博英, 渡邊俊司, 篠崎聡, 砂田圭二郎, 林芳和, 宮田知彦, 山本博徳  消化器内視鏡  22-  (9)  1390  -1396  2010/09  [Not refereed][Not invited]
  • H. Sakamoto, H. Mutoh, K. Sugano  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  25-  A36  -A36  2010/09  [Not refereed][Not invited]
  • 中山雅之, 岡崎洋雄, 目黒由行, 関根良介, 横山卓, 小島正幸, 荒井康之, 間中一至, 坂本博次, 小形幸代, 杉山照幸, 伊東紘一, 廣田紀男  映像情報Medical  42-  (6)  644  -645  2010/06  [Not refereed][Not invited]
  • 坂本博次, 矢野智則, 林芳和, 山本博徳  Front Gastroenterol  15-  (1)  42  -45  2010/01  [Not refereed][Not invited]
  • 坂本博次, 矢野智則, 西村直之, 新畑博英, 佐藤博之, 宮田知彦, 砂田圭二郎, 山本博徳  日本大腸検査学会総会プログラム・抄録集  28th-  53  2010  [Not refereed][Not invited]
  • 小形幸代, 間中一至, 荒井康之, 坂本博次, 中山雅之, 杉山照幸, 伊東紘一  茨城循環器研究会雑誌  16-  57  -62  2009/11  [Not refereed][Not invited]
  • H. Mutoh, H. Sakamoto, K. Ido, K. Sugano  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY  24-  A134  -A135  2009/10  [Not refereed][Not invited]
  • 北村絢, 矢野智則, 北出卓, 仲谷朋久, 本田徹郎, 津久井大介, 坂本博次, 茂森昌人, 岩下裕一, 篠崎聡, 林芳和, 福島寛美, 新城雅行, 宮田知彦, 砂田圭二郎, 山本博徳, 菅野健太郎  Gastroenterol Endosc  50-  (Supplement 2)  2278  2008/09  [Not refereed][Not invited]
  • 竹澤敬人, 仲谷朋久, 坂本博次, 福嶋寛美, 林芳和, 新城雅行, 矢野智則, 宮田知彦, 砂田圭二郎, 山本博徳, 菅野健太郎, 広中貢, 中村哲也, 藤盛孝博  Gastroenterol Endosc  50-  (Supplement 2)  2283  2008/09  [Not refereed][Not invited]
  • 坂本博次, 武藤弘行, 菅野健太郎  日本臨床  66-  95  -99  2008/07  [Not refereed][Not invited]
  • 坂本博次, 砂田圭二郎, 矢野智則, 新城雅行, 林芳和, 宮田知彦, 山本博徳  消化器内視鏡  20-  (6)  960  -965  2008/06  [Not refereed][Not invited]
  • SUNADA KEIJIRO, YANO TOMONORI, MIYATA TOMOHIKO, IWAMOTO MICHIKO, ARASHIRO MASAYUKI, AJIBE HIRONARI, FUKUSHIMA HIROMI, NAKAYA TOMOHISA, KITADE TAKASHI, HONDA TETSURO, TSUKUI DAISUKE, SAKAMOTO HIROTSUGU, SHIGEMORI MASATO, IWASHITA YUICHI, HAYASHI YOSHIKAZU, YAMAMOTO HIRONORI, SUGANO KENTARO  胃と腸  43-  (4)  435  -442  2008/04  [Not refereed][Not invited]
  • 仲谷朋久, 矢野智則, 北出卓, 本田徹郎, 津久井大介, 坂本博次, 茂森昌人, 岩下裕一, 福島寛美, 阿治部弘成, 新城雅行, 砂田圭二郎, 宮田知彦, 岩本美智子, 山本博徳, 菅野健太郎  Gastroenterol Endosc  50-  (Supplement 1)  909  2008/04  [Not refereed][Not invited]
  • 北出卓, 仲谷朋久, 本田徹郎, 坂本博次, 津久井大介, 矢野智則, 砂田圭二郎, 山本博徳, 菅野健太郎  Gastroenterol Endosc  50-  (Supplement 1)  881  2008/04  [Not refereed][Not invited]
  • 岩下裕一, 矢野智則, 北出卓, 本田徹郎, 仲谷朋久, 津久井大介, 坂本博次, 茂森昌人, 福島寛美, 阿冶部弘成, 新城雅行, 宮田知彦, 岩本美智子, 砂田圭二郎, 山本博徳, 菅野健太郎  Gastroenterol Endosc  50-  (Supplement 1)  848  2008/04  [Not refereed][Not invited]
  • 坂本博次, 林芳和, 山本博徳  Gastroenterol Endosc  50-  (Supplement 1)  693  2008/04  [Not refereed][Not invited]
