研究者総覧

宮谷 博幸 (ミヤタニ ヒロユキ)

  • 総合医学第1講座 教授
Last Updated :2021/09/22

研究者情報

学位

  • 博士(医学)(自治医科大学(JMU))

ホームページURL

J-Global ID

研究キーワード

  • 乳頭機能不全症   胆道疾患   超音波内視鏡   

研究分野

  • ライフサイエンス / 消化器内科学
  • ライフサイエンス / 内科学一般

経歴

  • 2013年 - 現在  自治医科大学准教授
  • 2004年 - 2013年  自治医科大学講師
  • 2001年 - 2004年  埼玉医科大学講師
  • 1996年 - 2001年  自治医科大学助手
  • 1996年 - 2001年  Jichi Medical School, Research Assistant

学歴

  •         - 1987年   自治医科大学(JMU)   医学部   医学
  •         - 1987年   自治医科大学   Faculty of Medicine

所属学協会

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

研究活動情報

論文

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

書籍

MISC

  • Satohiro Matsumoto, Hiroyuki Miyatani, Yukio Yoshida DIGESTIVE DISEASES AND SCIENCES 58 (5) 1306 -1312 2013年05月 [査読無し][通常論文]
     
    We examined the pathologies, treatment characteristics, and clinical course of elderly ulcerative colitis (UC) patients. Among 222 UC patients (127 men, 95 women; average age, 34 +/- A 16 years), we selected 109 with UC diagnosed between 20 and 39 years of age (young adult group) and 23 diagnosed at a parts per thousand yen60 years of age (elderly group). Moreover, 12 patients diagnosed between 60 and 64 years of age (late-onset group) and 6 patients aged a parts per thousand yen60 years diagnosed under 50 years old (long-standing group) were also extracted for sub-analysis. The clinical characteristics and course were compared among the groups. The average age at onset was 29 +/- A 6 years in the young adult group and 66 +/- A 5 years in the elderly group. The frequency of immunomodulator or steroid use did not differ between the two groups. The comorbidity rate was 14.7 % in the young adult group and 69.6 % in the elderly group (P < .0001). Seven patients (58.3 %) in the late-onset UC group and none of the patients in the long-standing UC group were on steroid treatment. None of the patients in the long-standing UC group required hospitalization/surgery for UC exacerbation, while 3 (25.0 %) and 2 patients (16.7 %) in the late-onset group required hospitalization and surgery, respectively. The comorbidity rate was significantly higher in the elderly group. Treatments did not differ significantly between the young adult and elderly groups. Therefore, it appears that the inflammation tends to subside with age in elderly patients with long-standing UC.
  • 山中 健一, 宮谷 博幸, 吉田 行雄 月刊地域医学 26 (11) 1054 -1057 2012年11月 [査読無し][通常論文]
  • 高松 徹, 大竹 はるか, 上原 健志, 新藤 雄司, 池谷 敬, 東海 浩一, 池田 正俊, 牛丸 信也, 浅野 岳春, 松本 吏弘, 岩城 孝明, 福西 昌徳, 鷺原 規喜, 浅部 伸一, 宮谷 博幸, 吉田 行雄 膵臓 = The Journal of Japan Pancreas Society 27 (5) 695 -700 2012年10月 [査読無し][通常論文]
  • 新藤 雄司, 宮谷 博幸, 上原 健志, 池谷 敬, 山中 健一, 池田 正俊, 東海 浩一, 牛丸 信也, 松本 吏弘, 浅野 岳晴, 高松 徹, 福西 昌徳, 岩城 孝明, 鷺原 規喜, 浅部 伸一, 吉田 行雄 日本消化器病學會雜誌 = The Japanese journal of gastro-enterology 109 (7) 1243 -1249 2012年07月 [査読無し][通常論文]
     
    症例は78歳男性.多発肝細胞癌の治療を6年間行っていた.腹痛があり,CT検査にて,肝S3より突出する肝細胞癌の穿破による胆汁瘻が疑われた.内視鏡的逆行性膵胆管造影にて肝内胆管,主膵管の途絶と造影剤の腹腔内への漏出を認め,肝細胞癌局所治療後の胆汁瘻に合併した大網脂肪織炎および膵液瘻と診断した.内視鏡的胆管および膵管ドレナージが病態の改善に極めて有効であった.
  • TAKAMATSU Toru, OOTAKE Haruka, UEHARA Takeshi, SHINDOU Yuji, IKEYA Takashi, TOUKAI Kouichi, IKEDA Masatoshi, USHIMARU Shinya, ASANO Takeharu, MATSUMOTO Satohiro, IWAKI Takaaki, FUKUNISHI Masanori, SAGIHARA Noriyoshi, ASABE Shinichi, MIYATANI Hiroyuki, YOSHIDA Yukio 自治医科大学紀要 34 87 -95 2012年03月 [査読無し][通常論文]
  • 高松 徹, 大竹 はるか, 上原 健志, 新藤 雄司, 池谷 敬, 東海 浩一, 池田 正俊, 牛丸 信也, 浅野 岳春, 松本 吏弘, 岩城 孝明, 福西 昌徳, 鷺原 規喜, 浅部 伸一, 宮谷 博幸, 吉田 行雄 自治医科大学紀要 34 87 -95 2012年03月 [査読無し][通常論文]
     
