医学部 内科学講座 消化器内科学部門

山本 博徳

ヤマモト ヒロノリ  (Hironori Yamamoto)

基本情報

所属
自治医科大学 医学部内科学講座 消化器内科学部門 教授

J-GLOBAL ID
201401033763571878
researchmap会員ID
B000238029

外部リンク

論文

 13
  • JW Pike, H Yamamoto, NK Shevde
    ADVANCES IN RENAL REPLACEMENT THERAPY 9(3) 168-174 2002年7月  査読有り
    Lipophilic hormones of steroidal origin such as the sex hormones and 1,25-dihydroxy vitamin D-3 (1,25[OH](2)D-3) function by regulating patterns of gene expression in cells. The mediators of such actions are nuclear receptors that recognize these ligands with high affinity and selectivity and function through several mechanisms as gene specific transcription factors. As a result of the mechanistic complexity of nuclear receptor action, recent studies have revealed that both synthetic analogs as well as novel mimetics of a receptor's natural hormonal ligand are capable of modulating functional responses in both cell- and gene-selective manners. These findings have given rise to the term selective receptor modulators, typified by such synthetic estrogen receptor ligands as tamoxifen and raloxifene. A number of vitamin D analogs have been prepared that appear to exhibit tissue-selective activity-most notable through their inability to induce levels of hypercalcemia typical of the activity of the natural hormone 1,25(OH)(2)D-3. Because this debilitating yet normal feature of the natural ligand limits its usefulness in a variety of clinical indications, including its application to prevent bone disease caused by secondary hyperparathyroidism, this feature of many of the new analogs is especially welcome. This article discusses what constitutes a selective receptor modulator and whether the current vitamin D analogs represent such entities. (C) 2002 by the National Kidney Foundation, Inc.
  • N Kashiwagi, K Sugimura, H Koiwai, H Yamamoto, T Yoshikawa, AR Saniabadi, M Adachi, T Shimoyama
    DIGESTIVE DISEASES AND SCIENCES 47(6) 1334-1341 2002年6月  査読有り
    Our aim was to understand the mechanism of immunological changes associated with the use of an adsorptive-type extracorporeal device (Adacolumn) that has been developed for selective adsorption of granulocytes and monocytes/macrophages from peripheral blood of patients with active ulcerative colitis. The column is filled with carriers (G-1 beads) that have a diameter of 2 mm and are made of cellulose diacetate. In peripheral blood treated with the G-1 beads or peripheral blood from patients with active ulcerative colitis following granulocyte and monocyte adsorption apheresis, a significant suppression of proinflammatory cytokines (tissue necrosis factor-alpha, interleukin-1beta, interleukin-6, and interleukin-8) production by leukocytes, neutrophil chemotaxis, down-regulation of leukocyte adhesion molecule (L-selectin) and neutrophil adhesion to interleukin-1beta-activated endothelial cells were observed. Furthermore, after granulocyte adsorption therapy, the number of CD10-negative premature granulocytes increased, indicating increased turnover of these cells in the circulation. Our observations suggest that selective granulocyte and monocyte adsorption is associated with modified peripheral blood leukocyte function favorable to patients with ulcerative colitis and possibly other autoimmune disorders which reflect leukocyte hyperactivity.
  • E Takeda, K Sakamoto, K Yokota, M Shinohara, Y Taketani, K Morita, H Yamamoto, K Miyamoto, M Shibayama
    JOURNAL OF NUTRITIONAL SCIENCE AND VITAMINOLOGY 48(2) 102-108 2002年4月  査読有り
    The awareness of phosphorus intake is important because hyperphosphatemia and hypophosphatemia both impair bone metabolism. Phosphorus consumption from food was obtained from values in the Food Balance Sheet (FBS) of Japan from 19 60 to 1995. The amounts of phosphorus calculated from the FBS increased gradually from 1,243 mg/d in 1960 to 1,332 mg/d in 1975 and to 1,421 mg/d in 1995. This is explained by the increased consumption of cow's milk and milk products, meat, and chicken eggs. The main foods supplying phosphorus in 1995 were cereals, milk and milk products, fishes and shellfishes, and vegetables; their contributions were 24.4, 15.8, 14.2, and 10.9%, respectively. The phosphorus-to-calcium ratio calculated from the FBS was 3.5.1. in 1960, which decreased to 2.89 in 1975 and 2.44 in 1995. Therefore total phosphorus consumption in 1995 was presumably more than 1,500 mg/d when imported food containing phosphorus and the consumption of phosphorus-containing food additives in Japan are also considered. These findings suggest that the phosphorus consumption estimated from the FBS is increasing and that more attention should be paid to the maintenance of healthy bones in Japan, where the average amount of calcium intake is less than 600 mg/d.
  • Nagashima T, Hirata D, Yamamoto H, Okazaki H, Minota S
    American journal of kidney diseases : the official journal of the National Kidney Foundation 37 E38 2001年5月  査読有り
  • H Yamamoto, Y Sekine, Y Sato, T Higashizawa, T Miyata, S Iino, K Ido, K Sugano
    GASTROINTESTINAL ENDOSCOPY 53(2) 216-220 2001年2月  査読有り
    Background: Deep insertion of an enteroscope by use of a push technique is difficult. A new method of enteroscopy was developed, a double-balloon method, to improve the access to the small intestine. Methods:The new method uses 2 balloons, one attached to the tip of the endoscope and another at the distal end of an overtube. By using these balloons to grip the intestinal wall, the endoscope can be inserted further without forming redundant loops in the small intestine. This method was tried with a standard upper endoscope in 3 patients and with a longer enteroscope in 1 patient. Results: Despite its short length the upper endoscope was successfully inserted as far as 30 to 50 cm beyond the ligament of Treitz in the 3 patients. In the fourth patient the longer enteroscope was successfully inserted beyond the ileo-cecal valve. Conclusions: The double-balloon method facilitates endoscopic access to the small intestine.

