三長 孝輔(ミナガ コウスケ)
医学科 | 特命准教授 |
Last Updated :2024/09/20
■教員コメント
コメント
膵癌、慢性膵炎、自己免疫性膵炎を中心に臨床研究、基礎研究を行っています。
■研究者基本情報
科研費研究者番号
30793814
J-Global ID
研究キーワード
- 超音波内視鏡 膵癌 慢性膵炎 自己免疫性膵炎
現在の研究分野(キーワード)
膵癌、慢性膵炎、自己免疫性膵炎を中心に臨床研究、基礎研究を行っています。
■経歴
経歴
委員歴
- 2024年07月 - 現在 日本消化器内視鏡学会 英文誌編集委員
- 2023年04月 - 現在 日本がん治療認定医機構 がん治療認定医
- 2022年09月 - 現在 日本消化器内視鏡学会 Fellow of JGES (FJGES)
- 2022年05月 - 現在 日本胆道学会 認定指導医
- 2022年01月 - 現在 日本消化器病学会 指導医
- 2022年01月 - 現在 日本消化器病学会 学会評議員
- 2021年04月 - 現在 日本消化器内視鏡学会 学術評議員
- 2021年01月 - 現在 日本膵臓学会 認定指導医
- 2021年01月 - 現在 日本膵臓学会 膵癌診療ガイドライン改定委員会 作成協力者
- 2019年12月 - 現在 日本消化器内視鏡学会 指導医
- 2014年 - 現在 弾性線維性仮性黄色腫診療ガイドライン策定委員会委員
- 2022年06月 公益社団法人 医療系大学間共用試験実施評価機構 第54回共用試験医学系臨床実習前OSCE評価者認定講習会終了
- 2014年09月 - 2019年01月 日本プライマリ・ケア連合学会 認定指導医
- 2016年08月 近畿大学緩和ケア研修会 修了
- 2014年10月 平成26年度 医師臨床研修指導医講習 修了
- 2010年04月 - 2014年03月 日本赤十字社和歌山医療センター 医師臨床研修制度におけるメンター
■研究活動情報
受賞
- 2024年05月 日本消化器内視鏡学会 Digestive Endoscopy Distinguished Reviewer
- 2024年05月 日本消化器内視鏡学会 DEN Open Best Reviewers Award for 2023
- 2023年05月 日本消化器内視鏡学会 Digestive Endoscopy Best Reviewers Award for 2022
- 2022年04月 日本内科学会 医学生・研修医の日本内科学会ことはじめ2022 指導教官賞
受賞者: 三長 孝輔 - 2022年03月 日本消化器内視鏡学会 DEN Open Best Reviewers Award for 2021
受賞者: 三長 孝輔 - 2022年03月 日本消化器内視鏡学会 Digestive Endoscopy Best Reviewers Award for 2021
受賞者: 三長 孝輔 - 2021年03月 日本消化器内視鏡学会 Digestive Endoscopy Best Reviewers Award for 2020
受賞者: 三長 孝輔 - 2020年12月 公益財団法人 日本膵臓病研究財団 第28回(令和2年度)膵臓病研究奨励賞
受賞者: 三長 孝輔 - 2020年11月 日本消化器内視鏡学会 2020年度 日本消化器内視鏡学会 学会賞
受賞者: 三長 孝輔 - 2019年10月 日本胆道学会 国際交流奨励賞
受賞者: 三長孝輔 - 2019年04月 独立行政法人日本学術振興会 平成30年度若手研究助成
- 2018年12月 Japan Digestive Disease Week The Best Presenter Award in International Session
受賞者: 三長孝輔 - 2018年11月 Asian Pacific Digestive Disease Week APDWF/JGHF Young Investigator Award
受賞者: 三長孝輔 - 2018年03月 近畿大学大学院部長賞
受賞者: 三長孝輔 - 2017年12月 公益財団法人 日本膵臓病研究財団 第25回(平成29年度)膵臓病研究奨励賞
受賞者: 三長孝輔 - 2017年11月 Korea Digestive Disease Week Travel Grant
受賞者: 三長孝輔 - 2017年04月 公益財団法人 内視鏡医学研究振興財団 平成29年度 内視鏡医学研究医海外派遣助成
受賞者: 三長孝輔
論文
- Naoya Omaru; Yasuo Otsuka; Akane Hara; Masayuki Kurimoto; Natsuki Okai; Yasuhiro Masuta; Sho Masaki; Ken Kamata; Kosuke Minaga; Hajime Honjo; Yasuyuki Arai; Kohei Yamashita; Masatoshi Kudo; Tomohiro WatanabeCytokine 183 156748 - 156748 2024年11月
- Akane Hara; Tomohiro Watanabe; Kosuke Minaga; Tomoe Yoshikawa; Masayuki Kurimoto; Ikue Sekai; Yasuhiro Masuta; Ryutaro Takada; Yasuo Otsuka; Ken Kamata; Shiki Takamura; Masatoshi Kudo; Warren StroberJCI Insight 2024年09月
- Munenori Kawai; Akihisa Fukuda; Ryo Otomo; Shunsuke Obata; Kosuke Minaga; Masanori Asada; Atsushi Umemura; Yoshito Uenoyama; Nobuhiro Hieda; Toshihiro Morita; Ryuki Minami; Saiko Marui; Yuki Yamauchi; Yoshitaka Nakai; Yutaka Takada; Kozo Ikuta; Takuto Yoshioka; Kenta Mizukoshi; Kosuke Iwane; Go Yamakawa; Mio Namikawa; Makoto Sono; Munemasa Nagao; Takahisa Maruno; Yuki Nakanishi; Mitsuharu Hirai; Naoki Kanda; Seiji Shio; Toshinao Itani; Shigehiko Fujii; Toshiyuki Kimura; Kazuyoshi Matsumura; Masaya Ohana; Shujiro Yazumi; Chiharu Kawanami; Yukitaka Yamashita; Hiroyuki Marusawa; Tomohiro Watanabe; Yoshito Ito; Masatoshi Kudo; Hiroshi SenoBritish Journal of Cancer 2024年08月Abstract Background Pancreatic cancer is often diagnosed at advanced stages, and early-stage diagnosis of pancreatic cancer is difficult because of nonspecific symptoms and lack of available biomarkers. Methods We performed comprehensive serum miRNA sequencing of 212 pancreatic cancer patient samples from 14 hospitals and 213 non-cancerous healthy control samples. We randomly classified the pancreatic cancer and control samples into two cohorts: a training cohort (N = 185) and a validation cohort (N = 240). We created ensemble models that combined automated machine learning with 100 highly expressed miRNAs and their combination with CA19-9 and validated the performance of the models in the independent validation cohort. Results The diagnostic model with the combination of the 100 highly expressed miRNAs and CA19-9 could discriminate pancreatic cancer from non-cancer healthy control with high accuracy (area under the curve (AUC), 0.99; sensitivity, 90%; specificity, 98%). We validated high diagnostic accuracy in an independent asymptomatic early-stage (stage 0-I) pancreatic cancer cohort (AUC:0.97; sensitivity, 67%; specificity, 98%). Conclusions We demonstrate that the 100 highly expressed miRNAs and their combination with CA19-9 could be biomarkers for the specific and early detection of pancreatic cancer.
- Sho Masaki; Hajime Honjo; Masayuki Kurimoto; Natsuki Okai; Yasuo Otsuka; Yasuhiro Masuta; Ken Kamata; Kosuke Minaga; Masatoshi Kudo; Tomohiro WatanabeClinical Journal of Gastroenterology 2024年07月
- Ikue Sekai; Kosuke Minaga; Akane Hara; Yasuo Otsuka; Yasuhiro Masuta; Hironori Shigeoka; Tomohiro Watanabe; Masatoshi KudoClinical Journal of Gastroenterology 2024年07月
- Kosuke Minaga; Yasuo Otsuka; Tomohiro WatanabeJournal of Gastroenterology 2024年06月
- Tomohiro Yamazaki; Ken Kamata; Tomoko Hyodo; Sung-Woon Im; Hidekazu Tanaka; Akihiro Yoshida; Tomohiro Fukunaga; Shunsuke Omoto; Kosuke Minaga; Mamoru Takenaka; Masatoshi KudoDigestive Diseases and Sciences 2024年06月
- Yasuo Otsuka; Kosuke Minaga; Akane Hara; Kentaro Yamao; Mamoru Takenaka; Takaaki Chikugo; Masatoshi KudoEndoscopy international open 12 6 E764-E766 2024年06月
- Hirofumi Yamazaki; Yasunobu Yamashita; Toshio Shimokawa; Kosuke Minaga; Takeshi Ogura; Masayuki KitanoDEN open 4 1 e274 2024年04月OBJECTIVES: Endoscopic ultrasound (EUS)-guided biliary drainage encompasses techniques such as EUS-guided hepaticogastrostomy (EUS-HGS) and EUS-guided choledochoduodenostomy (EUS-CDS). This meta-analysis compared the efficacy of EUS-CDS with that of EUS-HGS for the treatment of biliary obstruction. METHODS: A systematic meta-analysis of all relevant articles listed was performed by searching the Cochrane Library, PubMed, and Google Scholar databases. We used random effects or fixed effects models to compare success rates, adverse events, procedure times, and time to recurrent biliary obstruction after EUS-CDS and EUS-HGS. RESULTS: This meta-analysis included 18 eligible studies. There was no significant difference between EUS-CDS and EUS-HGS with respect to technical success rate (odds ratio [OR] 1.04; 95% confidence interval [CI] 0.62-1.73) and clinical success rate (OR 0.66; 95% CI 0.43-1.04), or with respect to total procedure-related adverse events (OR 1.39; 95% CI 1.00-1.93). Subgroup analysis of adverse events revealed that the rate of recurrent biliary obstruction (RBO) was significantly higher for EUS-HGS (OR 2.95; 95% CI 1.54-5.64). There was no significant difference between the two methods with respect to time to recurrent biliary obstruction (mean difference -11.93 days; 95% CI -47.77-23.91). However, the procedure time was longer for EUS-HGS (mean difference, 3.21 min; 95% CI 1.24-5.19). CONCLUSION: EUS-CDS and EUS-HGS are comparable in terms of technical success, clinical success, and rate of adverse events; however, EUS-CDS is superior with respect to procedure time and preventing RBO.
- Yasuo Otsuka; Kosuke Minaga; Masatoshi Kudo; Tomohiro WatanabeFrontiers in Immunology 15 2024年02月Introduction Intrapancreatic activation of trypsinogen caused by alcohol or high-fat intake and the subsequent autodigestion of the pancreas tissues by trypsin are indispensable events in the development of acute pancreatitis. In addition to this trypsin-centered paradigm, recent studies provide evidence that innate immune responses triggered by translocation of intestinal bacteria to the pancreas due to intestinal barrier dysfunction underlie the immunopathogenesis of acute pancreatitis. Although severe acute pancreatitis is often associated with pancreatic colonization by fungi, the molecular mechanisms linking fungus-induced immune responses to the development of severe acute pancreatitis are poorly understood. Leucine-rich repeat kinase 2 (LRRK2) is a multifunctional protein that mediates innate immune responses to fungi and bacteria. Mutations in Lrrk2 is a risk factor for Parkinson’s disease and Crohn’s disease, both of which are driven by innate immune responses to gut organisms. Discussion In this Minireview article, we discuss how activation of LRRK2 by the recognition of fungi induces severe acute pancreatitis.
- Akane Hara; Kosuke Minaga; Yasuo Otsuka; Hidekazu Tanaka; Mamoru Takenaka; Masatoshi KudoEndoscopy international open 12 2 E271-E273 2024年02月
- 萩原 智; 上嶋 一臣; 西田 直生志; 依田 広; 三長 孝輔; 南 康範; 田北 雅弘; 青木 智子; 盛田 真弘; 千品 寛和; 松原 卓哉; 大丸 直哉; 稲村 昇; 工藤 正俊肝臓 64 11 567 - 574 (一社)日本肝臓学会 2023年11月症例は30代男性.幼少期に完全大血管転位III型に対してFontan手術が施行され,近医に定期的に通院していた.20XX年7月腹部USで多発肝腫瘤を指摘され当院紹介受診となった.造影CTにて最大13cmの多発肝細胞癌と判明した(BCLC stage B).画像上は門脈圧亢進所見や明らかな肝形態異常を認めなかったが,肝生検でCongestive Hepatic Fibrosis Score 3であり,実際には線維化の進展を認めていた.肝内多発のため外科手術やRFAの適応外であった.また最大径の腫瘍は肝外に突出しており,腹腔内破裂の危険性もあることから,まずTACEを施行した.再発に応じて各種抗癌剤治療を行い,生存中である.画像上は肝線維化を示唆する所見はなかったが,Fontan術後の特殊な循環動態では,肝線維化が進展している可能性があり,本症例を通して肝癌サーベイランスの重要性を再考する.(著者抄録)
- Yasuo Otsuka; Akane Hara; Kosuke Minaga; Ikue Sekai; Masayuki Kurimoto; Yasuhiro Masuta; Ryutaro Takada; Tomoe Yoshikawa; Ken Kamata; Masatoshi Kudo; Tomohiro WatanabeClinical and Experimental Immunology 2023年10月Abstract Translocation of gut bacteria into the pancreas promotes the development of severe acute pancreatitis (SAP). Recent clinical studies have also highlighted the association between fungal infections and SAP. The sensing of gut bacteria by pattern recognition receptors promotes the development of SAP via the production of proinflammatory cytokines; however, the mechanism by which gut fungi mediate SAP remains largely unknown. Leucine-rich repeat kinase 2 (LRRK2) is a multifunctional protein that regulates innate immunity against fungi via Dectin-1 activation. Here, we investigated the role of LRRK2 in SAP development and observed that administration of LRRK2 inhibitors attenuated SAP development. The degree of SAP was greater in Lrrk2 transgenic (Tg) mice than in control mice and was accompanied by an increased production of nuclear factor-kappaB-dependent proinflammatory cytokines. Ablation of the fungal mycobiome by anti-fungal drugs inhibited SAP development in Lrrk2 Tg mice, whereas the degree of SAP was comparable in Lrrk2 Tg mice with or without gut sterilization by a broad range of antibiotics. Pancreatic mononuclear cells from Lrrk2 Tg mice produced large amounts of IL-6 and TNF-α upon stimulation with Dectin-1 ligands, and inhibition of the Dectin-1 pathway by a spleen tyrosine kinase inhibitor protected Lrrk2 Tg mice from SAP. These data indicate that LRRK2 activation is involved in the development of SAP through proinflammatory cytokine responses upon fungal exposure.
- Ken Kamata; Hajime Imai; Hisakazu Matsumoto; Yukitaka Yamashita; Takao Kato; Katsuhisa Nishi; Shunsuke Omoto; Kosuke Minaga; Kentaro Yamao; Tomoko Hyodo; Sung‐Woon Im; Akane Hara; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Kazuomi Ueshima; Yasutaka Chiba; Mamoru Takenaka; Tomohiro Watanabe; Masayuki Kitano; Masatoshi KudoJGH Open 2023年09月Abstract Background and Aim A multicenter, open‐label randomized Phase II trial was conducted to determine whether low‐dose gemcitabine plus nab‐paclitaxel (GnP) could improve tolerability and show equivalent efficacy to the standard‐dose GnP for elderly patients with metastatic pancreatic cancer. Methods Consecutive patients aged ≥65 years with metastatic pancreatic cancer who presented at one of four Japanese referral centers between November 2016 and January 2021 were enrolled. The 60 patients were randomly assigned to low‐ or standard‐dose groups with a 1:1 ratio. Patients in the low‐dose GnP group received gemcitabine at a dose of 250 mg/m2 and nab‐paclitaxel at 125 mg/m2. Results Low‐dose GnP significantly decreased the rate of cases requiring dose reduction (16.7% vs 63.3%). The response rate (36.7% vs 33.3%) and progression‐free survival (7.3 vs 8 months) were comparable between the low‐ and standard‐dose groups as determined by independent review. The difference in the median overall survival between the two groups was not significant (7.9 vs 12 months). The proportion of patients with hematologic and non‐hematologic treatment‐related adverse events was comparable between the two groups. Conclusion Low‐dose GnP had an equivalent efficacy to conventional therapy; however, it did not reduce adverse events.
- Yasuo Otsuka; Kosuke Minaga; Akane Hara; Yasuhiro Masuta; Mamoru Takenaka; Masatoshi KudoEndoscopy international open 11 9 E811-E813 2023年09月
- Ken Kamata; Mamoru Takenaka; Naoshi Nishida; Akane Hara; Yasuo Otsuka; Hidekazu Tanaka; Shunsuke Omoto; Kosuke Minaga; Kentaro Yamao; Yasutaka Chiba; Kazuko Sakai; Kazuto Nishio; Tomohiro Watanabe; Masatoshi KudoInternational journal of clinical oncology 28 11 1511 - 1519 2023年08月BACKGROUND: This prospective cohort study evaluated the feasibility of using endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) samples for comprehensive mutational analysis of cancer-related genes using microtissues. METHODS: Fifty patients with suspected pancreatic cancer presenting consecutively at the Kindai University Hospital between January 2018 and January 2019 were enrolled. Cancerous tissues from EUS-FNB were obtained from each tumor and subjected to histological examination and mutational analysis. The primary endpoint was the collection rate of EUS-FNB specimens suitable for comprehensive cancer panels using deep sequencing. Clinical history and genetic variations between the disease control and progressive disease groups of patients on chemotherapy were evaluated as secondary endpoints. RESULTS: The collection rate of EUS-FNB specimens suitable for comprehensive cancer panels using deep sequencing was 93.6%. The cancer panel was sequenced for 25 patients with pancreatic cancer treated initially with systemic chemotherapy. Mutation in p53 and Smad4 were positively and negatively associated, respectively, with disease control at the initial evaluation. The median time to progression in 15 patients with p53 and without Smad4 mutations was 182.0 days; whereas, it was 92.5 days in other 10 patients; this difference was significant (p = 0.020). CONCLUSIONS: Tissue samples from EUS-FNB were suitable for mutational analysis. Pancreatic cancers with p53 and without Smad4 mutations responded better to chemotherapy and had a better prognosis than those others.
- Yasuhiro Masuta; Kosuke Minaga; Yasuo Otsuka; Mamoru Takenaka; Masatoshi KudoEndoscopy international open 11 7 E651-E652 2023年07月
- Shogo Nakano; Kosuke Minaga; Kazuki Matsuyama; Hisakazu Matsumoto; Yoshito Uenoyama; Yukitaka YamashitaEndoscopy international open 11 6 E568-E570 2023年06月
- Tomohiro Watanabe; Kosuke Minaga; Hajime Honjo; Masatoshi KudoBiochemical and Biophysical Research Communications 2023年06月
- Kenji Ikezawa; Shiro Hayashi; Mamoru Takenaka; Takayuki Yakushijin; Koji Nagaike; Ryoji Takada; Takuo Yamai; Kengo Matsumoto; Masashi Yamamoto; Shunsuke Omoto; Kosuke Minaga; Shuji Ishii; Takeshi Shimizu; Kengo Nagai; Makoto Hosono; Tsutomu NishidaScientific reports 13 1 7824 - 7824 2023年05月This study aimed to examine occupational radiation exposure to the lens of the eyes during endoscopic retrograde cholangiopancreatography (ERCP). In this multicenter, prospective, observational cohort study, we collected data regarding occupational radiation exposure to the lens of the eyes during ERCP. We measured radiation exposure of patients and examined its correlation with occupational exposure. In dosimetrically-measured ERCPs (n = 631), the median air kerma at the patient entrance reference point, air kerma-area product, and fluoroscopy time were 49.6 mGy, 13.5 Gycm2, and 10.9 min, respectively. The median estimated annual radiation dose to the lens of the eyes was 3.7, 2.2, and 2.4 mSv for operators, assistants, and nurses, respectively. Glass badge over lead aprons and eye dosimeter results were similar in operators but differed in assistants and nurses. A strong correlation was shown between eye dosimeter measurements and patients' radiation exposure. The shielding rates of the lead glasses were 44.6%, 66.3%, and 51.7% for operators, assistants, and nurses, respectively. This study revealed the actual occupational exposure dose for the lens of the eyes during ERCP and the efficacy of lead glass. Values of radiation exposure to patients can help estimate exposure to the lens of the eyes of medical staff.
- Ken Kamata; Akane Hara; Kosuke Minaga; Tomoe Yoshikawa; Masayuki Kurimoto; Ikue Sekai; Natsuki Okai; Naoya Omaru; Yasuhiro Masuta; Yasuo Otsuka; Ryutaro Takada; Shiki Takamura; Masatoshi Kudo; Warren Strober; Tomohiro WatanabeClinical and Experimental Immunology 2023年05月Abstract The aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor expressed in hematopoietic and non-hematopoietic cells. Activation of the AhR by xenobiotics, microbial metabolites, and natural substances induces immunoregulatory responses. Autoimmune pancreatitis (AIP) is a chronic fibroinflammatory disorder of the pancreas driven by autoimmunity. Although AhR activation generally suppresses pathogenic autoimmune responses, the roles played by the AhR in AIP have been poorly defined. In this study, we examined how AhR activation affected the development of experimental AIP caused by the activation of plasmacytoid dendritic cells producing IFN-α and IL-33. Experimental AIP was induced in MRL/MpJ mice by repeated injections of polyinosinic-polycytidylic acid. Activation of the AhR by indole-3-pyruvic acid and indigo naturalis, which were supplemented in the diet, inhibited the development of experimental AIP, and these effects were independent of the activation of plasmacytoid dendritic cells producing IFN-α and IL-33. Interaction of indole-3-pyruvic acid and indigo naturalis with AhRs robustly augmented the production of IL-22 by pancreatic islet α cells. The blockade of IL-22 signaling pathways completely canceled the beneficial effects of AhR ligands on experimental AIP. Serum IL-22 concentrations were elevated in patients with type 1 AIP after the induction of remission with prednisolone. These data suggest that AhR activation suppresses chronic fibroinflammatory reactions that characterize AIP via IL-22 produced by pancreatic islet α cells.
- Hajime Honjo; Yasuhiro Masuta; Yasuo Otsuka; Sho Masaki; Kosuke Minaga; Masatoshi Kudo; Tomohiro WatanabeDEN Open 4 1 2023年05月 [査読有り]
- 消化管がんに対する超音波診断(EUS含む) 当院におけるスキルス胃癌および下部消化管粘膜下腫瘍に対するEUS精査症例の検討田中 秀和; 鎌田 研; 高田 隆太郎; 三長 孝輔; 竹中 完; 松井 繁長; 樫田 博史; 工藤 正俊超音波医学 50 Suppl. S211 - S211 (公社)日本超音波医学会 2023年04月
- Yasuo Otsuka; Kosuke Minaga; Tomohiro WatanabeGastroenterology 2023年02月
- Natsuki Okai; Yasuhiro Masuta; Yasuo Otsuka; Akane Hara; Sho Masaki; Ken Kamata; Kosuke Minaga; Hajime Honjo; Masatoshi Kudo; Tomohiro WatanabeJournal of Clinical Biochemistry and Nutrition 2023年
- Yasuo Otsuka; Yasuhiro Masuta; Kosuke Minaga; Natsuki Okai; Akane Hara; Ryutaro Takada; Sho Masaki; Ken Kamata; Hajime Honjo; Kouhei Yamashita; Masatoshi Kudo; Tomohiro WatanabeJournal of Clinical Biochemistry and Nutrition 2023年
- Yasuhiro Masuta; Kosuke Minaga; Yasuo Otsuka; Natsuki Okai; Akane Hara; Sho Masaki; Tomoyuki Nagai; Hajime Honjo; Masatoshi Kudo; Tomohiro WatanabeJournal of Clinical Biochemistry and Nutrition 2023年
- Hajime Honjo; Kosuke Minaga; Akane Hara; Ryutaro Takada; Yasuo Otsuka; Yasuhiro Masuta; Sho Masaki; Shigenaga Matsui; Masatoshi Kudo; Tomohiro WatanabeInternal Medicine 2023年
- Shogo Nakano; Kosuke Minaga; Eiki Chikugo; Hisakazu Matsumoto; Yoshito UenoyamaEndoscopic ultrasound 12 2 298 - 299 2023年
- Yasuhiro Masuta; Yasuo Otsuka; Kosuke Minaga; Hajime Honjo; Masatoshi Kudo; Tomohiro WatanabeJournal of Clinical Biochemistry and Nutrition 2023年
- Shunsuke Fujita; Hajime Honjo; Ryutaro Takada; Akane Hara; Yasuhiro Masuta; Yasuo Otsuka; Kohei Handa; Kosuke Minaga; Shigeyoshi Tsuji; Masatoshi Kudo; Tomohiro WatanabeInternal Medicine 2023年
- Kosuke Minaga; Masayuki Kitano; Yoshito Uenoyama; Keiichi Hatamaru; Hideyuki Shiomi; Kenji Ikezawa; Tsukasa Miyagahara; Hajime Imai; Nao Fujimori; Hisakazu Matsumoto; Yuzo Shimokawa; Atsuhiro Masuda; Mamoru Takenaka; Masatoshi Kudo; Yasutaka ChibaEndoscopic ultrasound 2022年12月BACKGROUND AND OBJECTIVES: Although the use of a long metal stent is favored for EUS-guided hepaticogastrostomy (EUS-HGS) for the relief of malignant biliary obstruction (MBO), endoscopic reintervention (E-RI) at the time of recurrent biliary obstruction (RBO) is challenging due to a long intragastric portion. This study evaluated the feasibility and safety of E-RI after a long partially covered metal stent (L-PCMS) placement during EUS-HGS. MATERIALS AND METHODS: We performed a multicenter retrospective study between January 2015 and December 2019 examining patients with MBO who underwent E-RI for RBO through the EUS-HGS route after the L-PCMS placement. Technical and clinical success rates, details of E-RI, adverse events (AEs), stent patency, and survival time were evaluated. RESULTS: Thirty-three patients at eight referral centers in Japan who underwent E-RI through the EUS-HGS route were enrolled. The location of MBO was distal in 54.5%. The median intragastric length of the L-PCMS was 5 cm. As the first E-RI attempt, E-RI via the distal end of the existing L-PCMS was successful in 60.6%. The overall technical and clinical success rates of E-RI were 100% and 81.8%, respectively. Liver abscess was noted in one patient. A proximal biliary stricture was associated with the clinical ineffectiveness of E-RI in multivariable analysis (odds ratio, 12.5, P = 0.04). The median survival and stent patency duration after E-RI were 140 and 394 days, respectively. CONCLUSIONS: Our study findings suggest that E-RI for RBO after EUS-HGS with a L-PCMS is technically feasible and clinically effective, without any severe AEs, especially for patients with distal MBO.
- S Yoshida; K Minaga; T Watanabe; M KudoJournal of Gastroenterology and Hepatology 2022年12月
- Ikue Sekai; Kosuke Minaga; Akane Hara; Yasuo Otsuka; Masayuki Kurimoto; Naoya Omaru; Natsuki Okai; Yasuhiro Masuta; Ryutaro Takada; Tomoe Yoshikawa; Ken Kamata; Masatoshi Kudo; Tomohiro WatanabeBiochemical and Biophysical Research Communications 2022年11月
- Naoya Omaru; Tomohiro Watanabe; Ken Kamata; Kosuke Minaga; Masatoshi KudoFrontiers in Immunology 13 2022年10月Hepatocytes and liver-resident antigen-presenting cells are exposed to microbe-associated molecular patterns (MAMPs) and microbial metabolites, which reach the liver from the gut via the portal vein. MAMPs induce innate immune responses via the activation of pattern recognition receptors (PRRs), such as toll-like receptors (TLRs), nucleotide-binding oligomerization domain 1 (NOD1), and NOD2. Such proinflammatory cytokine responses mediated by PRRs likely contribute to the development of chronic liver diseases and hepatocellular carcinoma (HCC), as shown by the fact that activation of TLRs and subsequent production of IL-6 and TNF-α is required for the generation of chronic fibroinflammatory responses and hepatocarcinogenesis. Similar to TLRs, NOD1 and NOD2 recognize MAMPs derived from the intestinal bacteria. The association between the activation of NOD1/NOD2 and chronic liver diseases is poorly understood. Given that NOD1 and NOD2 can regulate proinflammatory cytokine responses mediated by TLRs both positively and negatively, it is likely that sensing of MAMPs by NOD1 and NOD2 affects the development of chronic liver diseases, including HCC. Indeed, recent studies have highlighted the importance of NOD1 and NOD2 activation in chronic liver disorders. Here, we summarize the roles of NOD1 and NOD2 in hepatocarcinogenesis and liver injury.
- Yasuhiro Masuta; Kosuke Minaga; Tomohiro WatanabeGastroenterology 2022年10月
- Yasuhiro Masuta; Kosuke Minaga; Masayuki Kurimoto; Ikue Sekai; Akane Hara; Naoya Omaru; Natsuki Okai; Yasuo Otsuka; Ryutaro Takada; Tomoe Yoshikawa; Sho Masaki; Ken Kamata; Hajime Honjo; Yasuyuki Arai; Kouhei Yamashita; Masatoshi Kudo; Tomohiro WatanabeInternational Immunology 2022年09月Abstract Mutations in nucleotide-binding oligomerization domain 2 (NOD2) are associated with Crohn’s disease (CD). Although NOD2 activation contributes to the maintenance of intestinal homeostasis through the negative regulation of pro-inflammatory cytokine responses mediated by Toll-like receptors (TLRs), the effects of NOD2 activation on interferon (IFN)-α responses induced by TLR9 have been poorly defined. To explore the cross-talk between NOD2 and TLR9, human monocytes or dendritic cells (DCs) were stimulated with NOD2 and/or TLR9 ligands to measure IFN-α production. The severity of dextran sodium sulfate (DSS)-induced colitis was compared in mice treated with NOD2 and/or TLR9 ligands. Expression of IFN-α and IFN-stimulated genes (ISGs) was examined in the colonic mucosa of patients with inflammatory bowel disease (IBD). NOD2 activation reduced TLR9-induced IFN-α production by monocytes and DCs in a deubiquitinating enzyme A (DUBA)-dependent manner. Activation of DUBA induced by the co-stimulation of TLR9 and NOD2 inhibited Lys63-linked polyubiquitination of TRAF3 and suppressed TLR9-mediated IFN-α production. NOD2 activation in hematopoietic cells protected mice from TLR9-induced exacerbation of DSS-induced colitis by down-regulating IFN-α responses and up-regulating DUBA expression. Colonic mucosa of patients with active and remitted IBD phases was characterized by the enhanced and reduced expression of ISGs, respectively. Expression levels of IFN-α and IL-6 positively correlated in the active colonic mucosa of patients with ulcerative colitis and CD, whereas DUBA expression inversely correlated with that of IFN-α in patients with CD. Collectively, these data suggest that DUBA-dependent negative effect of NOD2 on TLR9-mediated IFN-α responses contributes to the maintenance of intestinal homeostasis.
- Hisakazu Matsumoto; Kosuke Minaga; Tomohiro WatanabeGastroenterology 2022年09月
- Tomoe Yoshikawa; Kosuke Minaga; Akane Hara; Ikue Sekai; Masayuki Kurimoto; Yasuhiro Masuta; Yasuo Otsuka; Ryutaro Takada; Ken Kamata; Ah-Mee Park; Shiki Takamura; Masatoshi Kudo; Tomohiro WatanabeInternational Immunology 2022年09月Abstract Autoimmune pancreatitis (AIP) and IgG4-related disease (IgG4-RD) are new disease entities characterized by enhanced IgG4 antibody responses and involvement of multiple organs, including the pancreas and salivary glands. Although the immunopathogenesis of AIP and IgG4-RD is poorly understood, we previously reported that intestinal dysbiosis mediates experimental AIP through the activation of IFN-α- and IL-33-producing plasmacytoid dendritic cells (pDCs). Because intestinal dysbiosis is linked to intestinal barrier dysfunction, we explored whether the latter affects the development of AIP and autoimmune sialadenitis in MRL/MpJ mice treated with repeated injections of polyinosinic–polycytidylic acid [poly (I:C)]. Epithelial barrier disruption was induced by the administration of dextran sodium sulfate (DSS) in the drinking water. Mice co-treated with poly (I:C) and DSS, but not those treated with either agent alone, developed severe AIP, but not autoimmune sialadenitis, which was accompanied by the increased accumulation of IFN-α- and IL-33-producing pDCs. Sequencing of 16S ribosomal RNA revealed that Staphylococcus sciuri translocation from the gut to the pancreas was preferentially observed in mice with severe AIP co-treated with DSS and poly (I:C). The degree of experimental AIP, but not of autoimmune sialadenitis, was greater in germ-free mice mono-colonized with S. sciuri and treated with poly (I:C) than in germ-free mice treated with poly (I:C) alone, which was accompanied by the increased accumulation of IFN-α- and IL-33-producing pDCs. Taken together, these data suggest that intestinal barrier dysfunction exacerbates AIP through the activation of pDCs and translocation of S. sciuri into the pancreas.
- Yasuo Otsuka; Ken Kamata; Kosuke Minaga; Tomohiro Watanabe; Masatoshi KudoFrontiers in Cellular and Infection Microbiology 12 940532 - 940532 2022年07月Acute pancreatitis is a common emergent disorder, a significant population of which develops the life-threatening condition, called severe acute pancreatitis (SAP). It is generally accepted that bacterial infection is associated with the development and persistence of SAP. In addition to bacterial infection, recent clinical studies disclosed a high incidence of fungal infection in patients with SAP. Moreover, SAP patients with fungal infection exhibit a higher mortality rate than those without infection. Although these clinical studies support pathogenic roles played by fungal infection in SAP, beneficial effects of prophylactic anti-fungal therapy on SAP have not been proved. Here we summarize recent clinical findings as to the relationship between fungal infection and the development of SAP. In addition, we discuss molecular mechanisms accounting for the development of SAP in the presence of fungal infection.