    食道・胃静脈瘤の治療指針はほぼ確立されているが,異所性静脈瘤の治療法については一定の見解が得られていない。我々は,十二指腸静脈瘤破裂に対して,透視下に行った内視鏡的硬化療法が有用であった1例を経験した。症例は73歳,肝硬変の女性で十二指腸静脈瘤破裂にて当院へ紹介となった。内視鏡検査にて,十二指腸下行脚に出血点と思われるびらんを伴うF3の静脈瘤を認めた。腹部CTでは膵十二指腸静脈を供血路としRetzius静脈に排血路を伴う十二指腸静脈瘤を認めた。n-butyl-2-cyanoacrylateとlipiodolを3:1に混合し,X線透視下に確認しながら3ヶ所に計6.0ml静脈瘤内に供血路,排血路が造影されるまで局注した。6日後の造影CTでは,静脈瘤から連続する供血路と排血路の一部にlipiodolの集積を認め,静脈瘤はほぼ硬化剤により置換されていた。透視下に硬化剤の注入範囲を確認しながら内視鏡的硬化療法を行うことで合併症なく,また追加治療を必要としない十分な十二指腸静脈瘤の治療が可能であった。
  • 浅野 岳晴, 中村 郁夫, 岡島 真里, 山中 健一, 浅部 伸一, 宮谷 博幸, 松浦 克彦, 吉田 行雄, 井廻 道夫 肝臓 53 (1) 55 -63 2012年01月 [査読無し][通常論文]
     
    症例は73歳,男性.C型慢性肝炎にて当院通院中であった.1999年,肝細胞癌(S5単発,径3 cm)が認められ肝右葉前区域切除術を施行した.術後は4-6カ月ごとに腹部USおよびCT検査にて経過観察していた.2009年3月の腹部CT検査にて,肝右葉の手術断端に,内部が不均一で一部造影効果を示す病変が認められた.同病変は同年5月のCTにて増大傾向を認め,仮性動脈瘤と診断された.腹部血管造影では,右肝動脈の前区域枝起始部に3 cm大の仮性動脈瘤を認めた.破裂予防のため,瘤のコイル塞栓術を施行した. 仮性動脈瘤の破裂の頻度や破裂後の死亡率は高率であるため,より早期の治療が望ましいとされている.また肝癌術後の画像フォローでは,術後晩期においても再発腫瘍の有無のみならず,動脈瘤や血栓などの血管変化にも留意する必要があると考えられた.
  • Hiromu Inoue, Hiroyuki Miyatani, Yoshiyuki Nakashima, Noriyoshi Sagihara, Yukio Yoshida DIGESTIVE ENDOSCOPY 23 (4) 325 -325 2011年10月 [査読無し][通常論文]
  • Takuhiro Ugajin, Hiroyuki Miyatani, Satohiro Matsumoto, Tohru Takamatsu, Masanori Fukunishi, Yukio Yoshida, Yoh Dobashi DIGESTIVE ENDOSCOPY 23 (4) 328 -328 2011年10月 [査読無し][通常論文]
  • 高松 徹, 東海 浩一, 牛丸 信也, 松本 吏弘, 岩城 孝明, 福西 昌徳, 鷺原 規喜, 宮谷 博幸, 吉田 行雄, 山田 茂樹 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 53 (9) 3023 -3027 2011年09月 [査読無し][通常論文]
     
    食道粘膜下腫瘍(SMT)は良性腫瘍が大部分を占め,悪性は稀とされている.しかし,画像所見のみでは良悪性の鑑別が困難な場合もあり,組織型により治療方針も異なるため組織診断を得ることが必要である.今回,われわれは30mmの食道SMTに対して超音波内視鏡下穿刺吸引生検術(EUS-FNAB)を試みたが,組織量が不十分で確定診断に至らず,粘膜切開後直視下生検にて確定診断が得られた症例を経験した.EUS-FNABはSMTに対する組織診断法の第一選択であるが,EUS-FNABにより十分な組織が得られない場合には,本法を試みてよいと思われた.
  • 高松 徹, 東海 浩一, 池田 正俊, 牛丸 信也, 浅野 岳晴, 松本 吏弘, 岩城 孝明, 福西 昌徳, 鷺原 規喜, 宮谷 博幸, 吉田 行雄, 山田 茂樹 日本消化器病學會雜誌 = The Japanese journal of gastro-enterology 108 (4) 658 -664 2011年04月 [査読無し][通常論文]
     
    60歳女性.突然ショック状態となり,造影CTにて脾臓および転移性肝腫瘍からの腹腔内出血と診断した.同部位に対するTAEにて血行動態は安定したが,第13病日死亡した.剖検にて腹膜播種,肝・肺・リンパ節転移をともなう脾原発血管肉腫と診断した.本疾患は原発臓器のみならず転移巣からも出血をともなうことがあり,TAEが出血性ショックに対する一時止血に有用であったと考えられ,本邦報告42例の検討とともに報告する.
  • 高松 徹, 上原 健志, 池谷 敬, 東海 浩一, 池田 正俊, 牛丸 信也, 浅野 岳春, 松本 吏弘, 岩城 孝明, 福西 昌徳, 鷺原 規喜, 浅部 伸一, 宮谷 博幸, 吉田 行雄, 野田 弘志, 土橋 洋 膵臓 = The Journal of Japan Pancreas Society 25 (5) 578 -584 2010年10月 [査読無し][通常論文]
  • 本田 英明, 宮谷 博幸, 池谷 敬, 山中 健一, 池田 正俊, 牛丸 信也, 高松 徹, 岩城 孝明, 鷺原 規喜, 吉田 行雄 日本消化器病學會雜誌 = The Japanese journal of gastro-enterology 107 (9) 1497 -1504 2010年09月 [査読無し][通常論文]
     