  • Keijiro Sunada, Tomonori Yano, Michiko Iwamoto, Tomohiko Miyata, Masayuki Arashiro, Hironari Ajibe, Hiromi Hukushima, Norikatsu Numao, Aya Kitamura, Takahito Takezawa, Tomohisa Nakaya, Takashi Kitade, Tetsuro Honda, Hirotsugu Sakamoto, Daisuke Tsukui, Masato Shigemori, Yuuichi Iwasshita, Yoshikazu Hayashi, Hironori Yamamoto, Kentaro Sugano  GASTROINTESTINAL ENDOSCOPY  67-  (5)  AB274  -AB274  2008/04  [Not refereed][Not invited]
  • Tomonori Yano, Keijiro Sunada, Mitsuyo Yoshizawa, Masato Shigemori, Hirotsugu Sakamoto, Tomohisa Nakaya, Hiromi Fukushima, Daisuke Tsukui, Tetsuro Honda, Takashi Kitade, Yuuichi Iwashita, Takahito Takezawa, Norikatsu Numao, Aya Kitarnura, Hozurmi Tanaka, Eiji Kobayashi, Hironori Yamamoto, Kentaro Sugano  GASTROINTESTINAL ENDOSCOPY  67-  (5)  AB260  -AB260  2008/04  [Not refereed][Not invited]
  • 砂田圭二郎, 宮田知彦, 新城雅行, 矢野智則, 岩本美智子, 阿治部弘成, 福島寛美, 仲谷朋久, 北出卓, 本田徹郎, 坂本博次, 津久井大介, 茂森昌人, 岩下裕一, 林芳和, 山本博徳  消化器内視鏡  20-  (3)  367  -372  2008/03  [Not refereed][Not invited]
  • 茂森昌人, 仲谷朋久, 吉澤充代, 本田哲朗, 北出卓, 津久井大介, 坂本博次, 岩下裕一, 新城雅行, 矢野智則, 砂田圭二郎, 岩本美智子, 宮田知彦, 山本博徳, 菅野健太郎  日本消化器病学会雑誌  105-  A329  2008/03  [Not refereed][Not invited]
  • 津久井大介, 矢野智則, 岩本美智子, 宮田智彦, 新城雅行, 福島寛美, 阿治部弘成, 沼尾規且, 北村絢, 竹澤敬人, 坂本博次, 本田徹郎, 北出卓, 仲谷朋久, 茂森昌人, 岩下裕一, 砂田圭二郎, 山本博徳, 菅野健太郎, 田中亨  日本消化器病学会雑誌  105-  A299  2008/03  [Not refereed][Not invited]
  • 新城雅行, 山本博徳, 宮田知彦, 砂田圭二郎, 矢野智則, 林芳和, 福島寛美, 阿治部弘成, 岩下裕一, 茂森昌人, 坂本博次, 津久井大介, 北出卓, 仲谷朋久, 本田徹郎, 佐藤貴一, 菅野健太郎  Prog Dig Endosc  73-  (1)  65  2008  [Not refereed][Not invited]
  • 中山雅之, 杉山照幸, 荒井康之, 間中一至, 坂本博次, 小形幸代, 伊東紘一  日本内科学会関東支部関東地方会  556th-  27  2008  [Not refereed][Not invited]
  • 北出卓, 阿治部弘成, 仲谷朋久, 本田徹郎, 津久井大介, 坂本博次, 福島寛美, 茂森昌人, 岩下裕一, 林芳和, 新城雅行, 宮田知彦, 砂田圭二郎, 矢野智則, 山本博徳, 菅野健太郎  Prog Dig Endosc  73-  (1)  102  2008  [Not refereed][Not invited]
  • 砂田圭二郎, 矢野智則, 宮田知彦, 岩本美智子, 新城雅行, 阿治部弘成, 福島寛美, 仲谷朋久, 北出卓, 本田徹郎, 坂本博次, 茂森昌人, 岩下裕一, 林芳和, 山本博徳  消化器の臨床  10-  (6)  627  -632  2007/12  [Not refereed][Not invited]
  • 武藤弘行, 坂本博次, 菅野健太郎  日本消化器病学会雑誌  104-  A480  2007/09  [Not refereed][Not invited]
  • 坂本博次, 井戸健一, 武藤弘行, 佐藤慎, 熊谷眞知夫, 礒田憲夫, 中澤克行, 大橋明, 和田伸一, 玉田喜一  胆道  21-  (3)  312  2007/08  [Not refereed][Not invited]
  • 武市和憲, 矢野智則, 吉田徹, 岩下裕一, 北出卓, 坂本博次, 津久井大介, 仲谷朋久, 本田徹郎, 阿治部弘成, 茂森昌人, 福島寛美, 林芳和, 新城雅之, 久野亜希子, 宮田知彦, 砂田圭二郎, 岩本美智子, 山本博徳, 菅野健太郎  Prog Dig Endosc  72-  (1)  104  2007  [Not refereed][Not invited]
  • 岩下裕一, 岩本美智子, 北村絢, 沼尾規且, 竹澤敬人, 北出卓, 本田徹郎, 仲谷朋久, 津久井大介, 武市和憲, 坂本博次, 茂森昌人, 福島寛美, 阿冶部弘成, 新城雅行, 矢野智則, 宮田知彦, 砂田圭二郎, 山本博徳, 菅野健太郎  Prog Dig Endosc  72-  (1)  76  2007  [Not refereed][Not invited]
  • 坂本博次, 武藤弘行, 佐藤貴一, 井戸健一, 菅野健太郎  日本消化器病学会雑誌  103-  A787  2006/09  [Not refereed][Not invited]
  • 坂本博次, 武藤弘行, 井戸健一  日本消化器病学会雑誌  103-  A139  2006/03  [Not refereed][Not invited]