- Natsuki Okai; Tomohiro Watanabe; Kosuke Minaga; Ken Kamata; Hajime Honjo; Masatoshi KudoWorld Journal of Gastroenterology 28 26 3063 - 3070 2022年07月
- Hidekazu Tanaka; Kosuke Minaga; Yasuo Otsuka; Yasuhiro Masuta; Ken Kamata; Kentaro Yamao; Mamoru Takenaka; Tomoko Hyodo; Masatomo Kimura; Tomohiro Watanabe; Masatoshi KudoFrontiers in Medicine 9 951834 - 951834 2022年07月Background Pancreatic neuroendocrine carcinoma (PanNEC) is a rare disease entity with rapid progression and poor prognosis. Here, we report a PanNEC case with unique morphological features mimicking intraductal papillary mucinous carcinoma. Case presentation A 69-year-old Japanese man was referred to our hospital for further evaluation of weight loss and deterioration of diabetes mellitus. Contrast-enhanced computed tomography showed a solid and cystic mass with hypo-enhancement at the tail of the pancreas. The main pancreatic duct (MPD) was diffusely dilated without obstruction, accompanied by marked parenchymal atrophy. Multiple peritoneal and omental nodules were observed, suggesting tumor dissemination. Endoscopic retrograde cholangiopancreatography revealed that the mass correlated with the dilated MPD. During pancreatography, a large amount of mucus was extruded from the pancreatic orifice of the ampulla. Based on these imaging findings, intraductal papillary mucinous carcinoma was suspected. Per-oral pancreatoscopy (POPS)-guided tumor biopsies were conducted for the lesion's solid components. Histopathological examination of the biopsied material confirmed small-cell-type PanNEC with a Ki-67 labeling index of 90%. Due to his condition's rapid decline, the patient was given the best supportive care and died 28 days after diagnosis. Conclusion Although rare, PanNEC, which correlates with the MPD and is accompanied by marked dilation of the MPD, does exist as one phenotype. In such cases, POPS-guided biopsy could be a useful diagnostic modality.
- Ayana Okamoto; Ken Kamata; Takeshi Miyata; Tomoe Yoshikawa; Rei Ishikawa; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Kosuke Minaga; Kentaro Yamao; Mamoru Takenaka; Yasutaka Chiba; Toshiharu Sakurai; Naoshi Nishida; Masayuki Kitano; Masatoshi KudoClinical endoscopy 55 4 558 - 563 2022年07月Background/Aims: Bispectral index (BIS) monitors process and display electroencephalographic data and are used to assess the depth of anesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS). Methods: This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was used in 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatory depression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours after leaving the endoscopy room. Results: The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg; p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in the non-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than in the non-BIS group (8.5% vs. 39.4%; p<0.001). Conclusions: During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients 75 years of age or older.
- Atsushi Nakai; Ken Kamata; Tomoko Hyodo; Takaaki Chikugo; Akane Hara; Yasuo Otsuka; Hidekazu Tanaka; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Shunsuke Omoto; Kosuke Minaga; Kentaro Yamao; Mamoru Takenaka; Yasutaka Chiba; Tomohiro Watanabe; Ippei Matsumoto; Yoshifumi Takeyama; Masatoshi KudoEndoscopic ultrasound 11 5 401 - 406 2022年07月Background: The value of contrast-enhanced harmonic EUS (CH-EUS) for diagnosis of portal vein invasion in patients with pancreatic cancer was evaluated. Patients and Methods: This single-center, retrospective study included consecutive patients with pancreatic cancer who underwent both surgical resection after preoperative EUS, CH-EUS, and contrast-enhanced computed tomography (CE-CT) examinations between April 2015 and August 2017. CH-EUS evaluation was performed during the late phase. Portal vein invasion on EUS and CH-EUS was defined as no continuity in the line of the vessel wall. Definition of portal vein invasion on CE-CT was based on the Loyer's criteria. The accuracy of three modalities for diagnosis of invasion into the portal vein was compared using the McNemar's test. Results: Eighty-eight patients (mean age: 71.0 years, ratio of male to female: 48:40) were eligible. Postoperative pathological results were as follows: seven cases of portal vein invasion; 81 cases without. Diagnostic accuracy of EUS, CH-EUS, and CE-CT for diagnosing invasion into the portal vein was 72.7%, 93.2%, and 81.8%, respectively. The differences between CH-EUS and CE-CT (P = 0.0094) and CH-EUS and EUS (P = 0.0022) were significant. EUS and CE-CT were comparable. Conclusion: CH-EUS is useful for diagnosis of portal vein invasion by pancreatic cancer.
- Masahiro Itonaga; Masayuki Kitano; Hiroyuki Isayama; Mamoru Takenaka; Takeshi Ogura; Yasunobu Yamashita; Toshio Fujisawa; Kosuke Minaga; Atsushi Okuda; Toshio ShimokawaMedicine 101 22 e29408 2022年06月INTRODUCTION: Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is a novel drainage option for patients with an inaccessible papilla. Although EUS-HGS has clinical benefits in patients for whom endoscopic retrograde cholangiopancreatography (ERCP) has failed, the rates of adverse events (AEs) associated with EUS-HGS, such as bile peritonitis and stent migration, are higher than for other procedures. The development of a dedicated system for EUS-HGS is therefore desirable to reduce the rate of AEs. We developed a dedicated system for EUS-HGS (HG01 system) which is composed of a 19-gauge needle, 0.025-inch guidewire, a thin delivery system for tract dilation, and an antimigration metal stent. This study is designed to evaluate the efficacy and safety of EUS-HGS using the HG01 system in malignant biliary obstruction. METHODS/DESIGN: This is a single-arm multicenter prospective study involving 40 patients across six tertiary centers in Japan. Patients with an unresectable malignant biliary obstruction in whom biliary drainage with ERCP failed, is not possible, or is very difficult will be registered in the study. The primary endpoint is the clinical success rate. The secondary endpoints are the technical success rate, procedure-related AE rate, procedure time, procedure success rate using only the HG01 system, stent patency rate, re-intervention success rate, re-intervention method, survival rate, and distance of movement of the stent position. DISCUSSION: We expect use of the HG01 system to reduce the rate of AEs during EUS-HGS, especially bile leakage and stent migration. If the efficacy and safety of EUS-HGS using the HG01 system is confirmed in the present study, it is likely to be considered the first-choice device for use during EUS-HGS.
- Masayuki Kitano; Keiichi Hatamaru; Kosuke Minaga(In: Teoh, A.Y., Giovaninni, M., Khashab, M.A., Itoi, T. eds). Atlas of Interventional EUS 111 - 115 2022年06月
- Kosuke Minaga; Masatoshi KudoDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 2022年05月
- Tomohiro Watanabe; Kosuke Minaga; Akane Hara; Tomoe Yoshikawa; Ken Kamata; Masatoshi KudoFrontiers in Immunology 13 859926 - 859926 2022年05月Efficient protection against coronavirus disease 2019 (COVID-19) has been achieved by immunization with mRNA-based vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, efficient immune responses against this novel virus by vaccination are accompanied by a wide variety of side effects. Indeed, flares or new-onset of autoimmune disorders have been reported soon after the COVID-19 vaccination. Although pro-inflammatory cytokine responses play pathogenic roles in the development of autoimmunity, cytokines charactering COVID-19 vaccination-related autoimmune responses have been poorly understood. Given that mRNA derived from COVID-19 vaccine is a potent inducer for pro-inflammatory cytokine responses, these cytokines might mediate autoimmune responses after COVID-19 vaccination. Here we report a case with new-onset rheumatoid arthritis (RA) following COVID-19 vaccination. Serum concentrations not only of arthrogenic cytokines, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), but also of type I interferon (IFN) were elevated at the active phase in this case. Induction of remission by methotrexate and tocilizumab was accompanied by a marked reduction in serum concentrations of type I IFN, IL-6, and TNF-α. These results suggest that production of type I IFN, IL-6, and TNF-α induced by COVID-19 vaccination might be involved in this case with new-onset RA.
- Ken Kamata; Makiko Kinoshita; Ikuharu Kinoshita; Hajime Imai; Takeshi Ogura; Hisakazu Matsumoto; Kosuke Minaga; Yasutaka Chiba; Mamoru Takenaka; Masatoshi Kudo; Masayuki KitanoInternational journal of clinical oncology 2022年04月OBJECTIVES: This study evaluated the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in combination with EUS-guided celiac ganglia neurolysis (EUS-CGN) for pancreatic cancer-associated pain. METHODS: This multicenter prospective trial was registered in the University Hospital Medical Information Network (UMIN000031228). Fifty-one consecutive patients with pancreatic cancer-associated pain who presented at one of five Japanese referral centers between February 2018 and March 2021 were enrolled. EUS-CGN was added in cases of visible celiac ganglia. The primary endpoint was effectiveness, defined as a decrease in the numerical rating scale (NRS) by ≥ 3 points. NRS data were prospectively acquired at 1 week after the procedure to evaluate its effectiveness and the extent of pain relief. RESULTS: The technical success rates of EUS-CPN and EUS-CGN were 100% and 80.4%, respectively. The overall efficacy rate was 82.4% [90% confidence interval (CI) 71.2-90.5, P < 0.0001]. The complete pain relief rate was 27.4%. The adverse events rate was 15.7%. The average pain relief period was 72 days. The efficacy rate was higher in the EUS-CPN plus EUS-CGN group than in the EUS-CPN alone group. EUS-CPN plus EUS-CGN was superior to EUS-CPN alone for achieving complete pain relief (P = 0.045). EUS-CGN did not improve the average length of the pain relief period. CONCLUSIONS: EUS-CPN combined with EUS-CGN is safe, feasible, and effective for pain relief in patients with pancreatic cancer. The patients who received additional EUS-CGN had a better short-term response. CLINICAL TRIAL NUMBER: UMIN000031228.
- Shogo Nakano; Kosuke Minaga; Yasuhiro Tani; Kohei Tonomura; Yusuke Hanawa; Hiroki Morimura; Tomoko Terashita; Hisakazu Matsumoto; Hiroyoshi Iwagami; Yasuki Nakatani; Takuji Akamatsu; Yoshito Uenoyama; Chikara Maeda; Kazuo Ono; Tomohiro Watanabe; Yukitaka YamashitaInternal medicine (Tokyo, Japan) 2022年04月An 82-year-old man with fever and back pain was referred to our hospital and was thus found to be thrombocytopenic. A bone marrow biopsy revealed the diffuse infiltration of poorly differentiated neuroendocrine carcinoma (NEC). Computed tomography revealed a large hepatic mass. Considering the risk of bleeding due to thrombocytopenia, a needle biopsy was not performed. The patient rapidly deteriorated and died 10 days after presentation. An autopsy confirmed the diagnosis of primary hepatic NEC, with diffuse metastasis to the spleen, bone marrow, and systemic lymph nodes. This is an extremely rare case of NEC presenting with thrombocytopenia due to extensive bone marrow and splenic infiltration.
- Yasuhiro Masuta; Tomohiro Watanabe; Kosuke Minaga; Masatoshi KudoInflammatory bowel diseases 28 8 e113 2022年04月
- Kosuke Minaga; Tomohiro Watanabe; Ken Kamata; Masatoshi Kudo; Warren StroberCurrent protocols 2 4 e422 2022年04月Pancreatitis occurs in two forms defined by its chronicity. Acute pancreatitis (AP) occurs suddenly and only lasts for several days. Consequently, most patients with AP recover without permanent damage to the pancreas, and about 20% of patients with AP have severe disease. In contrast, chronic pancreatitis (CP) is a long-lasting inflammation that causes permanent damage to pancreatic tissue; consequently, this form is marked by the emergence of persistent endocrine and exocrine pancreatic insufficiency. Despite these differences, AP and CP share central mechanisms of disease: in both forms, inflammation is initiated and/or sustained by the intrapancreatic activation of pancreatic digestive enzymes followed by the autodigestion of pancreatic tissues. In addition, in both forms enzymatic damage is accompanied by changes in intestinal permeability and entry of commensal organisms into the pancreas where they elicit innate immune responses that ultimately dominate and define pancreatic inflammation. In the murine models of AP and CP described here, both of these elements of pancreatitis pathogenesis are taken into account. Thus, in one approach mice are administered high doses of cerulein, a cholecystokinin analog with the ability at this dose to induce excessive activation of the cholecystokinin receptor expressed in pancreatic acinar cells and the release of active trypsin that causes both direct and indirect acinar damages due to entry of commensal organisms and stimulation of innate immune responses. In a second approach mice are administered low doses of cerulein, which causes little or no damage to the pancreas unless given along with nucleotide-binding oligomerization domain 1 (NOD1) ligand, which in the presence of low-dose cerulein administration induces a pathologic innate immune response mediated by NOD1. These approaches are adopted to produce AP when cerulein or cerulein plus NOD1 ligand is applied only once or to produce CP when a similar regimen is applied multiple times. © 2022 Wiley Periodicals LLC. Basic Protocol 1: Cerulein-induced acute pancreatitis Alternate Protocol 1: Acute pancreatitis induced by cerulein and NOD1 ligand Basic Protocol 2: Cerulein-induced chronic pancreatitis Alternate Protocol 2: Chronic pancreatitis induced by cerulein and NOD1 ligand Support Protocol: Isolation of pancreatic mononuclear cells.
- Mamoru Takenaka; Madan M Rehani; Makoto Hosono; Tomohiro Yamazaki; Shunsuke Omoto; Kosuke Minaga; Ken Kamata; Kentaro Yamao; Shiro Hayashi; Tsutomu Nishida; Masatoshi KudoJournal of clinical medicine 11 6 2022年03月Fluoroscopy forms an essential part of endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) and hepaticogastrostomy with antegrade stenting (EUS-HGAS). To date, no study has assessed and compared radiation exposure between EUS-HGS and EUS-HGAS. This study aimed to compare the radiation exposure parameters between EUS-HGS and EUS-HGAS. This retrospective single-center cohort study included consecutive patients who underwent EUS-HGS or EUS-HGAS from October 2017 to March 2019. The air kerma (AK: mGy), kerma-area product (KAP: Gycm2), fluoroscopy time (FT: min), and procedure time (PT: min) were assessed and compared between the two procedures. Altogether, 45 and 24 patients underwent EUS-HGS and EUS-HGAS, respectively. The median AK, KAP, FT, and PT were higher in the EUS-HGAS group than in the EUS-HGS group. A comparison revealed no difference in the technical success rate, complications rate, adverse event occurrence rate, and re-intervention rate between both procedures. This is the first report in which radiation exposure was used as a comparative parameter between EUS-HGS and EUS-HGAS. This study revealed that radiation exposure is significantly higher in EUS-HGAS than in EUS-HGS. Increased awareness on radiation exposure is warranted among gastroenterologists so that they choose the procedure with lower radiation exposure in cases where both procedures are indicated.
- Yasuhiro Masuta; Tomohiro Watanabe; Kosuke Minaga; Masatoshi KudoInflammatory bowel diseases 28 8 e110-e111 2022年02月
- Hidekazu Tanaka; Ken Kamata; Rika Ishihara; Hisashi Handa; Yasuo Otsuka; Akihiro Yoshida; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Kosuke Minaga; Kentaro Yamao; Mamoru Takenaka; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoJournal of gastroenterology and hepatology 37 5 841 - 846 2022年01月BACKGROUND AND AIM: Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) is useful for the diagnosis of lesions inside and outside the digestive tract. This study evaluated the value of artificial intelligence (AI) in the diagnosis of gastric submucosal tumors by CH-EUS. METHODS: This retrospective study included 53 patients with gastrointestinal stromal tumors (GISTs) and leiomyomas, all of whom underwent CH-EUS between June 2015 and February 2020. A novel technology, SiamMask, was used to track and trim the lesions in CH-EUS videos. CH-EUS was evaluated by AI using deep learning involving a residual neural network and leave-one-out cross-validation. The diagnostic accuracy of AI in discriminating between GISTs and leiomyomas was assessed and compared with that of blind reading by two expert endosonographers. RESULTS: Of the 53 patients, 42 had GISTs and 11 had leiomyomas. Mean tumor size was 26.4 mm. The consistency rate of the segment range of the tumor image extracted by SiamMask and marked by the endosonographer was 96% with a Dice coefficient. The sensitivity, specificity, and accuracy of AI in diagnosing GIST were 90.5%, 90.9%, and 90.6%, respectively, whereas those of blind reading were 90.5%, 81.8%, and 88.7%, respectively (P = 0.683). The κ coefficient between the two reviewers was 0.713. CONCLUSIONS: The diagnostic ability of CH-EUS results evaluated by AI to distinguish between GISTs and leiomyomas was comparable with that of blind reading by expert endosonographers.
- Sho Masaki; Tomohiro Watanabe; Yasuyuki Arai; Ikue Sekai; Akane Hara; Masayuki Kurimoto; Yasuo Otsuka; Yasuhiro Masuta; Tomoe Yoshikawa; Ryutaro Takada; Ken Kamata; Kosuke Minaga; Kouhei Yamashita; Masatoshi KudoClinical and Experimental Immunology 207 3 340 - 350 2022年01月
Abstract Cellular inhibitor of apoptosis proteins 1 (cIAP1) and 2 (cIAP2) are involved in signaling pathways mediated by Toll-like receptors (TLRs) and tumor necrosis factor (TNF)-α. Excessive activation of TLRs and TNF-αunderlies the immunopathogenesis of Crohn’s disease (CD) and ulcerative colitis (UC). However, the roles played by cIAP1 and cIAP2 in the development of CD and UC remain poorly understood. In this study, we attempted to clarify the molecular link between cIAP1/cIAP2 and colonic inflammation. Human monocyte-derived dendritic cells (DCs) treated with siRNAs specific for cIAP1 or cIAP2 exhibited reduced pro-inflammatory cytokine responses upon stimulation with TLR ligands. Expression of cIAP1 and cIAP2 in human DCs was suppressed in the presence of interferon regulatory factor 4 (IRF4). This effect was associated with inhibition of cIAP1 and cIAP2 polyubiquitination. To verify these in vitro findings, we created mice overexpressing IRF4 in DCs and showed that these mice were resistant to trinitrobenzene sulfonic acid-induced colitis as compared with wild-type mice; these effects were accompanied by reduced expression levels of cIAP1 and cIAP2. Pro-inflammatory cytokine production by mesenteric lymph node cells upon stimulation with TLR ligands was reduced in mice with DC-specific IRF4 overexpression as compared with that in wild-type mice. Finally, in clinical samples of the colonic mucosa from patients with CD, there was a negative relationship between the percentage of IRF4 + DCs and percentages of cIAP1 + or cIAP2 + lamina propria mononuclear cells. These data suggest that the colitogenic roles of cIAP1 and cIAP2 are negatively regulated by IRF4. - Akira Iwanaga; Atsushi Utani; Yuta Koike; Yumi Okubo; Yutaka Kuwatsuka; Yuichiro Endo; Hideaki Tanizaki; Mari Wataya-Kaneda; Atsushi Hatamochi; Kosuke Minaga; Tomoo Ogi; Yosuke Yamamoto; Satoshi Ikeda; Eiko Tsuiki; Hiroshi Tamura; Koji Maemura; Takashi Kitaoka; Hiroyuki MurotaThe Journal of dermatology 49 3 e91-e98 2022年01月Pseudoxanthoma elasticum (PXE) is a progressive hereditary disease that affects tissues such as the skin, retina, blood vessels, and gastrointestinal tracts. Therefore, comprehensive medical care across clinical departments specialized in specific organs is needed to provide the best clinical practices to PXE patients. The Japanese version of clinical guidelines developed by the Japanese Dermatological Association was published in 2017, and aimed to promote equal accessibility of PXE-related medical care. Here, the English version of Japanese guideline is reported, and is intended to be worldwide reference for medical care of PXE.
- Kosuke Minaga; Masayuki Kitano; Yoshito Uenoyama; Keiichi Hatamaru; Hideyuki Shiomi; Kenji Ikezawa; Tsukasa Miyagahara; Hajime Imai; Nao Fujimori; Hisakazu Matsumoto; Yuzo Shimokawa; Atsuhiro Masuda; Mamoru Takenaka; Masatoshi Kudo; Yasutaka ChibaEndoscopic ultrasound 11 6 478 - 486 2022年BACKGROUND AND OBJECTIVES: Although the use of a long metal stent is favored for EUS-guided hepaticogastrostomy (EUS-HGS) for the relief of malignant biliary obstruction (MBO), endoscopic reintervention (E-RI) at the time of recurrent biliary obstruction (RBO) is challenging due to a long intragastric portion. This study evaluated the feasibility and safety of E-RI after a long partially covered metal stent (L-PCMS) placement during EUS-HGS. MATERIALS AND METHODS: We performed a multicenter retrospective study between January 2015 and December 2019 examining patients with MBO who underwent E-RI for RBO through the EUS-HGS route after the L-PCMS placement. Technical and clinical success rates, details of E-RI, adverse events (AEs), stent patency, and survival time were evaluated. RESULTS: Thirty-three patients at eight referral centers in Japan who underwent E-RI through the EUS-HGS route were enrolled. The location of MBO was distal in 54.5%. The median intragastric length of the L-PCMS was 5 cm. As the first E-RI attempt, E-RI via the distal end of the existing L-PCMS was successful in 60.6%. The overall technical and clinical success rates of E-RI were 100% and 81.8%, respectively. Liver abscess was noted in one patient. A proximal biliary stricture was associated with the clinical ineffectiveness of E-RI in multivariable analysis (odds ratio, 12.5, P = 0.04). The median survival and stent patency duration after E-RI were 140 and 394 days, respectively. CONCLUSIONS: Our study findings suggest that E-RI for RBO after EUS-HGS with a L-PCMS is technically feasible and clinically effective, without any severe AEs, especially for patients with distal MBO.
- Kosuke Minaga; Mamoru Takenaka; Masatoshi KudoDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 34 1 79 - 81 2022年01月
- Kentaro Yamao; Masakatsu Tsurusaki; Kota Takashima; Hidekazu Tanaka; Akihiro Yoshida; Ayana Okamoto; Tomohiro Yamazaki; Shunsuke Omoto; Ken Kamata; Kosuke Minaga; Mamoru Takenaka; Takaaki Chikugo; Yasutaka Chiba; Tomohiro Watanabe; Masatoshi KudoDiagnostics (Basel, Switzerland) 11 10 2021年10月BACKGROUND: Pancreatic cancer (PC) exhibits extremely rapid growth; however, it remains largely unknown whether the early stages of PC also exhibit rapid growth speed equivalent to advanced PC. This study aimed to investigate the natural history of early PCs through retrospectively assessing pre-diagnostic images. METHODS: We examined the data of nine patients, including three patients with carcinoma in situ (CIS), who had undergone magnetic resonance cholangiopancreatography (MRCP) to detect solitary main pancreatic duct (MPD) stenosis >1 year before definitive PC diagnosis. We retrospectively analyzed the time to diagnosis and first-time tumor detection from the estimated time point of first-time MPD stenosis detection without tumor lesion. RESULTS: The median tumor size at diagnosis and the first-time tumor detection size were 14 and 7.5 mm, respectively. The median time to diagnosis and first-time tumor detection were 26 and 49 months, respectively. CONCLUSIONS: No studies have investigated the PC history, especially that of early PCs, including CIS, based on the initial detection of MPD stenosis using MRCP. Assessment of a small number of patients showed that the time to progression can take several years in the early PC stages. Understanding this natural history is very important in the clinical setting.
- Ryutaro Takada; Tomohiro Watanabe; Akane Hara; Ikue Sekai; Masayuki Kurimoto; Yasuo Otsuka; Yasuhiro Masuta; Tomoe Yoshikawa; Ken Kamata; Kosuke Minaga; Masatoshi KudoBiochemical and biophysical research communications 568 55 - 61 2021年09月Nucleotide-binding oligomerization domain 2 (NOD2) is an intracellular receptor for muramyl dipeptide derived from the intestinal microbiota. Loss-of-function mutations in Nod2 are associated with the development of Crohn's disease, suggesting that NOD2 signaling plays critical roles in the maintenance of intestinal immune homeostasis. Although NOD2 activation prevents the development of short-term experimental colitis, it remains unknown whether the sensitivity to long-term experimental colitis is influenced by NOD2. In this study, we explored the roles played by NOD2 in the development of long-term adoptive transfer colitis. Unexpectedly, we found that Rag1-/-Nod2-/- mice were more resistant to adoptive transfer colitis than Rag1-/- mice and had reduced proinflammatory cytokine responses and enhanced accumulation of regulatory T cells (Tregs) expressing forkhead box P3 in the colonic mucosa. Prevention of colitis in Rag1-/-Nod2-/- mice was mediated by TGF-β1 because neutralization of TGF-β1 resulted in the development of more severe colitis due to reduced accumulation of Tregs. Such paradoxical Treg responses in the absence of NOD2 could explain why Nod2 mutations in humans are not sufficient to cause Crohn's disease.
- Noriko Juri; Kosuke Minaga; Yoshito Uenoyama; Yukitaka YamashitaDigestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2021年08月
- Yasuo Otsuka; Ken Kamata; Tomoko Hyodo; Takaaki Chikugo; Akane Hara; Hidekazu Tanaka; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Kosuke Minaga; Kentaro Yamao; Mamoru Takenaka; Yasutaka Chiba; Tomohiro Watanabe; Takuya Nakai; Ippei Matsumoto; Yoshifumi Takeyama; Masatoshi KudoSurgical endoscopy 36 5 3254 - 3260 2021年08月BACKGROUND: The value of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for T-staging in patients with extrahepatic bile duct cancer was evaluated. METHODS: This single-center, retrospective study included consecutive patients with extrahepatic bile duct cancer who underwent surgical resection after preoperative EUS, CH-EUS, and contrast-enhanced CT (CE-CT) examinations between June 2014 and August 2017. The capacity of these modalities for T-staging of extrahepatic bile duct cancer was evaluated by assessing invasion beyond the biliary wall into the surrounding tissue, gallbladder, liver, pancreas, duodenum, portal vein system (portal vein and/or superior mesenteric vein), inferior vena cava, and hepatic arteries (proper hepatic artery, right. and/or left. hepatic artery). Blind reading of EUS, CH-EUS, and CE-CT images was performed by two expert reviewers each. RESULTS: 38 patients were eligible for analysis, of which eight had perihilar bile duct cancer and 30 had distal bile duct cancer. Postoperative T-staging was T1 in 6, T2 in 16, and T3 in 16 cases. CH-EUS was superior to CE-CT for diagnosing invasion beyond the biliary wall into surrounding tissue (92.1% vs. 45.9%, P = 0.0002); the ability to detect invasion to other organs did not differ significantly between the two modalities. The accuracy of CH-EUS for T-staging of tumors was better than that of CE-CT (73.7% vs. 39.5%, P = 0.0059). CH-EUS tended to have a better accuracy than EUS for the diagnosis of invasion beyond the biliary wall into the surrounding tissue (92.1% vs. 78.9%, P = 0.074) and T-staging (73.7% vs. 60.5%, P = 0.074). CONCLUSION: CH-EUS is useful for T-staging of extra hepatic bile duct cancer, especially in terms of invasion beyond the biliary wall into the surrounding tissue.
- Masayuki Kitano; Kosuke Minaga; Keiichi Hatamaru; Reiko AshidaDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 2021年08月Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a first-line procedure for definitive tissue diagnosis of pancreatic cancer because of its high accuracy and low complication rate. The overall sensitivity of EUS-FNA for the diagnosis of pancreatic cancer is approximately 90%; however, its diagnostic ability for small lesions (<10 mm) remains limited. Although EUS-FNA is a relatively safe procedure with an overall morbidity of ≤2%, it should be noted that needle tract seeding (NTS) can occur after EUS-FNA, which may affect patient prognosis negatively. In patients with resected pancreatic tumors, preoperative EUS-FNA is not associated with an increased risk of postoperative recurrence. However, NTS after EUS-FNA for resectable pancreatic body and tail cancer has been highlighted recently, particularly by Japanese endoscopists. Thus, the use of preoperative EUS-FNA for the diagnosis of resectable pancreatic body and tail cancer has become a clinical dilemma that challenges gastroenterologists and must be carefully considered on a case-by-case basis by weighing the benefits and risks. This review summarizes the pros and cons of performing EUS-FNA in patients with resectable pancreatic body and tail cancer and provides valuable insight for gastroenterologists treating pancreatic cancer.
- Ryutaro Takada; Kosuke Minaga; Akane Hara; Yasuo Otsuka; Shunsuke Omoto; Ken Kamata; Kentaro Yamao; Mamoru Takenaka; Satoru Hagiwara; Hajime Honjo; Shigenaga Matsui; Takaaki Chikugo; Tomohiro Watanabe; Masatoshi KudoJournal of clinical medicine 10 16 2021年08月Due to the tendency of gastric linitis plastica (GLP) to cause extensive submucosal infiltration, a superficial endoscopic biopsy sometimes yields no evidence of malignancy, hindering definite diagnosis. The present study was a single-center retrospective analysis of 54 consecutive patients diagnosed with GLP between 2016 and 2020 to evaluate EUS-guided fine-needle aspiration (EUS-FNA) biopsy outcomes in patients with negative endoscopic biopsy findings. A pathological GLP diagnosis was achieved by endoscopic biopsy in 40 patients (74.1%). EUS-FNA biopsy with a 22-gauge needle was performed in 13 of the remaining 14 patients, and GLP diagnosis was confirmed in 10 patients, with a median of three needle passes. The remaining four patients were laparoscopically diagnosed with GLP. The diagnostic ability of EUS-FNA biopsy for GLP was 76.9%, and EUS-FNA biopsy contributed to GLP diagnosis in 18.5% (10/54) of all cases. None of the 13 patients exhibited EUS-FNA biopsy-related adverse events. Univariable and multivariable analyses revealed an absence of superficial ulcerations as a predictor of false-negative endoscopic biopsy findings in patients with GLP. These results suggest EUS-FNA biopsy as a minimally invasive and safe alternative diagnostic modality for GLP in cases where conventional endoscopic biopsy fails to verify malignancy, although prospective studies with larger cohorts are warranted to confirm these findings.
- Yasuhiro Masuta; Yoriaki Komeda; Ikue Sekai; Akane Hara; Masayuki Kurimoto; Keisuke Yoshikawa; Yasuo Otsuka; Ryutaro Takada; Tomoe Yoshikawa; Ken Kamata; Kosuke Minaga; Osamu Maenishi; Tomohiro Watanabe; Masatoshi KudoAsian Pacific journal of allergy and immunology 2021年07月BACKGROUND: Granulomatosis with polyangiitis (GPA) is characterized by granulomatous inflammation, vasculitis, and elevated levels of serum proteinase 3 (PR3)-anti-neutrophil cytoplasmic antibody (PR3-ANCA). OBJECTIVE: We tried to characterize immune cells accumulated into the lung lesions of a GPA patient exhibiting spontaneous regression. METHODS: Transbronchial lung biopsy (TBLB) samples were subjected to immunohistochemical analyses. RESULTS: Multiple lung nodules were detected by CT. TBLB showed granulomatous inflammation and small vessel vasculitis. This case was diagnosed as GPA based on pathological findings and elevation of PR-3 ANCA levels. Spontaneous disappearance of multiple lung nodules was observed in CT. CD3+ T cells and CD20+ B cells accumulated in the inflammatory lesions surrounding the vessels whereas granulomatous inflammation was mainly comprised of CD3+ T cells and CD68+ macrophages, but not B cells or myeloperoxidase+ neutrophils. CONCLUSIONS: We characterized immune cell compositions of the lung lesions of a patient with GPA exhibiting spontaneous regression.
- Akihiro Yoshida; Mamoru Takenaka; Kota Takashima; Hidekazu Tanaka; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Kosuke Minaga; Ken Kamata; Kentaro Yamao; Yoriaki Komeda; Naoshi Nishida; Masatoshi KudoJournal of clinical medicine 10 13 2021年06月Unsuccessful stent replacement in transpapillary biliary drainage with plastic stents (PSs) has a significant impact on patient prognosis; thus, a safe and reliable replacement method is required. We aimed to compare the snare-over-the-guidewire (SOG) method, wherein the PS lumen is used as an access route to the biliary tract and the PS is removed with a snare inserted via the inserted guidewire, with the conventional side-of-stent (SOS) method, wherein the biliary approach is performed from the side of the PS. This retrospective single-center study included 244 consecutive patients who underwent biliary PS replacement between January 2018 and July 2020. The procedural success rates were compared between the two methods. A predictive analysis of unsuccessful PS replacement was also performed. The procedural success rate in the SOG group was significantly higher than that in the SOS group (p = 0.026). In the proximal biliary stenosis lesion, the same trend was observed (p = 0.025). Multivariate analysis also showed that the SOS method (p = 0.0038), the presence of proximal biliary stenosis (p < 0.0001), and parapapillary diverticulum (p = 0.0007) were predictors of unsuccessful PS replacement. The SOG method may be useful for biliary PS replacement, especially in cases of proximal hilar bile duct stenosis.
