論文 - 仲瀬　裕志

Pyogenic spondylitis following endoscopic submucosal dissection for early gastric cancer.

Shun Takai, Gota Sudo, Atsushi Yawata, Hiroshi Nakase

BMJ case reports   15 ( 7 )  2022年07月  [国際誌]

　概要を見る

A man in his 80s who had a history of diabetes mellitus and aortic valve replacement was referred to our hospital for treatment of early gastric cancer and underwent endoscopic submucosal dissection (ESD). Three days after ESD, the patient presented with low back pain and fever (38.7°). We initially considered adverse events associated with gastric ESD such as delayed perforation. Moreover, thromboembolism and infectious endocarditis were suspected because of his medical history. However, there were no remarkable findings suggestive of these diseases. Finally, based on the results of blood cultures and MRI, the diagnosis of pyogenic spondylitis (PS) was made. We administered antibiotics for 12 weeks, and the patient improved without neurological impairments. This case indicates that bacteraemia and subsequent PS can occur following gastric ESD. Physicians should not overlook the patient's physical signs related to various adverse events after ESD.

DOI PubMed

Double-balloon enteroscopy-assisted polypectomy for a solitary jejunal Peutz-Jeghers polyp causing anemia.

Kazunori Onuma, Gota Sudo, Hiroyuki Inoue, Takahiro Kuriyama, Yumemi Takada, Atsushi Yawata, Hiroshi Nakase

Endoscopy    2022年07月  [国際誌]

DOI PubMed

Synergistic effect of IFN-γ and IL-1β on PD-L1 expression in hepatocellular carcinoma.

Yasunao Numata, Noriyuki Akutsu, Keisuke Ishigami, Hideyuki Koide, Kohei Wagatsuma, Masayo Motoya, Shigeru Sasaki, Hiroshi Nakase

Biochemistry and biophysics reports   30   101270 - 101270  2022年07月  [国際誌]

　概要を見る

Immunotherapy using anti-programmed death 1 ligand 1 (PD-L1) antibodies has shown clinical efficacy against hepatocellular carcinoma (HCC) and is recognized as the first-line treatment for unresectable HCC. PD-L1 expression is affected by various cytokines produced by immune cells in the tumor microenvironment; however, there is limited information about the effects of cytokine interactions on PD-L1 expression. In this study, we examined how cytokines induce PD-L1 expression in HCC cells. Both interferon gamma (IFN-γ) and interleukin 1 beta (IL-1β) induced PD-L1 expression, and the two cytokines enhanced PD-L1 expression in combination compared to that when administered alone. The Janus kinase/signal transducer and activator of transcription signaling pathway activated by IFN-γ is the major pathway of PD-L1 expression. The increase in interferon regulatory factor 1 expression and IFN-γ receptor expression induced by IL-1β was associated with the synergistic effect of IFN-γ and IL-1β on PD-L1 expression. These findings strongly indicate that IFN-γ and IL-1β affect the mechanism underlying immune resistance in HCC cells.

DOI PubMed

Delayed-onset bleeding after transrectal prostate biopsy presenting as a rectal Dieulafoy's lesion.

Mitsunobu Saito, Gota Sudo, Hiroyuki Inoue, Yumemi Takada, Katsuyoshi Miura, Atsushi Yawata, Hiroshi Nakase

Endoscopy    2022年06月  [国際誌]

DOI PubMed

Both fecal calprotectin and fecal immunochemical tests are useful in children with inflammatory bowel disease.