    症例は40歳,男性.主訴は心窩部痛・嘔吐.急性膵炎に膵仮性嚢胞,閉塞性黄疸,十二指腸狭窄を合併したと診断した.発熱,腹痛,CRP上昇から嚢胞感染を疑い第6病日にEUS-CDを施行した.嚢胞が縮小し,黄疸と十二指腸狭窄が解除されたため経鼻ドレナージチューブをプラスチックステントに交換した.内視鏡的逆行性膵胆管造影で膵頭部主膵管の狭窄を認め,膵管ステントを留置した.5日後両ステントを抜去したが,膵炎・嚢胞は再燃しなかった.
  • 宮谷 博幸, 吉田 行雄 月刊地域医学 24 (6) 424 -430 2010年06月 [査読無し][通常論文]
  • 岩城 孝明, 宮谷 博幸, 池谷 敬, 山中 健一, 池田 正俊, 牛丸 信也, 松本 吏弘, 高松 徹, 福西 昌徳, 鷺原 規喜, 吉田 行雄 膵臓 = The Journal of Japan Pancreas Society 25 (2) 132 -137 2010年04月 [査読無し][通常論文]
  • 横田 和久, 宮谷 博幸, 吉田 行雄 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 52 (4) 1257 -1260 2010年04月 [査読無し][通常論文]
     
    症例は55歳の男性.既往歴として,十二指腸潰瘍穿孔にて胃十二指腸切除術(ビルロートI法)が施行されている.サバを生食した4日後に吐血したため,緊急上部消化管内視鏡検査を施行したところ,吻合部の胃側大彎にA1ステージの潰瘍を認め,その潰瘍底にアニサキス虫体の刺入を認めた.生検鉗子にて虫体を摘出後,潰瘍底の露出血管に対し止血処置を施した.プロトンポンプ阻害剤(PPI)の投与にて加療した.サバの生食14日後には,潰瘍はH2ステージへ改善を認めた.アニサキスによる出血性胃潰瘍の発生が推測された.
  • 清崎 浩一, 周東 千緒, 斉藤 正昭, 千葉 文博, 高田 理, 吉田 卓義, 鈴木 浩一, 小西 文雄, 宮谷 博幸, 吉田 行雄 日本外科学会雑誌 111 (2) 2010年03月 [査読無し][通常論文]
  • MIYATANI Hiroyuki, SAWADA Yukihisa, NAKASHIMA Yoshiyuki, ISHII Akira, SAGIHARA Noriyoshi, IKEDA Masatoshi, IWAKI Takaaki, YOSHIDA Yukio 自治医科大学紀要 32 103 -109 2010年03月 [査読無し][通常論文]
  • 宮谷 博幸, 澤田 幸久, 中島 嘉之, 石井 彰, 鷺原 規喜, 池田 正俊, 岩城 孝明, 吉田 行雄 自治医科大学紀要 32 103 -109 2010年03月 [査読無し][通常論文]
     
    症例:77歳 男性.11年前に胃癌のため遠位側胃切除(ビルロートII法再建),8年前急性膵炎の既往あり,高アミラーゼ血症を伴う腹痛発作を繰り返すため精査目的に当センターに入院した。透明キャップを装着した直視鏡にてERCPを試みたが,主乳頭からは胆管のみ造影され,膵管は全く造影されなかった。MRCPにて膵管非癒合が疑われたため,ERCP再検,副乳頭造影にて背側膵管の造影が得られたが,腹側膵管は造影されず,膵管形態から腹側膵管欠損型の膵管非癒合と考えられた。膵管にガイドワイヤー留置後,先細カテーテルの挿入を試みたが不可能なため,ワイヤーガイド下に針状ナイフで副乳頭を切開し,膵管ステントを留置して終了した。高アミラーゼ血症は以後認められず,腹痛も一時改善した。腹側膵管欠損症は主乳頭からは膵管造影が得られないため,副膵管造影をしないと診断できない。本症を疑った場合は積極的に副乳頭からアプローチすべきである
  • 宮谷 博幸 月刊地域医学 24 (2) 124 -128 2010年02月 [査読無し][通常論文]
  • 福田 重信, 宮谷 博幸, 山中 健一, 牛丸 信也, 松本 吏弘, 高松 徹, 岩城 孝明, 中島 嘉之, 鷺原 規喜, 吉田 行雄 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 52 (1) 58 -63 2010年01月 [査読無し][通常論文]
     