- Yasunobu Yamashita; Masahiro Itonaga; Chimyon Gon; Yuki Kawaji; Takashi Tamura; Keiichi Hatamaru; Kosuke Minaga; Mamoru Takenaka; Takeshi Ogura; Masayuki KitanoGastrointestinal endoscopy 94 5 999 - 1008 2021年06月BACKGROUND AND AIMS: EUS-guided hepaticogastrostomy (EUS-HGS) is associated with high rates of adverse events. The present study evaluated the feasibility of a newly designed stent equipped with a dilatation and antimigration system for EUS-HGS in phantom and animal models. METHODS: The newly designed stent was a partially covered laser-cut stent with antimigration anchoring hooks and a thin tapered tip (7.2F). The feasibility of these stents for biliary obstruction was compared with that of conventional stents. Evaluated outcomes were resistance force to migration in phantom and ex vivo models, rates of technical success and adverse events, and histology in an in vivo model. RESULTS: The resistance forces on the distal (3.59 vs 1.73 N and 6.21 vs 1.74 N) and proximal (3.58 vs 1.5 N and 5.97 vs 1.67 N) sides in phantom and ex vivo models were significantly higher for hook stents than for conventional stents. Although EUS-HGS was successfully performed in all cases with both stents (100% [10/10] vs 100% [8/8]), the success rate of EUS-HGS without using a fistulous tract dilation device was significantly higher with hook stents (100% [10/10]) than with conventional stents (13% [1/8]). No adverse events occurred with either stent. Pathologic examination showed adhesion between the stomach and liver. CONCLUSIONS: The strong resistance to migration and the absence of the dilation step are important advantages of newly designed hook stents. These stents may therefore be feasible and safe for EUS-HGS.
- Hoonsub So; Dongwook Oh; Mamoru Takenaka; Kosuke Minaga; Shinya Uemura; Takuji Iwashita; Tomotaka Saito; Yousuke Nakai; Seon Ok Kim; Do Hyun ParkJournal of hepato-biliary-pancreatic sciences 28 12 1130 - 1137 2021年06月BACKGROUND/PURPOSE: This study aimed to evaluate the feasibility of endoscopic ultrasound (EUS)-guided antegrade covered stent placement with long duodenal extension (EASL) for malignant distal biliary obstruction (MDBO) with duodenal obstruction (DO) or surgically altered anatomy (SAA) after failed endoscopic retrograde cholangiopancreatography (ERCP). METHODS: Outcomes were technical and clinical success, reintervention rate, adverse events, stent patency, and overall survival. Inverse probability of treatment weighting (IPTW) and competing-risk analysis were performed to compare with conventional EUS-BD. RESULTS: Twenty-five patients (DO, n = 18; SAA, n = 7) were included. The technical and clinical success rates were 96% and 84%, respectively. Reintervention occurred in two patients (8.3%). Adverse events occurred in six patients (24%; two cholangitis, 16%; four mild postprocedural pancreatitis [24% (n = 4/17) in patients with non-pancreatic cancers]). The median patency was 9.4 months, and the overall survival was 2.73 months. After IPTW adjustment, the median patency in the EASL (n = 25) and conventional EUS-BD (n = 29) were 10.1 and 6.5 months, respectively (P = .018). CONCLUSIONS: EASL has acceptable clinical outcomes with a low reintervention rate but higher rate of postprocedural pancreatitis in patients with non-pancreatic cancers. Randomized trials comparing EASL and conventional EUS-BD for MDBO with pancreatic cancers and DO/SAA after failed ERCP are needed to validate our findings.
- Junichi Kawai; Takeshi Ogura; Mamoru Takenaka; Hideyuki Shiomi; Kazuya Ueshima; Saori Ueno; Atsushi Okuda; Jun Matsuno; Kousuke Minaga; Shunsuke Omoto; Atsushi Nakai; Takuya Ikegawa; Akitoshi Hakoda; Kazuhide HiguchiJournal of hepato-biliary-pancreatic sciences 29 11 1195 - 1203 2021年06月BACKGROUND AND AIM: Bilateral stent deployment for malignant biliary obstruction (MHBO) can be achieved using side-by-side (SBS) or stent-in-stent (SIS) procedures. Compared with SBS techniques, the procedural steps of SIS are technically complex due to the necessity of introducing the delivery system into a contralateral biliary tract through the mesh of the SEMS. To overcome this issue, a novel uncovered SEMS, the HILZO Moving Cell Stent (MCS) has been released. The present study examined the technical feasibility of treating MHBO using bilateral deployment of this novel stent without dilating the mesh of the first stent to achieve insertion of the second stent within a single session, using a prospective, multicenter setting. METHOD: The primary outcome in the present study was the technical success rate. Technical success was defined as deployment of bilateral MCSs into two or more biliary tracts using SIS without a dilation device in a single-session. RESULTS: A total of 27 patients with complications of MHBO were enrolled in this study. Bilateral SIS using two MCS was successfully performed in 23 patients without using dilation devices among 27 patients (initial technical success rate; 85.2%). Median time to recurrent biliary obstruction (TRBO) was 271 days. Stent dysfunction was observed in 12 patients (44.4%), and re-intervention was successfully performed in all patients without one patient who instead received best supportive care. CONCLUSIONS: The SIS technique using MCS without dilation of the mesh may be technically feasible and safe. In addition, this may be useful for re-intervention. Further comparative randomized trials are needed.
- Mamoru Takenaka; Makoto Hosono; Madan M Rehani; Yasutaka Chiba; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Kosuke Minaga; Ken Kamata; Kentaro Yamao; Shiro Hayashi; Tsutomu Nishida; Masatoshi KudoDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 34 3 579 - 586 2021年06月OBJECTIVES: The transpapillary drainage by endoscopic retrograde cholangiopancreatography (ERCP-D) cannot be performed without fluoroscopy, and there are many situations in which fluoroscopy is required even in endoscopic ultrasound-guided drainage (EUS-D). Previous studies have compared the efficacy, but not the radiation exposure of EUS-D and ERCP-D. While radiation exposure in ERCP-D has been previously evaluated, there is a paucity of information regarding radiation doses in EUS-D. This study aimed to assess radiation exposure in EUS-D compared with that in ERCP-D. METHODS: This retrospective single-center cohort study included consecutive patients who underwent EUS-D and ERCP-D between October 2017 and March 2019. The air kerma (AK, mGy), kerma-area product (KAP, Gycm2 ), fluoroscopy time (FT, min), and procedure time (PT, min) were assessed. The invasive probability weighting method was used to qualify the comparisons. RESULTS: We enrolled 372 and 105 patients who underwent ERCP-D and EUS-D, respectively. The mean AK, KAP, and FT in the EUS-D group were higher by 53%, 28%, and 27%, respectively, than those in the ERCP-D group, whereas PT was shorter by approximately 11% (AK, 135.0 vs. 88.4; KAP, 28.1 vs. 21.9; FT, 20.4 vs. 16.0; PT, 38.7 vs. 43.5). The sub-analysis limited to biliary drainage cases showed the same trend (AK, 128.3 vs. 90.9; KAP, 27.0 vs. 22.2; FT, 16.4 vs. 16.1; PT, 32.5 vs. 44.4). CONCLUSIONS: This is the first study to assess radiation exposure in EUS-D compared with that in ERCP-D. Radiation exposure was significantly higher in EUS-D than in ERCP-D, despite the shorter procedure time.
- Akane Hara; Tomohiro Watanabe; Kosuke Minaga; Tomoe Yoshikawa; Ken Kamata; Masatoshi KudoWorld journal of gastroenterology 27 19 2257 - 2269 2021年05月Solitary organ autoimmune disorders, formerly known as autoimmune pancreatitis (AIP), autoimmune sialadenitis, and autoimmune sclerosing cholangitis, are now considered organ-specific manifestations of systemic immunoglobulin G4-related disease (IgG4-RD). AIP and IgG4-RD are characterized by elevated serum concentration of IgG4 antibody (Ab), accumulation of IgG4-expressing plasmacytes in the affected organs, and involvement of multiple organs. It is well established that enhanced IgG4 Ab responses are a hallmark of AIP and IgG4-RD for diagnosis and monitoring disease activity. However, a significant fraction of patients with AIP and IgG4-RD who develop chronic fibroinflammatory responses have normal serum concentrations of this IgG subtype. In addition, disease flare-up is sometimes seen even in the presence of normalized serum concentrations of IgG4 Ab after successful induction of remission by prednisolone. Therefore, it is necessary to identify new biomarkers based on the understanding of the pathophysiology of AIP and IgG4-RD. Recently, we found that activation of plasmacytoid dendritic cells producing both interferon-α (IFN-α) and interleukin-33 (IL-33) mediate murine AIP and human IgG4-RD. More importantly, we provided evidence that serum concentrations of IFN-α and IL-33 could be useful biomarkers for the diagnosis and monitoring of AIP and IgG4-RD activity after induction of remission in these autoimmune disorders. In this Frontier article, we have summarized and discussed biomarkers of AIP and IgG4-RD, including Igs, autoAbs, and cytokines to provide useful information not only for clinicians but also for researchers.
- Satoru Hagiwara; Tomohiro Watanabe; Masatoshi Kudo; Kosuke Minaga; Yoriaki Komeda; Ken Kamata; Masatomo Kimura; Hidetoshi Hayashi; Kazuhiko Nakagawa; Kazuomi Ueshima; Yasunori Minami; Tomoko Aoki; Masahiro Takita; Masahiro Morita; Hirokazu Cishina; Hiroshi Ida; Ah-Mee Park; Naoshi NishidaScientific reports 11 1 9242 - 9242 2021年04月Immune checkpoint inhibitors (ICIs) targeting programmed cell death 1 (PD-1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) are widely used to treat advanced metastatic cancers. Neutralisation of PD-1 or CTLA-4 by ICIs results in immune-related adverse events (irAEs). The clinicopathological features of twelve patients with hepatic irAEs were evaluated and compared to those of ten patients with autoimmune hepatitis (AIH) or graft-versus-host disease (GVHD). No significant difference was seen in serum levels of transaminases, whereas serum levels of IgG and anti-nuclear antibody were higher in patients with AIH than in those with GVHD or hepatic irAEs. Inflammation was limited to the liver lobes in patients with GVHD or hepatic irAEs, whereas patients with AIH exhibited both portal and lobular inflammation. Immunohistochemical analyses revealed a predominant infiltration of CD8+ T cells and defective accumulation of regulatory T cells (Tregs) expressing forkhead box p3 (FOXP3) in the lobular areas of patients with hepatic irAEs and GVHD. In contrast, periportal lesions of patients with AIH were characterised by an infiltration of CD4+ T cells, CD8+ T cells, CD20+ B cells, and FOXP3+ Tregs. Overall, the activation of CD8+ T cells in the absence of activation of Tregs potentially underlies the immunopathogenesis of hepatic irAEs.
- Tomohiro Yamazaki; Mamoru Takenaka; Shunsuke Omoto; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Atsushi Nakai; Kosuke Minaga; Ken Kamata; Kentaro Yamao; Yoriaki Komeda; Tomohiro Watanabe; Naoshi Nishida; Keiko Kamei; Ippei Matsumoto; Yoshifumi Takeyama; Takaaki Chikugo; Yasutaka Chiba; Masatoshi KudoJournal of clinical medicine 10 9 2021年04月This study aimed to investigate whether the incorporation of contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) into the international consensus guidelines (ICG) for the management of intraductal papillary mucinous neoplasm (IPMN) could improve its malignancy diagnostic value. In this single-center retrospective study, 109 patients diagnosed with IPMN who underwent preoperative CH-EUS between March 2010 and December 2018 were enrolled. We analyzed each malignancy diagnostic value (sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV)) by replacing fundamental B-mode EUS with CH-EUS as the recommended test for patients with worrisome features (WF) (the CH-EUS incorporation ICG) and comparing the results to those obtained using the 2017 ICG. The malignancy diagnostic values as per the 2017 ICG were 78.9%, 42.3%, 60.0%, and 64.7% for Se, Sp, PPV, and NPV, respectively. The CH-EUS incorporation ICG plan improved the malignancy diagnostic values (Se 78.9%/Sp, 53.8%/PPV, 65.2%/NPV 70.0%). CH-EUS may be useful in determining the appropriate treatment strategies for IPMN.
- Hajime Honjo; Tomohiro Watanabe; Natsuki Okai; Masashi Kono; Ken Kamata; Kosuke Minaga; Yoriaki Komeda; Shigeyoshi Tsuji; Masatoshi KudoAsian Pacific journal of allergy and immunology 2021年04月BACKGROUND: Despite the high incidence of spondyloarthritis (SpA) as an extra-intestinal manifestation of Crohn's disease (CD), the immunopathogenesis of CD-associated SpA remains largely unknown. OBJECTIVE: We tried to explore molecular mechanisms accounting for the development of CD-associated SpA in a patient successfully treated with infliximab. METHODS: Peripheral blood mononuclear cells (PBMCs) before infliximab treatment were stimulated with Toll-like receptor (TLR) ligands to measure pro-inflammatory cytokine responses. Endoscopic biopsy samples before and after infliximab treatment were subjected to quantitative polymerase chain reaction. RESULTS: PBMCs from this CD-associated SpA patient exhibited higher production of pro-inflammatory cytokines upon stimulation with TLR ligands than PBMCs from healthy controls. Induction of remission by infliximab was associated with the downregulation of pro-inflammatory cytokine responses in the small intestinal mucosa, which is continually exposed to TLR ligands. CONCLUSIONS: Excessive pro-inflammatory cytokine responses to TLR ligands might underlie the immunopathogenesis of CD-associated SpA.
- Kosuke Minaga; Masayuki KitanoGastrointestinal endoscopy 93 3 773 - 774 2021年03月
- Tomoe Yoshikawa; Kosuke Minaga; Akane Hara; Ikue Sekai; Yasuo Otsuka; Ryutaro Takada; Ken Kamata; Tomohiro Watanabe; Masatoshi KudoAsian Pacific journal of allergy and immunology 2021年02月BACKGROUND: Type 1 autoimmune pancreatitis (AIP) is a pancreatic manifestation of IgG4-related disease (IgG4-RD). Although AIP and IgG4-RD are characterized by multiple organ involvement including salivary glands, lung, and kidney, co-occurrence of chronic rhinosinusitis (CRS) and AIP/IgG4-RD has been poorly defined. OBJECTIVE: We explored molecular mechanism accounting for the co-occurrence of CRS and AIP/IgG4-RD. METHODS: Serum concentrations of IFN-α and IL-33 were measured by enzyme-linked immune-sorbent assay. RESULTS: We encountered a patient with concurrent type 1 AIP/IgG4-RD and CRS. Induction of remission by prednisolone (PSL) for type 1 AIP/IgG4-RD led to a marked improvement of CRS. Serum cytokine analysis after PSL treatment revealed a marked reduction in serum concentrations of IFN-α and IL-33, both of which are candidate pathogenic cytokines for AIP/IgG4-RD. CONCLUSIONS: Given that IL-33 is shared as one of pathogenic cytokines by type 1 AIP/IgG4-RD and CRS, enhanced IL33 responses may cause concurrent type 1 AIP/IgG4-RD and CRS.
- Kosuke Minaga; Tomohiro Watanabe; Masatoshi KudoDigestive diseases and sciences 2021年01月
- Akihiro Yoshida; Yasutake Uchima; Naoki Hosaka; Kosuke Minaga; Masatoshi KudoBMC gastroenterology 21 1 11 - 11 2021年01月BACKGROUND: Colonic volvulus, a condition in which a colonic segment partially twists around its base, is the third leading cause of large bowel obstruction after colonic neoplasms and diverticular disease. However, volvulus of the transverse colon is the rarest type of large intestinal volvulus. Moreover, the occurrence of transverse colonic volvulus secondary to a benign tumor originating from outside the intestine has never been reported. We hereby report a case of transverse colonic volvulus caused by mesenteric fibromatosis. CASE PRESENTATION: A 53-year-old female with a history of rheumatoid arthritis and thyroid tumor presented with abdominal pain for 1 day. Abdominal computed tomography revealed intestinal torsion at the hepatic flexure. Twisted and obstructed mucosa of the transverse colon was observed during colonoscopy, but no tumor invasion of the mucosal surface was detected. A solid mass of a mesenteric origin with involvement of the transverse colon was observed during surgery. The mass was diagnosed surgically as transverse colonic volvulus induced by a mesenteric tumor. Hence, the patient underwent a right hemicolectomy. Histopathological results indicated mesenteric desmoid-type fibromatosis. The postoperative recovery was uneventful, and the patient was discharged 8 days after surgery. CONCLUSIONS: Although mesenteric fibromatosis is rare, this disease should be considered when managing transverse colonic volvulus resulting from nonmucosal tumors.
- Ikue Sekai; Tomohiro Watanabe; Keisuke Yoshikawa; Ryutaro Takada; Akane Hara; Tomoe Yoshikawa; Ken Kamata; Kosuke Minaga; Masatoshi KudoClinical journal of gastroenterology 2021年01月Eosinophilic gastroenteritis (EGE) is a chronic allergic disorder characterized by infiltration of eosinophils in the gastrointestinal (GI) tract and hypereosinophilia. Although T helper type 2 (Th2) responses play pathogenic roles in EGE, roles of innate immunity cytokines including IL-6 and TNF-α have been poorly defined. Here, we describe a case of EGE exhibiting accumulation of eosinophils in the upper GI mucosa and hypereosinophilia. Induction of remission by prednisolone reduced expression levels not only of Th2 cytokines but also of IL-6 and TNF-α in the GI mucosa. Moreover, induction of remission was accompanied by a marked reduction in serum levels of chemokine C-C motif ligand 17 (CCL17, TARC), IL-6 and TNF-α, implicating that both Th2 and innate immune responses were involved in the development of EGE in this case. Collectively, this case suggests possible involvement of IL-6 and TNF-α in the development of EGE.
- Masayuki Kurimoto; Tomohiro Watanabe; Ken Kamata; Kosuke Minaga; Masatoshi KudoFrontiers in physiology 12 781012 - 781012 2021年IL-33 is a pleiotropic cytokine that promotes inflammation and fibrosis. IL-33 is produced by a broad range of cells, including antigen-presenting cells (APCs), epithelial cells, and fibroblasts. IL-33 produced by the innate immune cells has been shown to activate pro-inflammatory T helper type 1 (Th1) and T helper type 2 (Th2) responses. The intestinal barrier and tolerogenic immune responses against commensal microbiota contribute to the maintenance of gut immune homeostasis. Breakdown of tolerogenic responses against commensal microbiota as a result of intestinal barrier dysfunction underlies the immunopathogenesis of inflammatory bowel diseases (IBD) and pancreatitis. Recent studies have provided evidence that IL-33 is an innate immune cytokine that bridges adaptive Th1 and Th2 responses associated with IBD and pancreatitis. In this Mini Review, we discuss the pathogenic roles played by IL-33 in the development of IBD and pancreatitis and consider the potential of this cytokine to be a new therapeutic target.
- Hajime Honjo; Tomohiro Watanabe; Ken Kamata; Kosuke Minaga; Masatoshi KudoFrontiers in pharmacology 12 650403 - 650403 2021年Inflammatory bowel diseases (IBDs) are becoming more frequent worldwide. A significant fraction of patients with IBD are refractory to various types of therapeutic biologics and small molecules. Therefore, identification of novel therapeutic targets in IBD is required. Receptor-interacting serine/threonine kinase 2 (RIPK2), also known as receptor-interacting protein 2 (RIP2), is a downstream signaling molecule for nucleotide-binding oligomerization domain 1 (NOD1), NOD2, and Toll-like receptors (TLRs). RIPK2 is expressed in antigen-presenting cells, such as dendritic cells and macrophages. Recognition of microbe-associated molecular patterns by NOD1, NOD2, and TLRs leads to the interaction between RIPK2 and these innate immune receptors, followed by the release of pro-inflammatory cytokines such as TNF-α, IL-6, and IL-12/23p40 through the activation of nuclear factor kappa B and mitogen-activated protein kinases. Thus, activation of RIPK2 plays a critical role in host defense against microbial infections. Recent experimental and clinical studies have provided evidence that activation of RIPK2 is involved in the development of autoimmune diseases, especially IBDs. In addition, the colonic mucosa of patients with IBD exhibits enhanced expression of RIPK2 and associated signaling molecules. Furthermore, the blockage of RIPK2 activation ameliorates the development of experimental murine colitis. Thus, activation of RIPK2 underlies IBD immunopathogenesis. In this review, we attempt to clarify the roles played by RIPK2 in the development of IBD by focusing on its associated signaling pathways. We also discuss the possibility of using RIPK2 as a new therapeutic target in IBD.
- Keisuke Yoshikawa; Tomohiro Watanabe; Ikue Sekai; Ryutaro Takada; Akane Hara; Masayuki Kurimoto; Yasuhiro Masuta; Yasuo Otsuka; Tomoe Yoshikawa; Sho Masaki; Ken Kamata; Kosuke Minaga; Yoriaki Komeda; Takaaki Chikugo; Masatoshi KudoFrontiers in medicine 8 679237 - 679237 2021年Behçet's disease (BD) is a rare inflammatory condition characterized by oral and genital ulcers, skin lesions, as well as ophthalmological, neurological, and gastrointestinal manifestations. BD involving the gastrointestinal tract is known as intestinal BD. The mucosa of the gastrointestinal tract of patients with intestinal BD exhibits enhanced levels of proinflammatory cytokines, such as IL-1β, IL-6, and TNF-α. These proinflammatory cytokines play pathogenic roles in the development of BD, as evidenced by the fact that biologics targeting these cytokines effectively induce BD remission. It should be noted, however, that the molecular mechanisms by which the blockade of these cytokines suppresses chronic inflammatory responses in BD are poorly understood. Herein, we report a case of intestinal BD resistant to prednisolone that was successfully treated with infliximab (IFX). The induction of remission by IFX was accompanied by a marked elevation of IL-6 and forkhead box P3 (FOXP3) at mRNA level. This case suggests that induction of remission by IFX is mediated not only by the suppression of TNF-α-mediated signaling pathways, but also by the promotion of IL-6 expression and accumulation of regulatory T cells expressing FOXP3.
- Ryutaro Takada; Tomohiro Watanabe; Ikue Sekai; Keisuke Yoshikawa; Akane Hara; Yasuo Otsuka; Tomoe Yoshikawa; Ken Kamata; Kosuke Minaga; Yoriaki Komeda; Takaaki Chikugo; Yasuyuki Arai; Kohei Yamashita; Masatoshi KudoFrontiers in oncology 11 656219 - 656219 2021年Double expressor lymphoma (DEL), defined as overexpression of BCL2 and MYC, is an aggressive subtype of diffuse large B cell lymphoma (DLBCL). Here we report a case of a 64-year-old female diagnosed with abdominal DEL transformed from jejunum follicular lymphoma (FL). 18F-fluorodeoxyglucose (FDG)-positron emission tomography showed diffuse accumulation of FDG into the peritoneum and small bowel wall. Double balloon-assisted enteroscopy revealed whitish submucosal tumors in the proximal jejunum. Aggregation of atypical lymphocytes positive for CD20, CD79a, and BCL2 was seen in the jejunal biopsy samples. These atypical lymphocytes were monoclonal since cell surface expression of Ig light chains was limited to κ chain by flow-cytometry. Thus, immunohistochemical and flowcytometric analyses data were consistent with FL of the jejunum. Neoplastic lymphocytes obtained from ascites were positive for CD10, CD20, CD79a, BCL2, and BCL6. Fluorescence in situ hybridization (FISH) showed formation of BCL2/IgH fusion gene and extra copies of MYC, the former of which is a characteristic chromosomal abnormality of FL. These genetic alterations and protein expression profiles of ascitic fluid cells were consistent with those of DEL transformed from FL. Given that a significant population of patients with indolent FL of the gastrointestinal tract developed into aggressive DLBCL, it is likely that primary FL of the jejunum transformed into the abdominal aggressive DEL in this case. This case is unique in that concurrent occurrence of FL and DEL was confirmed by immunohistochemical and FISH analyses and that abdominal DEL transformed from jejunal FL was highly suspected.
- Hajime Honjo; Tomohiro Watanabe; Mizuki Tomooka; Takuya Matsubara; Masashi Kono; Ikue Sekai; Akane Hara; Masayuki Kurimoto; Keisuke Yoshikawa; Yasuhiro Masuta; Yasuo Otsuka; Ryutaro Takada; Tomoe Yoshikawa; Ken Kamata; Kosuke Minaga; Shigenaga Matsui; Masatomo Kimura; Masatoshi KudoFrontiers in medicine 8 678268 - 678268 2021年Collagenous colitis (CC), a prototypical microscopic colitis, is a chronic inflammatory disorder of the colon. The diagnosis of CC depends on the pathological examination. The colonic mucosa of patients with CC is characterized by the presence of a substantially thickened collagen band (>10μm) under the surface epithelium. In addition, intraepithelial and lamina propria lymphocytes are markedly increased in patients with CC. However, the roles played by the lymphocytes accumulating in the colonic mucosa of patients with CC are poorly defined. Recent studies indicate that T cells infiltrating the colonic mucosa of patients with CC are mainly represented by CD4+ T cells, CD8+ T cells, and forkhead box P3 (FOXP3)+ regulatory T cells (Tregs). Given that activation of CD4+/CD8+ T cells and FOXP3+ Tregs usually mediates pro-inflammatory and anti-inflammatory responses, respectively, alterations in the colonic numbers of these adaptive T cells might be related to the resolution of colitis in patients with CC. We determined alterations in the composition of colonic T cells by extensive immunohistochemical (IHC) analyses in a case of CC successfully treated with budesonide and metronidazole. Colonic lamina propria immune cells mainly comprised CD3+ T cells, CD4+ T cells, CD8+ T cells, CD68+ macrophages, and FOXP3+ Tregs, but not CD20+ B cells or myeloperoxidase (MPO)+ granulocytes in the active phase. During remission, the numbers of CD3+ T cells, CD4+ T cells, CD8+ T cells, and CD68+ macrophages did not change significantly in the colonic lamina propria, whereas FOXP3+ Tregs were markedly decreased, suggesting that induction of remission was achieved in a Treg-independent manner. Thus, our study indicates that accumulation of FOXP3+ Tregs in the colonic mucosa of patients with CC might be a counter-regulatory mechanism reflecting persistent inflammation and that induction of remission might be achieved without activation of Tregs.
- Kosuke Minaga; Tomohiro Watanabe; Akane Hara; Tomoe Yoshikawa; Ken Kamata; Masatoshi KudoFrontiers in immunology 12 713779 - 713779 2021年Although plasmacytoid dendritic cells (pDCs) able to produce large amounts of type 1 interferons (IFN-I) play beneficial roles in host defense against viral infections, excessive activation of pDCs, followed by robust production of IFN-I, causes autoimmune disorders including systemic lupus erythematosus (SLE) and psoriasis. Autoimmune pancreatitis (AIP), which is recognized as a pancreatic manifestation of systemic immunoglobulin G4-related disease (IgG4-RD), is a chronic fibroinflammatory disorder driven by autoimmunity. IgG4-RD is a multi-organ autoimmune disorder characterized by elevated serum concentrations of IgG4 antibody and infiltration of IgG4-expressing plasmacytes in the affected organs. Although the immunopathogenesis of IgG4-RD and AIP has been poorly elucidated, recently, we found that activation of pDCs mediates the development of murine experimental AIP and human AIP/IgG4-RD via the production of IFN-I and interleukin-33 (IL-33). Depletion of pDCs or neutralization of signaling pathways mediated by IFN-I and IL-33 efficiently inhibited the development of experimental AIP. Furthermore, enhanced expression of IFN-I and IL-33 was observed in the pancreas and serum of human AIP/IgG4-RD. Thus, AIP and IgG4-RD share their immunopathogenesis with SLE and psoriasis because in all these conditions, IFN-I production by pDCs contributes to the pathogenesis. Because the enhanced production of IFN-I and IL-33 by pDCs promotes chronic inflammation and fibrosis characteristic for AIP and IgG4-RD, neutralization of IFN-I and IL-33 could be a new therapeutic option for these disorders. In this Mini Review, we discuss the pathogenic roles played by the pDC-IFN-I-IL-33 axis and the development of a new treatment targeting this axis in AIP and IgG4-RD.
- Tomoe Yoshikawa; Tomohiro Watanabe; Ken Kamata; Akane Hara; Kosuke Minaga; Masatoshi KudoFrontiers in immunology 12 621532 - 621532 2021年Autoimmune pancreatitis (AIP) is a chronic fibro-inflammatory disorder of the pancreas. Recent clinicopathological analysis revealed that most cases of AIP are pancreatic manifestations of systemic IgG4-related disease (IgG4-RD), a newly established disease characterized by enhanced IgG4 antibody responses and the involvement of multiple organs. Although the immuno-pathogenesis of AIP and IgG4-RD has been poorly defined, we recently showed that activation of plasmacytoid dendritic cells (pDCs) with the ability to produce large amounts of IFN-α and IL-33 mediates chronic fibro-inflammatory responses in experimental and human AIP. Moreover, M2 macrophages producing a large amount of IL-33 play pathogenic roles in the development of human IgG4-RD. Interestingly, recent studies including ours provide evidence that compositional alterations of gut microbiota are associated with the development of human AIP and IgG4-RD. In addition, intestinal dysbiosis plays pathological roles in the development of chronic pancreatic inflammation as dysbiosis mediates the activation of pDCs producing IFN-α and IL-33, thereby causing experimental AIP. In this Mini Review, we focus on compositional alterations of gut microbiota in AIP and IgG4-RD to clarify the mechanisms by which intestinal dysbiosis contributes to the development of these disorders.
- K. Kamata; T. Watanabe; K. Minaga; A. Hara; I. Sekai; Y. Otsuka; T. Yoshikawa; A.‐M. Park; M. KudoClinical & Experimental Immunology 202 3 308 - 320 2020年12月
- Rei Ishikawa; Ken Kamata; Akane Hara; Hidekazu Tanaka; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Kosuke Minaga; Kentaro Yamao; Mamoru Takenaka; Yasunori Minami; Tomohiro Watanabe; Yasutaka Chiba; Takaaki Chikugo; Ippei Matsumoto; Yoshifumi Takeyama; Yuko Matsukubo; Tomoko Hyodo; Masatoshi KudoDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 33 5 829 - 839 2020年10月BACKGROUND AND AIMS: Pancreatic neuroendocrine neoplasms (PanNENs), including Grade 1 (G1) or G2 tumors, can have a poor prognosis. This study investigated the value of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for predicting the prognosis of PanNENs. METHODS: This single-center, retrospective study included 47 consecutive patients who underwent CH-EUS and were diagnosed with PanNEN by surgical resection or EUS-guided fine needle aspiration between December 2011 and February 2016. Patients were divided into aggressive and non-aggressive groups according to the degree of clinical malignancy. CH-EUS was assessed regarding its capacity for diagnosing aggressive PanNEN, the correspondence between contrast patterns and pathological features, and its ability to predict the prognosis of PanNEN. RESULTS: There were 19 cases of aggressive PanNEN and 28 cases of non-aggressive PanNEN. The aggressive group included three G1, four G2, three G3 tumors, three mixed neuroendocrine non-neuroendocrine neoplasms, and six neuroendocrine carcinomas. CH-EUS was superior to contrast-enhanced computed tomography for the diagnosis of aggressive PanNEN (P < 0.001): hypo-enhancement on CH-EUS was an indicator of aggressive PanNEN, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 94.7%, 100%, 100%, 96.6%, and 97.9%, respectively. Among G1/G2 PanNENs, cases with hypo-enhancement on CH-EUS had a poorer prognosis than those with hyper/iso-enhancement (P = 0.0009). Assessment of 36 resected specimens showed that hypo-enhancement on CH-EUS was associated with smaller and fewer vessels and greater degree of fibrosis. CONCLUSION: CH-EUS may be useful for predicting the prognosis of PanNENs.
- Kosuke Minaga; Tomohiro Watanabe; Akane Hara; Ken Kamata; Shunsuke Omoto; Atsushi Nakai; Yasuo Otsuka; Ikue Sekai; Tomoe Yoshikawa; Kentaro Yamao; Mamoru Takenaka; Yasutaka Chiba; Masatoshi KudoScientific reports 10 1 14879 - 14879 2020年09月IgG4-related disease (IgG4-RD) is a multi-organ autoimmune disease characterized by elevated serum IgG4 concentration. Although serum IgG4 concentration is widely used as a biomarker for IgG4-RD and type 1 autoimmune pancreatitis (AIP), a pancreatic manifestation of IgG4-RD, a significant number of patients have normal serum IgG4 levels, even in the active phase of the disease. Recently, we reported that the development of experimental AIP and human type 1 AIP is associated with increased expression of IFN-α and IL-33 in the pancreas. In this study, we assessed the utility of serum IFN-α and IL-33 levels as biomarkers for type 1 AIP and IgG4-RD. Serum IFN-α and IL-33 concentrations in patients who met the diagnostic criteria for definite type 1 AIP and/or IgG4-RD were significantly higher than in those with chronic pancreatitis or in healthy controls. Strong correlations between serum IFN-α, IL-33, and IgG4 concentrations were observed. Diagnostic performance of serum IFN-α and IL-33 concentrations as markers of type 1 AIP and/or IgG4-RD was comparable to that of serum IgG4 concentration, as calculated by the receiver operating characteristic curve analysis. Induction of remission by prednisolone treatment markedly decreased the serum concentration of these cytokines. We conclude that serum IFN-α and IL-33 concentrations can be useful as biomarkers for type 1 AIP and IgG4-RD.