Hirotaka Shimizu, Ryo Ebana, Takahiro Kudo, Takuro Sato, Tomoko Hara, Kenji Hosoi, Masaaki Usami, Masashi Yoshida, Ichiro Takeuchi, Hiroshi Nakase, Itaru Iwama, Katsuhiro Arai, Toshiaki Shimizu

Journal of gastroenterology   57 ( 5 ) 344 - 356  2022年05月  [国内誌]

　概要を見る

BACKGROUND: Noninvasive biomarkers of intestinal inflammation can reduce the number of endoscopies in children with inflammatory bowel disease (IBD). This study aimed to prospectively investigate the usefulness of fecal calprotectin (FCP) and fecal immunochemical test (FIT) in pediatric IBD. METHODS: Patients aged 6-17 years who underwent ileocolonoscopy for established or suspected IBD were eligible for this study. Fecal samples for FCP and FIT were collected before colonoscopy. RESULTS: A total of 251 samples were analyzed: 88 from ulcerative colitis (UC), 74 from Crohn's disease (CD), 75 from healthy controls (HC), and 14 from children with functional gastrointestinal disorders and normal colonoscopy (NC). At IBD diagnosis, both FCP and FIT were significantly higher in the newly diagnosed UC/CD group than in the HC/NC group (P < 0.001). The optimal cutoffs of FCP and FIT to predict IBD diagnosis were 217 mg/kg and 87 ng/mL, respectively. Patients without mucosal healing (MH) showed higher FCP and FIT than those with MH in both UC and CD (P < 0.001). The FCP increased exponentially as the endoscopic activity score increased. The optimal cutoff values of FCP and FIT for predicting MH were 161 mg/kg and 106 ng/mL for UC and 367 mg/kg and 57 ng/mL for CD, respectively. FCP showed better specificity than the FIT. Patients with CD and normal ileocolonoscopy had elevated FCP during active small intestinal inflammation. CONCLUSIONS: Both FCP and FIT correlate well with endoscopic activity in pediatric patients with IBD. The FCP is a superior marker for predicting MH.

DOI PubMed

【大腸鋸歯状病変のすべて】治療 大腸鋸歯状病変はどこまで切除すべきか 選択的に切除する立場から

三宅 高和, 吉井 新二, 山野 泰穂, 柴田 泰弘, 久保 俊之, 仲瀬 裕志

消化器内視鏡 ( (株)東京医学社 )  34 ( 5 ) 974 - 980  2022年05月

Direct clipping using underwater inversion method for colonic diverticular bleeding.

Mitsunobu Saito, Gota Sudo, Shun Takai, Atsushi Yawata, Hiroshi Nakase

VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy   7 ( 5 ) 187 - 189  2022年05月  [国際誌]

　概要を見る

Video 1Endoscopic direct clipping using an underwater inversion method for diverticular bleeding in the descending colon.

DOI PubMed

Positive Pattern Recognition System Using Alanine Aminotransferase, Type IV Collagen 7s, and E Value (Liver Stiffness) for the Diagnosis of Nonalcoholic Steatohepatitis Based on Natural History.

Masayuki Tsujisaki, Shigeru Sasaki, Noriyuki Akutsu, Takenori Takamura, Tetsuyuki Igarashi, Mitsuru Yoshimoto, Hideto Itoh, Yoshio Kurihara, Hiroshi Nakase

JMA journal   5 ( 2 ) 230 - 239  2022年04月  [国内誌]

　概要を見る

Introduction: The use of a simple diagnostic system for nonalcoholic fatty liver disease (NAFLD) instead of a biopsy is expected. We investigated a positive pattern recognition system for the evaluation of nonalcoholic fatty liver (NAFL) and the stages of nonalcoholic steatohepatitis (NASH). Methods: A total of 68 Japanese patients with biopsy-confirmed NAFLD were enrolled. Serological biomarkers and medical imaging markers were investigated to determine candidate markers. The markers were statistically evaluated, and the patients were distributed to pattern combinations. Results: We selected three markers based on natural history and set the critical values: alanine aminotransferase/ALT (persistent ≧ 44 IU/L) as a marker for hepatitis, type IV collagen 7S (≧5.1 ng/mL) for fibrosis, and E value (≧5.5 kPa) for stiffness. After evaluation of statistical accuracies, every patient was classified into their combination patterns. Comparing the relationships between histological classifications and positive patterns, the patients with NAFL were mainly distributed in pattern (ALT, type IV collagen, E value: -, -, -), those with NASH stage 0-1 in (+, -, +), those with NASH stage 2-3 in (+, +, +), and those with NASH stage 4 in (-, +, +). Conclusions: The positive patters changed with the NAFL and NASH conditions. Our results indicated a correlation between the positive patterns using three markers and the histological results. The positive pattern recognition system based on natural history is useful for the differential diagnosis of NAFLD and for the evaluation of the severity of fibrosis in patients with NASH.