    腹膜透析患者の大腸内視鏡検査・処置後には腹膜炎等の致死的な偶発症が生じる可能性がある.医療の進歩によって,透析患者の長期予後が期待されるようになり,今後腹膜透析患者に対する内視鏡検査件数の増加が予想される.今回,我々は腹膜透析患者における大腸粘膜切除術を2例経験したので,内視鏡時の注意点を含めて報告する.
  • 山中 健一, 宮谷 博幸, 中島 嘉之, 池谷 敬, 池田 正俊, 牛丸 信也, 松本 吏弘, 本田 英明, 高松 徹, 岩城 孝明, 福西 昌徳, 鷺原 規喜, 吉田 行雄, 野田 弘志, 遠山 信幸, 土橋 洋 肝臓 51 (7) 387 -393 2010年 [査読無し][通常論文]
     
    症例は78歳,男性.68歳時から多発肝嚢胞と腎嚢胞を指摘されていた.2007年12月,経過観察のCTで多発肝嚢胞と一部嚢胞内に充実性腫瘤を認めたため精査加療目的に2008年3月当科紹介受診.腹部超音波で肝両葉に多発嚢胞を認め,左葉S3の嚢胞内と右葉S7の嚢胞内に乳頭状隆起性腫瘤があった.腹部CTでもS3とS7の嚢胞内に淡く造影効果を伴う軟部組織濃度の腫瘤を認めた.FDG-PETでは肝内に異常集積像を認めなかった.ERCP,MRCPではS3とS7の嚢胞と胆管との交通は確認できなかった.嚢胞性腫瘍を強く疑い,肝部分切除術を施行した.病理学的所見としてはいずれも多房性嚢腫であった.一部に認められた,壁の充実性部分は肥厚した嚢胞壁を形成する血管結合組織で,画像上で嚢胞内隆起性病変と考えた部分は嚢胞内出血による凝血塊と,その部分的な器質化であった.腺腫や癌を疑う所見はなかった.同時多発性で増大傾向のある肝嚢胞内出血の症例は極めて稀であり,若干の文献的考察を加えて報告する.
  • 鷺原 規喜, 宮谷 博幸, 池田 正俊, 牛丸 信也, 本田 英明, 高松 徹, 岩城 孝明, 中島 嘉之, 吉田 行雄, 山田 茂樹 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 51 (12) 3085 -3091 2009年12月 [査読無し][通常論文]
     
    症例は64歳男.糖尿病・深部静脈血栓症の既往があり,ステロイド及びワーファリンを内服中.腹痛で来院した.白血球数上昇,黄疸を認めた為入院した.ERCPにて十二指腸乳頭部が腫脹し,暗赤色を呈していた.ENBDにて減黄後,乳頭切開術・胆管ドレナージチューブ留置を施行した.超音波内視鏡により十二指腸乳頭部血腫と診断した.第31病日退院した.外傷,生検,治療例以外での十二指腸乳頭部血腫は極めて稀であり示唆に富むと考えられたので報告する.
  • Hiroyuki Miyatani, Yukio Yoshida, Shinya Ushimaru, Noriyoshi Sagihara, Shigeki Yamada DIGESTIVE ENDOSCOPY 21 (4) 255 -257 2009年10月 [査読無し][通常論文]
     
    We report a rare case of flat-type primary malignant melanoma of the esophagus treated with endoscopic mucosal resection (EMR). A 64-year-old woman was referred for examination of a small pigmented lesion located in the mid esophagus. On endoscopy, the lesion exhibited almost no change in size over the year. Cap-assisted EMR was performed en bloc. The histopathological findings showed atypical melanocyte proliferation in the basal layer, spindle cells, and epithelioid cell proliferation with nuclear enlargement and a few mitotic figures. Histopathological examination confirmed the diagnosis of primary malignant melanoma. Immunostaining for S-100 protein and HMB-45 antibody were positive, and the Ki-67 index was low. The patient was discharged without additional surgical resection and/or chemotherapy. The patient had no symptoms and no signs of recurrence 20 months after EMR. There has been no report on a slow growing esophageal melanoma. It is difficult to estimate the malignant behavior of this case.
  • Hiroyuki Miyatani, Yukio Yoshida, Shinya Ushimaru, Noriyoshi Sagihara, Shigeki Yamada DIGESTIVE ENDOSCOPY 21 (4) 255 -257 2009年10月 [査読無し][通常論文]
     
    We report a rare case of flat-type primary malignant melanoma of the esophagus treated with endoscopic mucosal resection (EMR). A 64-year-old woman was referred for examination of a small pigmented lesion located in the mid esophagus. On endoscopy, the lesion exhibited almost no change in size over the year. Cap-assisted EMR was performed en bloc. The histopathological findings showed atypical melanocyte proliferation in the basal layer, spindle cells, and epithelioid cell proliferation with nuclear enlargement and a few mitotic figures. Histopathological examination confirmed the diagnosis of primary malignant melanoma. Immunostaining for S-100 protein and HMB-45 antibody were positive, and the Ki-67 index was low. The patient was discharged without additional surgical resection and/or chemotherapy. The patient had no symptoms and no signs of recurrence 20 months after EMR. There has been no report on a slow growing esophageal melanoma. It is difficult to estimate the malignant behavior of this case.
  • 宮谷 博幸, 吉田 行雄 膵臓 = The Journal of Japan Pancreas Society 24 (4) 532 -536 2009年08月 [査読無し][通常論文]
  • 高松 徹, 宮谷 博幸, 牛丸 信也, 本田 英明, 岩城 孝明, 福西 昌徳, 宇賀神 卓広, 中島 嘉之, 鷺原 規喜, 吉田 行雄 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 51 (2) 237 -241 2009年02月 [査読無し][通常論文]
     