  • 坂本博次, 武藤弘行, 佐藤貴一, 井戸健一, 菅野健太郎  日本消化器病学会雑誌  102-  A724  2005/09  [Not refereed][Not invited]
  • 渡辺俊司, 薄井尊信, 間中一至, 高山慎吾, 坂本博次, 藤枝毅, 石沢達也, 高橋保正, 長田明  茨城県臨床医学雑誌  (40)  8  2004/11  [Not refereed][Not invited]
  • 砂田富美子, 坂本博次, 天貝賢二, 大倉久直, 板橋正幸, 奥村敏之  Gastroenterol Endosc  46-  (Supplement 1)  658  2004/04  [Not refereed][Not invited]
  • 坂本博次, 砂田富美子, 吉沢充代, 五頭三秀, 天貝賢二, 大倉久直  日本消化器病学会雑誌  101-  A280  2004/03  [Not refereed][Not invited]
  • 砂田富美子, 坂本博次, 吉沢充代, 五頭三秀, 天貝賢二, 大倉久直  日本消化器病学会雑誌  101-  A222  2004/03  [Not refereed][Not invited]
  • 坂本博次, 砂田富美子, 大倉久直, 吉見富洋, 岡本光順, 田中敏明, 板橋正幸  日本消化器病学会雑誌  100-  A645  2003/09  [Not refereed][Not invited]
  • 砂田富美子, 花塚和伸, 坂本博次, 横瀬智之, 板橋正幸, 女屋博昭, 大倉久直, 吉沢充代, 天貝賢二  日本消化器病学会雑誌  100-  A750  2003/09  [Not refereed][Not invited]
  • 坂本博次, 花塚和伸, 砂田富美子, 吉沢充代, 五頭三秀, 天貝賢二, 大倉久直  日本消化器病学会雑誌  100-  A754  2003/09  [Not refereed][Not invited]
  • 坂本博次, 砂田富美子, 佐藤慎, 吉沢充代, 五頭三秀, 天貝賢二, 大倉久直  日本消化器病学会雑誌  100-  A644  2003/09  [Not refereed][Not invited]
  • 坂本博次, 砂田富美子, 吉沢充代, 五頭三秀, 天貝賢二, 大倉久直, 板橋正幸  日本消化器病学会雑誌  100-  A267  2003/03  [Not refereed][Not invited]
  • 堀光雄, 今井恵美子, 永田至男, 内田好明, 横瀬智之, 堀真佐男, 坂本博次, 大倉久直  茨城県臨床医学雑誌  (38)  16  -17  2002/11  [Not refereed][Not invited]
  • 増田裕也, 大塚稔, 緑川剛, 鈴木聖一, 森井太郎, 瀬下崇, 坂本博次, 山辺登  茨城県臨床医学雑誌  (38)  71  2002/11  [Not refereed][Not invited]
  • 砂田富美子, 天貝賢二, 坂本博次, 吉沢充代, 花塚和伸, 五頭三秀, 大倉久直  日本消化器病学会雑誌  99-  A584  2002/09  [Not refereed][Not invited]
  • 坂本博次, 砂田富美子, 花塚和伸, 天貝賢二, 吉沢充代, 五頭三秀, 大倉久直  Gastroenterol Endosc  44-  (Supplement 2)  1528  2002/09  [Not refereed][Not invited]
  • 矢野智則, 山本博徳, 川田浩, 坂本博次, 川上訓, 宮田知彦, 佐藤貴一, 井戸健一, 菅野健太郎  Gastroenterol Endosc  44-  (Supplement 2)  1512  2002/09  [Not refereed][Not invited]
  • 坂本博次, 砂田富美子, 天貝賢二, 吉沢充代, 花塚和伸, 五頭三秀, 大倉久直, 塩山靖和  日本消化器病学会雑誌  99-  A340  2002/03  [Not refereed][Not invited]
  • 池田真美, 吉見富洋, 田中良太, 鈴木章史, 坂本博次, 田中敏明, 岡大嗣, 中里宜正, 雨宮隆太  日本臨床外科学会雑誌  62-  (9)  2348  2001/09  [Not refereed][Not invited]
  • 坂本博次, 天貝賢二, 砂田富美子, 小俣勝哉, 吉沢充代, 大倉久直, 田中良太, 吉見富洋, 板橋正幸  日本内科学会関東地方会  493rd-  19  2001/09  [Not refereed][Not invited]
  • 坂本博次, 舘泰雄, 池内利夫, 植草義史, 大倉久直, 岡崎伸生  茨城県臨床医学雑誌  (37)  1  -2  2001/09  [Not refereed][Not invited]
  • SAKAMOTO HIROTSUGU, TATE YASUO, IKEUCHI TOSHIO, UEKUSA YOSHIFUMI, OKURA HISANAO, OKAZAKI NOBUO  茨城県立病院医学雑誌  18-  (2)  79  -83  2000/09  [Not refereed][Not invited]

Research Grants & Projects

  • Japan Society for the Promotion of Science:Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)
    Date (from‐to) : 2014/04 -2017/03 
    Author : Hirosawa Takuya
     