DOI PubMed

Extensive mucosal sloughing of the small intestine and colon in a patient with severe COVID‐19

Tsukasa Yamakawa, Keisuke Ishigami, Ayumu Takizawa, Yumemi Takada, Sae Ohwada, Yoshihiro Yokoyama, Tomoe Kazama, Daisuke Hirayama, Shinji Yoshii, Hiro‐O Yamano, Rina Ohizumi, Naofumi Bunya, Taro Sugawara, Mitsuhiro Tsujiwaki, Shintaro Sugita, Satoshi Takahashi, Eichi Narimatsu, Hiroshi Nakase

DEN Open ( Wiley )  2 ( 1 )  2022年04月

DOI

胆膵癌におけるEUS-FNA検体を用いたMSI検査

川上 裕次郎, 本谷 雅代, 仲瀬 裕志, 我妻 康平, 沼田 泰尚, 石上 敬介, 柾木 喜晴, 室田 文子, 阿久津 典之

Gastroenterological Endoscopy ( (一社)日本消化器内視鏡学会 )  64 ( Suppl.1 ) 766 - 766  2022年04月

ESD、EMRと比較した大腸hybrid ESDの位置付け メタアナリシスによる解析

吉井 新二, 菊地 剛史, 林 優希, 三宅 高和, 大和田 紗枝, 平山 大輔, 菅野 伸一, 風間 友江, 野島 正寛, 山野 泰穂, 仲瀬 裕志

Gastroenterological Endoscopy ( (一社)日本消化器内視鏡学会 )  64 ( Suppl.1 ) 756 - 756  2022年04月

スライディングチューブを併用した経大腸EUS-FNA

谷口 正浩, 川上 裕次郎, 沼田 有斗, 越前 栄次朗, 我妻 康平, 沼田 泰尚, 石上 敬介, 柾木 喜晴, 室田 文子, 本谷 雅代, 仲瀬 裕志

Gastroenterological Endoscopy ( (一社)日本消化器内視鏡学会 )  64 ( Suppl.1 ) 830 - 830  2022年04月

術後5年目に発症した肝門部胆管癌大腸転移の1例

浪岡 万由子, 本谷 雅代, 世戸 凌太, 我妻 康平, 川上 裕次郎, 柾木 喜晴, 石上 敬介, 室田 文子, 沖田 憲司, 木村 康利, 竹政 伊知朗, 仲瀬 裕志

日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集 ( 日本消化器病学会-北海道支部 )  130回・124回   48 - 48  2022年03月

Interim analysis of a multicenter registry study of COVID-19 patients with inflammatory bowel disease in Japan (J-COSMOS).

Hiroshi Nakase, Yuki Hayashi, Daisuke Hirayama, Takayuki Matsumoto, Minoru Matsuura, Hideki Iijima, Katsuyoshi Matsuoka, Naoki Ohmiya, Shunji Ishihara, Fumihito Hirai, Daiki Abukawa, Tadakazu Hisamatsu

Journal of gastroenterology   57 ( 3 ) 174 - 184  2022年03月  [国内誌]