- Hajime Honjo; Tomohiro Watanabe; Yasuyuki Arai; Ken Kamata; Kosuke Minaga; Yoriaki Komeda; Kouhei Yamashita; Masatoshi KudoInternational immunology 33 2 91 - 105 2020年09月Polymorphisms in the autophagy-related protein 16 like 1 (ATG16L1) and nucleotide-binding oligomerization domain 2 (NOD2) genes are associated with Crohn's disease (CD). Impaired interaction between ATG16L1 and NOD2 underlies CD immunopathogenesis. Although activation of the receptor-interacting serine/threonine kinase (RICK, also known as RIP2), a downstream signaling molecule for NOD2 and multiple toll-like receptors (TLRs), plays a pathogenic role in the development of inflammatory bowel disease, the molecular interaction between ATG16L1 and RICK/RIP2 remains poorly understood. In this study, we examined the physical interaction between ATG16L1 and RICK/RIP2 in human embryonic kidney 293 (HEK293) cells and human monocyte-derived dendritic cells (DCs) expressing excessive and endogenous levels of these proteins, respectively. We established that ATG16L1 binds to RICK/RIP2 kinase domain and negatively regulates TLR2-mediated nuclear factor-kappa B (NF-κB) activation and proinflammatory cytokine responses by inhibiting the interaction between TLR2 and RICK/RIP2. Binding of ATG16L1 to RICK/RIP2 suppressed NF-κB activation by downregulating RICK/RIP2 polyubiquitination. Notably, the percentage of colonic DCs expressing ATG16L1 inversely correlated with IL-6 and TNF-α expression levels in the colon of CD patients. These data suggest that the interaction between ATG16L1 and RICK/RIP2 maintains intestinal homeostasis via the downregulation of TLR-mediated proinflammatory cytokine responses.
- Mamoru Takenaka; Tomoe Yoshikawa; Kosuke Minaga; Kentaro Yamao; Masatoshi KudoVideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy 5 9 389 - 394 2020年09月 [査読有り]
- Kentaro Yamao; Mamoru Takenaka; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Ken Kamata; Kosuke Minaga; Ippei Matsumoto; Yoshifumi Takeyama; Isao Numoto; Masakatsu Tsurusaki; Takaaki Chikugo; Yasutaka Chiba; Tomohiro Watanabe; Masatoshi KudoDiagnostics 10 7 2020年07月 [査読有り]
© 2020 by the authors. Background: This study aimed to evaluate and identify the specific CT findings by focusing on abnormalities in the main pancreatic duct (MPD) and pancreatic parenchyma in patients with small pancreatic cancer (PC) including carcinoma in situ (CIS). Methods: Nine CT findings indicating abnormalities of MPD and pancreatic parenchyma were selected as candidate findings for the presence of small PC ≤ 10 mm. The proportions of patients positive for each finding were compared between small PC and benign MPD stenosis groups. Interobserver agreement between two independent image reviewers was evaluated using kappa statistics. Results: The final analysis included 24 patients with small PC (including 11 CIS patients) and 28 patients with benign MPD stenosis. The proportion of patients exhibiting partial pancreatic parenchymal atrophy (PPA) corresponding to the distribution of MPD stenosis (45.8% vs. 7.1%, p < 0.01), upstream PPA arising from the site of MPD stenosis (33.3% vs. 3.6%, p = 0.01), and MPD abrupt stenosis (45.8% vs. 14.3%, p = 0.03) was significantly higher in the small PC group than in the benign MPD stenosis group. Conclusions: The presence of partial PPA, upstream PPA, and MPD abrupt stenosis on a CT image was highly suggestive of the presence of small PCs including CIS. - Akane Hara; Kosuke Minaga; Tomohiro WatanabeGastroenterology 2020年06月 [査読有り]
- Kosuke Minaga; Masayuki Kitano; Atsushi Nakai; Shunsuke Omoto; Ken Kamata; Kentaro Yamao; Mamoru Takenaka; Masakatsu Tsurusaki; Takaaki Chikugo; Ippei Matsumoto; Yasutaka Chiba; Tomohiro Watanabe; Masatoshi KudoGastrointestinal Endoscopy 2020年06月 [査読有り]
- Kosuke Minaga; Mamoru Takenaka; Kentaro Yamao; Ken Kamata; Shunsuke Omoto; Atsushi Nakai; Tomohiro Yamazaki; Ayana Okamoto; Rei Ishikawa; Tomoe Yoshikawa; Yasutaka Chiba; Tomohiro Watanabe; Masatoshi KudoWorld journal of gastroenterology 26 9 947 - 959 2020年03月 [査読有り]
BACKGROUND: Although several techniques for endoscopic ultrasound-guided biliary drainage (EUS-BD) are available at present, an optimal treatment algorithm of EUS-BD has not yet been established. AIM: To evaluate the clinical utility of treatment method conversion during single endoscopic sessions for difficult cases in initially planned EUS-BD. METHODS: This was a single-center retrospective analysis using a prospectively accumulated database. Patients with biliary obstruction undergoing EUS-BD between May 2008 and April 2016 were included. The primary outcome was to evaluate the improvement in EUS-BD success rates by converting the treatment methods during a single endoscopic session. Secondary outcomes were clarification of the factors leading to the conversion from the initial EUS-BD and the assessment of efficacy and safety of the conversion as judged by technical success, clinical success, and adverse events (AEs). RESULTS: A total of 208 patients underwent EUS-BD during the study period. For 18.8% (39/208) of the patients, the treatment methods were converted to another EUS-BD technique from the initial plan. Biliary obstruction was caused by pancreatobiliary malignancies, other malignant lesions, biliary stones, and other benign lesions in 22, 11, 4, and 2 patients, respectively. The reasons for the difficulty with the initial EUS-BD were classified into the following 3 procedures: Target puncture (n = 13), guidewire manipulation (n = 18), and puncture tract dilation (n = 8). Technical success was achieved in 97.4% (38/39) of the cases and clinical success was achieved in 89.5% of patients (34/38). AEs occurred in 10.3% of patients, including bile leakage (n = 2), bleeding (n = 1), and cholecystitis (n = 1). The puncture target and drainage technique were altered in subsequent EUS-BD procedures in 25 and 14 patients, respectively. The final technical success rate with 95%CI for all 208 cases was 97.1% (95%CI: 93.8%-98.9%), while that of the initially planned EUS-BD was 78.8% (95%CI: 72.6%-84.2%). CONCLUSION: Among multi-step procedures in EUS-BD, guidewire manipulation appeared to be the most technically challenging. When initially planned EUS-BD is technically difficult, treatment method conversion in a single endoscopic session may result in successful EUS-BD without leading to severe AEs. - Akihiro Yoshida; Kosuke Minaga; Osami Takeda; Hajime Hanno; Shigenori Takayanagi; Toshio Dozaiku; Masatoshi KudoEndoscopy 52 9 E333-E334 2020年03月 [査読有り]
- Mamoru Takenaka; Kosuke Minaga; Ken Kamata; Kentaro Yamao; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Yoriaki Komeda; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Yasutaka Chiba; Chang-Il Kwon; Seok Jeong; Tae Hoon Lee; Masatoshi KudoSurgical endoscopy 34 3 1432 - 1441 2020年03月 [査読有り]
BACKGROUND: Balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (BE-ERCP) has been reported to be effective for patients with surgically altered gastrointestinal anatomy. However, selective biliary cannulation remains difficult in BE-ERCP. We examined the usefulness of a modified double-guidewire technique using an uneven double lumen cannula (the uneven method) for BE-ERCP in patients with surgically altered gastrointestinal anatomy. METHODS: To clarify the usefulness of the uneven method for selective biliary cannulation in BE-ERCP in comparison to the pancreatic guidewire (PGW) method, 40 patients with surgically altered gastrointestinal anatomy who underwent BE-ERCP with successful placement of a guidewire in the pancreatic duct were evaluated. The uneven method was used in 18 cases (uneven group) and the PGW method was used in the remaining 22 cases (PGW group). RESULTS: The technical success rate of biliary cannulation was higher in the uneven group than in the PGW group (83.3 vs. 59.0%; P = 0.165). In addition, the time to biliary cannulation were significantly shorter in the uneven group than in the PGW group (6 vs. 18 min; P = 0.004; respectively). In the PGW group, post-ERCP pancreatitis (PEP) occurred in 3 of 22 cases (13.6%). No adverse events, including PEP, occurred in the uneven group. CONCLUSIONS: The uneven method may be a useful option of selective biliary cannulation in BE-ERCP for the patients with surgically altered gastrointestinal anatomy. - Saki Yoshida; Mariko Matsumura; Kiyoshi Maekawa; Kosuke Minaga; Ken Kamata; Masahiro Nozawa; Tomohiro Watanabe; Masatoshi KudoClinical journal of gastroenterology 13 4 621 - 625 2020年02月 [査読有り]
Nephroptosis is a benign disorder defined as a significant descent of the affected kidney as the patient moves from supine to erect. Patients with nephroptosis sometimes manifest symptoms including abdominal pain, back pain, nausea and hematuria, while the majority of those are asymptomatic. Downward migration of the affected kidney induced by a postural change from the supine to the upright position underlies the pathophysiology of nephroptosis. The diagnosis of nephroptosis is difficult since routine imaging examinations are conducted in the supine position alone. Here, we report a case presenting recurrent abdominal pain due to unknown causes. This patient was successfully diagnosed as nephroptosis by ultrasonography and drip infusion pyelography, both of which were performed in both supine and upright positions. This case report strongly suggests that we need to take into consideration a possibility of nephroptosis when we encounter with patients complaining abdominal and/or back pain due to unknown causes. - Kosuke Minaga; Tomohiro Watanabe; Yasuyuki Arai; Masahiro Shiokawa; Akane Hara; Tomoe Yoshikawa; Ken Kamata; Kouhei Yamashita; Masatoshi KudoJournal of gastroenterology 55 5 565 - 576 2020年01月 [査読有り]
BACKGROUND: Excessive type I IFN (IFN-I) production by plasmacytoid dendritic cells (pDCs) promotes autoimmunity. Recently, we reported that a prominent feature of both experimental autoimmune pancreatitis (AIP) and human type 1 AIP is pDC activation followed by enhanced production of IFN-I and IL-33. However, the roles played by interferon regulatory factor 7 (IRF7), a critical transcription factor for IFN-I production in pDCs, in these disorders have not been clarified. METHODS: Whole and nuclear extracts were isolated from pancreatic mononuclear cells (PMNCs) from MRL/MpJ mice exhibiting AIP. Expression of phospho-IRF7 and nuclear translocation of IRF7 was examined in these extracts by immunoblotting. Pancreatic expression of IRF7 was assessed by immunofluorescence analysis in experimental AIP. Nuclear translocation of IRF7 upon exposure to neutrophil extracellular traps (NETs) was assessed in peripheral blood pDCs from type 1 AIP patients. Pancreatic IRF7 expression was examined in surgically operated specimens from type 1 AIP patients. RESULTS: IRF7 activation was induced in pancreatic pDCs in experimental AIP. siRNA-mediated knockdown of IRF7 expression prevented AIP development, which was accompanied by a marked reduction in both pancreatic accumulation of pDCs and production of IFN-α and IL-33. Notably, in peripheral blood pDCs isolated from patients with type 1 AIP, nuclear translocation of IRF7 was enhanced as compared with the translocation in pDCs from healthy controls. Furthermore, IRF7-expressing pDCs were detected in the pancreas of patients with type 1 AIP. CONCLUSIONS: These findings suggest that the IRF7-IFN-I-IL-33 axis activated in pDCs drives pathogenic innate immune responses associated with type 1 AIP. - Sho Masaki; Tomohiro Watanabe; Kosuke Minaga; Ken Kamata; Yoriaki Komeda; Masatomo Kimura; Masatoshi KudoClinical journal of gastroenterology 13 4 473 - 476 2020年01月 [査読有り]
Although patients with anorexia nervosa (AN) present with various gastrointestinal disorders, little has been understood regarding the incidence and pathophysiology of gastrointestinal ulcers related to AN. A 20-year-old woman with a past history of AN was hospitalized for further examination of dysphagia and chest pain. Her nutritional status was very poor as evidenced by very low body mass index. Esophagogastroduodenoscopy detected longitudinal and geographical ulcers in the entire circumference of the cervical and upper esophagus. Enhanced expression of autophagy-related proteins, LC3B and p62, was seen in the esophageal epithelium surrounding the active ulcers. Expression of these autophagy markers disappeared from the esophageal epithelium soon after the nutritional rehabilitation. Given the fact that starvation and malnutrition are potent inducers for autophagy, these findings suggest that autophagy might be involved in the development of gastrointestinal ulcers in patients with AN. - Kosuke Minaga; Mamoru Takenaka; Takeshi Ogura; Takashi Tamura; Taira Kuroda; Toyoma Kaku; Yoshito Uenoyama; Chishio Noguchi; Hidefumi Nishikiori; Hajime Imai; Ryota Sagami; Nao Fujimori; Kazuhide Higuchi; Masatoshi Kudo; Yasutaka Chiba; Masayuki KitanoTherapeutic advances in gastroenterology 13 1756284820930964 - 1756284820930964 2020年 [査読有り]
Background: Endoscopic treatment for malignant biliary obstruction (MBO) in patients bearing surgically altered anatomy (SAA) is not well-established. Although endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as a new treatment option for MBO, limited data are available regarding the efficacy and safety of EUS-BD in patients with SAA. We conducted a multicenter prospective registration study to evaluate the efficacy and safety of EUS-BD in this population. Methods: This study involved 10 referral centers in Japan. Patients with SAA who were scheduled to receive EUS-BD for unresectable MBO between May 2016 and September 2018 were prospectively registered. The primary endpoint was technical success and the secondary outcomes were clinical success, procedure time, procedure-related adverse events (AEs), stent patency, and overall survival. Results: In total, 40 patients were prospectively enrolled. The surgical reconstruction methods were gastrectomy with Roux-en-Y reconstruction (47.5%), gastrectomy with Billroth-II reconstruction (15%), pancreaticoduodenectomy (27.5%), and hepaticojejunostomy with Roux-en-Y reconstruction (10%). EUS-BD was performed for primary biliary drainage in 31 patients and for rescue biliary drainage in nine patients. Transmural stenting alone (60%), antegrade stenting alone (5%), and a combination of the two techniques (35%) were selected for patients treated with EUS-BD. Technical and clinical success rates were 100% (95% confidence interval, 91.2-100.0%) and 95% (95% confidence interval, 83.1-99.4%), respectively. Mean procedure time was 36.5 min. Early AEs were noted in six patients (15%): three self-limited bile leak, one bile peritonitis, and two pneumoperitonea. Late AEs occurred in six patients (15%): one jejunal ulcer and five stent occlusions. Stent patency rate after 3 months of survival was 95.7% (22/23). Median overall survival was 96 days. Conclusion: EUS-BD for MBO in patients with SAA appears to be effective and safe not only as a rescue drainage technique after failed endoscopic retrograde cholangiography but also as a primary drainage technique. Clinical Trial Registration: UMIN000022101. - Shogo Nakano; Kosuke Minaga; Yukitaka YamashitaArab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology 20 4 209 - 210 2019年12月 [査読有り]
- Kosuke Minaga; Mamoru Takenaka; Ayana Okamoto; Shunsuke Omoto; Ken Kamata; Kentaro Yamao; Masatoshi KudoEndoscopy 52 5 E152-E153 2019年11月 [査読有り]
- Ken Kamata; Tomohiro Watanabe; Kosuke Minaga; Akane Hara; Tomoe Yoshikawa; Ayana Okamoto; Kentaro Yamao; Mamoru Takenaka; Ah-Mee Park; Masatoshi KudoInternational immunology 31 12 795 - 809 2019年11月 [査読有り]
Autoimmune pancreatitis (AIP) is a pancreatic manifestation of a newly proposed disease entity, IgG4-related disease (IgG4-RD), characterized by enhanced IgG4 antibody responses and involvement of multiple organs. We have previously reported that innate immune activation contributes to the development of AIP and IgG4-RD, as these diseases are characterized by the production of IFN-α and IL-33 by plasmacytoid dendritic cells (pDCs) that mediate chronic fibroinflammatory responses. In this study, we investigated the roles played by innate immunity against intestinal microflora in experimental AIP induced in MRL/MpJ mice by repeated administrations of 100 µg of polyinosinic-polycytidylic acid [poly (I:C)]. Bowel sterilization with a broad spectrum of antibiotics inhibited pancreatic accumulation of pDCs producing IFN-α and IL-33, and thereby suppressed the development of AIP. Mice treated with 10 µg of poly (I:C) developed severe AIP equivalent to that induced by 100 µg of poly (I:C) upon co-housing with mice treated with 100 µg of poly (I:C). Fecal microbiota transplantation (FMT) from donor mice treated with 100 µg of poly (I:C) led to the development of severe AIP in the recipient mice upon injection with 10 µg of poly (I:C). Induction of severe AIP in mice with 10 µg of poly (I:C) was associated with pancreatic accumulation of pDCs producing IFN-α and IL-33 in the co-housing and FMT experiments. These data collectively suggest that innate immune responses against intestinal microflora are involved in the development of experimental AIP, and that intestinal dysbiosis increases sensitivity to experimental AIP via activation of pDCs. - Kosuke Minaga; Tomoe Yoshikawa; Yukitaka Yamashita; Hiroko Akamatsu; Maiko Ikenouchi; Tatsuya Ishii; Hisakazu Matsumoto; Hiroyoshi Iwagami; Yasuki Nakatani; Keiichi Hatamaru; Mamoru Takenaka; Takuji Akamatsu; Yoshito Uenoyama; Tomohiro Watanabe; Kazuo Ono; Yasutaka Chiba; Masatoshi KudoDigestive Diseases and Sciences 64 10 2982 - 2991 2019年10月 [査読有り]
- Tomohiro Watanabe; Kosuke Minaga; Ken Kamata; Toshiharu Sakurai; Yoriaki Komeda; Tomoyuki Nagai; Atsushi Kitani; Masaki Tajima; Ivan J Fuss; Masatoshi Kudo; Warren StroberInternational Immunology 31 10 669 - 683 2019年09月 [査読有り]
Abstract Previous studies have shown that inhibition of receptor-interacting serine/threonine kinase (RICK) (also known as RIP2) results in amelioration of experimental colitis. This role has largely been attributed to nucleotide-binding oligomerization domain 2 (NOD2) signaling since the latter is considered a major inducer of RICK activation. In this study, we explored the molecular mechanisms accounting for RICK-mediated inhibition of inflammatory bowel disease (IBD). In an initial series of studies focused on trinitrobenzene sulfonic acid (TNBS)-colitis and dextran sodium sulfate (DSS)-colitis we showed that down-regulation of intestinal RICK expression in NOD2-intact mice by intra-rectal administration of a plasmid expressing RICK-specific siRNA was accompanied by down-regulation of pro-inflammatory cytokine responses in the colon and protection of the mice from experimental colitis. Somewhat surprisingly, intra-rectal administration of RICK-siRNA also inhibited TNBS-colitis and DSS-colitis in NOD2-deficient and in NOD1/NOD2-double deficient mice. In complementary studies of humans with IBD we found that expression of RICK, cellular inhibitor of apoptosis protein 2 (cIAP2) and downstream signaling partners were markedly increased in inflamed tissue of IBD compared to controls without marked elevations of NOD1 or NOD2 expression. In addition, the increase in RICK expression correlated with disease activity and pro-inflammatory cytokine responses. These studies thus suggest that NOD1- or NOD2-independenent activation of RICK plays a major role in both murine experimental colitis and human IBD. - Kosuke Minaga; Takeshi Ogura; Hideyuki Shiomi; Hajime Imai; Noriyuki Hoki; Mamoru Takenaka; Hidefumi Nishikiori; Yukitaka Yamashita; Takeshi Hisa; Hironari Kato; Hideki Kamada; Atsushi Okuda; Ryota Sagami; Hiroaki Hashimoto; Kazuhide Higuchi; Yasutaka Chiba; Masatoshi Kudo; Masayuki KitanoDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 31 5 575 - 582 2019年09月 [査読有り]
BACKGROUND AND AIM: Endoscopic ultrasound-guided biliary drainage (EUS-BD) can be carried out by two different approaches: choledochoduodenostomy (CDS) and hepaticogastrostomy (HGS). We compared the efficacy and safety of these approaches in malignant distal biliary obstruction (MDBO) patients using a prospective, randomized clinical trial. METHODS: Patients with malignant distal biliary obstruction after failed endoscopic retrograde cholangiopancreatography were randomly selected for either CDS or HGS. The procedures were carried out at nine tertiary centers from September 2013 to March 2016. Primary endpoint was technical success rate, and the noninferiority of HGS to CDS was examined with a one-sided significance level of 5%, where the noninferiority margin was set at 15%. Secondary endpoints were clinical success, adverse events (AE), stent patency, survival time, and overall technical success including alternative EUS-BD procedures. RESULTS: Forty-seven patients (HGS, 24; CDS, 23) were enrolled. Technical success rates were 87.5% and 82.6% in the HGS and CDS groups, respectively, where the lower limit of the 90% confidence interval of the risk difference was -12.2% (P = 0.0278). Clinical success rates were 100% and 94.7% in the HGS and CDS groups, respectively (P = 0.475). Overall AE rate, stent patency, and survival time did not differ between the groups. Overall technical success rates were 100% and 95.7% in the HGS and CDS groups, respectively (P = 0.983). CONCLUSIONS: This study suggests that HGS is not inferior to CDS in terms of technical success. When one procedure is particularly challenging, readily switching to the other could increase technical success. - Ogura T; Takenaka M; Shiomi H; Goto D; Tamura T; Hisa T; Kato H; Nishioka N; Minaga K; Masuda A; Onoyama T; Kudo M; Higuchi K; Kitano MEndoscopic ultrasound 2019年09月 [査読有り]
- Hidekazu Tanaka; Ken Kamata; Mamoru Takenaka; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Kosuke Minaga; Kentaro Yamao; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Yasutaka Chiba; Masayuki Kitano; Masatoshi KudoDigestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 51 8 1130 - 1134 2019年08月 [査読有り]
BACKGROUND AND AIMS: Contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) is used for the diagnosis of pancreatic cancer (PC). Here, we examined the usefulness of CH-EUS for evaluating therapeutic responses in PC. METHODS: The study included 23 patients with PC who received chemotherapy. Patients underwent contrast-enhanced computed tomography (CE-CT) and CH-EUS before chemotherapy and at the time of evaluation of the therapeutic response. Patients with a ≧50% reduction in serum carbohydrate antigen 19-9 levels after chemotherapy were defined as "super responders". The incidence of an avascular area in the tumor on CH-EUS after chemotherapy was compared between "super responders" and non-super responders. RESULTS: Nine patients were included in the "super responders" group.Tumor reduction rates did not differ significantly between CE-CT and CH-EUS in the "super responders". The appearance of an avascular area was detected in 7 of 9 super responders (77.8%) and in 4 of 14 non-super responders (28.6%), and the difference was significant (P = 0.036). The mean survival time of patients with an avascular area after chemotherapy was longer than that of without an avascular area. CONCLUSIONS: Detection of avascular areas by CH-EUS after chemotherapy may predict long-term survival of patients with PC. - Hidekazu Tanaka; Tomohiro Watanabe; Tomoyuki Nagai; Kosuke Minaga; Ken Kamata; Yoriaki Komeda; Masatoshi KudoClinical Journal of Gastroenterology 12 4 316 - 319 2019年08月 [査読有り]
- Kentaro Yamao; Mamoru Takenaka; Tomoe Yoshikawa; Rei Ishikawa; Ayana Okamoto; Tomohiro Yamazaki; Atsushi Nakai; Shunsuke Omoto; Ken Kamata; Kosuke Minaga; Satoru Hagiwara; Toshiharu Sakurai; Naoshi Nishida; Yasutaka Chiba; Tomohiro Watanabe; Masatoshi KudoInternal medicine (Tokyo, Japan) 58 14 1993 - 2002 2019年07月 [査読有り]
Objective Although modified FOLFIRINOX (mFOLFIRINOX, mFFX) is widely used for patients with advanced pancreatic ductal adenocarcinoma (PDAC), maintenance of the standard dose intensity is often difficult due to the high incidence of neutropenic events. Pegylated granulocyte colony-stimulating factor (G-CSF) (Peg G) is a long-lasting G-CSF agent that is applicable for prophylaxis against neutropenic complications. The aim of this study was to assess the clinical safety and efficacy of mFFX combined with secondary prophylaxis using Peg G in advanced PDAC patients. Methods Advanced PDAC patients who had received more than two cycles of mFFX were analyzed. The clinical safety and efficacy were compared between patients in the Peg G group and those in the non-Peg G group in a retrospective manner. Results Among 45 patients treated with mFFX, 28 exhibited grade 3-4 neutropenia or febrile neutropenia. Among these 28 patients, 4 who received only 1 or 2 mFFX cycles were excluded from this study. Finally, 11 patients in the Peg G group and 13 in the non-Peg G group were enrolled. The combination therapy with Peg G and mFFX markedly prolonged the progression-free survival compared with the non-Peg G group, and its effects were associated with a reduced incidence of neutropenic events as well as lower rates of dosage reduction, delayed chemotherapy due to neutropenic events and altered blood cell counts after chemotherapy. Conclusion The scheduled administration of secondary prophylactic Peg G prolonged the progression-free survival in patients treated with mFFX. The combination therapy of Peg G and mFFX may be recommended in patients who exhibit grade 3-4 neutropenic events after prior mFFX cycles. - Masashi Kono; Toshiharu Sakurai; Kazuki Okamoto; Tomoyuki Nagai; Yoriaki Komeda; Hiroshi Kashida; Kosuke Minaga; Ken Kamata; Mamoru Takenaka; Satoru Hagiwara; Tomohiro Watanabe; Naoshi Nishida; Eisuke Enoki; Hiroaki Inoue; Itaru Matsumura; Masatoshi KudoInternal medicine (Tokyo, Japan) 58 14 2029 - 2033 2019年07月 [査読有り]
Autoimmune diseases including inflammatory bowel disease (IBD) occur in association with myelodysplastic syndrome (MDS). MDS-associated IBD frequently demonstrates a complicated course. We herein report the first case with MDS-associated IBD that was successfully treated with ustekinumab (UST), an anti-interleukin (IL) 12/23p40 monoclonal antibody. A 63-year-old man with a 7-year history of MDS was referred for examination of diarrhea, abdominal pain and fever. A blood examination revealed a marked elevation of C-reactive protein. Colonoscopy showed multiple ulcers in the terminal ileum. He was resistant to anti-tumor necrosis factor (TNF)-α antibody and azacitidine. Subsequently, UST treatment reduced colonic IL-17 and IL-6 expression and the patient currently maintains a state of remission. - Takenaka M; Minaga K; Yoshikawa T; Okamoto A; Nakai A; Omoto S; Kudo MEndoscopy 51 12 E362-E363 2019年07月 [査読有り]
- Minaga K; Okada K; Uenoyama Y; Yamashita YDigestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2019年07月 [査読有り]
- Minaga Kosuke; Takenaka Mamoru; Yoshikawa Tomoe; Okamoto Ayana; Ishikawa Rei; Yamazaki Tomohiro; Nakai Atsushi; Omoto Shunsuke; Kamata Ken; Yamao Kentaro; Kudo MasatoshiGASTROINTESTINAL ENDOSCOPY 89 6 AB299 2019年06月 [査読有り]
- Itonaga Masahiro; Kitano Masayuki; Hatamaru Keiichi; Tamura Takashi; Nuta Junya; Kawaji Yuki; Takenaka Mamoru; Minaga Kosuke; Kudo Masatoshi; Ogura Takeshi; Higuchi Kazuhide; Chiba YasutakaGASTROINTESTINAL ENDOSCOPY 89 6 AB315 2019年06月 [査読有り]
- Ogura Takeshi; Takenaka Mamoru; Shiomi Hideyuki; Goto Daisuke; Hisa Takeshi; Tamura Takashi; Kato Hironari; Nishioka Nobu; Minaga Kosuke; Kudo Masatoshi; Higuchi Kazuhide; Kitano MasayukiGASTROINTESTINAL ENDOSCOPY 89 6 AB297 2019年06月 [査読有り]
- Okamoto Ayana; Kamata Ken; Takenaka Mamoru; Yoshikawa Tomoe; Ishikawa Rei; Yamazaki Tomohiro; Nakai Atsushi; Omoto Shunsuke; Minaga Kosuke; Yamao Kentaro; Kudo MasatoshiGASTROINTESTINAL ENDOSCOPY 89 6 AB602 - AB603 2019年06月 [査読有り]
- Omoto Shunsuke; Takenaka Mamoru; Ishikawa Rei; Okamoto Ayana; Nakai Atsushi; Yamazaki Tomohiro; Minaga Kosuke; Kamata Ken; Yamao Kentaro; Kudo MasatoshiGASTROINTESTINAL ENDOSCOPY 89 6 AB584 2019年06月 [査読有り]
- Takenaka Mamoru; Yoshikawa Tomoe; Ishikawa Rei; Okamoto Ayana; Yamazaki Tomohiro; Nakai Atsushi; Omoto Shunsuke; Minaga Kosuke; Kamata Ken; Yamao Kentaro; Kudo MasatoshiGASTROINTESTINAL ENDOSCOPY 89 6 AB223 2019年06月 [査読有り]
- Takenaka Mamoru; Hayashi Shiro; Nishida Tsutomu; Hosono Makoto; Yoshikawa Tomoe; Ishikawa Rei; Okamoto Ayana; Yamazaki Tomohiro; Nakai Atsushi; Omoto Shunsuke; Minaga Kosuke; Kamata Ken; Yamao Kentaro; Kudo MasatoshiGASTROINTESTINAL ENDOSCOPY 89 6 AB444 - AB445 2019年06月 [査読有り]
- Hayashi Y; Minaga K; Yoshikawa T; Ishii T; Matsumoto H; Uenoyama Y; Yamashita YArab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology 20 2 117 - 120 2019年06月 [査読有り]
- Minaga K; Watanabe T; Kamata K; Takenaka M; Yasukawa S; Kudo MThe American journal of gastroenterology 114 6 1002 - 1003 2019年06月 [査読有り]
- Ayana Okamoto; Tomohiro Watanabe; Ken Kamata; Kosuke Minaga; Masatoshi KudoInternal Medicine 58 11 1533 - 1539 2019年06月 [査読有り]
- Kosuke Minaga; Tomohiro Watanabe; Hobyung Chung; Masatoshi KudoWorld Journal of Gastroenterology 25 19 2308 - 2314 2019年05月 [査読有り]
- Okamoto A; Minaga K; Takenaka M; Yoshikawa T; Kamata K; Yamao K; Kudo MEndoscopy 51 9 E255-E256 2019年05月 [査読有り]
- Masashi Kono; Toshiharu Sakurai; Kazuki Okamoto; Shou Masaki; Tomoyuki Nagai; Yoriaki Komeda; Ken Kamata; Kosuke Minaga; Kentarou Yamao; Mamoru Takenaka; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoInternal Medicine 58 9 1263 - 1266 2019年05月 [査読有り]
- Tomoe Yoshikawa; Tomohiro Watanabe; Kosuke Minaga; Ken Kamata; Masatoshi KudoModern Rheumatology 29 2 219 - 225 2019年03月 [査読有り]
- Kosuke Minaga; Yukitaka Yamashita; Takeshi Ogura; Mamoru Takenaka; Yuzo Shimokawa; Takeshi Hisa; Masahiro Itonaga; Hironari Kato; Hidefumi Nishikiori; Atsushi Okuda; Hisakazu Matsumoto; Yoshito Uenoyama; Tomohiro Watanabe; Yasutaka Chiba; Kazuhide Higuchi; Masatoshi Kudo; Masayuki KitanoDigestive Endoscopy 31 2 180 - 187 2019年03月 [査読有り]
- Takenaka M; Yoshikawa T; Okamoto A; Nakai A; Minaga K; Yamao K; Kudo MEndoscopy 51 6 E132-E134 2019年03月 [査読有り]
- Ayana Okamoto; Kosuke Minaga; Mamoru Takenaka; Tomoe Yoshikawa; Toshimitsu Iwasaki; Masakatsu Tsurusaki; Masatoshi KudoEndoscopy 51 03 E42 - E44 2019年03月 [査読有り]
- Ken Kamata; Mamoru Takenaka; Kosuke Minaga; Shunsuke Omoto; Takeshi Miyata; Kentaro Yamao; Hajime Imai; Atsushi Nakai; Hidekazu Tanaka; Yasutaka Chiba; Tomohiro Watanabe; Toshiharu Sakurai; Naoshi Nishida; Takaaki Chikugo; Ippei Matsumoto; Yoshifumi Takeyama; Masayuki Kitano; Masatoshi KudoGastroenterological Endoscopy 61 4 417 - 426 2019年Background and Aim: This study evaluated the utility of endoscopic ultrasonography (EUS) combined with contrast-enhanced harmonic EUS (CH-EUS) for surveillance of the remnant pancreas after surgery for intraductal papillary mucinous neoplasm (IPMN). Methods: This was a single-center, retrospective, descriptive study. A total of 134 consecutive patients who underwent surgical resection for IPMN between April 2009 and March 2015 were evaluated. Rates of recurrence and development of IPMN-concomitant pancreatic ductal adenocarcinoma (PDAC) during follow up were assessed. Clinical findings of patients with recurrence or development of PDAC were also evaluated. Results: Of 134 resected IPMN 56 (41.8%) and 78 (58.2%) were classified as benign and malignant, respectively. Patients were followed up for a median of 29 months, 33 (24.6%) by both contrast-enhanced computed tomography (CE-CT) and EUS, and 101 (75.4%) by computed tomography (CT) alone. Thirteen patients (9.7%) showed tumor recurrence, five with intra-pancreatic recurrence and eight with extra-pancreatic metastases. An enhancing mural nodule within the dilated main pancreatic duct was successfully detected by EUS in one patient, but not by CE-CT. Two patients developed IPMN-concomitant PDAC during follow up. EUS combined with CH-EUS successfully detected small IPMN-concomitant PDAC in two patients, whereas these lesions were not detected by CT. CH-EUS was useful for better visualization of the margins of IPMN-concomitant PDAC in one of these two patients. Conclusion: Endoscopic ultrasonography combined with CH-EUS may improve follow up of patients with resected IPMN.