    症例は46歳男性.アルコール性慢性膵炎,膵頭部仮性膵嚢胞にて外来通院中に膵嚢胞内感染,慢性膵炎急性増悪にて入院した.当初ERPで膵管と嚢胞の交通を認めなかったが,経皮的膵嚢胞ドレナージ後に交通枝を認めるようになり,経乳頭的に膵嚢胞ドレナージチューブ挿入が可能となった症例を経験したので報告する.
  • Takuhiro Ugajin, Hiroyuki Miyatani, Toshio Demitsu, Takaaki Iwaki, Shinya Ushimaru, Yoshiyuki Nakashima, Yukio Yoshida INTERNAL MEDICINE 48 (9) 693 -695 2009年 [査読無し][通常論文]
     
    A 15-year-old, woman, Crohn's disease patient, who carried the TPMT *3C heterozygous mutant, complained of alopecia 3 days after starting 6-mercaptopurine (6-MP) and then developed severe myelosuppression 6 weeks after starting 6-MP. The alopecia involved scalp hair only (body hair preserved) and was dominant in the temporal region. Following these side effects, transient remission of Crohn's disease occurred. Myelosuppression due to 6-MP is a rare but life-threatening side effect that is difficult to predict despite continuous monitoring of complete blood cell counts. In the present case, 6-MP-induced alopecia preceded myelosuppression and progressed rapidly as the myelosuppression worsened.
  • 宮谷 博幸, 中島 嘉之, 岩城 孝明 月刊地域医学 22 (11) 1136 -1141 2008年11月 [査読無し][通常論文]
  • ORIHASHI Kazumasa, MIYATANI Hiroyuki Journal of medical ultrasonics : official journal of the Japan Society of Ultrasonics in Medicine 35 (3) 147 -148 2008年09月 [査読無し][通常論文]
  • 福田 重信, 宮谷 博幸, 本田 英明, 高松 徹, 福西 昌徳, 岩城 孝明, 宇賀神 卓広, 中島 嘉之, 鷺原 規喜, 吉田 行雄 膵臓 = The Journal of Japan Pancreas Society 23 (4) 533 -540 2008年08月 [査読無し][通常論文]
  • 鷺原 規喜, 宮谷 博幸, 吉田 行雄 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 50 (5) 1338 -1339 2008年05月 [査読無し][通常論文]
  • Hiroyuki Miyatani, Yukio Yoshida, Masatoshi Ikeda, Noriyoshi Sagihara 47 (4) 2008年 [査読無し][通常論文]
  • Biliopancreatic fistula with portal vein thrombosis caused by a pancreatic pseudocyst
    Hiroyuki Miyatani, Noriyoshi Sagihara, Yukio Yoshida, Yoshihisa Suminaga Clinical J Gastroenterol 1 (59) 63 2008年 [査読無し][通常論文]
  • Takuhiro Ugajin, Hiroyuki Miyatani, Shin-ichi Momomura, Masamitsu Sanui, Yoshiyuki Nakashima, Yukio Yoshida INTERNAL MEDICINE 47 (7) 609 -612 2008年 [査読無し][通常論文]
     
    While ventricular premature contractions have been noted during colonoscopy (CS), ventricular fibrillation (VF) is rare. We recently had a patient who developed VF during CS and recovered without any sequelae despite severe complications after cardiopulmonary resuscitation (CPR). If electrocardiogram (ECG) monitoring had been done during CS, a direct current shock defibrillation could have been accomplished and prevented complications. CS in high-risk patients should be done with ECG monitoring.
  • Hiroyuki Miyatani, Yukio Yoshida, Masatoshi Ikeda, Noriyoshi Sagihara INTERNAL MEDICINE 47 (4) 321 -322 2008年 [査読無し][通常論文]
  • Takuhiro Ugajin, Hiroyuki Miyatani, Yoshiaki Watanabe, Junji Nishida, Yukio Yoshida INTERNAL MEDICINE 47 (9) 879 -880 2008年 [査読無し][通常論文]
  • 村山 淳子, 宮谷 博幸, 牛丸 信也, 本田 英明, 澤田 幸久, 中島 嘉之, 宇賀神 卓広, 鷺原 規喜, 吉田 行雄, 吉田 卓義 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 49 (12) 2972 -2977 2007年12月 [査読無し][通常論文]
  • MIYATANI Hiroyuki, YOSHIDA Yukio, USHIMARU Shinya, IKEDA Masatoshi, HONDA Hideaki, SAWADA Yukihisa, NAKASHIMA Yoshiyuki, UGAJIN Takuhiro, OCHIAI Kaori, SAGIHARA Noriyoshi, KAWAMURA Yutaka J 自治医科大学紀要 30 155 -158 2007年12月 [査読無し][通常論文]
  • Hiroyuki Miyatani, Yukio Yoshida Journal of Medical Ultrasonics 34 (4) 205 -207 2007年12月 [査読無し][通常論文]
     