MISC

 43
  • 矢野 智則, 山本 博徳, 砂田 圭二郎, 林 芳和, 佐藤 博之, 竹澤 敬人, 井野 祐治, 北村 絢, 菅野 健太郎
    Nippon Shokakibyo Gakkai Zasshi 110(7) 1198-1204 2013年  
    小腸出血の原因病変として,血管性病変,炎症性病変,腫瘍性病変,憩室が挙げられる.初期評価のdynamic造影CTで異常所見があればバルーン内視鏡で精査し,異常所見がなければカプセル内視鏡を行って,バルーン内視鏡の要否を判断する.出血源を同定できれば,その診断に応じた治療を行うが,血管性病変については,拍動性の有無に着目した小腸血管性病変の内視鏡分類を参考に治療方針を決定する.小腸出血の診断率向上には,出血エピソードからできるだけ早いタイミングでの検査が必要であり,カプセル内視鏡とバルーン内視鏡の普及の妨げとなっている保険点数の改訂が望まれる.
  • 矢野 智則, 山本 博徳
    臨床外科 67(1) 90-95 2012年1月  
  • 岩間 達, 鍵本 聖一, 萩原 真一郎, 辻 由貴, 田附 裕子, 前田 貢作, 矢野 智則, 山本 博徳
    日本小児外科学会雑誌 47(7) 1102-1103 2011年12月20日  
  • 三澤 俊一, 堀江 久永, 熊野 秀俊, 鯉沼 広治, 宮倉 安幸, 富樫 一智, 安田 是和, 矢野 智則, 山本 博徳, 菅野 健太郎, 長瀬 通隆
    日本消化器病學會雜誌 = The Japanese journal of gastro-enterology 108(3) 429-435 2011年3月5日  
    過去20年間に当院外科で治療がなされた原発性小腸癌10例の臨床病理学的検討を行った.癌占拠部位は空腸が6例,回腸が4例で,全例有症状であった.腫瘍径の中央値は50mm(30~110mm)であり全例2型進行癌で輪状狭窄をともなっていた.組織型は高分化腺癌8例,中分化腺癌1例,低分化腺癌1例で,壁深達度はSE 8例,SI 2例であった.リンパ節転移は6例,肝転移は3例,腹膜播種は4例に認めた.ダブルバルーン内視鏡導入以降に経験した9例中8例は術前に病理学的診断が可能であった.stage II(4例),III(2例)症例には中間リンパ節郭清をともなう小腸部分切除が施行され,stage II症例は4例とも無再発生存中である.
  • 矢野 智則, 西村 直之, 三浦 義正, 新畑 博英, 佐藤 博之, 林 芳和, 宮田 知彦, 砂田 圭二郎, 山本 博徳
    日本内科学会雑誌 100(1) 102-107 2011年1月10日  
    カプセル内視鏡とバルーン内視鏡という新たな方法が登場して小腸疾患に対する診断・治療戦略が大きく変化した.これまで困難であった小腸良性腫瘍の内視鏡的診断が可能になり,正確な診断をもとにして治療方針を決定できるようになった.また,内視鏡的治療も可能になったことで,Peutz-Jeghers syndromeの小腸ポリープなど,開腹手術となる前に早期発見して治療することが重要となってきている.