- Takenaka M; Hosono M; Nakai A; Omoto S; Minaga K; Kamata K; Yamao K; Hayashi S; Nishida T; Kudo MNihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 116 12 1053 - 1055 2019年 [査読有り]
- Toshiharu Sakurai; Yoriaki Komeda; Tomoyuki Nagai; Ken Kamata; Kosuke Minaga; Kentarou Yamao; Mamoru Takenaka; Satoru Hagiwara; Tomohiro Watanabe; Naoshi Nishida; Hiroshi Kashida; Kazuhiko Nakagawa; Masatoshi KudoDigestion 1 - 9 2018年12月 [査読有り]
- Yasuo Otsuka; Ken Kamata; Kosuke Minaga; Mamoru Takenaka; Tomohiro Watanabe; Masatoshi KudoInternal Medicine 57 21 3075 - 3078 2018年11月 [査読有り]
- Tomohiro Watanabe; Kosuke Minaga; Ken Kamata; Masatoshi Kudo; Warren StroberTrends in Immunology 39 11 874 - 889 2018年11月 [査読有り]
- Itonaga M; Kitano M; Hatamaru K; Tamura T; Nuta J; Kawaji Y; Takenaka M; Minaga K; Kudo M; Ogura T; Higuchi K; Chiba YDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 31 3 291 - 298 2018年11月 [査読有り]
BACKGROUND AND AIM: When endoscopic retrograde cholangiopancreatography (ERCP) fails in patients with malignant distal biliary obstruction, endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) is an alternative. It has high technical and clinical success rates, but also has high adverse event rates. This prospective cohort study was aimed to evaluate the clinical efficacy and safety of EUS-CDS with our newly developed partially covered self-expandable metal stent with a thin delivery system. METHODS: Patients consisted of all consecutive patients in three tertiary referral centers with unresectable malignant distal obstruction in whom ERCP failed and in whom EUS-CDS with the thin delivery system was selected as the second-line approach. Rates of clinical success, technical success, technical success in cases not requiring fistulous tract dilation, adverse events, and stent dysfunction were determined. RESULTS: In the 20 patients, technical and clinical success rates were 95.0% (19/20) and 100% (19/19), respectively. In 31.6% (6/19), the delivery system was successfully inserted into the bile duct without requiring a fistulous-tract dilatation device. These patients had significantly shorter procedure times than patients requiring fistulous-tract dilatation (12.7 ± 3.1 vs 23.2 ± 2.1 min; P < 0.01). One patient (5.0%) who required fistulous dilation had an adverse event, which was managed conservatively. There were no procedure-related deaths. During follow up, four patients (21.1%) developed stent dysfunction. Reintervention was successful in all cases. CONCLUSIONS: The EUS-CDS approach had 95% technical and 100% clinical success rates, with adverse events reported in 5% of cases. EUS-CDS may become safer if efforts are made to avoid the dilation step (UMIN 000023938). - Takenaka M; Yamao K; Minaga K; Nakai A; Omoto S; Kamata K; Kudo MEndoscopy 51 2 E30-E31 2018年11月 [査読有り]
- Naoshi Nishida; Takafumi Nishimura; Toshimi Kaido; Kosuke Minaga; Kentaro Yamao; Ken Kamata; Mamoru Takenaka; Hiroshi Ida; Satoru Hagiwara; Yasunori Minami; Toshiharu Sakurai; Tomohiro Watanabe; Masatoshi KudoCancers 10 10 367 - 367 2018年09月 [査読有り]
Hepatocellular carcinoma (HCC) causes one of the most frequent cancer-related deaths; an HCC subset shows rapid progression that affects survival. We clarify molecular features of aggressive HCC, and establish a molecular scoring system that predicts metastasis after curative treatment. In total, 125 HCCs were examined for TP53, CTNNB1, and TERT promoter mutation, methylation of 8 tumor suppressor genes, and 3 repetitive DNA sequences to estimate promoter hypermethylation and global hypomethylation. A fractional allelic loss (FAL) was calculated to represent chromosomal instability through microsatellite analysis. Molecular subclasses were determined using corresponding and hierarchical clustering analyses. Next, twenty-five HCC patients who underwent liver transplantation were analyzed for associations between molecular characteristics and metastatic recurrence; survival analyses were validated using a publicly available dataset of 376 HCC cases from the Cancer Genome Atlas (TCGA). An HCC subtype characterized by TP53 mutation, high FAL, and global hypomethylation was associated with aggressive tumor characteristics, like vascular invasion; CTNNB1 mutation was a feature of the less-progressive phenotype. A number of molecular risk factors, including TP53 mutation, high FAL, significant global hypomethylation, and absence of CTNNB1 mutation, were noted to predict shorter recurrence-free survival in patients who underwent liver transplantation (p = 0.0090 by log-rank test). These findings were validated in a cohort of resected HCC cases from TCGA (p = 0.0076). We concluded that molecular risks determined by common genetic and epigenetic alterations could predict metastatic recurrence after curative treatments, and could be a marker for considering systemic therapy for HCC patients. - Ken Kamata; Mamoru Takenaka; Masayuki Kitano; Shunsuke Omoto; Takeshi Miyata; Kosuke Minaga; Kentaro Yamao; Hajime Imai; Tosiharu Sakurai; Naoshi Nishida; Hiroshi Kashida; Takaaki Chikugo; Yasutaka Chiba; Takuya Nakai; Yoshifumi Takeyama; Andrea Lisotti; Pietro Fusaroli; Masatoshi KudoGastroenterological Endoscopy 60 1611 - 1620 2018年09月Copyright© 2018 Japan Gastroenterological Endoscopy Society. All rights reserved. Background and Aim: Differential diagnosis of localized gallbladder lesions is challenging. The aim of the present study was to evaluate the utility of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for diagnosis of localized gallbladder lesions. Methods: One hundred and twenty-five patients with localized gallbladder lesions were evaluated by CH-EUS between March 2007 and February 2014. This was a single-center retrospective study. Utilities of fundamental B-mode EUS (FB-EUS) and CH-EUS in the differentiation of gallbladder lesions and sludge plug were initially compared. Thereafter, these two examinations were compared with respect to their accuracy in the diagnosis of malignant lesions. Five reviewers blinded to the clinicopathological results evaluated microcirculation patterns in the vascular and perfusion images. Results: In the differentiation between gallbladder lesions and sludge plug, FB-EUS had a sensitivity, specificity, and accuracy of 82%, 100%, and 95%, respectively, whereas CH-EUS had a sensitivity, specificity, and accuracy of 100%, 99%, and 99%, respectively. FB-EUS-based diagnosis of carcinomas based on tumor size and/or shape had a sensitivity, specificity, and accuracy of 61-87%, 71-88%, and 74-86%, respectively. Additional information regarding irregular vessel patterns in the vascular image and/or heterogeneous enhancement in the perfusion image on CH-EUS increased the sensitivity, specificity, and accuracy for the diagnosis of carcinomas to 90%, 98 %, and 96%, respectively. There was a significant difference between FB-EUS and CH-EUS in terms of carcinoma diagnosis. Conclusion: CH-EUS was useful for the evaluation of localized gallbladder lesions.
- Ken Kamata; Mamoru Takenaka; Kosuke Minaga; Shunsuke Omoto; Takeshi Miyata; Kentaro Yamao; Hajime Imai; Atsushi Nakai; Hidekazu Tanaka; Yasutaka Chiba; Tomohiro Watanabe; Toshiharu Sakurai; Naoshi Nishida; Takaaki Chikugo; Ippei Matsumoto; Yoshifumi Takeyama; Masayuki Kitano; Masatoshi KudoDigestive Endoscopy 30 5 659 - 666 2018年09月 [査読有り]
- Yoshida A; Yamao K; Takenaka M; Nakai A; Omoto S; Kamata K; Minaga K; Miyata T; Imai H; Matsumoto I; Takeyama Y; Chikugo T; Kudo MInternal medicine (Tokyo, Japan) 57 23 3377 - 3380 2018年08月 [査読有り]
Neurilemmomas are benign tumors arising from the sheaths of peripheral nerves. They appear rarely in the abdominal cavity. We herein report an 80-year-old man with a multilocular cystic neurilemmoma mimicking a liver lesion. Preoperative images showed a lesion in the porta hepatis. Although a preoperative diagnosis was difficult, surgery was undertaken because of the possibility of malignancy. Histologically, the tumor consisted of spindle-shaped cells with positivity for S-100 protein. The final diagnosis was a neurilemmoma. Porta hepatic neurilemmomas are rare. When we encounter a multilocular cystic lesion of the liver, neurilemmoma should be considered in the differential diagnosis. - Takenaka M; Minaga K; Kudo MDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 31 1 e1-e2 2018年08月 [査読有り]
- Kosuke Minaga; Mamoru Takenaka; Ayana Okamoto; Shunsuke Omoto; Takeshi Miyata; Hajime Imai; Masatoshi KudoEndoscopy 50 7 E153 - E154 2018年07月 [査読有り]
- Kosuke Minaga; Masayuki Kitano; Masahiro Itonaga; Hajime Imai; Takeshi Miyata; Kentaro Yamao; Takashi Tamura; Junya Nuta; Kenji Warigaya; Masatoshi KudoJournal of Medical Ultrasonics 45 3 391 - 397 2018年07月 [査読有り]
Purpose: This study was designed to evaluate the feasibility and safety of a newly designed self-expandable metal stent for endoscopic ultrasound-guided biliary drainage (EUS-BD) when it was delivered via three different stent delivery systems: a 7.5Fr delivery catheter with a bullet-shaped tip (7.5Fr-bullet), a 7Fr catheter with a bullet-shaped tip (7Fr-bullet), or a 7Fr catheter with a tee-shaped tip (7Fr-tee). Methods: This experimental study utilized a porcine model of biliary dilatation involving ten pigs. In the animal study, technical feasibility and clinical outcomes of the stent when placed with each of the delivery systems were examined. In addition, a phantom model was used to measure the resistance of these delivery systems to advancement. Results: Phantom experiments showed that, compared with 7Fr-bullet, 7Fr-tee had less resistance force to the advancement of the stent delivery system. EUS-BD was technically successful in all ten pigs. Fistulous tract dilation was necessary in 100% (2/2), 75% (3/4), and 0% (0/4) of the pigs that underwent EUS-BD using 7.5Fr-bullet, 7Fr-bullet, and 7Fr-tee, respectively. There were no procedure-related complications. Conclusion: Our newly designed metal stent may be feasible and safe for EUS-BD, particularly when delivered by 7Fr-tee, because it eliminates the need for fistulous tract dilation. - Kentaro Yamao; Masayuki Kitano; Mamoru Takenaka; Kosuke Minaga; Toshiharu Sakurai; Tomohiro Watanabe; Takahisa Kayahara; Tomoe Yoshikawa; Yukitaka Yamashita; Masanori Asada; Yoshihiro Okabe; Keiji Hanada; Yasutaka Chiba; Masatoshi KudoGastrointestinal Endoscopy 88 1 66 - 75.e2 2018年07月 [査読有り]
- Minaga Kosuke; Kitano Masayuki; Ogura Takeshi; Shiomi Hideyuki; Hoki Noriyuki; Nishikiori Hidefumi; Yamashita Yukitaka; Hisa Takeshi; Kato Hironari; Kamada Hideki; Takenaka Mamoru; Higuchi Kazuhide; Chiba Yasutaka; Kudo MasatoshiGASTROINTESTINAL ENDOSCOPY 87 6 AB147 2018年06月 [査読有り]
- Ogura Takeshi; Kitano Masayuki; Takenaka Mamoru; Minaga Kosuke; Yamao Kentaro; Yamashita Yukitaka; Hatamaru Keiichi; Noguchi Chishio; Kuroda Taira; Nishikiori Hidefumi; Higuchi Kazuhide; Chiba YasutakaGASTROINTESTINAL ENDOSCOPY 87 6 AB146 2018年06月 [査読有り]
- Tamura Takashi; Itonaga Masahiro; Yamao Kentaro; Imanishi Miyuki; Minaga Kosuke; Hirono Seiko; Okada Ken-ichi; Higuchi Kazuhide; Takenaka Mamoru; Ogura Takeshi; Yamaue Hiroki; Kitano MasayukiGASTROINTESTINAL ENDOSCOPY 87 6 AB227 - AB228 2018年06月 [査読有り]
- Takenaka Mamoru; Nakai Atsushi; Omoto Shunsuke; Miyata Takeshi; Minaga Kosuke; Kamata Ken; Yamao Kentaro; Imai Hajime; Kudo MasatoshiGASTROINTESTINAL ENDOSCOPY 87 6 AB209 - AB210 2018年06月 [査読有り]
- Yoshikawa Tomoe; Ishii Tatsuya; Minaga Kosuke; Uenoyama Yoshito; Yamashita YukitakaGASTROINTESTINAL ENDOSCOPY 87 6 AB357 2018年06月 [査読有り]
- Takenaka M; Minaga K; Kudo MDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society 30 5 700 - 701 2018年06月 [査読有り]
- Kazuki Okamoto; Tomohiro Watanabe; Yoriaki Komeda; Ayana Okamoto; Kosuke Minaga; Ken Kamata; Kentaro Yamao; Mamoru Takenaka; Satoru Hagiwara; Toshiharu Sakurai; Tomonori Tanaka; Hiroki Sakamoto; Kiyoshige Fujimoto; Naoshi Nishida; Masatoshi KudoFrontiers in Immunology 9 918 2018年05月 [査読有り]
- Kosuke Minaga; Tomohiro Watanabe; Ken Kamata; Naoki Asano; Masatoshi KudoWorld Journal of Gastroenterology 24 16 1725 - 1733 2018年04月 [査読有り]
- Masashi Kono; Yoriaki Komeda; Toshiharu Sakurai; Ayana Okamoto; Kosuke Minaga; Ken Kamata; Satoru Hagiwara; Hiroaki Inoue; Eisuke Enoki; Itaru Matsumura; Tomohiro Watanabe; Masatoshi KudoJournal of Crohn's and Colitis 12 4 499 - 502 2018年03月 [査読有り]
- Takeshi Ogura; Masayuki Kitano; Mamoru Takenaka; Atsushi Okuda; Kosuke Minaga; Kentaro Yamao; Yukitaka Yamashita; Keiichi Hatamaru; Chishio Noguchi; Yasuhiko Gotoh; Taira Kuroda; Tomoyuki Yokota; Hidefumi Nishikiori; Ryota Sagami; Kazuhide Higuchi; Yasutaka ChibaDigestive Endoscopy 30 2 252 - 259 2018年03月 [査読有り]
Background and Aim: Endoscopic ultrasonography-guided hepaticogastrostomy (EUS-HGS) is often indicated for advanced stage patients. Therefore it is important to prevent adverse events associated with EUS-HGS procedures and obtain long stent patency. EUS-guided antegrade stenting (AS) has been developed as an advanced technique. Thus, to prevent adverse events and achieve long stent patency, EUS-AS combined with EUS-HGS (EUS-HGAS) has been reported. The aim of the present study was to evaluate the technical feasibility and efficacy of EUS-HGAS in a multicenter, prospective study. Methods: This prospective study was carried out at each hospital of the Therapeutic Endoscopic Ultrasound Group. Primary endpoint of this multicenter prospective study was stent patency of EUS-HGAS. Results: A total of 49 patients were enrolled. Technical success rate of EUS-HGS was 95.9% (47/49). EUS-AS failed in five patients because the guidewire could not be advanced into the intestine across the bile duct obstruction site. Therefore, EUS-HGAS was successfully carried out in 40 patients (technical success rate: 85.7%). Median overall survival was 114 days. Median stent patency including stent dysfunction and patient death was 114 days. In contrast, mean stent patency was 320 days. Adverse events were seen in 10.2% (5/49) of cases. Hyperamylasemia was seen in four patients, and bleeding was seen in one patient. Conclusions: The present study is the first to evaluate EUS-HGAS. EUS-HGAS has clinical benefit for obtaining long stent patency and avoiding adverse events, although the possibility of acute pancreatitis as a result of obstruction of the orifice of the pancreatic duct must be considered. - Kosuke Minaga; Mamoru Takenaka; Ken Kamata; Masatoshi KudoDigestive and Liver Disease 50 3 311 2018年03月 [査読有り]
- Hideyuki Shiomi; Kentaro Yamao; Noriyuki Hoki; Takeshi Hisa; Takeshi Ogura; Kosuke Minaga; Atsuhiro Masuda; Kazuya Matsumoto; Hironari Kato; Hideki Kamada; Daisuke Goto; Hajime Imai; Mamoru Takenaka; Chishio Noguchi; Hidefumi Nishikiori; Yasutaka Chiba; Hiromu Kutsumi; Masayuki KitanoDigestive diseases and sciences 63 3 787 - 796 2018年03月 [査読有り]
BACKGROUND: Endoscopic ultrasound-guided rendezvous technique (EUS-RV) has emerged as an effective salvage method for unsuccessful biliary cannulation. However, its application for benign and resectable malignant biliary disorders has not been fully evaluated. AIMS: To assess the efficacy and safety of EUS-RV for benign and resectable malignant biliary disorders. METHODS: This was a multicenter prospective study from 12 Japanese referral centers. Patients who underwent EUS-RV after failed biliary cannulation for biliary disorder were candidates for this study. Inclusion criteria were unsuccessful biliary cannulation for therapeutic endoscopic retrograde cholangiopancreatography with benign and potentially resectable malignant biliary obstruction. Exclusion criteria included unresectable malignant biliary obstruction, inaccessible papillae due to surgically altered upper gastrointestinal anatomy or duodenal stricture, and previous sphincterotomy and/or biliary stent placement. The primary outcome was the technical success rate of biliary cannulation; procedure time, adverse events, and clinical outcomes were secondary outcomes. RESULTS: Twenty patients were prospectively enrolled. The overall technical success rate and median procedure time were 85% and 33 min, respectively. Guidewire manipulation using a 4-Fr tapered tip catheter contributed to the success in advancing the guidewire into the duodenum. Adverse events were identified in 15% patients, including 2 with biliary peritonitis and 1 mild pancreatitis. EUS-RV did not affect surgical maneuvers or complications associated with surgery, or postoperative course. CONCLUSIONS: EUS-RV may be a safe and feasible salvage method for unsuccessful biliary cannulation for benign or resectable malignant biliary disorders. Use of a 4-Fr tapered tip catheter may improve the overall EUS-RV success rate. - Kosuke Minaga; Mamoru Takenaka; Ken Kamata; Tomoe Yoshikawa; Atsushi Nakai; Shunsuke Omoto; Takeshi Miyata; Kentaro Yamao; Hajime Imai; Hiroki Sakamoto; Masayuki Kitano; Masatoshi KudoCancers 10 2 2018年02月 [査読有り]
The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described. In this transgastric anterior approach, a neurolytic agent is injected around the celiac trunk under EUS guidance. The procedure gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. We focus on two relatively new techniques of EUS-guided neurolysis: EUS-guided celiac ganglia neurolysis and EUS-guided broad plexus neurolysis, which have been developed to improve efficacy. Although the techniques are safe and effective in general, some serious adverse events including ischemic and infectious complications have been reported as the procedure has gained widespread popularity. We summarize reported clinical outcomes of EUS-guided neurolysis in pancreatic cancer (from the PubMed and Embase databases) with a goal of providing information useful in developing strategies for pancreatic cancer-associated pain alleviation. - Mamoru Takenaka; Ken Kamata; Kosuke Minaga; Atsushi Nakai; Shunsuke Omoto; Takeshi Miyata; Kentaro Yamao; Hajime Imai; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoEndoscopic Ultrasound 7 5 349 - 349 2018年 [査読有り]
- Kosuke Minaga; Mamoru Takenaka; Shunsuke Omoto; Takeshi Miyata; Ken Kamata; Kentaro Yamao; Hajime Imai; Tomohiro Watanabe; Masayuki Kitano; Masatoshi KudoJournal of Medical Ultrasonics 45 1 161 - 165 2018年01月 [査読有り]
- Ken Kamata; Mamoru Takenaka; Shunsuke Omoto; Takeshi Miyata; Kosuke Minaga; Kentaro Yamao; Hajime Imai; Toshiharu Sakurai; Naoshi Nishida; Takaaki Chikugo; Yasutaka Chiba; Ippei Matsumoto; Yoshifumi Takeyama; Masatoshi KudoGASTROINTESTINAL ENDOSCOPY 87 1 158 - 163 2018年01月 [査読有り]
Background and Aims: EUS-guided FNA (EUS-FNA) is used for the diagnosis of pancreatic adenocarcinoma, but sometimes the method results in a false negative. Occasionally, an avascular area may be observed within the pancreatic adenocarcinoma tumor during contrast-enhanced harmonic EUS (CH-EUS). The aim of this study was to evaluate whether the diagnostic sensitivity of EUS-FNA for pancreatic adenocarcinoma was affected by the presence of avascularity on CH-EUS. Methods: Two hundred ninety-two patients with pancreatic adenocarcinoma who presented at Kindai University Hospital for EUS-FNA and CH-EUS between June 2009 and August 2013 were retrospectively evaluated. This was a single-center retrospective analysis of prospectively collected data held in a registry. The overall sensitivity of EUS-FNA for the diagnosis of pancreatic adenocarcinoma was calculated. The sensitivities of cytology, histology, and the combination of cytology and histology were also evaluated. These variables were individually evaluated according to the presence or absence of an avascular area on CH-EUS to assess whether the diagnostic sensitivity of EUS-FNA for pancreatic adenocarcinoma was related to the presence of an avascular area within the tumors. Results: The overall sensitivity of EUS-FNA was 90.8% (265/292). The sensitivities of EUS-FNA for lesions with and without an avascular area were 72.9% (35/48) and 94.3% (230/244), respectively, with the difference being statistically significant (P <.001). Conclusions: EUS-FNA has lower sensitivity for pancreatic adenocarcinoma with avascular areas on CH-EUS. - Ken Kamata; Mamoru Takenaka; Masayuki Kitano; Shunsuke Omoto; Takeshi Miyata; Kosuke Minaga; Kentaro Yamao; Hajime Imai; Tosiharu Sakurai; Naoshi Nishida; Hiroshi Kashida; Takaaki Chikugo; Yasutaka Chiba; Takuya Nakai; Yoshifumi Takeyama; Andrea Lisotti; Pietro Fusaroli; Masatoshi KudoDigestive Endoscopy 30 1 98 - 106 2018年01月 [査読有り]
Background and Aim: Differential diagnosis of localized gallbladder lesions is challenging. The aim of the present study was to evaluate the utility of contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for diagnosis of localized gallbladder lesions. Methods: One hundred and twenty-five patients with localized gallbladder lesions were evaluated by CH-EUS between March 2007 and February 2014. This was a single-center retrospective study. Utilities of fundamental B-mode EUS (FB-EUS) and CH-EUS in the differentiation of gallbladder lesions and sludge plug were initially compared. Thereafter, these two examinations were compared with respect to their accuracy in the diagnosis of malignant lesions. Five reviewers blinded to the clinicopathological results evaluated microcirculation patterns in the vascular and perfusion images. Results: In the differentiation between gallbladder lesions and sludge plug, FB-EUS had a sensitivity, specificity, and accuracy of 82%, 100%, and 95%, respectively, whereas CH-EUS had a sensitivity, specificity, and accuracy of 100%, 99%, and 99%, respectively. FB-EUS-based diagnosis of carcinomas based on tumor size and/or shape had a sensitivity, specificity, and accuracy of 61–87%, 71–88%, and 74–86%, respectively. Additional information regarding irregular vessel patterns in the vascular image and/or heterogeneous enhancement in the perfusion image on CH-EUS increased the sensitivity, specificity, and accuracy for the diagnosis of carcinomas to 90%, 98%, and 96%, respectively. There was a significant difference between FB-EUS and CH-EUS in terms of carcinoma diagnosis. Conclusion: CH-EUS was useful for the evaluation of localized gallbladder lesions. - Kosuke Minaga; Masayuki KitanoDigestive Endoscopy 30 1 38 - 47 2018年01月 [査読有り]
Endoscopic ultrasound-guided biliary drainage (EUS-BD) is increasingly used as an alternative in patients with biliary obstruction who fail standard endoscopic retrograde cholangiopancreatography (ERCP). The two major endoscopic approach routes for EUS-BD are the transgastric intrahepatic and the transduodenal extrahepatic approaches. Biliary drainage can be achieved by three different methods, transluminal biliary stenting, transpapillary rendezvous technique, and antegrade biliary stenting. Choice of approach route and drainage method depends on individual anatomy, underlying disease, and location of the biliary stricture. Recent meta-analyses have revealed that cumulative technical success and adverse event rates were 90–94% and 16–23%, respectively. Development of new dedicated devices for EUS-BD would help refine the technical aspects and minimize the possibility of complications, making it a more promising procedure. - Ken Kamata; Tomohiro Watanabe; Kosuke Minaga; Warren Strober; Masatoshi KudoCurrent Protocols in Immunology 120 1 15.31.1 - 15.31.8 2018年01月 [査読有り]
- Kamata K; Takenaka M; Minaga K; Kudo MGastrointestinal endoscopy 86 6 1177 - 1179 2017年12月 [査読有り]
- Yasuo Otsuka; Ken Kamata; Mamoru Takenaka; Kosuke Minaga; Hidekazu Tanaka; Masatoshi KudoENDOSCOPY 49 12 E316 - E318 2017年12月 [査読有り]
- Takeshi Miyata; Mamoru Takenaka; Shunsuke Omoto; Ken Kamata; Kosuke Minaga; Kentaro Yamao; Hajime Imai; Masatoshi KudoOncology (Switzerland) 93 1 98 - 101 2017年12月 [査読有り]