    Intestinal metaplasia is precancerous lesion of the stomach. We investigated the expression of Lgr5 in intestinal metaplasia and gastric carcinoma. By crossbreeding Cdx2-transgenic mouse and Lgr5-EGFP-ires-CreERT2 mouse, Lgr5-expression in intestinal metaplasia and gastric carcinoma was identified. By crossbreeding Lgr5-EGFP-ires-CreERT2-mouse, ROSA26-Loxp-stop-Loxp-LacZ-mouse, Cdx2-transgenic mouse, it was suggested that Lgr5 is induced by Cdx2.
  • Ministry of Education, Culture, Sports, Science and Technology:Grants-in-Aid for Scientific Research(基盤研究(C))
    Date (from‐to) : 2009 -2011 
    Author : Hirotsugu SAKAMOTO, Hiroyuki MUTOH
     
    Cdx1 and Cdx2, which are transcription factors regulating normal intestinal development, have been studied as potential key molecules in the pathogenesis of the precancerous intestinal metaplasia of the human stomach. However, the regulation of Cdx1 expression in the intestinal metaplasia is poorly understood. Cdx2-expressing gastric mucosa of Cdx2-transgenic mouse stomach was replaced by intestinal metaplastic mucosa. The aim of this study was to investigate the following :(a) Cdx1 expression in the intestinal metaplastic mucosa of the Cdx2-transgenic mouse stomach ; and(b) the relationship between Cdx1 and Cdx2.A mouse model of intestinal metaplasia, the Cdx2-transgenic mouse, was used to investigate Cdx1 gene expression by RT-PCR. DNA methylation profile analysis was performed by bisulfite sequencing, and the interaction of Cdx2 with the Cdx1 promoter was examined by chromatin immunoprecipitation assay, electrophoretic mobility shift assay, and luciferase reporter assays. Cdx2 mRNA was expressed in the Cdx2-transgenic mouse stomach. However, endogenous Cdx2 mRNA was not expressed in the intestinal metaplasia of the Cdx2-transgenic mouse stomach. On the other hand, endogenous Cdx1 mRNA and protein were expressed in the intestinal metaplasia of the Cdx2-transgenic mouse stomach. The Cdx1 promoter was unmethylated in the intestinal metaplasia of the Cdx2-transgenic mouse stomach. Chromatin immunoprecipitation assay and electrophoretic mobility shift assay showed that Cdx2 was bound to the Cdx1 promoter region in the intestinal metaplasia and the normal intestine. Cdx2 upregulated and siRNA-Cdx2 downregulated the transcriptional activity of the Cdx1 gene in the human gastric carcinoma cell lines AGS, MKN45, and MKN74.In conclusion, transgenic Cdx2 induced endogenous Cdx1 through the binding of Cdx2 to the unmethylated Cdx1 promoter region in the intestinal metaplasia of the Cdx2-transgenic mouse stomach.


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