　概要を見る

BACKGROUND: The spread of coronavirus disease 2019 (COVID-19) had a major impact on the health of people worldwide. The clinical background and clinical course of inflammatory bowel disease (IBD) among Japanese patients with COVID-19 remains unclear. METHODS: This study is an observational cohort of Japanese IBD patients diagnosed with COVID-19. Data on age, sex, IBD (classification, treatment, and activity), COVID-19 symptoms and severity, and treatment of COVID-19 were analyzed. RESULTS: From 72 participating facilities in Japan, 187 patients were registered from June 2020 to October 2021. The estimated incidence of COVID19 in Japanese IBD patients was 0.61%. The majority of IBD patients with COVID-19 (73%) were in clinical remission. According to the WHO classification regarding COVID-19 severity, 93% (172/184) of IBD patients had non-severe episodes, while 7% (12/184) were severe cases including serious conditions. 90.9% (165/187) of IBD patients with COVID-19 had no change in IBD disease activity. A logistic regression analysis stepwise method revealed that older age, higher body mass index (BMI), and steroid use were independent risk factors for COVID-19 severity. Six of nine patients who had COVID-19 after vaccination were receiving anti-tumor necrosis factor (TNF)-α antibodies. CONCLUSION: Age, BMI and steroid use were associated with COVID-19 severity in Japanese IBD patients.

DOI PubMed

病態解明による大腸腫瘍診療の新展開 早期大腸がん浸潤先進部の分子解析による新規バイオマーカー・治療標的の探索

須藤 豪太, 鈴木 拓, 仲瀬 裕志

日本消化器病学会雑誌 ( (一財)日本消化器病学会 )  119 ( 臨増総会 ) A104 - A104  2022年03月

高齢者に対する内視鏡的胃粘膜下層剥離術の偶発症における予後予測因子の検討

三宅 高和, 吉井 新二, 谷口 正浩, 大和田 紗恵, 風間 友江, 平山 大輔, 菅野 伸一, 山野 泰穂, 仲瀬 裕志

日本消化器病学会雑誌 ( (一財)日本消化器病学会 )  119 ( 臨増総会 ) A336 - A336  2022年03月

治療困難肝内結石に対するSpyGlass DSを用いた胆道鏡下治療の検討

越前 栄次朗, 川上 裕次郎, 我妻 康平, 沼田 泰尚, 石上 敬介, 柾木 喜晴, 室田 文子, 阿久津 典之, 本谷 雅代, 佐々木 茂, 仲瀬 裕志

日本消化器病学会雑誌 ( (一財)日本消化器病学会 )  119 ( 臨増総会 ) A372 - A372  2022年03月

胆道鏡下生検検体で遺伝パネル検査を施行しえた切除不能胆嚢管癌の1例

越前 栄次朗, 川上 裕次郎, 我妻 康平, 沼田 泰尚, 石上 敬介, 柾木 喜晴, 室田 文子, 阿久津 典之, 本谷 雅代, 佐々木 茂, 杉田 真太郎, 櫻井 晃洋, 仲瀬 裕志

日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集 ( 日本消化器病学会-北海道支部 )  130回・124回   58 - 58  2022年03月

転移性肺腫瘍に対するEUS-FNAにて診断した後腹膜原発の絨毛癌の1例

廣部 洋輔, 川上 裕次郎, 越前 栄次朗, 我妻 康平, 沼田 泰尚, 石上 敬介, 柾木 喜晴, 室田 文子, 阿久津 典之, 本谷 雅代, 佐々木 茂, 辻脇 光洋, 舛森 直哉, 仲瀬 裕志

日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集 ( 日本消化器病学会-北海道支部 )  130回・124回   45 - 45  2022年03月

当科における免疫関連大腸炎の検討

大和田 紗恵, 三宅 高和, 風間 友江, 平山 大輔, 菅野 伸一, 吉井 新二, 山野 泰穂, 仲瀬 裕志

日本消化器病学会雑誌 ( (一財)日本消化器病学会 )  119 ( 臨増総会 ) A390 - A390  2022年03月