Repeated pancreatic juice cytology via endoscopic nasopancreatic drainage (ENPD) has a high diagnostic yield and might be useful for the diagnosis of early-stage pancreatic cancer. A 67-year-old man presented with a pancreatic cyst occasionally detectable in the body of the pancreas by ultrasonography (US). No obvious pancreatic tumor was detected by US, computed tomography (CT), magnetic resonance cholangiopancreatography, and endoscopic ultrasound (EUS) (although the latter did reveal a weak, low echoic area). Endoscopic retrograde pancreatography showed irregular narrowing of the main pancreatic duct (MPD) at the pancreatic body. Pancreatic juice cytology was also performed, but did not give evidence of a malignancy. Therefore, the patient was followed up. CT and EUS performed after 3 months showed the same findings as did endoscopic retrograde pancreatography however, the results of repeated pancreatic juice cytology performed via ENPD tube revealed a suspected malignancy on 2 of 6 occasions. Therefore, we performed a central pancreatectomy. Histopathological examination of a resected specimen revealed carcinoma in situ in the narrow MPD at the body of the pancreas. In the current case, repeated pancreatic juice cytology via ENPD was effective. A weak low echoic area around the MPD stricture on EUS might be related to the inflammatory change accompanying carcinoma in situ of the pancreas. - Satoshi Ogawa; Tatsuya Ishii; Kosuke Minaga; Yasuki Nakatani; Keiichi Hatamaru; Takuji Akamatsu; Takeshi Seta; Shunji Urai; Yoshito Uenoyama; Yukitaka Yamashita; Masatoshi KudoOncology (Switzerland) 93 1 43 - 48 2017年12月 [査読有り]
Objectives: This study aimed to evaluate the characteristics and the feasibility of 18-mm-diameter stents for obstructive colorectal cancer, comparing the clinical courses with 22-mm-diameter stents. Methods: We retrospectively compared 33 consecutive cases treated with 18-mm-diameter stents (bridge to surgery [BTS] in 25, palliative therapy [PAL] in 8) with 27 consecutive cases treated with 22-mm-diameter stents (BTS in 21, PAL in 6) for obstructive colorectal cancer between May 2013 and November 2015 in our institution. Results: There were no significant differences between the 18-mm and 22-mm groups in technical success rates (97 and 96%, respectively) and clinical success rates (100 and 100%, respectively). As a BTS, the rates of complications and stoma formation were not significantly different between groups. For PAL, although the rates of complications and stent patency were similar, stent occlusion occurred in 1 patient (12.5%) in the 18-mm group. Conclusions: The 18-mm-diameter stents were similarly effective when compared with 22-mm-diameter stents. Because 18-mm-diameter stents are easy to handle and produce less mechanical stress, they have the potential to decrease the perforation rate and mitigate the stent's impact on the tumors. 18-mm-diameter stents can be useful and safe, especially as a BTS. - 渡邉 智裕; 三長 孝輔; 鎌田 研; 山雄 健太郎; 竹中 完; 工藤 正俊肝・胆・膵 75 5 991 - 996 (株)アークメディア 2017年11月
- Kosuke Minaga; Mamoru Takenaka; Masayuki Kitano; Yasutaka Chiba; Hajime Imai; Kentaro Yamao; Ken Kamata; Takeshi Miyata; Shunsuke Omoto; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoSURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 31 11 4764 - 4772 2017年11月 [査読有り]
Treatment of unresectable malignant hilar biliary stricture (UMHBS) is challenging, especially after failure of repeated transpapillary endoscopic stenting. Endoscopic ultrasonography-guided intrahepatic biliary drainage (EUS-IBD) is a recent technique for intrahepatic biliary decompression, but indications for its use for complex hilar strictures have not been well studied. The aim of this study was to assess the feasibility and safety of EUS-IBD for UMHBS after failed transpapillary re-intervention. Retrospective analysis of all consecutive patients with UMHBS of Bismuth II grade or higher who, between December 2008 and May 2016, underwent EUS-IBD after failed repeated transpapillary interventions. The technical success, clinical success, and complication rates were evaluated. Factors associated with clinical ineffectiveness of EUS-IBD were explored. A total of 30 patients (19 women, median age 66 years [range 52-87]) underwent EUS-IBD for UMHBS during the study period. Hilar biliary stricture morphology was classified as Bismuth II, III, or IV in 5, 13, and 12 patients, respectively. The median number of preceding endoscopic interventions was 4 (range 2-14). EUS-IBD was required because the following procedures failed: duodenal scope insertion (n = 4), accessing the papilla after duodenal stent insertion (n = 5), or achieving desired intrahepatic biliary drainage (n = 21). Technical success with EUS-IBD was achieved in 29 of 30 patients (96.7%) and clinical success was attained in 22 of these 29 (75.9%). Mild peritonitis occurred in three of 30 (10%) and was managed conservatively. Stent dysfunction occurred in 23.3% (7/30). There was no procedure-related mortality. On multivariable analysis, Bismuth IV stricture predicted clinical ineffectiveness (odds ratio = 12.7, 95% CI 1.18-135.4, P = 0.035). EUS-IBD may be a feasible and effective rescue alternative with few major complications after failed transpapillary endoscopic re-intervention in patients with UMHBS, particularly for Bismuth II or III strictures. - Kosuke Minaga; Mamoru Takenaka; Takeshi Miyata; Kentaro Yamao; Ken Kamata; Masayuki Kitano; Masatoshi KudoENDOSCOPIC ULTRASOUND 6 6 412 - 413 2017年11月 [査読有り]
- Kosuke Minaga; Mamoru Takenaka; Ken Kamata; Takeshi Miyata; Kentaro Yamao; Hajime Imai; Masatoshi KudoENDOSCOPY 49 11 E281 - E282 2017年11月 [査読有り]
- Toshiharu Sakurai; Norihisa Yada; Satoru Hagiwara; Tadaaki Arizumi; Kosuke Minaga; Ken Kamata; Mamoru Takenaka; Yasunori Minami; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoCANCER SCIENCE 108 10 1996 - 2003 2017年10月 [査読有り]
Most hepatocellular carcinomas (HCC) develop as a result of chronic liver inflammation. We have shown that the oncoprotein gankyrin is critical for inflammation-induced tumorigenesis in the colon. Although the invitro function of gankyrin is well known, its role invivo remains to be elucidated. We investigated the effect of gankyrin in the tumor microenvironment of mice with liver parenchymal cell-specific gankyrin ablation (Alb-Cre;gankyrin(f/f)) and gankyrin deletion both in liver parenchymal and non-parenchymal cells (Mx1-Cre;gankyrin(f/f)). Gankyrin upregulates vascular endothelial growth factor expression in tumor cells. Gankyrin binds to Src homology 2 domain-containing protein tyrosine phosphatase-1 (SHP-1), mainly expressed in liver non-parenchymal cells, resulting in phosphorylation and activation of signal transducer and activator of transcription 3 (STAT3). Gankyrin deficiency in non-parenchymal cells, but not in parenchymal cells, reduced STAT3 activity, interleukin (IL)-6 production, and cancer stem cell marker (Bmi1 and epithelial cell adhesion molecule [EpCAM]) expression, leading to attenuated tumorigenic potential. Chronic inflammation enhances gankyrin expression in the human liver. Gankyrin expression in the tumor microenvironment is negatively correlated with progression-free survival in patients undergoing sorafenib treatment for HCC. Thus, gankyrin appears to play a critical oncogenic function in tumor microenvironment and may be a potential target for developing therapeutic and preventive strategies against HCC. - Ken Kamata; Mamoru Takenaka; Masayuki Kitano; Shunsuke Omoto; Takeshi Miyata; Kosuke Minaga; Kentaro Yamao; Hajime Imai; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Takaaki Chikugo; Yasutaka Chiba; Haruhiko Imamoto; Takushi Yasuda; Andrea Lisotti; Pietro Fusaroli; Masatoshi KudoJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 32 10 1686 - 1692 2017年10月 [査読有り]
Background and Aim: The study aims to evaluate contrast-enhanced harmonic endoscopic ultrasonography (CH-EUS) for the differential diagnosis of submucosal tumors (SMT) of the upper gastrointestinal tract. Methods: Between June 2008 and May 2015, 157 consecutive patients with submucosal lesions of the upper gastrointestinal tract were evaluated by CH-EUS. This was a single-center retrospective analysis of prospectively collected data in a registry. The data from 73 patients who later underwent surgical resection were analyzed in this study. Surgical specimens served as the final diagnoses. The two CH-EUS variables of blood flow (hyper-enhancement vs hypo-enhancement) and homogeneity of enhancement pattern were evaluated. Results: The final diagnoses were 58 gastrointestinal stromal tumors (GISTs) and 15 benign SMTs (two lipomas, five leiomyomas, five schwannomas, two glomus tumors, and one ectopic pancreas). On CH-EUS, 49 of 58 (84.5%) GISTs presented with hyper-enhancement, whereas 4 of 15 (26.7%) benign SMTs showed hyper-enhancement; 21 of 58 (36.2%) GISTs showed inhomogeneous contrast enhancement, while only 2 of 15 (13.3%) benign SMTs demonstrated inhomogeneous contrast enhancement. If hyper-enhancement was considered to indicate GISTs, the sensitivity, specificity, and accuracy were 84.5%, 73.3%, and 82.2%, respectively. If inhomogeneous enhancement was considered to indicate GISTs, the sensitivity, specificity, and accuracy were 36.2%, 86.7%, and 46.6%, respectively. In lesions of less than 2cm, hyper-enhancement was a more sensitive indicator of GISTs than inhomogeneous enhancement. Conclusions: Hyper-enhancement and inhomogeneous enhancement were found to be a characteristic of GISTs. CH-EUS was useful for discrimination of benign SMTs from GISTs. - Toshiharu Sakurai; Norihisa Yada; Satoru Hagiwara; Tadaaki Arizumi; Kosuke Minaga; Ken Kamata; Mamoru Takenaka; Yasunori Minami; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoCancer Science 108 10 1996 - 2003 2017年10月 [査読有り]
Most hepatocellular carcinomas (HCC) develop as a result of chronic liver inflammation. We have shown that the oncoprotein gankyrin is critical for inflammation-induced tumorigenesis in the colon. Although the in vitro function of gankyrin is well known, its role in vivo remains to be elucidated. We investigated the effect of gankyrin in the tumor microenvironment of mice with liver parenchymal cell-specific gankyrin ablation (Alb-Cre gankyrinf/f) and gankyrin deletion both in liver parenchymal and non-parenchymal cells (Mx1-Cre gankyrinf/f). Gankyrin upregulates vascular endothelial growth factor expression in tumor cells. Gankyrin binds to Src homology 2 domain-containing protein tyrosine phosphatase-1 (SHP-1), mainly expressed in liver non-parenchymal cells, resulting in phosphorylation and activation of signal transducer and activator of transcription 3 (STAT3). Gankyrin deficiency in non-parenchymal cells, but not in parenchymal cells, reduced STAT3 activity, interleukin (IL)-6 production, and cancer stem cell marker (Bmi1 and epithelial cell adhesion molecule [EpCAM]) expression, leading to attenuated tumorigenic potential. Chronic inflammation enhances gankyrin expression in the human liver. Gankyrin expression in the tumor microenvironment is negatively correlated with progression-free survival in patients undergoing sorafenib treatment for HCC. Thus, gankyrin appears to play a critical oncogenic function in tumor microenvironment and may be a potential target for developing therapeutic and preventive strategies against HCC. - Yoriaki Komeda; Tomohiro Watanabe; Shigenaga Matsui; Hiroshi Kashida; Toshiharu Sakurai; Masashi Kono; Kosuke Minaga; Tomoyuki Nagai; Satoru Hagiwara; Eisuke Enoki; Masatoshi KudoJGH Open 1 2 74 - 75 2017年10月 [査読有り]
- Minaga Kosuke; Takenaka Mamoru; Kamata Ken; Miyata Takeshi; Yamao Kentaro; Imai Hajime; Omoto Shunsuke; Nakai Atsushi; Yoshikawa Tomoe; Watanabe Tomohiro; Kudo MasatoshiJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 32 240 2017年09月 [査読有り]
- Ishii T; Minaga K; Ogawa S; Ikenouchi M; Yoshikawa T; Akamatsu T; Seta T; Urai S; Uenoyama Y; Yamashita YEndoscopy international open 5 9 E834 - E838 2017年09月 [査読有り]
- Masayuki Kitano; Mamoru Takenaka; Kosuke Minaga; Takeshi Miyata; Ken KamataInnovation of Diagnosis and Treatment for Pancreatic Cancer 13 - 28 2017年07月
- Ken Kamata; Mamoru Takenaka; Kosuke Minaga; Shunsuke Omoto; Takeshi Miyata; Kentaro Yamao; Hajime Imai; Masatoshi KudoARAB JOURNAL OF GASTROENTEROLOGY 18 2 120 - 121 2017年06月 [査読有り]
EUS-guided hepaticogastrostomy (EUS-HGS) is useful for treating obstructive jaundice. However, stent migration may sometimes occur both during and after the procedure. This report describes a patient with pancreatic cancer and massive ascites who underwent EUS-HGS combined with EUS-guided antegrade stenting (EUS-AS), with additional EUS-AS playing a role in troubleshooting for stent migration during EUS-HGS. (C) 2017 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved. - Kosuke Minaga; Mamoru Takenaka; Masayuki Kitano; Hajime Imai; Kentaro Yamao; Ken Kamata; Takeshi Miyata; Shunsuke Omoto; Tomoe Yoshikawa; Masatoshi KudoGASTROINTESTINAL ENDOSCOPY 85 5 AB493 - AB493 2017年05月 [査読有り]
- Kosuke Minaga; Mamoru Takenaka; Masayuki Kitano; Hajime Imai; Kentaro Yamao; Ken Kamata; Takeshi Miyata; Shunsuke Omoto; Tomoe Yoshikawa; Masatoshi KudoGASTROINTESTINAL ENDOSCOPY 85 5 AB53 - AB53 2017年05月 [査読有り]
- Kentaro Yamao; Masayuki Kitano; Takahisa Kayahara; Etsuji Ishida; Hiroshi Yamamoto; Tomoe Yoshikawa; Kosuke Minaga; Yukitaka Yamashita; Masanori Asada; Yoshihiro Okabe; Yukio Osaki; Juri Ikemoto; Keiji Hanada; Mamoru Takenaka; Masatoshi KudoGASTROINTESTINAL ENDOSCOPY 85 5 AB327 - AB328 2017年05月 [査読有り]
- Tomoe Yoshikawa; Yoshito Uenoyama; Tatsuya Ishii; Kosuke Minaga; Yukitaka YamashitaGASTROINTESTINAL ENDOSCOPY 85 5 AB241 - AB241 2017年05月 [査読有り]
- Watanabe T; Yamashita K; Arai Y; Minaga K; Kamata K; Nagai T; Komeda Y; Takenaka M; Hagiwara S; Ida H; Sakurai T; Nishida N; Strober W; Kudo MJournal of immunology (Baltimore, Md. : 1950) 198 10 3886 - 3896 2017年05月 [査読有り]
In previous studies, we found that human IgG4-related autoimmune pancreatitis (AIP) and murine AIP are driven by activation of plasmacytoid dendritic cells (pDCs) producing IFN-alpha. In the present studies we examined additional roles of pDC-related mechanisms in AIP pathogenesis, particularly those responsible for induction of fibrosis. We found that in murine AIP (MRL/Mp mice treated with polyinosinic-polycytidylic acid) not only the pancreatic infiltration of immune cells but also the development of fibrosis were markedly reduced by the depletion of pDCs or blockade of type I IFN signaling; moreover, such treatment was accompanied by a marked reduction of pancreatic expression of IL-33. Conversely, polyinosinic-polycytidylic acid-induced inflamed pancreatic tissue in murine AIP exhibited increased expression of type I IFNs and IL-33 (and downstream IL-33 cytokines such as IL-13 and TGF-beta 1). pDCs stimulated by type I IFN were the source of the IL-33 because purified populations of these cells isolated from the inflamed pancreas produced a large amount of IL-33 upon activation by TLR9 ligands, and such production was abrogated by the neutralization of type I IFN. The role of IL-33 in murine AIP pathogenesis was surprisingly important because blockade of IL-33 signaling by anti-ST2 Ab attenuated both pancreatic inflammation and accompanying fibrosis. Finally, whereas patients with both conventional pancreatitis and IgG4-related AIP exhibited increased numbers of acinar cells expressing IL-33, only the latter also exhibited pDCs producing this cytokine. These data thus suggest that pDCs producing IFN-alpha and IL-33 play a pivotal role in the chronic fibro-inflammatory responses underlying murine AIP and human IgG4-related AIP. - Kosuke Minaga; Masayuki Kitano; Chimyon Gon; Kentaro Yamao; Hajime Imai; Takeshi Miyata; Ken Kamata; Shunsuke Omoto; Mamoru Takenaka; Masatoshi KudoDIGESTIVE ENDOSCOPY 29 2 211 - 217 2017年03月 [査読有り]
Background and AimEndoscopic ultrasonography (EUS)-guided choledochoduodenostomy (EUS-CDS) is increasingly used in the treatment of malignant distal biliary obstruction. Standardized use of this technique requires improvements in instruments, including more convenient and safer devices. The present study was designed to evaluate the resistance force to migration (RFM) of a newly designed laser-cut metal stent and the feasibility of EUS-CDS using this stent. MethodsThis experimental study used a porcine model of biliary dilatation involving five male pigs. The new stent is a fully covered laser-cut stent with anti-migration anchoring hooks. The RFM of the new stents was compared with those of three commercially available covered metal stents using a phantom model. In the animal study, after ligation of Vater's ampulla with endoscopic clips, the dilated common bile duct was punctured under EUS guidance, followed by EUS-CDS using the new stent. One week after the procedure, the stents were removed endoscopically and the fistulas were assessed after the pigs were killed. Technical feasibility and clinical outcomes were evaluated. ResultsAmong the four stents, the new stent had the highest RFM. Metal stent placement was successful in all five pigs, with no procedure-related complications occurring during and 1 week after endoscopic intervention. All stents remained in place without migration and were removed easily using a snare. At necropsy, fistulas were created between the bile duct and duodenum in all pigs. ConclusionEUS-CDS using a newly designed metal stent was feasible and effective in this porcine model of biliary dilatation. - Kosuke Minaga; Masayuki Kitano; Yukitaka Yamashita; Yasuki Nakatani; Masatoshi KudoGASTROINTESTINAL ENDOSCOPY 85 1 263 - 264 2017年01月 [査読有り]
- Ken Kamata; Mamoru Takenaka; Masayuki Kitano; Shunsuke Omoto; Takeshi Miyata; Kosuke Minaga; Kentaro Yamao; Hajime Imai; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoWORLD JOURNAL OF GASTROENTEROLOGY 23 4 661 - 667 2017年01月 [査読有り]
AIM To assess the long-term outcomes of this procedure after removal of self-expandable metal stent (SEMS). The efficacy and safety of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with SEMS were also assessed. METHODS Between January 2010 and April 2015, 12 patients with acute calculous cholecystitis, who were deemed unsuitable for cholecystectomy, underwent EUS-GBD with a SEMS. EUS-GBD was performed under the guidance of EUS and fluoroscopy, by puncturing the gallbladder with a needle, inserting a guidewire, dilating the puncture hole, and placing a SEMS. The SEMS was removed and/or replaced with a 7-Fr plastic pigtail stent after cholecystitis improved. The technical and clinical success rates, adverse event rate, and recurrence rate were all measured. RESULTS The rates of technical success, clinical success, and adverse events were 100%, 100%, and 0%, respectively. After cholecystitis improved, the SEMS was removed without replacement in eight patients, whereas it was replaced with a 7-Fr pigtail stent in four patients. Recurrence was seen in one patient (8.3%) who did not receive a replacement pigtail stent. The median follow-up period after EUS-GBD was 304 d (78-1492). CONCLUSION EUS-GBD with a SEMS is a possible alternative treatment for acute cholecystitis. Long-term outcomes after removal of the SEMS were excellent. Removal of the SEMS at 4-wk after SEMS placement and improvement of symptoms might avoid migration of the stent and recurrence of cholecystitis due to food impaction. - Masashi Kono; Naoshi Nishida; Satoru Hagiwara; Tomohiro Minami; Hirokazu Chishina; Tadaaki Arizumi; Kosuke Minaga; Ken Kamata; Yoriaki Komeda; Toshiharu Sakurai; Mamoru Takenaka; Masahiro Takita; Norihisa Yada; Hiroshi Ida; Yasunori Minami; Kazuomi Ueshima; Tomohiro Watanabe; Masatoshi KudoDIGESTIVE DISEASES 35 6 556 - 564 2017年 [査読有り]
Background and Aims: Direct-acting antivirals (DAAs) dramatically improve the sustained virological response (SVR) of chronic hepatitis C (CHC) patients. However, continuous liver damage after SVR may be a risk of hepatocellular carcinoma (HCC). We clarified pretreatment characteristics related to sustained liver damage after SVR. Methods: A total of 286 CHC patients were treated with an interferon-free DAA regimen. Among them, 250 patients achieved SVR for 12 weeks after the end of treatment (SVR12); these individuals were classified based on a-fetoprotein (AFP) and alanine transaminase (ALT) levels posttreatment. Baseline characteristics significantly associated with AFP > 5 ng/mL and ALT level >= 20 IU/L after SVR were clarified using multivariate analyses. Results: Among the pretreatment factors examined, serum AFP values and the presence of fatty liver (FL) were significantly associated with abnormal AFP (p < 0.0001) and ALT levels 12 weeks after SVR12 (SVR24; p = 0.0109). For 126 patients who showed an increase in baseline AFP level, FL, fibrosis-4 (FIB-4) index, and albumin levels before treatment were related to abnormal AFP at SVR24 (p = 0.0005, 0.0232, and 0.0400 for FL, FIB-4 index, and albumin, respectively). Similarly, for 150 patients with abnormal baseline ALT levels, FL was associated with an ALT level = 30 IU/L after SVR (p = 0.0430). Conclusions: High FIB-4 index, low albumin level, and FL before DAA treatment were associated with a risk of sustained liver damage with AFP and ALT elevation after SVR; patients with these factors should be carefully monitored for emergence of HCC. (C) 2017 S. Karger AG, Basel - Tadaaki Arizumi; Tomohiro Minami; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Hiroshi Ida; Kazuomi Ueshima; Ken Kamata; Kosuke Minaga; Yoriaki Komeda; Mamoru Takenaka; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoDIGESTIVE DISEASES 35 6 583 - 588 2017年 [査読有り]
Background: Tumors classified based on the Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) are heterogeneous in nature. Previously, the Kinki criterion was proposed for a more precise subclassification of tumors in BCLC-stage B. However, tumors in sub-stage B2 include various size and number of HCCs even with the Kinki criteria, which could lead to heterogeneity for overall survival (OS). In this study, we assessed how the size and number of tumors affect the OS and time to progression (TTP) in patients with Kinki criteria stage B2 tumors and treated with transarterial chemoembolization (TACE). Methods: Of 906 HCC patients treated with TACE at Kindai University Hospital, 236 patients with HCC considered as Kinki criteria stage B2 were examined. They were classified into the following 4 groups according to the maximum tumor diameter and number of tumors: B2a group, tumor size <= 6 cm and total number of tumors <= 6; B2b group, size <= 6 cm and number >6; B2c group, size >6 cm and number <= 6; and B2d group, size >6 cm and number >6. The OS and TTP of patients in each group were compared. Results: There were 131 patients (55.5%) in the B2a group, 58 (24.6%) in the B2b group, 41 (17.4%) in the B2c group, and 6 (0.03%) in the B2d group. Comparison of the survivals revealed that the median OS was 2.8 years (95% CI 2.0-3.5) in the B2a group, 2.8 years (95% CI 2.0-3.3) in the B2b group, 1.9 years (95% CI 0.8-4.0) in the B2c group, and 2.3 years (95% CI 1.2-ND [no data]) in the B2d group, respectively (p = 0.896). The median TTP in B2a, B2b, B2c, and B2d sub-substage HCC were13.2, 12.1, 13.8, and 11.5 months, respectively (p = 0.047). The median TTP in B2a + B2c sub-substage patients was longer than that in B2b + B2d sub-substage HCC patients (14.0 months and 10.4 months; p = 0.002). Conclusion: No significant differences were observed in the OS among HCC patients subclassified based on the maximum tumor diameter and tumor number in Kinki criteria stage B2. Consequently, Kinki criteria stage B2 HCC is a homogeneous subgroup in terms of OS prediction. However, shorter TTP in B2b + B2c sub-substage HCC patients than that in B2a + B2c sub-substage HCC patients suggests that different treatment strategy, such as systemic therapy with targeted agents instead of TACE, may be suitable to preserve the liver function. (C) 2017 S. Karger AG, Basel - Tadaaki Arizumi; Tomohiro Minami; Hirokazu Chishina; Masashi Kono; Masahiro Takita; Norihisa Yada; Satoru Hagiwara; Yasunori Minami; Hiroshi Ida; Kazuomi Ueshima; Ken Kamata; Kosuke Minaga; Yoriaki Komeda; Mamoru Takenaka; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoDIGESTIVE DISEASES 35 6 589 - 597 2017年 [査読有り]