    Aortoesophageal fistula (AEF) is very rare and is associated with a high mortality rate. AEF manifests with massive gastrointestinal bleeding and is difficult to diagnose from endoscopic findings and clinical features. We encountered a patient with an AEF that was promptly diagnosed by endoscopic ultrasonography (EUS) using a microprobe. A 58-year-old man was admitted to our hospital because of hematemesis. Endoscopic examination revealed a submucosal tumor (SMT)-like lesion 2 cm in diameter 25 cm from the dental arch. EUS with a 20-MHz microprobe revealed a blood vessel-like structure with hypoechoic flowing contents and a high echoic area suggestive of a thrombus protruding into the esophageal lumen. AEF resulting from a ruptured thoracic aortic aneurysm was suggested from the EUS findings and was definitely diagnosed by computed tomography. Graft replacement of the descending aorta was successfully performed. The patient is now in good health 6 years after the first admission. This is the first report of a case of AEF diagnosed by EUS with a microprobe. © 2007 The Japan Society of Ultrasonics in Medicine.
  • 宇賀神 卓広, 宮谷 博幸, 税田 和夫, 飯島 裕生, 吉田 行雄 自治医科大学紀要 30 115 -121 2007年12月 [査読無し][通常論文]
     
    症例は肝細胞癌合併C型肝硬変の80歳男性。主訴は腰痛,発熱。炎症反応は強陽性で,敗血症によるpre DICの状態であった。MRIの所見から腰椎の化膿性脊椎炎・腸腰筋膿瘍と診断。抗生剤のみではCRPが陰性化せず,病巣掻爬術にて治癒した。血液培養と掻爬の手術材料培養でともにCitrobactor diversusが検出され,明らかな感染のフォーカスが不明であったことから,bacterial translocationによる感染が疑われた。化膿性脊椎炎と腸腰筋膿瘍の肝硬変合併例の報告は比較的希だが,実際には診断に至らないケースも多いことが予想される。留意すべき貴重な症例であり,文献的考察を加えて報告する。
  • 宮谷 博幸, 吉田 行雄, 牛丸 信也, 池田 正俊, 本田 英明, 澤田 幸久, 中島 嘉之, 宇賀神 卓広, 落合 香織, 鷺原 規喜, 河村 裕 自治医科大学紀要 30 156 -158 2007年12月 [査読無し][通常論文]
     
    症例 16歳男性 潰瘍性大腸炎にて全結腸切除・回腸瘻造設術の既往あり。癒着性イレウスの診断で入院。2日間にわたりX線透視下にイレウス管挿入を約1時間ずつかけて試みるもトライツ靭帯よりチューブが進まなかった。そのためダブルバルーン内視鏡下でのイレウス管挿入を施行した。ダブルバルーン内視鏡を十二指腸から空腸へ貯留した腸液とガスを吸引しながら挿入した。トライツ靭帯付近は癒着のため屈曲が強く内視鏡の挿入がやや困難であった。内視鏡を空腸内に十分深く挿入後,ガイドワイヤーを留置してスコープを抜去,ガイドワイヤーを胃管を使用し鼻から出したあと,ガイドワイヤーガイド下にイレウス管を空腸内に留置した。その後腸管減圧が成功し27日後退院した。本法はトライツ靭帯や空腸の癒着などのため通常の方法でイレウス管挿入が困難な場合にチューブを深部挿入できる点で大変有用である。
  • 福本 顕史, 宮谷 博幸, 吉田 行雄, 牛丸 信也, 工藤 康孝, 本田 英明, 澤田 幸久, 宇賀神 卓広, 中島 嘉之, 鷺原 規喜 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 49 (8) 1839 -1843 2007年08月 [査読無し][通常論文]
  • H. Miyatani, Y. Yoshida ENDOSCOPY 39 E246 -E246 2007年02月 [査読無し][通常論文]
  • Decompression tube insertion using double balloon endoscopy in a case following initial difficulty in passing the duodenojejunal junction. 30: 155-158. 2007.
    Hiroyuki Miyatani, Yukio Yoshida, Shinya Ushimaru, Masatoshi Ikeda, Hideaki Honda, Yukihisa Sawada, Yoshiyuki Nakashima, Takuhiro Ugajin, Kaori Ochiai, Noriyoshi Sagihara, Yutaka J. Kawamura Jichi Medical University Journal 30 155 -158 2007年 [査読無し][通常論文]
  • 十二指腸腫瘍の内視鏡治療.埼玉県医学会雑誌,42:377-380, 2007.
    宮谷博幸,吉田行雄,牛丸信也,池田正俊,本田英明,増井利治,澤田幸久,中島嘉之,宇賀神卓広,落合香織,鷺原規喜 42 377 -380 2007年 [査読無し][通常論文]
  • Hiroyuki Miyatani, Yukio Yoshida JOURNAL OF MEDICAL ULTRASONICS 34 (4) 205 -207 2007年 [査読無し][通常論文]
     