Background: Transarterial chemoembolization (TACE) is recommended for patients with hepatocellular carcinoma (HCC) in Barcelona Clinic Liver Cancer (BCLC) stage B. However, because of the heterogeneity of HCC in BCLC stage B; various subclassification systems have been proposed to predict the prognosis of patients. Previously, we proposed the Kinki criteria for precise classification of HCC cases in BCLC stage B. In this study, we compared the time to TACE refractoriness in HCC patients with Kinki criteria substages B1 and B2-HCC. Summary: Between January 2006 and December 2013, 592 HCC patients (substage B1, n = 118; substage B2, n = 170) underwent TACE. Time to progression under TACE treatment was defined as the time to untreatable progression (TTUP). TTUP and changes in liver function were analyzed in patients with substages B1 and B2-HCC. The median TTUP was 25.7 months (95% CI 19.3-37.3) and 16.4 months (95% CI 13.1-20.2) in patients with substage B1-HCC and substage B2-HCC, respectively (p = 0.0050). In patients with substage B2-HCC, median Child-Pugh scores after the first TACE session was significantly different from those after third and fifth TACE sessions (first-third, p = 0.0020; first-fifth, p = 0.0008). Key Message: TACE refractoriness occurred earlier in patients with substage B2-HCC than those with substage B1-HCC; deterioration of liver function with repeated TACE was more obvious in HCC cases with stage-B1 tumor. Shorter TTUP and impaired liver function due to repeated TACE could be responsible for the shorter survival in patients with substage B2-HCC. (C) 2017 S. Karger AG, Basel - Shunsuke Omoto; Mamoru Takenaka; Masayuki Kitano; Takeshi Miyata; Ken Kamata; Kosuke Minaga; Tadaaki Arizumi; Kentaro Yamao; Hajime Imai; Hiroki Sakamoto; Yogesh Harwani; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Yoshifumi Takeyama; Yasutaka Chiba; Masatoshi KudoOncology 93 1 55 - 60 2017年 [査読有り]
- Hajime Imai; Mamoru Takenaka; Shunsuke Omoto; Ken Kamata; Takeshi Miyata; Kosuke Minaga; Kentaro Yamao; Toshiharu Sakurai; Naoshi Nishida; Tomohiro Watanabe; Masayuki Kitano; Masatoshi KudoOncology 93 1 69 - 75 2017年 [査読有り]
- Kosuke Minaga; Mamoru Takenaka; Akio Katanuma; Masayuki Kitano; Yukitaka Yamashita; Ken Kamata; Kentaro Yamao; Tomohiro Watanabe; Hiroyuki Maguchi; Masatoshi KudoOncology 93 1 107 - 112 2017年 [査読有り]
- Kazuki Okamoto; Tomohiro Watanabe; Yoriaki Komeda; Tatsuya Kono; Kouta Takashima; Ayana Okamoto; Masashi Kono; Mitsunari Yamada; Tadaaki Arizumi; Ken Kamata; Kosuke Minaga; Kentaro Yamao; Tomoyuki Nagai; Yutaka Asakuma; Mamoru Takenaka; Toshiharu Sakurai; Shigenaga Matsui; Naoshi Nishida; Takaaki Chikugo; Hiroshi Kashida; Masatoshi KudoOncology 93 1 35 - 42 2017年 [査読有り]
- Kentaro Yamao; Mamoru Takenaka; Hajime Imai; Atsushi Nakai; Shunske Omoto; Ken Kamata; Kosuke Minaga; Takeshi Miyata; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Ippei Matsumoto; Yosihumi Takeyama; Takaaki Chikugo; Masatoshi KudoOncology 93 1 76 - 80 2017年 [査読有り]
- Kentaro Yamao; Mamoru Takenaka; Atsushi Nakai; Shunske Omoto; Ken Kamata; Kosuke Minaga; Takeshi Miyata; Hajime Imai; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Ippei Matsumoto; Yosihumi Takeyama; Takaaki Chikugo; Masatoshi KudoOncology 93 1 81 - 86 2017年 [査読有り]
- Yoriaki Komeda; Hiroshi Kashida; Toshiharu Sakurai; Yutaka Asakuma; George Tribonias; Tomoyuki Nagai; Masashi Kono; Kosuke Minaga; Mamoru Takenaka; Tadaaki Arizumi; Satoru Hagiwara; Shigenaga Matsui; Tomohiro Watanabe; Naoshi Nishida; Takaaki Chikugo; Yasutaka Chiba; Masatoshi KudoOncology 93 1 49 - 54 2017年 [査読有り]
- Kazuki Okamoto; Shigenaga Matsui; Tomohiro Watanabe; Yutaka Asakuma; Yoriaki Komeda; Ayana Okamoto; Ishikawa Rei; Masashi Kono; Mitsunari Yamada; Tomoyuki Nagai; Tadaaki Arizumi; Kosuke Minaga; Ken Kamata; Kentaro Yamao; Mamoru Takenaka; Toshiharu Sakurai; Naoshi Nishida; Hiroshi Kashida; Takaaki Chikugo; Masatoshi KudoOncology 93 1 9 - 14 2017年 [査読有り]
- Ken Kamata; Mamoru Takenaka; Kosuke Minaga; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Masatoshi KudoOncology 93 1 87 - 88 2017年 [査読有り]
- Toshiharu Sakurai; Teppei Adachi; Masashi Kono; Tadaaki Arizumi; Ken Kamata; Kosuke Minaga; Kentaro Yamao; Yoriaki Komeda; Mamoru Takenaka; Satoru Hagiwara; Tomohiro Watanabe; Naoshi Nishida; Hiroshi Kashida; Masatoshi KudoOncology 93 1 27 - 29 2017年 [査読有り]
- Teppei Adachi; Shigenaga Matsui; Tomohiro Watanabe; Kazuki Okamoto; Ayana Okamoto; Masashi Kono; Mitsunari Yamada; Tomoyuki Nagai; Yoriaki Komeda; Kosuke Minaga; Ken Kamata; Kentaro Yamao; Mamoru Takenaka; Yutaka Asakuma; Toshiharu Sakurai; Naoshi Nishida; Hiroshi Kashida; Masatoshi KudoOncology 93 1 15 - 19 2017年 [査読有り]
- Mitsunari Yamada; Toshiharu Sakurai; Yoriaki Komeda; Tomoyuki Nagai; Ken Kamata; Kosuke Minaga; Kentaro Yamao; Mamoru Takenaka; Satoru Hagiwara; Shigenaga Matsui; Tomohiro Watanabe; Naoshi Nishida; Hiroshi Kashida; Masatoshi KudoOncology 93 1 20 - 26 2017年 [査読有り]
- Ken Kamata; Mamoru Takenaka; Atsushi Nakai; Shunsuke Omoto; Takeshi Miyata; Kosuke Minaga; Tomohiro Matsuda; Kentaro Yamao; Hajime Imai; Yasutaka Chiba; Toshiharu Sakurai; Tomohiro Watanabe; Naoshi Nishida; Takaaki Chikugo; Ippei Matsumoto; Yoshifumi Takeyama; Masatoshi KudoOncology 93 1 102 - 106 2017年 [査読有り]
- Takeshi Miyata; Mamoru Takenaka; Masayuki Kitano; Tomohiko Matsuda; Syunsuke Omoto; Ken Kamata; Kosuke Minaga; Kentaro Yamao; Hajime Imai; Masatoshi KudoJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 31 248 - 248 2016年11月 [査読有り]
- Tomoe Yoshikawa; Tatsuya Ishii; Kosuke Minaga; Yasuki Nakatani; Keiichi Hatamaru; Takuji Akamatsu; Takeshi Seta; Shunji Urai; Yoshito Uenoyama; Yukitaka YamashitaJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 31 343 - 344 2016年11月 [査読有り]
- Kentaro Yamao; Masayuki Kitano; Takahisa Kayahara; Etsuji Ishida; Hiroshi Yamamoto; Kosuke Minaga; Yukitaka Yamashita; Jun Nakajima; Masanori Asada; Yoshihiro Okabe; Yukio Osaki; Yasutaka Chiba; Hajime Imai; Masatoshi KudoGASTROINTESTINAL ENDOSCOPY 84 5 757 - + 2016年11月 [査読有り]
Background and Aims: Endoscopic gastroduodenal stenting for malignant gastric outlet obstruction recently has become more effective, but the factors that predict gastroduodenal stenting outcomes are poorly defined. This multicenter retrospective cohort study evaluated the clinical outcomes of gastroduodenal stenting in malignant gastroduodenal obstruction and identified factors predicting clinical ineffectiveness, stent dysfunction, and adverse events. Methods: All consecutive patients with malignant gastroduodenal obstruction who underwent through-the-scope gastroduodenal stenting from 2009 to 2014 at 4 tertiary-care medical centers were identified. Clinically ineffective stenting was defined as symptom recurrence and a gastric outlet obstruction scoring system (GOOSS) score < 2. Results: Of the 278 patients (mean age +/- standard deviation [SD] 71.7 +/- 11.4 years), 121 (43.5%) and 87 (31.3%) had pancreatic and gastric cancer, respectively. Technical success was achieved in 277 patients (99.6%). GOOSS scores rose from 0.5 +/- 0.6 to 2.6 +/- 0.8. Stenting was ineffective in 32 patients (12.6%). Stent dysfunction that caused symptom recurrence during follow-up developed in 46 patients (16.6%). Adverse events occurred in 49 patients (17.7%). Three or more stenosis sites (odds ratio [OR] = 6.11; P < .01) and Karnofsky performance scores <= 50 (OR Z 6.63; P < .01) predicted clinical ineffectiveness. Karnofsky performance scores <= 50 predicted stent dysfunction (hazard ratio [HR] = 3.63; P < .01). Bile duct stenosis (HR = 9.55; P =. 02) and liver metastasis (HR = 9.42; P <.01) predicted stent overgrowth. Covered stent predicted stent migration (HR = 12.63; P < .01). Deployment of 2 stents predicted perforation (HR Z 854.88; P < .01). Conclusions: Through-the-scope gastroduodenal stenting tended to be ineffective in patients with poor performance status and long stenosis sites. Stent dysfunction occurred more frequently in patients with poorer performance status. Deployment of 2 stents was a risk factor for perforation. Identification of these risk variables may help yield better gastroduodenal stenting outcomes. - Kosuke Minaga; Masayuki Kitano; Mamoru TakenakaDIGESTIVE ENDOSCOPY 28 7 758 - 758 2016年11月 [査読有り]
- Kosuke Minaga; Masayuki Kitano; Eisuke Enoki; Hiroshi Kashida; Masatoshi KudoAMERICAN JOURNAL OF GASTROENTEROLOGY 111 11 1515 - 1515 2016年11月 [査読有り]
- Fusaroli P; Napoleon B; Gincul R; Lefort C; Palazzo L; Palazzo M; Kitano M; Minaga K; Caletti G; Lisotti AGastrointestinal endoscopy 84 4 587 - + 2016年10月 [査読有り]
Background and Aims: The use of contrast-harmonic EUS (CH-EUS) in routine clinical practice is increasing rapidly but is not yet standardized. We present the levels of evidence (LEs) found in the literature to put its clinical outcomes in the appropriate perspective. Methods: We conducted a systematic review of the available English-language articles. The LEs were stratified according to the Oxford Centre for Evidence-Based Medicine guidelines. Results: Overall, 210 articles were included and presented according to different pathologic conditions. For pancreatic solid neoplasms, the pooled sensitivity and specificity in the diagnosis of pancreatic carcinoma were very high (LE 1); quantitative analysis and guidance of FNA were reported as investigational research (LE 2-3). For pancreatic cystic lesions, the identification of neoplastic solid components as hyperenhanced lesions represented a promising application of CH-EUS (LE 2). For lymph nodes, CH-EUS increased the diagnostic yield of B-mode EUS for the detection of malignancy (LE 2). For submucosal tumors, CH-EUS seemed useful for differential diagnosis and risk stratification (LE 2-3). For other applications, differential diagnosis of gallbladder and vascular abnormalities by CH-EUS were reported (LE 2-3). Conclusions: The LEs of CH-EUS in the literature have evolved from the initial descriptive studies to multicenter and prospective trials, and even meta-analyses. The differential diagnosis between benign and malignant lesions is the main field of application of CH-EUS. With regard to pancreatic solid neoplasms, the concomitant use of both CH-EUS and EUS-FNA may have additive value in increasing the overall accuracy by overcoming the false-negative results associated with each individual technique. Other applications are promising but still investigational. - Kosuke Minaga; Masayuki Kitano; Hajime Imai; Yogesh Harwani; Kentaro Yamao; Ken Kamata; Takeshi Miyata; Shunsuke Omoto; Kumpei Kadosaka; Toshiharu Sakurai; Naoshi Nishida; Masatoshi KudoWORLD JOURNAL OF GASTROENTEROLOGY 22 30 6917 - 6924 2016年08月 [査読有り]
AIM: To assess anti-migration potential of six biliary covered self-expandable metal stents (C-SEMSs) by using a newly designed phantom model. METHODS: In the phantom model, the stent was placed in differently sized holes in a silicone wall and retracted with a retraction robot. Resistance force to migration (RFM) was measured by a force gauge on the stent end. Radial force (RF) was measured with a RF measurement machine. Measured flare structure variables were the outer diameter, height, and taper angle of the flare (ODF, HF, and TAF, respectively). Correlations between RFM and RF or flare variables were analyzed using a linear correlated model. RESULTS: Out of the six stents, five stents were braided, the other was laser-cut. The RF and RFM of each stent were expressed as the average of five replicate measurements. For all six stents, RFM and RF decreased as the hole diameter increased. For all six stents, RFM and RF correlated strongly when the stent had not fully expanded. This correlation was not observed in the five braided stents excluding the laser cut stent. For all six stents, there was a strong correlation between RFM and TAF when the stent fully expanded. For the five braided stents, RFM after full stent expansion correlated strongly with all three stent flare structure variables (ODF, HF, and TAF). The laser-cut C-SEMS had higher RFMs than the braided C-SEMSs regardless of expansion state. CONCLUSION: RF was an important anti-migration property when the C-SEMS did not fully expand. Once fully expanded, stent flare structure variables plays an important role in anti-migration. - Ken Kamata; Masayuki Kitano; Shunsuke Omoto; Kumpei Kadosaka; Takeshi Miyata; Kosuke Minaga; Kentaro Yamao; Hajime Imai; Masatoshi KudoUltrasonography 35 3 169 - 179 2016年07月 [査読有り]
Endoscopic ultrasonography (EUS) is widely used to evaluate pancreaticobiliary diseases, especially pancreatic masses. EUS has a good ability to detect pancreatic masses, but it is not sufficient for the differential diagnosis of various types of lesions. In order to address the limitations of EUS, new techniques have been developed to improve the characterization of the lesions detected by EUS. EUS-guided fine needle aspiration (EUS-FNA) has been used for diagnosing pancreatic tumors. In order to improve the histological diagnostic yield, a EUS-FNA needle with a core trap has recently been developed. Contrast-enhanced harmonic EUS is a new imaging modality that uses an ultrasonographic contrast agent to visualize blood flow in fine vessels. This technique is useful in the diagnosis of pancreatic solid lesions and in confirming the presence of vascularity in mural nodules for cystic lesions. EUS elastography analyzes several different variables to measure tissue elasticity, color patterns, and strain ratio, using analytical techniques such as hue-histogram analysis, and artificial neural networks, which are useful for the diagnosis of chronic pancreatitis and pancreatic cancer. - Kosuke Minaga; Masayuki Kitano; Hiroki Sakamoto; Takeshi Miyata; Hajime Imai; Kentaro Yamao; Ken Kamata; Shunsuke Omoto; Kumpei Kadosaka; Toshiharu Sakurai; Naoshi Nishida; Yasutaka Chiba; Masatoshi KudoTHERAPEUTIC ADVANCES IN GASTROENTEROLOGY 9 4 483 - 494 2016年07月 [査読有り]
Background: Interventional endoscopic ultrasound (EUS)-guided procedures such as EUS-guided celiac ganglia neurolysis (EUS-CGN) and EUS-guided broad plexus neurolysis (EUS-BPN) were developed to treat abdominal cancer-associated pain; however, these procedures are not always effective. The aim of this study was to explore predictors of pain response in EUS-guided neurolysis for pancreatic cancer-associated pain. Methods: This was a retrospective analysis of prospectively collected data of 112 consecutive patients who underwent EUS-BPN in our institution. EUS-CGN was added in cases of visible celiac ganglia. The neurolytic-spread area was divided into six sections and evaluated by post-procedural computed tomography scanning. Pain intensity was assessed using a visual analog scale (VAS), and a decrease in VAS scores by 3 points after neurolysis was considered a good pain response. Univariable and multivariable logistic regression analyses were performed to explore predictors of pain response at 1 and 4 weeks, and complications. Results: A good pain response was obtained in 77.7% and 67.9% of patients at 1 and 4 weeks, respectively. In the multivariable analysis of these patients, the combination method (EUS-BPN plus CGN) was a significant positive predictive factor at 1 week (odds ratio = 3.69, p = 0.017) and 4 weeks (odds ratio = 6.37, p = 0.043). The numbers of neurolytic/contrast spread areas (mean SD) were 4.98 +/- 1.08 and 4.15 +/- 1.12 in patients treated with the combination method and single method, respectively (p < 0.001). There was no significant predictor of complications. Conclusions: EUS-BPN in combination with EUS-CGN was a predictor of a good pain response in EUS-guided neurolysis for pancreatic cancer-related pain. The larger number of neurolytic/contrast spread areas may lead to better outcomes in patients receiving combination treatment. - Kosuke Minaga; Masayuki Kitano; Hajime Imai; Kentaro Yamao; Ken Kamata; Takeshi Miyata; Tomohiko Matsuda; Shunsuke Omoto; Kumpei Kadosaka; Tomoe Yoshikawa; Masatoshi KudoWORLD JOURNAL OF GASTROENTEROLOGY 22 21 5132 - 5136 2016年06月 [査読有り]
We report a successful endoscopic ultrasonography-guided drainage of a huge infected multilocular walled-off necrosis (WON) that was treated by a modified single transluminal gateway transcystic multiple drainage (SGTMD) technique. After placing a wide-caliber fully covered metal stent, follow-up computed tomography revealed an undrained subcavity of WON. A large fistula that was created by the wide-caliber metal stent enabled the insertion of a forward-viewing upper endoscope directly into the main cavity, and the narrow connection route within the main cavity to the subcavity was identified with a direct view, leading to the successful drainage of the subcavity. This modified SGTMD technique appears to be useful for seeking connection routes between subcavities of WON in some cases. - Kosuke Minaga; Masayuki Kitano; Hajime Imai; Kentaro Yamao; Ken Kamata; Takeshi Miyata; Tomohiko Matsuda; Shunsuke Omoto; Kumpei Kadosaka; Tomoe Yoshikawa; Masatoshi KudoGASTROINTESTINAL ENDOSCOPY 83 5 AB521 - AB521 2016年05月 [査読有り]
- Kosuke Minaga; Masayuki Kitano; Hajime Imai; Takeshi Miyata; Masatoshi KudoGASTROINTESTINAL ENDOSCOPY 83 5 1039 - 1040 2016年05月 [査読有り]
- Kosuke Minaga; Masayuki Kitano; Hajime Imai; Kentaro Yamao; Ken Kamata; Takeshi Miyata; Shunsuke Omoto; Kumpei Kadosaka; Tomoe Yoshikawa; Masatoshi KudoWORLD JOURNAL OF GASTROENTEROLOGY 22 16 4264 - 4269 2016年04月 [査読有り]
Acute obstructive suppurative cholangitis (AOSC) due to biliary lithiasis is a life-threatening condition that requires urgent biliary decompression. Although endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is the current gold standard for biliary decompression, it can sometimes be difficult because of failed biliary cannulation. In this retrospective case series, we describe three cases of successful biliary drainage with recovery from septic shock after urgent endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) was performed for AOSC due to biliary lithiasis. In all three cases, technical success in inserting the stents was achieved and the patients completely recovered from AOSC with sepsis in a few days after EUS-CDS. There were no procedure-related complications. When initial ERCP fails, EUS-CDS can be an effective life-saving endoscopic biliary decompression procedure that shortens the procedure time and prevents post-ERCP pancreatitis, particularly in patients with AOSC-induced sepsis. - Masayuki Kitano; Kosuke Minaga; Masatoshi KudoEndoscopic Imaging Techniques and Tools 187 - 208 2016年01月 [査読有り]
Recent advances in endoscopic ultrasonography (EUS) imaging technology has led to the evolution of the image-enhanced EUS modalities called contrast-enhanced EUS and EUS elastography. These modalities can depict tissue structure in detail and thus are clinically useful for diagnosing pancreatobiliary and upper gastrointestinal diseases. Moreover, they complement EUS-guided fine-needle aspiration (EUS-FNA) by correctly diagnosing lesions with EUS-FNA false-negative findings and by identifying the most appropriate target site of EUS-FNA. This chapter focuses on the upcoming techniques of imaging in the field of EUS and how these techniques improve the diagnostic ability of EUS, particularly in terms of characterizing conventional EUS-detected lesions. - Kosuke Minaga; Masayuki Kitano; Tomoe Yoshikawa; Shunsuke Omoto; Ken Kamata; Kentaro Yamao; Masatoshi KudoENDOSCOPY 48 E228 - E229 2016年 [査読有り]
- Kosuke Minaga; Mamoru Takenaka; Takeshi Miyata; Yasuhiro Ueda; Masayuki Kitano; Masatoshi KudoENDOSCOPY 48 S 01 E369 - E370 2016年 [査読有り]
- Shunsuke Omoto; Masayuki Kitano; Hiroki Sakamoto; Hajime Imai; Kentaro Yamao; Ken Kamata; Takeshi Miyata; Kosuke Minaga; Kumpei Kadosaka; Masatoshi KudoJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 30 141 - 141 2015年12月 [査読有り]
- 当院でのinterventional EUSの治療成績石井 達也; 三長 孝輔; 中井 智己; 益田 朋典; 松本 久和; 多木 未央; 籔内 洋平; 東 俊二郎; 小川 智; 岩上 裕吉; 太田 彩貴子; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 57 Suppl.2 2157 - 2157 (一社)日本消化器内視鏡学会 2015年09月
- 胆管金属ステント留置後胆嚢炎症例の検討小川 智; 石井 達也; 益田 朋典; 中井 智己; 東 俊二郎; 多木 未央; 松本 久和; 籔内 洋平; 岩上 裕吉; 太田 彩貴子; 三長 孝輔; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 57 Suppl.2 2191 - 2191 (一社)日本消化器内視鏡学会 2015年09月
- Kosuke Minaga; Masayuki Kitano; Yukitaka YamashitaJOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 22 9 708 - 709 2015年09月 [査読有り]
- 当院での超高齢者(85歳以上)に対するEPLBD下切石術の検討石井 達也; 池ノ内 真衣子; 梅村 壮一郎; 林 佑樹; 中井 智己; 益田 朋典; 東 俊二郎; 小川 智; 多木 未央; 松本 久和; 籔内 洋平; 岩上 裕吉; 太田 彩貴子; 三長 孝輔; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 57 Suppl.1 861 - 861 (一社)日本消化器内視鏡学会 2015年04月
- 当院で経験した胃静脈瘤破裂の検討中井 智己; 池ノ内 真衣子; 梅村 壮一郎; 林 佑樹; 石井 達也; 益田 朋典; 東 俊二郎; 小川 智; 多木 未央; 松本 久和; 籔内 洋平; 岩上 裕吉; 太田 彩貴子; 三長 孝輔; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸隆Gastroenterological Endoscopy 57 Suppl.1 922 - 922 (一社)日本消化器内視鏡学会 2015年04月
- 当院で経験した3年間の結腸軸捻転の検討松本 久和; 石井 達也; 益田 朋典; 中井 智己; 小川 智; 東 俊二郎; 多木 未央; 籔内 洋平; 太田 彩貴子; 岩上 裕吉; 三長 孝輔; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 57 Suppl.1 928 - 928 (一社)日本消化器内視鏡学会 2015年04月
- 術後再建腸管を有する胆道病変に対し超音波内視鏡ガイド下アプローチが有用であった3例岩上 裕吉; 林 佑樹; 梅村 壮一郎; 池ノ内 真衣子; 益田 朋典; 中井 智己; 石井 達也; 小川 智; 籔内 洋平; 松本 久和; 多木 未央; 東 俊二郎; 太田 彩貴子; 三長 孝輔; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 57 Suppl.1 940 - 940 (一社)日本消化器内視鏡学会 2015年04月
- ESD前の情報共有にブリーフィングは有用である 当科で胃ESDを施行した超高齢者(85歳以上)の患者背景と治療成績もふまえて赤松 拓司; 山下 幸孝; 池ノ内 真衣子; 梅村 壮一郎; 林 佑樹; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 多木 未央; 松本 久和; 籔内 洋平; 岩上 裕吉; 太田 彩貴子; 三長 孝輔; 中谷 泰樹; 幡丸 景一; 浦井 俊二; 瀬田 剛史; 上野山 義人Gastroenterological Endoscopy 57 Suppl.1 961 - 961 (一社)日本消化器内視鏡学会 2015年04月
- 当センターにおける術後再建腸管を有する胆膵疾患に対する治療介入症例の検討岩上 裕吉; 林 祐樹; 梅村 壮一郎; 池ノ内 真衣子; 益田 朋典; 中井 智己; 石井 達也; 小川 智; 松本 久和; 多木 未央; 東 俊二郎; 太田 彩貴子; 三長 孝輔; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝日本消化器病学会雑誌 112 臨増総会 A381 - A381 (一財)日本消化器病学会 2015年03月
- 当院における切除不能膵癌に対するFOLFIRINOX療法の検討小川 智; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 多木 未央; 松本 久和; 籔内 洋平; 岩上 裕吉; 太田 彩貴子; 三長 孝輔; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝日本消化器病学会雑誌 112 臨増総会 A506 - A506 (一財)日本消化器病学会 2015年03月
- より安全なEUSガイド下胆嚢ドレナージ術(EUS-GBD) PTGBD留置後のEUS-GBD石井 達也; 三長 孝輔; 中井 智己; 益田 朋典; 東 俊二郎; 小川 智; 多木 未央; 松本 久和; 籔内 洋平; 岩上 裕吉; 太田 彩貴子; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝日本消化器病学会雑誌 112 臨増総会 A508 - A508 (一財)日本消化器病学会 2015年03月
- 消化管術後の閉塞性黄疸に対してEUS-HGS及びEUS-AGの併用が有用であった2例三長 孝輔; 石井 達也; 益田 朋典; 松本 久和; 岩上 裕吉; 山下 幸孝日本腹部救急医学会雑誌 35 2 443 - 443 (一社)日本腹部救急医学会 2015年02月
- 潰瘍性大腸炎の急性増悪が疑われた腸管スピロヘータ症の1例松本 久和; 石井 達也; 益田 朋典; 小川 智; 三長 孝輔; 山下 幸孝日本腹部救急医学会雑誌 35 2 513 - 513 (一社)日本腹部救急医学会 2015年02月
- 松本 久和; 上野山 義人; 三長 孝輔; 山下 幸孝; 岩上 裕吉; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二日本消化器病学会雑誌 112 6 1046 - 1053 一般財団法人 日本消化器病学会 2015年91歳女性.鮮血便を主訴に受診され,大腸内視鏡検査にて直腸Rbに潰瘍をともなった粘膜下腫瘍を認めた.出血部に対してアルゴンプラズマ凝固法(APC)にて止血を行った後超音波内視鏡下穿刺吸引法(EUS-FNA)にてgastrointestinal stromal tumor(GIST)と診断した.経過中に再度出血をきたしたため経カテーテル動脈塞栓術(TAE)にて左右の内腸骨動脈を塞栓し,止血を得た.退院後の内視鏡検査,CT検査では腫瘍の著明な縮小を認めた.直腸GISTに対してTAEで止血のみならず腫瘍縮小効果を報告した例はまれであり,ここに報告する.
- Kousuke Minaga; Yukitaka Yamashita; Masayuki KitanoDIGESTIVE ENDOSCOPY 26 6 756 - 757 2014年11月 [査読有り]
- 非切除肝門部悪性胆道狭窄に対する内視鏡的胆管メタリックステント留置術の検討籔内 洋平; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 野口 未央; 松本 久和; 岩上 裕吉; 太田 彩貴子; 三長 孝輔; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 浦井 俊二; 瀬田 剛史; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 56 Suppl.2 3040 - 3040 (一社)日本消化器内視鏡学会 2014年09月
- 当院におけるEPLBD時の偶発症の検討石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 野口 未央; 松本 久和; 籔内 洋平; 岩上 裕吉; 太田 彩貴子; 三長 孝輔; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 56 Suppl.2 3045 - 3045 (一社)日本消化器内視鏡学会 2014年09月
- 高齢者早期胃癌に対して内視鏡治療を施行し、ガイドライン適応外病変と診断した症例の長期予後の検討赤松 拓司; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 野口 未央; 松本 久和; 藪内 洋平; 岩上 裕吉; 太田 彩貴子; 三長 孝輔; 中谷 泰樹; 幡丸 景一; 浦井 俊二; 瀬田 剛史; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 56 Suppl.2 3073 - 3073 (一社)日本消化器内視鏡学会 2014年09月
- 当院で経験したCronkhite-Canada症候群6例の検討中井 智己; 益田 朋典; 石井 達也; 籔内 洋平; 松本 久和; 野口 未央; 東 俊二郎; 太田 彩貴子; 岩上 裕吉; 三長 孝輔; 谷口 洋平; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝日本消化器病学会雑誌 111 臨増大会 A903 - A903 (一財)日本消化器病学会 2014年09月
- ESDを施行した表在型食道類基底細胞癌の一例赤松 拓司; 籔内 洋平; 山下 幸孝; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 野口 未央; 松本 久和; 岩上 裕吉; 太田 彩貴子; 信岡 未由; 三長 孝輔; 谷口 洋平; 中谷 泰樹; 幡丸 景一; 瀬田 剛史; 浦井 俊二; 上野山 義人Gastroenterological Endoscopy 56 Suppl.1 1206 - 1206 (一社)日本消化器内視鏡学会 2014年04月
- EUSガイド下肝内胆管穿刺による胆道ドレナージを行った5症例の検討三長 孝輔; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 野口 未央; 松本 久和; 籔内 洋平; 太田 彩貴子; 信岡 未由; 岩上 裕吉; 谷口 洋平; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 56 Suppl.1 1234 - 1234 (一社)日本消化器内視鏡学会 2014年04月