    Aortoesophageal fistula (AEF) is very rare and is associated with a high mortality rate. AEF manifests with massive gastrointestinal bleeding and is difficult to diagnose from endoscopic findings and clinical features. We encountered a patient with an AEF that was promptly diagnosed by endoscopic ultrasonography (EUS) using a microprobe. A 58-year-old man was admitted to our hospital because of hematemesis. Endoscopic examination revealed a submucosal tumor (SMT)-like lesion 2 cm in diameter 25 cm from the dental arch. EUS with a 20-MHz microprobe revealed a blood vessel-like structure with hypoechoic flowing contents and a high echoic area suggestive of a thrombus protruding into the esophageal lumen. AEF resulting from a ruptured thoracic aortic aneurysm was suggested from the EUS findings and was definitely diagnosed by computed tomography. Graft replacement of the descending aorta was successfully performed. The patient is now in good health 6 years after the first admission. This is the first report of a case of AEF diagnosed by EUS with a microprobe.
  • Hiromu Inoue, Yukihisa Sawada, Kaori Ochiai, Hideaki Honda, Junko Murayama, Yasutaka Kudo, Yoshiyuki Nakashima, Noriyoshi Sagihara, Hiroyuki Miyatani, Ikuo Nakamura, Yukio Yoshida INTERNAL MEDICINE 46 (12) 845 -848 2007年 [査読無し][通常論文]
     
    A 71-year-old man was admitted to our hospital with abdominal pain. Hepatocellular carcinoma (HCC) had been diagnosed 2 years earlier and he had undergone 7 courses of intra-hepato-arterial chemotherapy (IHAC). We performed gastrointestinal fiberscopy and identified a massive protrusion on the lesser curvature. Abdominal contrast-enhanced computed tomography revealed multiple hepatic masses and an extrahepatic enlarged mass with invasion to the pancreas and stomach. A specimen for endoscopic biopsy revealed adenocarcinoma that stained positive for alpha-fetoprotein. Gastrointestinal bleeding resulting from direct invasion of HCC is unusual.
  • Hiroyuki Miyatani, Yukio Yoshida JOURNAL OF MEDICAL ULTRASONICS 34 (4) 205 -207 2007年 [査読無し][通常論文]
     
    Aortoesophageal fistula (AEF) is very rare and is associated with a high mortality rate. AEF manifests with massive gastrointestinal bleeding and is difficult to diagnose from endoscopic findings and clinical features. We encountered a patient with an AEF that was promptly diagnosed by endoscopic ultrasonography (EUS) using a microprobe. A 58-year-old man was admitted to our hospital because of hematemesis. Endoscopic examination revealed a submucosal tumor (SMT)-like lesion 2 cm in diameter 25 cm from the dental arch. EUS with a 20-MHz microprobe revealed a blood vessel-like structure with hypoechoic flowing contents and a high echoic area suggestive of a thrombus protruding into the esophageal lumen. AEF resulting from a ruptured thoracic aortic aneurysm was suggested from the EUS findings and was definitely diagnosed by computed tomography. Graft replacement of the descending aorta was successfully performed. The patient is now in good health 6 years after the first admission. This is the first report of a case of AEF diagnosed by EUS with a microprobe.
  • OGI Maoko, KAWAMURA Yutaka J, KONISHI Fumio, MIYATANI Hiroyuki, YAMADA Sigeki 自治医科大学紀要 29 217 -221 2006年12月 [査読無し][通常論文]
  • MIYATANI Hiroyuki, YOSHIDA Yukio, USHIMARU Shinya, KUDO Yasutaka, HONDA Hideaki, MURAYAMA Junko, SAWADA Yukihisa, NAKASHIMA Yoshiyuki, UGAJIN Takuhiro, OCHIAI Kaori, SAGIHARA Noriyoshi, NAKAMURA Ikuo 自治医科大学紀要 29 193 -200 2006年12月 [査読無し][通常論文]
  • 宮谷 博幸, 吉田 行雄, 牛丸 信也, 工藤 康孝, 本田 英明, 村山 淳子, 澤田 幸久, 中島 嘉之, 宇賀神 卓広, 落合 香織, 鷺原 規喜, 中村 郁夫 自治医科大学紀要 29 193 -200 2006年12月 [査読無し][通常論文]
     
    症例 48歳男性 2004年4月に急性膵炎にて膵頭部のnecrosectomyの既往あり。術後,外来にて経過観察中に膵頭部に8cm大の膵仮性嚢胞が出現した。膵嚢胞圧迫による閉塞性黄疸および肝機能障害を生じたため,2005年4月加療目的に入院した。入院後EUS下に胃体下部後壁より膵嚢胞を通電穿刺,6F pig-tailカテーテルを経鼻的に嚢胞内に留置しドレナージを施行した。穿刺時に胃内腔側に出血を認めたが,自然止血された。2週間後,経鼻カテーテルを抜去し,ガイドワイヤー下に7F,3cm長の両端pigtail biliary stentを留置した。その後,黄疸および膵嚢胞は消失し,検査成績も正常化した。外来にて11ヶ月間観察中であるが,膵嚢胞の再発なく経過良好である。閉塞性黄疸を合併した膵仮性嚢胞症例は比較的稀であり,手術やPTBDを併用した経乳頭的治療,経皮嚢胞ドレナージなどの報告はあるが,EUS下ドレナージのみにより治療し得た症例報告は検索範囲で存在しないため,今回報告する。
  • 大岐 真生子, 河村 裕, 小西 文雄, 宮谷 博幸, 山田 茂樹 自治医科大学紀要 29 217 -221 2006年12月 [査読無し][通常論文]
     
    症例は44歳男性。2日間断続的に続く下血を主訴に来院した。緊急下部消化管内視鏡検査を施行したところ,大腸全体に血液がみられたが,出血部位の同定が困難であった。しかし,繰り返し洗浄し観察したところ,虫垂口から間欠的に血液が流出する所見がみられ,虫垂内腔からの出血であると判断した。緊急虫垂切除術を施行した。摘出標本では虫垂先端に血腫が存在していたが,病理組織学的には血腫の原因となる明らかな腫瘍性病変,血管異常などは認めなかった。下部消化管出血の原因部位として虫垂が占める割合は小さいが,可能性として考慮する必要がある。また,内視鏡的に出血部位を同定するのは困難ではあるが,正確な診断をするためには,根気よく洗浄・観察を続けることが必要であり,虫垂出血と診断した場合にはすみやかに外科的治療に移行する必要があると考える。
  • 上平 晶一, 吉田 行雄, 宮谷 博幸 日本大腸肛門病学会雑誌 59 (2) 101 -105 2006年02月 [査読無し][通常論文]
     
    In this study, we attempted to clarify the rate of recurrence of ischemic colitis (IC) and the clinical features of recurrent IC. Sixty-five patients diagnosed with IC at Omiya Medical Center, Jichi Medical School, from November 1991 to October 2001 were retrospectively reviewed. We sent the patients a questionnaire to ascertain whether they had experienced recurrences in their IC in the years following their treatment at our institution. We reviewed data on 58 patients who replied to the questionnaire.<BR>Ten (17.2%) of the 58 IC patients who replied to the questionnaire had experienced recurrence. The mean age of patients with recurrence was 49.2 years, and that of patients without recurrence was 62.1 years. Eight (88.9%) of 9 patients in the recurrence group and 17 (45.9%) of the 37 patients in the non-recurrence group had experienced constipation.<BR>Many of the patients in the recurrence group were without basic disorders. Furthermore, the recurrences were recognized at almost the same location. All lesions in the recurrence group were the transient type.<BR>In this retrospective study, patients with recurrent IC were younger than patients without it (p<0.05) and tended to experience constipation (p<0.05).
  • 澤田 幸久, 上平 晶一, 浅野 聡, 中島 嘉之, 木原 昌則, 落合 香織, 兵頭 隆史, 宮谷 博幸, 藤原 俊文, 平川 隆一, 中村 郁夫, 井廻 道夫 日本消化器病學會雜誌 = The Japanese journal of gastro-enterology 101 (2) 188 -190 2004年02月 [査読無し][通常論文]
  • 宮谷 博幸, 山中 桓夫 胆道 = Journal of Japan Biliary Association 15 (4) 283 -287 2001年10月 [査読無し][通常論文]
  • 宮谷 博幸, 中山 桓夫 胆道 = Journal of Japan Biliary Association 15 (4) 301 -305 2001年10月 [査読無し][通常論文]
  • 胆道 15(4), 283-287 2001年 [査読無し][通常論文]
  • 澤田 明宏, 松浦 克彦, 濱田 健司, 小林 泰之, 田中 修, 宮谷 博幸, 山中 恒夫, 山田 茂樹 日本画像医学雑誌 = Japanese journal of medical imaging 18 (3) 144 -150 1999年09月 [査読無し][通常論文]
  • 砂田 圭二郎, 山中 桓夫, 多治見 守泰, 宮谷 博幸, 兵頭 隆史, 二村 貢, 吉田 行雄, 井廻 道夫 Journal of medical ultrasonics = 超音波医学 26 (4) 1999年04月 [査読無し][通常論文]
  • 上平 晶一, 吉田 行雄, 小池 正喜, 佐藤 佳宏, 兵頭 隆史, 宮谷 博幸, 溝岡 雅文, 大澤 博之, 二村 貢, 平川 隆一, 大石 孝, 山中 桓夫 日本消化器内視鏡学会雑誌 = Gastroenterological endoscopy 41 (1) 36 -41 1999年01月 [査読無し][通常論文]
  • ERBD施行例の検討
    日本消化器内視鏡学会埼玉部会で発表 1999年 [査読無し][通常論文]
  • 新開発穿刺用超音波内視鏡の使用経験-胃粘膜下腫瘍の診断-
    消化器内視鏡 11 1591 -1595 1999年 [査読無し][通常論文]
  • M OHARA, M HIROHATA, T TOSHIMORI, H MIYATANI, R OKAMOTO, S HIRASAKI, H KUMASHIRO, H MORITANI, Y TOMINAGA, M IMAI INTERNAL MEDICINE 31 (3) 397 -399 1992年03月 [査読無し][通常論文]
     
    A-39-year-old man was admitted to our hospital because of a markedly decreased level of serum cholinesterase found incidentally by a blood test. Detailed examination did not reveal severe liver disease, malignant tumor, infection or organophosphate compound poisoning. Investigation of three generations of his family revealed two homozygous and five heterozygous family members with the cholinesterase deficiency gene E1s indicating familial serum cholinesterase deficiency.

共同研究・競争的資金等の研究課題

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


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