- 膵異時性多発癌の一例岩上 裕吉; 益田 朋典; 中井 智己; 石井 達也; 籔内 洋平; 松本 久和; 野口 未央; 東 俊二郎; 太田 彩貴子; 信岡 未由; 三長 孝輔; 谷口 洋平; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 56 Suppl.1 1238 - 1238 (一社)日本消化器内視鏡学会 2014年04月
- 超高齢者(85歳以上)の下部消化管出血症例に対する内視鏡治療の検討東 俊二郎; 石井 達也; 中井 智己; 益田 朋典; 野口 未央; 松本 久和; 籔内 洋平; 岩上 裕吉; 太田 彩貴子; 信岡 未由; 三長 孝輔; 谷口 洋平; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 56 Suppl.1 1273 - 1273 (一社)日本消化器内視鏡学会 2014年04月
- 当院における消化管粘膜下腫瘍に対するEUS-FNAの現況籔内 洋平; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 野口 未央; 松本 久和; 岩上 裕吉; 太田 彩貴子; 信岡 未由; 三長 孝輔; 谷口 洋平; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 56 Suppl.1 1338 - 1338 (一社)日本消化器内視鏡学会 2014年04月
- 当院での潰瘍性大腸炎に対するInfliximab治療の検討石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 野口 未央; 松本 久和; 藪内 洋平; 岩上 裕吉; 太田 彩貴子; 信岡 未由; 三長 孝輔; 谷口 洋平; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝日本消化器病学会雑誌 111 臨増総会 A354 - A354 (一財)日本消化器病学会 2014年03月
- クエン酸マグネシウムにて高マグネシウム血症を呈し意識障害を来したと考えられる一例松本 久和; 中井 智己; 石井 達也; 益田 朋典; 東 俊二郎; 野口 未央; 籔内 洋平; 太田 彩貴子; 信岡 未由; 岩上 裕吉; 三長 孝輔; 谷口 洋平; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝日本腹部救急医学会雑誌 34 2 561 - 561 (一社)日本腹部救急医学会 2014年02月
- 当院における大腸悪性狭窄に対する大腸ステント11例の検討野口 未央; 三長 孝輔; 山下 幸孝; 石井 達也; 中井 智己; 益田 朋典; 藪内 洋平; 松本 久和; 東 俊二郎; 信岡 未由; 太田 彩貴子; 岩上 裕吉; 谷口 洋平; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人Gastroenterological Endoscopy 55 Suppl.2 2862 - 2862 (一社)日本消化器内視鏡学会 2013年09月
- 導入初期施設における胆膵疾患に対するEUS-FNAの現況三長 孝輔; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 野口 未央; 松本 久和; 籔内 洋平; 信岡 未由; 太田 彩貴子; 岩上 裕吉; 谷口 洋平; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝Gastroenterological Endoscopy 55 Suppl.2 2911 - 2911 (一社)日本消化器内視鏡学会 2013年09月
- 最近3年間に経験した胆嚢捻転症6例の検討三長 孝輔; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 野口 未央; 松本 久和; 籔内 洋平; 信岡 未由; 太田 彩貴子; 岩上 裕吉; 谷口 洋平; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝日本消化器病学会雑誌 110 臨増大会 A842 - A842 (一財)日本消化器病学会 2013年09月
- Kousuke Minaga; Takahisa Kayahara; Yoshihide Ueda; Kazuo Ono; Takeshi Seta; Shunji Urai; Yoshito Uenoyama; Yukitaka Yamashita; Tsutomu ChibaNihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology 108 5 799 - 804 2011年05月 [査読有り]
A 27-year-old man was admitted to our hospital for evaluation and treatment of liver dysfunction with jaundice and hepatosplenomegaly. The patient had severe photosensitivity from childhood. Upper gastrointestinal endoscopy revealed mild esophageal varices. The clinical manifestations, analyses of the urine and blood for porphyrins and skin biopsy led us to a diagnosis of erythropoietic protoporphyria. Because of acute deterioration of liver function, living donor liver transplantation was performed. The resected liver revealed cirrhosis. We report a rare case of erythropoietic protoporphyria with severe liver dysfunction and present a review of the literature.
MISC
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- 竹中 完; 高島 耕太; 田中 秀和; 福永 朋洋; 吉田 晃浩; 山崎 友祐; 大本 俊介; 三長 孝輔; 鎌田 研; 工藤 正俊 胆と膵 45 (4) 385 -390 2024年04月
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- 大塚 康生; 三長 孝輔; 渡邉 智裕 日本消化器病学会雑誌 120 (臨増大会) A718 -A718 2023年10月
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- 地域基幹病病院におけるTherapeutic EUSの導入と治療成績中野 省吾; 三長 孝輔; 松本 久和; 上野山 義人; 山下 幸孝 Gastroenterological Endoscopy 64 (Suppl.2) 2128 -2128 2022年10月
- 胆膵内視鏡施行時のプロポフォールを用いた鎮静における当院での取り組み 胆膵田中 秀和; 竹中 完; 高島 耕太; 福永 朋洋; 吉田 晃浩; 山崎 友裕; 大本 俊介; 三長 孝輔; 鎌田 研; 工藤 正俊 Gastroenterological Endoscopy 64 (Suppl.2) 2188 -2188 2022年10月
- 松本 久和; 中野 省吾; 三長 孝輔; 北田 智也; 筑後 英紀; 寺下 友子; 森村 博樹; 下山 雅之; 荻野 真也; 脇田 碧; 枝川 剛也; 小西 隆文; 岩上 裕吉; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝 日本消化器病学会雑誌 119 (臨増大会) A734 -A734 2022年10月
- 【肝胆膵疾患とサルコペニア】胆道・膵疾患 急性膵炎とサルコペニア竹中 完; 田中 隆光; 山崎 友祐; 大本 俊介; 三長 孝輔; 鎌田 研; 工藤 正俊 肝胆膵 85 (2) 229 -238 2022年08月
- 竹中 完; 大本 俊介; 三長 孝輔; 鎌田 研; 工藤 正俊 内科 130 (1) 13 -19 2022年07月
- 山雄 健太郎; 竹中 完; 鎌田 研; 三長 孝輔; 工藤 正俊 内科 130 (1) 69 -71 2022年07月
- 大学病院全体で取り組むACPの推進 学生教育・院内教育・各領域での実践・地域連携・市民啓発まで吉田 健史; 松村 光一郎; 三長 孝輔; 柏田 孝美; 藤野 崇; 森脇 裕子; 隅野 幸江; 仲里 美穂; 中川 和彦 Palliative Care Research 17 (Suppl.) S.195 -S.195 2022年07月
- 竹中 完; 大本 俊介; 三長 孝輔; 鎌田 研; 工藤 正俊 内科 130 (1) 13 -19 2022年07月
- 山雄 健太郎; 竹中 完; 鎌田 研; 三長 孝輔; 工藤 正俊 内科 130 (1) 69 -71 2022年07月
- 大学病院全体で取り組むACPの推進 学生教育・院内教育・各領域での実践・地域連携・市民啓発まで吉田 健史; 松村 光一郎; 三長 孝輔; 柏田 孝美; 藤野 崇; 森脇 裕子; 隅野 幸江; 仲里 美穂; 中川 和彦 Palliative Care Research 17 (Suppl.) S.195 -S.195 2022年07月
- 【膵神経内分泌腫瘍-新たなる胎動2022-】画像診断 膵神経内分泌腫瘍の内視鏡診断大塚 康生; 鎌田 研; 山崎 友裕; 大本 俊介; 三長 孝輔; 竹中 完; 樫田 博史; 工藤 正俊 肝胆膵 84 (6) 783 -788 2022年06月
- 胆膵内視鏡治療の工夫とリスクマネージメント 胆嚢結石を合併した総胆管結石に対する内視鏡治療戦略の検討 術前にとるか術後にとるか高島 耕太; 三長 孝輔; 鎌田 研; 竹中 完; 工藤 正俊 日本消化器内視鏡学会近畿支部例会プログラム・抄録集 108回 49 -49 2022年06月
- 胆膵内視鏡治療の工夫とリスクマネージメント 高齢者の総胆管結石症に対する長期予後を含む治療成績の検討 EPLBD下切石術とEST下切石術の比較中野 省吾; 松本 久和; 三長 孝輔; 上野山 義人; 山下 幸孝 日本消化器内視鏡学会近畿支部例会プログラム・抄録集 108回 49 -49 2022年06月
- 胆膵内視鏡治療の工夫とリスクマネージメント 胆嚢結石を合併した総胆管結石に対する内視鏡治療戦略の検討 術前にとるか術後にとるか高島 耕太; 三長 孝輔; 鎌田 研; 竹中 完; 工藤 正俊 日本消化器内視鏡学会近畿支部例会プログラム・抄録集 108回 49 -49 2022年06月
- ERCP時の術者被ばく線量、および防護メガネによる水晶体被ばく低減効果の検討 REX-GI試験からの検討池澤 賢治; 林 史郎; 竹中 完; 藥師神 崇行; 長生 幸司; 高田 良司; 山井 琢陽; 松本 健吾; 山本 政司; 鎌田 研; 三長 孝輔; 石井 修二; 清水 健史; 長井 健悟; 細野 眞; 西田 勉; REX-GI試験グループ Gastroenterological Endoscopy 64 (Suppl.1) 807 -807 2022年04月
- 竹中 完; 高島 耕太; 田中 秀和; 福永 朋洋; 吉田 晃浩; 山崎 友祐; 大本 俊介; 三長 孝輔; 鎌田 研; 工藤 正俊 胆と膵 43 (4) 267 -279 2022年04月
- 竹中 完; 大本 俊介; 三長 孝輔; 鎌田 研; 工藤 正俊 消化器内視鏡 34 (4) 813 -818 2022年04月
- 竹中 完; 山崎 友裕; 大本 俊介; 三長 孝輔; 鎌田 研; 工藤 正俊 臨床消化器内科 37 (5) 571 -575 2022年04月
- ERCP時の術者被ばく線量、および防護メガネによる水晶体被ばく低減効果の検討 REX-GI試験からの検討池澤 賢治; 林 史郎; 竹中 完; 藥師神 崇行; 長生 幸司; 高田 良司; 山井 琢陽; 松本 健吾; 山本 政司; 鎌田 研; 三長 孝輔; 石井 修二; 清水 健史; 長井 健悟; 細野 眞; 西田 勉; REX-GI試験グループ Gastroenterological Endoscopy 64 (Suppl.1) 807 -807 2022年04月
- 鎌田 研; 渡邉 智裕; 吉川 智恵; 原 茜; 三長 孝輔; 工藤 正俊 Progress in Medicine 42 (3) 259 -263 2022年03月
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- 浸潤性膵管癌、腺扁平上皮癌が重複膵管に同時発生した1例加藤 弘樹; 大本 俊介; 原 茜; 大塚 康夫; 益田 康弘; 高島 耕太; 吉田 晃浩; 福永 朋洋; 岡本 彩那; 山崎 友裕; 鎌田 研; 三長 孝輔; 竹中 完; 筑後 孝章; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 116回 111 -111 2022年02月
- 制御性T細胞に依存性しない寛解導入が得られたCollagenous Colitisの一例瀬海 郁衣; 本庶 元; 今村 瑞貴; 松原 卓哉; 河野 匡志; 原 茜; 栗本 真之; 吉川 馨介; 益田 康弘; 大塚 康生; 高田 隆太郎; 吉川 智恵; 鎌田 研; 三長 孝輔; 松井 繁長; 木村 雅友; 渡邉 智裕; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 116回 117 -117 2022年02月
- 腸内細菌に対する炎症性サイトカイン応答の増強を示すクローン病関連脊椎関節炎の一例福西 香栄; 本庶 元; 岡井 夏輝; 河野 匡志; 鎌田 研; 三長 孝輔; 米田 頼晃; 辻 成佳; 渡邉 智裕; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 116回 108 -108 2022年02月
- 浸潤性膵管癌、腺扁平上皮癌が重複膵管に同時発生した1例加藤 弘樹; 大本 俊介; 原 茜; 大塚 康夫; 益田 康弘; 高島 耕太; 吉田 晃浩; 福永 朋洋; 岡本 彩那; 山崎 友裕; 鎌田 研; 三長 孝輔; 竹中 完; 筑後 孝章; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 116回 111 -111 2022年02月
- 制御性T細胞に依存性しない寛解導入が得られたCollagenous Colitisの一例瀬海 郁衣; 本庶 元; 今村 瑞貴; 松原 卓哉; 河野 匡志; 原 茜; 栗本 真之; 吉川 馨介; 益田 康弘; 大塚 康生; 高田 隆太郎; 吉川 智恵; 鎌田 研; 三長 孝輔; 松井 繁長; 木村 雅友; 渡邉 智裕; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 116回 117 -117 2022年02月
- 【膵Interventionの最前線】悪性胃十二指腸閉塞に対する内視鏡的消化管ステンティング山雄 健太郎; 竹中 完; 高島 耕太; 吉田 晃浩; 岡本 彩那; 山崎 友裕; 大本 俊介; 鎌田 研; 三長 孝輔; 工藤 正俊 肝胆膵 83 (6) 899 -904 2021年12月
- 【胆膵疾患、一歩進んだ診断のコツ】早期膵癌発見における膵実質萎縮の意義と検出方法山雄 健太郎; 竹中 完; 高島 耕太; 田中 秀和; 吉田 晃浩; 岡本 彩那; 山崎 友裕; 大本 俊介; 鎌田 研; 三長 孝輔; 工藤 正俊 消化器・肝臓内科 10 (6) 655 -660 2021年12月
- ここまで進んだEUSとその関連手技 超音波内視鏡ガイド下腹腔神経叢ブロック(EUS-guided celiac plexus neurolysis:EUS-CPN)関連手技の現状竹中 完; 岡本 彩那; 山崎 友裕; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 工藤 正俊 日本超音波医学会関西地方会学術集会 48回 64 -64 2021年10月
- IPMNの壁在結節におけるDetective flow imaging(DFI)の有用性について高島 耕太; 大本 俊介; 吉田 晃浩; 岡本 彩那; 山崎 友裕; 三長 孝輔; 鎌田 研; 山雄 健太郎; 竹中 完; 工藤 正俊 日本超音波医学会関西地方会学術集会 48回 83 -83 2021年10月
- 【肝胆膵疾患におけるバイオマーカーの意義を探る】膵疾患のバイオマーカー 自然免疫反応からみた自己免疫性膵炎・IgG4関連疾患の血清バイオマーカー IFN-α・IL-33原 茜; 三長 孝輔; 吉川 智恵; 鎌田 研; 渡邉 智裕; 工藤 正俊 肝胆膵 83 (4) 617 -623 2021年10月
- 竹中 完; 福永 朋洋; 高島 耕太; 田中 秀和; 吉田 晃浩; 岡本 彩那; 山崎 友裕; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 工藤 正俊 消化器内視鏡 33 (9) 1459 -1466 2021年09月
- TNF-αおよびIL-6の関与が考えられた好酸球性胃腸炎の1例瀬海 郁衣; 吉川 馨介; 高田 隆太郎; 原 茜; 吉川 智恵; 鎌田 研; 三長 孝輔; 渡邉 智裕; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 115回 81 -81 2021年09月
- Detective flow imaging(DFI)にて特徴的な血流血管を観察し得たIntraductal papillary neoplasm of bile duct(IPNB)の2例上中 大地; 岡本 彩那; 大本 俊介; 原 茜; 大塚 康生; 益田 康弘; 高島 耕太; 吉田 晃浩; 山崎 友裕; 三長 孝輔; 鎌田 研; 山雄 健太郎; 竹中 完; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 115回 98 -98 2021年09月
- 松本 逸平; 三長 孝輔; 村瀬 貴昭; 宮田 剛; 川口 晃平; 亀井 敬子; 水野 修吾; 糸井 隆夫; 大原 弘隆; 正宗 淳; 阪上 順一; 佐田 尚宏; 竹中 完; 北野 雅之; 乾 和郎; 竹山 宜典 膵臓 36 (3) A123 -A123 2021年08月
- 竹中 完; 高島 耕太; 田中 秀和; 福永 朋洋; 吉田 晃浩; 岡本 彩那; 山崎 友裕; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 工藤 正俊 膵臓 36 (3) A200 -A200 2021年08月
- 高島 耕太; 大本 俊介; 大塚 康生; 吉田 晃浩; 吉川 智恵; 岡本 彩那; 山崎 友裕; 三長 孝輔; 鎌田 研; 山雄 健太朗; 竹中 完; 工藤 正俊 胆道 35 (3) 519 -519 2021年08月
- 慢性膵炎による難治性疼痛に対する内科的インターベンション治療と外科治療の比較解析松本 逸平; 三長 孝輔; 村瀬 貴昭; 宮田 剛; 川口 晃平; 亀井 敬子; 水野 修吾; 糸井 隆夫; 大原 弘隆; 正宗 淳; 阪上 順一; 佐田 尚宏; 竹中 完; 北野 雅之; 乾 和郎; 竹山 宜典 膵臓 36 (3) A123 -A123 2021年08月
- 膵疾患におけるinterventional endoscopyの進歩 Walled-off necrosisに対するContrast enhanced EUS-guided cyst drainageの有用性竹中 完; 高島 耕太; 田中 秀和; 福永 朋洋; 吉田 晃浩; 岡本 彩那; 山崎 友裕; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 工藤 正俊 膵臓 36 (3) A200 -A200 2021年08月
- 渡邉智裕; 三長孝輔; 工藤正俊 消化器病学サイエンス 5 (3) 2021年
- 吉川馨介; 渡邉智裕; 瀬海郁江; 高田隆太郎; 原茜; 栗本真之; 益田康弘; 大塚康夫; 吉川友恵; 正木翔; 鎌田研; 三長孝輔; 米田頼晃; 筑後孝章; 工藤正俊 日本消化器病学会近畿支部例会プログラム・抄録集 115th 2021年
- 竹中完; 岡本彩那; 山崎友裕; 大本俊介; 三長孝輔; 鎌田研; 山雄健太郎; 工藤正俊 臨床消化器内科 36 (9) 1109 -1118 2021年
- 松本逸平; 三長孝輔; 村瀬貴昭; 宮田剛; 川口晃平; 亀井敬子; 水野修吾; 糸井隆夫; 大原弘隆; 正宗淳; 阪上順一; 佐田尚宏; 竹中完; 北野雅之; 乾和郎; 竹山宜典 膵臓(Web) 36 (3) 2021年
- 竹中完; 高島耕太; 田中秀和; 福永朋洋; 吉田晃浩; 岡本彩那; 山崎友裕; 大本俊介; 三長孝輔; 鎌田研; 山雄健太郎; 工藤正俊 膵臓(Web) 36 (3) 2021年
- 三長孝輔; 渡邉智裕; 工藤正俊 消化器病学サイエンス 5 (1) 2021年
- 【進化するEUS】診断的EUS 造影ハーモニックEUS三長 孝輔; 原 茜; 田中 秀和; 大本 俊介; 鎌田 研; 山雄 健太郎; 竹中 完; 工藤 正俊 消化器内視鏡 32 (11) 1641 -1649 2020年11月
- 内視鏡的乳頭切除術後胆管狭窄に対する予防的金属ステント留置の有用性岡本 彩那; 竹中 完; 田中 隆光; 田中 秀和; 吉田 晃浩; 吉川 智恵; 石川 嶺; 山崎 友裕; 中井 敦史; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 工藤 正俊 Gastroenterological Endoscopy 62 (Suppl.2) 2136 -2136 2020年10月
- 三長 孝輔; 渡邉 智裕; 工藤 正俊 日本消化器病学会雑誌 117 (臨増大会) A678 -A678 2020年10月
- 田中 隆光; 竹中 完; 吉田 晃弘; 田中 秀和; 吉川 智恵; 石川 嶺; 岡本 彩那; 山崎 友裕; 中井 敦史; 大本 俊輔; 三長 孝輔; 鎌田 研; 山雄 健太郎; 松本 逸平; 竹山 宜典; 工藤 正俊 日本消化器病学会雑誌 117 (臨増大会) A789 -A789 2020年10月
- 内視鏡的乳頭切除術後胆管狭窄に対する予防的金属ステント留置の有用性岡本 彩那; 竹中 完; 田中 隆光; 田中 秀和; 吉田 晃浩; 吉川 智恵; 石川 嶺; 山崎 友裕; 中井 敦史; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 工藤 正俊 Gastroenterological Endoscopy 62 (Suppl.2) 2136 -2136 2020年10月
- Detective flow imaging(DFI)にて特徴的な腫瘍内血流を観察し得たIntraductal papillary neoplasm of the bile duct(IPNB)の1例尼崎 雅也; 大本 俊介; 吉田 晃浩; 田中 秀和; 石川 嶺; 岡本 彩那; 山崎 友裕; 中井 敦史; 三長 孝輔; 鎌田 研; 竹中 完; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 113回 85 -85 2020年10月
- 消化器領域から見たIgG4関連疾患研究の進歩 IRF7-I型IFN-IL-33経路がIgG4関連疾患の病態に果たす役割とバイオマーカーとしての有用性三長 孝輔; 渡邉 智裕; 工藤 正俊 日本消化器病学会雑誌 117 (臨増大会) A678 -A678 2020年10月
- 急性膵炎におけるプレサルコペニアの臨床的意義に関しての検討田中 隆光; 竹中 完; 吉田 晃弘; 田中 秀和; 吉川 智恵; 石川 嶺; 岡本 彩那; 山崎 友裕; 中井 敦史; 大本 俊輔; 三長 孝輔; 鎌田 研; 山雄 健太郎; 松本 逸平; 竹山 宜典; 工藤 正俊 日本消化器病学会雑誌 117 (臨増大会) A789 -A789 2020年10月
- 急性胆嚢炎に対する経皮経肝胆嚢ドレナージ後の超音波内視鏡下胆嚢ドレナージによる内瘻化の検討原田 宜幸; 荻野 真也; 下山 雅之; 寺下 友子; 森村 博樹; 池田 結香; 中野 省吾; 脇田 碧; 我妻 信和; 岡田 圭次郎; 谷 泰弘; 池ノ内 真衣子; 梅村 壮一郎; 松本 久和; 三長 孝輔; 中谷 泰樹; 赤松 拓司; 浦井 俊二; 瀬田 剛史; 上野山 義人; 山下 幸孝 Gastroenterological Endoscopy 62 (Suppl.1) 1311 -1311 2020年08月
- 【肝胆膵における結石診療のベストプラクティス】胆嚢結石症 Confluence stoneとMirizzi症候群はどう違うのか Biliobiliary fistulaと合わせて竹中 完; 石川 嶺; 岡本 彩那; 山崎 友裕; 中井 敦史; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 工藤 正俊 肝・胆・膵 81 (2) 305 -312 2020年08月
- 山雄 健太郎; 竹中 完; 田中 秀和; 田中 隆光; 吉田 晃浩; 石川 嶺; 岡本 彩那; 中井 敦; 山崎 友裕; 大本 俊介; 鎌田 研; 三長 孝輔; 渡邉 智裕; 工藤 正俊 胆と膵 41 (8) 713 -718 2020年08月
- 急性胆嚢炎に対する経皮経肝胆嚢ドレナージ後の超音波内視鏡下胆嚢ドレナージによる内瘻化の検討原田 宜幸; 荻野 真也; 下山 雅之; 寺下 友子; 森村 博樹; 池田 結香; 中野 省吾; 脇田 碧; 我妻 信和; 岡田 圭次郎; 谷 泰弘; 池ノ内 真衣子; 梅村 壮一郎; 松本 久和; 三長 孝輔; 中谷 泰樹; 赤松 拓司; 浦井 俊二; 瀬田 剛史; 上野山 義人; 山下 幸孝 Gastroenterological Endoscopy 62 (Suppl.1) 1311 -1311 2020年08月
- 三長 孝輔; 渡邉 智裕; 工藤 正俊 日本消化器病学会雑誌 117 (臨増総会) A200 -A200 2020年07月
- 原 茜; 三長 孝輔; 吉川 智恵; 鎌田 研; 渡邉 智裕; 工藤 正俊 日本消化器病学会雑誌 117 (臨増総会) A299 -A299 2020年07月
- 重里 徳子; 三長 孝輔; 中野 省吾; 脇田 碧; 原田 宜幸; 我妻 信和; 岡田 圭次郎; 谷 泰弘; 池ノ内 真衣子; 梅村 壮一郎; 松本 久和; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝 日本消化器病学会雑誌 117 (臨増総会) A385 -A385 2020年07月
- 中野 省吾; 松本 久和; 三長 孝輔; 山下 幸孝 日本消化器病学会雑誌 117 (臨増総会) A393 -A393 2020年07月
- 切除不能遠位悪性胆道閉塞に対する超音波内視鏡下胆道ドレナージにおけるcholedochoduodenostomyおよびhepaticogastrostomyのアプローチルートの有効性と安全性を比較検討する多施設共同前向き無作為化試験三長 孝輔; 小倉 健; 塩見 英之; 今井 元; 伯耆 徳之; 竹中 完; 錦織 英史; 山下 幸孝; 比佐 岳史; 加藤 博也; 鎌田 英紀; 奥田 篤; 佐上 亮太; 橋本 宏明; 樋口 和秀; 千葉 康敬; 工藤 正俊; 北野 雅之; Therapeutic Endoscopic Ultrasound研究会 Gastroenterological Endoscopy 62 (7) 817 -826 2020年07月
- 三長 孝輔; 渡邉 智裕; 工藤 正俊 日本消化器病学会雑誌 117 (臨増総会) A200 -A200 2020年07月
- 原 茜; 三長 孝輔; 吉川 智恵; 鎌田 研; 渡邉 智裕; 工藤 正俊 日本消化器病学会雑誌 117 (臨増総会) A299 -A299 2020年07月
- 重里 徳子; 三長 孝輔; 中野 省吾; 脇田 碧; 原田 宜幸; 我妻 信和; 岡田 圭次郎; 谷 泰弘; 池ノ内 真衣子; 梅村 壮一郎; 松本 久和; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝 日本消化器病学会雑誌 117 (臨増総会) A385 -A385 2020年07月
- 岡本 彩那; 鎌田 研; 河野 辰哉; 田中 秀和; 石川 嶺; 山崎 友裕; 中井 敦史; 大本 俊介; 三長 孝輔; 山雄 健太郎; 竹中 完; 工藤 正俊 日本消化器病学会雑誌 117 (臨増総会) A389 -A389 2020年07月
- 中野 省吾; 松本 久和; 三長 孝輔; 山下 幸孝 日本消化器病学会雑誌 117 (臨増総会) A393 -A393 2020年07月
- 急性膵炎に対する局所合併症治療 Walled-off necrosisに対するLAMS with 10 FrENCD持続洗浄治療の有用性について竹中 完; 石川 嶺; 岡本 彩那; 中井 敦史; 山崎 友裕; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 松本 逸平; 竹山 宜典; 工藤 正俊 膵臓 35 (3) A209 -A209 2020年07月
- PanNETG1/G2における造影ハーモニックEUSの悪性度評価の有用性に関する検討石川 嶺; 鎌田 研; 田中 秀和; 岡本 彩那; 山崎 友裕; 中井 敦史; 大本 俊介; 三長 孝輔; 竹中 完; 工藤 正俊 膵臓 35 (3) A367 -A367 2020年07月
- 三長 孝輔; 小倉 健; 塩見 英之; 今井 元; 伯耆 徳之; 竹中 完; 錦織 英史; 山下 幸孝; 比佐 岳史; 加藤 博也; 鎌田 英紀; 奥田 篤; 佐上 亮太; 橋本 宏明; 樋口 和秀; 千葉 康敬; 工藤 正俊; 北野 雅之; Therapeutic Endoscopic Ultrasound研究会 Gastroenterological Endoscopy 62 (7) 817 -826 2020年07月
- 竹中 完; 三長 孝輔; 鎌田 研; 山雄 健太郎; 工藤 正俊 消化器内視鏡 32 (6) 862 -864 2020年06月
- 渡邉 智裕; 吉川 智恵; 原 茜; 鎌田 研; 三長 孝輔; 工藤 正俊 炎症と免疫 28 (4) 310 -314 2020年06月
- 竹中 完; 中井 敦史; 大本 俊輔; 三長 孝輔; 鎌田 研; 山雄 健太郎; 工藤 正俊 消化器内視鏡 32 (3) 358 -364 2020年03月
- 【EUSの現状と将来】診断 造影ハーモニック超音波内視鏡の実際と将来展望鎌田 研; 原 茜; 岡本 彩那; 山崎 友裕; 中井 敦史; 大本 俊介; 三長 孝輔; 山雄 健太郎; 竹中 完; 工藤 正俊 肝・胆・膵 80 (3) 403 -411 2020年03月
- 【慢性膵炎診療2020】基礎研究・病態 腸内細菌は慢性膵炎発症に関連するのか渡邉 智裕; 三長 孝輔; 原 茜; 鎌田 研; 工藤 正俊 肝・胆・膵 80 (2) 241 -246 2020年02月
- 【慢性膵炎診療2020】診断 早期慢性膵炎のEUS所見は特異的か 加齢や他疾患の影響は竹中 完; 中井 敦史; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 渡邉 智裕; 松本 逸平; 竹山 宜典; 工藤 正俊 肝・胆・膵 80 (2) 295 -302 2020年02月
- 【慢性膵炎診療2020】治療・予後 膵石の内視鏡治療vs.外科治療 最近の知見松本 逸平; 松本 正孝; 村瀬 貴昭; 亀井 敬子; 里井 俊平; 武部 敦志; 中居 卓也; 三長 孝輔; 竹中 完; 竹山 宜典 肝・胆・膵 80 (2) 355 -362 2020年02月
- 生活習慣の乱れに起因する腸管バリア機能の破綻がIgG4関連疾患・自己免性膵炎の発症に果たす役割の解明三長 孝輔 日本膵臓病研究財団研究報告書 28回 17 -20 2020年
- 三長孝輔 日本膵臓病研究財団研究報告書(Web) 28th 17 -20 2020年
- 石川嶺; 鎌田研; 田中秀和; 岡本彩那; 山崎友裕; 中井敦史; 大本俊介; 三長孝輔; 竹中完; 工藤正俊 膵臓(Web) 35 (3) 2020年
- 竹中完; 石川嶺; 岡本彩那; 中井敦史; 山崎友裕; 大本俊介; 三長孝輔; 鎌田研; 山雄健太郎; 松本逸平; 竹山宜典; 工藤正俊 膵臓(Web) 35 (3) 2020年
- 岡本彩那; 鎌田研; 河野辰哉; 田中秀和; 石川嶺; 山崎友裕; 中井敦史; 大本俊介; 三長孝輔; 山雄健太郎; 竹中完; 工藤正俊 日本消化器病学会雑誌(Web) 117 2020年
- 田中隆光; 竹中完; 吉田晃弘; 田中秀和; 吉川智恵; 石川嶺; 岡本彩那; 山崎友裕; 中井敦史; 大本俊輔; 三長孝輔; 鎌田研; 山雄健太郎; 松本逸平; 竹山宜典; 工藤正俊 日本消化器病学会雑誌(Web) 117 2020年
- 岡本彩那; 竹中完; 田中隆光; 田中秀和; 吉田晃浩; 吉川智恵; 石川嶺; 山崎友裕; 中井敦史; 大本俊介; 三長孝輔; 鎌田研; 山雄健太郎; 工藤正俊 Gastroenterological Endoscopy (Web) 62 (Supplement2) 2020年
- 竹中 完; 細野 眞; 中井 敦史; 大本 俊介; 三長 孝輔; 鎌田 研; 山雄 健太郎; 林 史郎; 西田 勉; 工藤 正俊 日本消化器病学会雑誌 116 (12) 1053 -1055 2019年12月
- EUS-FNA後に膵炎を発症した異所性膵の1例重里 徳子; 三長 孝輔; 松本 久和; 中野 省吾; 脇田 碧; 我妻 信和; 原田 宜幸; 岡田 圭次郎; 谷 泰弘; 池ノ内 真衣子; 梅村 壮一郎; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝 日本消化器病学会近畿支部例会プログラム・抄録集 111回 90 -90 2019年10月
- EUS施行時のプロポフォール持続注入による鎮静の有用性の検討岡本 彩那; 鎌田 研; 竹中 完; 吉川 智恵; 石川 嶺; 山崎 友裕; 中井 敦史; 大本 俊介; 三長 孝輔; 山雄 健太郎; 工藤 正俊 Gastroenterological Endoscopy 61 (Suppl.2) 2182 -2182 2019年10月
- 血清IFN-α/IL-33が治療効果判定に有用と考えられた自己免疫性膵炎/IgG4関連疾患の1例原 茜; 三長 孝輔; 岡本 彩那; 石川 嶺; 山崎 友裕; 中井 敦史; 大本 俊介; 鎌田 研; 山雄 健太郎; 竹中 完; 渡邉 智裕; 安川 覚; 工藤 正俊 日本消化器病学会近畿支部例会プログラム・抄録集 111回 78 -78 2019年10月
- 渡邉 智裕; 三長 孝輔; 工藤 正俊 検査と技術 47 (10) 1160 -1165 2019年10月
- 肝細胞癌術後胆汁瘻に対し経皮的アプローチと内視鏡的アプローチを組み合わせてステント留置を施行した1例鈴木 絢子; 沼本 勲男; 鶴崎 正勝; 小田 晃義; 門場 智也; 柳生 行伸; 石井 一成; 岡本 彩那; 三長 孝輔; 岩崎 寿光 日本インターベンショナルラジオロジー学会雑誌 34 (1) 79 -79 2019年09月
- 【膵癌における内視鏡診断・治療の最前線】術後膵液瘻に対する内視鏡的ドレナージの現状竹中 完; 中井 敦史; 吉川 智恵; 石川 嶺; 岡本 彩那; 山崎 友裕; 大本 俊輔; 三長 孝輔; 鎌田 研; 山雄 健太郎; 亀井 敬子; 松本 逸平; 竹山 宜典; 工藤 正俊 胆と膵 40 (9) 807 -814 2019年09月
- 【術後内視鏡診療のすべて】消化器手術後の内視鏡検査 サーベイランスと異時性病変の診断 消化管再建術後における超音波内視鏡を用いたスクリーニング検査鎌田 研; 原 茜; 田中 秀和; 石川 嶺; 岡本 彩那; 中井 敦史; 大本 俊介; 三長 孝輔; 山雄 健太郎; 竹中 完; 工藤 正俊 消化器内視鏡 31 (9) 1331 -1336 2019年09月
- 渡邉 智裕; 三長 孝輔; 吉川 智恵; 原 茜; 鎌田 研; 工藤 正俊 消化器病学サイエンス = Science of gastroenterology 3 (3) 132,142 -148 2019年09月
- 竹中 完; 中井 敦史; 吉川 智恵; 石川 嶺; 岡本 彩那; 山崎 友裕; 大本 俊輔; 三長 孝輔; 鎌田 研; 山雄 健太郎; 亀井 敬子; 松本 逸平; 竹山 宜典; 工藤 正俊 胆と膵 40 (9) 807 -814 2019年09月
- 鎌田 研; 原 茜; 田中 秀和; 石川 嶺; 岡本 彩那; 中井 敦史; 大本 俊介; 三長 孝輔; 山雄 健太郎; 竹中 完; 工藤 正俊 消化器内視鏡 31 (9) 1331 -1336 2019年09月
- 肝細胞癌術後胆汁瘻に対し経皮的アプローチと内視鏡的アプローチを組み合わせてステント留置を施行した1例鈴木 絢子; 沼本 勲男; 鶴崎 正勝; 小田 晃義; 門場 智也; 柳生 行伸; 石井 一成; 岡本 彩那; 三長 孝輔; 岩崎 寿光 日本インターベンショナルラジオロジー学会雑誌 34 (1) 79 -79 2019年09月
- 竹中完; 大本俊介; 吉川智恵; 石川嶺; 岡本彩那; 山崎友裕; 中井敦史; 三長孝輔; 鎌田研; 山雄健太郎; 松本逸平; 竹山宜典; 工藤正俊 膵臓(Web) 34 (3) A30‐A31(J‐STAGE) 2019年06月
- 山雄健太郎; 竹中完; 吉川智恵; 石川嶺; 岡本彩那; 中井敦; 山崎友宏; 大本俊介; 鎌田研; 三長孝輔; 松本逸平; 竹山宜典; 鶴崎正勝; 渡邉智裕; 工藤正俊 膵臓(Web) 34 (3) A33‐A34(J‐STAGE) 2019年06月
- 竹中完; 大本俊介; 竹山宜典; 吉川智恵; 石川嶺; 岡本彩那; 山崎友裕; 中井敦史; 三長孝輔; 鎌田研; 山雄健太郎; 松本逸平; 工藤正俊 膵臓(Web) 34 (3) A101‐A102(J‐STAGE) 2019年06月
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- 膵・胆道癌に対する内視鏡的診断法の新たな展開 膵癌肝転移診断におけるKupffer imageを用いた造影EUSの有用性竹中 完; 三長 孝輔; 工藤 正俊 日本消化器病学会雑誌 114 (臨増大会) A612 -A612 2017年09月
- 膵・胆道癌に対する内視鏡的診断法の新たな展開 膵癌肝転移診断におけるKupffer imageを用いた造影EUSの有用性竹中 完; 三長 孝輔; 工藤 正俊 Gastroenterological Endoscopy 59 (Suppl.2) 2056 -2056 2017年09月
- 三長 孝輔; 大本 俊介; 門阪 薫平; 松田 友彦; 宮田 剛; 鎌田 研; 山雄 健太郎; 今井 元; 北野 雅之; 工藤 正作 和歌山医学 68 (2) 88 -88 2017年06月
- 竹中 完; 大本 俊介; 三長 孝輔; 宮田 剛; 鎌田 研; 山雄 健太郎; 今井 元; 工藤 正俊 膵臓 32 (3) 360 -360 2017年05月
- 竹中 完; 大本 俊介; 三長 孝輔; 宮田 剛; 鎌田 研; 山雄 健太郎; 今井 元; 工藤 正俊 膵臓 32 (3) 377 -377 2017年05月
- 竹中 完; 大本 俊介; 三長 孝輔; 宮田 剛; 鎌田 研; 山雄 健太郎; 今井 元; 工藤 正俊 膵臓 32 (3) 422 -422 2017年05月
- 三長 孝輔; 竹中 完; 北野 雅之; 中井 敦史; 大本 俊介; 宮田 剛; 鎌田 研; 山雄 健太郎; 今井 元; 渡邉 智裕; 工藤 正俊 膵臓 32 (3) 552 -552 2017年05月
- EUS下胆道ドレナージ(戦略と安全な手技) 経乳頭的re-intervention困難例の悪性肝門部胆道閉塞に対するEUS下胆道ドレナージの有用性三長 孝輔; 竹中 完; 工藤 正俊 Gastroenterological Endoscopy 59 (Suppl.1) 817 -817 2017年04月
- 硬化性胆管炎と診断された膵癌、閉塞性黄疸の1例中井 敦史; 山雄 健太郎; 大本 俊介; 鎌田 研; 三長 孝輔; 宮田 剛; 今井 元; 竹中 完; 松本 逸平; 竹山 宜典; 筑後 孝章; 工藤 正俊 Gastroenterological Endoscopy 59 (Suppl.1) 1061 -1061 2017年04月
- 慢性膵炎診断における超音波の役割 早期慢性膵炎EUS所見の臨床的意義について竹中 完; 大本 俊介; 三長 孝輔; 宮田 剛; 鎌田 研; 山雄 健太郎; 今井 元; 樫田 博史; 工藤 正俊 超音波医学 44 (Suppl.) S242 -S242 2017年04月
- 造影ハーモニックEUSによる上部消化管粘膜下腫瘍の鑑別診断 EUS-FNA診断との併用鎌田 研; 竹中 完; 大本 俊介; 宮田 剛; 三長 孝輔; 山雄 健太郎; 今井 元; 筑後 孝章; 安田 卓司; 工藤 正俊 超音波医学 44 (Suppl.) S438 -S438 2017年04月
- 竹中 完; 大本 俊介; 三長 孝輔; 宮田 剛; 鎌田 研; 山雄 健太郎; 今井 元; 工藤 正俊 消化器・肝臓内科 1 (3) 247 -256 2017年03月
- 宇谷 厚志; 三長 孝輔; 荻 朋男; 山本 洋介; 池田 聡司; 築城 英子; 田村 寛; 前村 浩二; 北岡 隆; 岩永 聰; 小池 雄太; 大久保 佑美; 鍬塚 大; 遠藤 雄一郎; 谷崎 英昭; 金田 眞理; 籏持 淳 日本皮膚科学会雑誌 127 (11) 2447 -2454 2017年
- 竹中完; 山雄健太郎; 鎌田研; 三長孝輔; 宮田剛; 今井元; 松本逸平; 竹山宜典; 前西修; 工藤正俊 日本消化器画像診断研究会プログラム・抄録集 67th 2017年
- 中井敦史; 山雄健太郎; 大本俊介; 鎌田研; 三長孝輔; 宮田剛; 今井元; 竹中完; 松本逸平; 竹山宜典; 筑後孝章; 工藤正俊 Gastroenterological Endoscopy (Web) 59 (Supplement1) 2017年
- 三長孝輔; 北野雅之; 宮田剛; 今井元; 竹中完; 工藤正俊 臨床消化器内科 32 (8) 2017年
- 三長孝輔; 竹中完; 工藤正俊 Gastroenterological Endoscopy (Web) 59 (Supplement1) 2017年
- 鎌田 研; 竹中 完; 北野 雅之; 大本 俊介; 三長 孝輔; 宮田 剛; 山雄 健太郎; 今井 元; 工藤 正俊 膵臓 32 (1) 38 -44 2017年
- 鎌田研; 竹中完; 北野雅之; 大本俊介; 三長孝輔; 宮田剛; 山雄健太郎; 今井元; 工藤正俊 すい臓 32 (1) 38‐44(J‐STAGE) 2017年
- 宇谷厚志; 岩永聰; 小池雄太; 大久保佑美; 鍬塚大; 遠藤雄一郎; 谷崎英昭; 金田眞理; 籏持淳; 三長孝輔; 荻朋男; 山本洋介; 池田聡司; 築城英子; 田村寛; 田村寛; 前村浩二; 北岡隆 日本皮膚科学会雑誌 127 (11) 2447‐2454(J‐STAGE) 2017年
- 三長 孝輔 日本膵臓病研究財団研究報告書 = Pancreas Research Foundation of Japan annual report 25 59 -62 2017年
- Ken Kamata; Mamoru Takenaka; Masayuki Kitano; Shunsuke Omoto; Kosuke Minaga; Takeshi Miyata; Kentaro Yamao; Hajime Imai; Masatoshi Kudo JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 31 341 -341 2016年11月
- Kosuke Minaga; Mamoru Takenaka; Masayuki Kitano; Hajime Imai; Kentaro Yamao; Ken Kamata; Takeshi Miyata; Shunsuke Omoto; Masatoshi Kudo JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 31 222 -222 2016年11月
- 竹中 完; 北野 雅之; 鎌田 研; 三長 孝輔; 大本 俊介; 宮田 剛; 山雄 健太郎; 今井 元; 工藤 正俊 消化器内視鏡 28 (10) 1669 -1678 2016年10月
- IPMN切除例からみた国際診療ガイドラインの妥当性およびEUS実施の意義の検証松田 友彦; 北野 雅之; 大本 俊介; 鎌田 研; 三長 孝輔; 宮田 剛; 山雄 健太郎; 工藤 正俊 Gastroenterological Endoscopy 58 (Suppl.2) 1976 -1976 2016年10月
- 三長孝輔; 北野雅之; 竹山宜典; 大本俊介; 宮田剛; 鎌田研; 山雄健太郎; 工藤正俊 肝胆膵 73 (1) 41‐51 2016年07月
- 三長 孝輔; 北野 雅之; 竹山 宜典; 大本 俊介; 宮田 剛; 鎌田 研; 山雄 健太郎; 工藤 正俊 肝・胆・膵 73 (1) 41 -51 2016年07月
- 石井 達也; 山下 幸孝; 三長 孝輔; 小川 智; 多木 未央; 籔内 洋平; 松本 久和; 赤松 拓司; 瀬田 剛史; 上野山 義人 日本消化器内視鏡学会雑誌 58 (2) 121 -129 2016年
- 北野 雅之; 三長 孝輔; 今井 元; 工藤 正俊 胆道 30 (4) 689 -698 2016年
- Takashisa Kayahara; Kentaro Yamao; Masayuki Kitano; Etsuji Ishida; Kousuke Minaga; Sumihiro Okabe; Masanori Asada; Yasutaka Chiba; Yukitaka Yamasita JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 30 17 -17 2015年12月
- S. Ogawa; T. Ishii; K. Minaga; K. Okada; Y. Tani; M. Ikenouchi; S. Umemura; Y. Hayashi; T. Nakai; T. Masuda; S. Azuma; H. Matsumoto; S. Ota; H. Iwagami; Y. Nakatani; K. Hatamaru; T. Akamatsu; T. Seta; S. Urai; Y. Uenoyama; Y. Yamashita JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 30 84 -84 2015年12月
- K. Minaga; M. Kitano; H. Sakamoto; H. Imai; K. Yamao; K. Kamata; T. Miyata; S. Omoto; K. Kadosaka; M. Kudo JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 30 246 -247 2015年12月
- 北野 雅之; 今井 元; 山雄 健太郎; 鎌田 研; 宮田 剛; 三長 孝輔; 大本 俊介; 門阪 薫平; 松田 友彦; 工藤 正俊 胆と膵 36 (臨増特大) 969 -974 2015年10月
- 今井 元; 北野 雅之; 大本 俊介; 門阪 薫平; 宮田 剛; 鎌田 研; 三長 孝輔; 松田 友彦; 山雄 健太郎; 工藤 正俊 胆と膵 36 (8) 779 -783 2015年08月
- 瀬田 剛史; 山下 幸孝; 池ノ内 真衣子; 梅村 壮一郎; 林 佑樹; 石井 達也; 中井 智己; 益田 朋典; 東 俊二郎; 小川 智; 多木 未央; 松本 久和; 籔内 洋平; 岩上 裕吉; 太田 彩貴子; 三長 孝輔; 中谷 泰樹; 幡丸 景一; 赤松 拓司; 浦井 俊二; 上野山 義人; 中村 昌弘 日本赤十字社和歌山医療センター医学雑誌 = Medical journal of Japanese Red Cross Society Wakayama Medical Center 32 (32) 11 -18 2015年05月
- 三長 孝輔; 山下 幸孝; 籔内 洋平; 岩上 裕吉; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人 日本消化器内視鏡学会雑誌 57 (1) 21 -29 2015年
- 三長 孝輔; 小野 一雄; 山下 幸孝; 岡 智子; 松本 久和; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人; 赤松 裕子 日本消化器内視鏡学会雑誌 57 (8) 1609 -1615 2015年
- 石井 達也; 山下 幸孝; 三長 孝輔; 岩上 裕吉; 幡丸 景一; 中谷 泰樹; 赤松 拓司; 瀬田 剛史; 浦井 俊二; 上野山 義人 日本消化器内視鏡学会雑誌 57 (7) 1502 -1508 2015年
- 三長孝輔; 岩上裕吉; 山下幸孝; 谷口洋平; 幡丸景一; 中谷泰樹; 赤松拓司; 瀬田剛史; 浦井俊二; 上野山義人 Gastroenterol Endosc 56 (8) 2400 -2406 2014年08月
- 三長孝輔; 山下幸孝; 宇谷厚志; 谷口洋平; 幡丸景一; 中谷泰樹; 赤松拓司; 瀬田剛史; 浦井俊二; 上野山義人 Gastroenterol Endosc 56 (5) 1756 -1762 2014年05月
- 石井達也; 三長孝輔; 野口未央; 川口直; 中井智己; 益田朋典; 松本久和; 東俊二郎; 籔内洋平; 太田彩貴子; 信岡未由; 岩上裕吉; 谷口洋平; 幡丸景一; 中谷泰樹; 赤松拓司; 瀬田剛史; 浦井俊二; 上野山義人; 山下幸孝 Gastroenterological Endoscopy 56 (Supplement 1) 2014年
- 三長 孝輔; 山下 幸孝; 千代 孝夫 救急医学 = The Japanese journal of acute medicine 38 (1) 117 -122 2014年01月
- 赤松拓司; 山下幸孝; 信岡未由; 東俊二郎; 野口未央; 松本久和; 籔内洋平; 岩上裕吉; 太田彩貴子; 三長孝輔; 谷口洋平; 中谷泰樹; 浦井俊二; 瀬田剛史; 上野山義人 肝臓 54 (12) 826 -833 2013年
- 中谷泰樹; 東俊二郎; 野口未央; 籔内洋平; 松本久和; 太田彩貴子; 信岡未由; 三上貴生; 岩上裕吉; 津田喬之; 三長孝輔; LEE Minami; 中村文保; 谷口洋平; 赤松拓司; 瀬田剛史; 浦井俊二; 上野山義人; 山下幸孝 日本赤十字社和歌山医療センター医学雑誌 30 63 -72 2012年12月
- 三長 孝輔; 萱原 隆久; 上田 佳秀; 小野 一雄; 瀬田 剛史; 浦井 俊二; 上野山 義人; 山下 幸孝; 千葉 勉 日本消化器病学会雑誌 108 (5) 799 -804 2011年05月
- 瀬田剛史; 山下幸孝; 岩上裕吉; 三上貴生; 太田彩貴子; 信岡未由; 津田喬之; 三長孝輔; LEE Minami; 谷口洋平; 中村文保; 中谷泰樹; 幡丸景一; 田中敦俊; 赤松拓司; 浦井俊二; 上野山義人 日本赤十字社和歌山医療センター医学雑誌 28 115 -119 2010年12月
- 三長 孝輔; 三長 秀男; 真鍋 黌 南紀生物 47 (2) 153 -155 2005年12月
所属学協会
共同研究・競争的資金等の研究課題
- 独立行政法人 日本学術振興会:科学研究費助成事業(科学研究費補助金)基盤研究(C)研究期間 : 2023年04月 -2026年03月代表者 : 三長 孝輔; 渡邉 智裕
- ビタミンAの免疫制御機能を利用した自己免疫性膵炎の新規治 療法の開発近畿大学:令和5年度 近畿大学学内助成金 一般研究助成金研究期間 : 2023年04月 -2024年03月
- 独立行政法人 日本学術振興会:科学研究費助成事業(科学研究費補助金)若手研究研究期間 : 2021年04月 -2023年03月代表者 : 三長 孝輔飲酒・高脂肪食などの生活習慣は、腸管バリア機能の低下とdysbiosisを誘導し、leaky gut syndromeと呼ばれる病態を通じて、生活習慣病を引き起こすことが知られている。一方で、われわれは、dysbiosisがIgG4関連疾患の発症に重要な役割を果たしていることを過去の研究で見出しており、これらの生活習慣の乱れがIgG4関連疾患の発症に及ぼす影響を疾患モデルマウスを用いて検討した。 MRL/MpJマウスにpoly (I:C)を反復投与することでIgG4関連疾患(自己免疫性膵炎・唾液腺炎)を誘導した。高脂肪飼料を摂取した群(HFD群)では標準飼料を摂取した群(ND群)に比べて膵炎が増悪することが病理組織学的評価で明らかとなった。フローサイトメトリーによる膵臓に浸潤する免疫細胞の解析により、HFD群では、形質細胞様樹状細胞(pDC)の浸潤が増加しており、炎症性サイトカインであるIFN-α・IL-33の発現が増加していることが判明した。一方で、IgG4関連疾患の膵臓以外の好発臓器である唾液腺においては、HFD群において唾液腺炎の増悪は認められず、pDCやIFN-α・IL-33の増加も伴わなかった。高脂肪食摂取が肝臓に及ぼす影響を検討した結果、pDCやIFN-α・IL-33に変化は認めなかったが、肝臓の脂質定量においてHFD群では中性脂肪の含有量が有意に増加していた。 これらの結果から、IgG4関連疾患モデルマウスにおいて、高脂肪食の摂取により膵炎が増悪するが、唾液腺炎には影響しないことが明らかとなった。高脂肪食の摂取により誘導された脂肪肝の影響で、dysbiosisや腸管バリア機能の破綻が起こり、病的pDCが炎症性サイトカインIFN-α・IL-33を過剰に産生することにより膵炎を増悪させるといった「肝臓-腸管-膵臓免疫ネットワーク」が機能している可能性が示唆された。
- 腸内細菌Akkermansia muciniphilaを用いた慢性膵炎・膵癌のプロバイオティクス療法の開発近畿大学:令和3年度 近畿大学学内奨励研究助成金研究期間 : 2021年04月 -2022年03月代表者 : 三長 孝輔
- 慢性膵炎の発症を制御する腸内細菌の同定とその機能解析独立行政法人 日本学術振興会:科学研究費助成事業(科学研究費補助金)若手研究研究期間 : 2019年04月 -2021年03月代表者 : 三長 孝輔