Papers - MIHARA Hiroshi

Factors correlated with drug use for constipation: perspectives from the 2016 open Japanese National Database

Hiroshi Mihara, Aiko Murayama, Sohachi Nanjo, Takayuki Ando, Kazuto Tajiri, Haruka Fujinami, Masaaki Yamada, Ichiro Yasuda

BMC Gastroenterology ( Springer Science and Business Media LLC )  20 ( 1 ) 284 - 284  2020.12  [International journal]

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The prevalence of chronic constipation is increased in females and with age or environmental (low temperature), racial, socioeconomic, and habitual risk factors. The impact of low outside temperature on constipation drug use remains unclear. Here, we investigated risk factors for constipation drug use by evaluating data from the Japanese National Database. This ecological study used the 2016 open Japanese National Database of health insurance claims (prescriptions) to acquire the number of health insurance prescription claims in all 47 prefectures for drugs to relieve constipation, antihypertensives, vasodilators, as well as medical check-ups and questionnaire responses. Internet survey on room temperatures in 2010 were also used. Pearson correlation coefficients (r) between the number of population-based prescriptions for each item were calculated and multiple linear regression analysis (MLR) was performed. Prescriptions for magnesium laxatives significantly correlated with aging (r = 0.58), vasodilators (r = 0.53), being female (r = 0.43), antihypertensives (r = 0.39), and inversely with eating ≤2 h before bedtime (r = − 0.37), total crime rate (r = − 0.33), insomnia (r = − 0.33), and population density (r = − 0.31). Stimulant laxatives (sennoside and picosulfate) were significantly correlated with antihypertensives (r = 0.79), aging (r = 0.69), vasodilators (r = 0.67), and being female (r = 0.56), and were inversely associated with average outside temperature (r = − 0.62), total crime rate (r = − 0.52), average income (r = − 0.51), and 30-min of vigorous exercise (r = − 0.44). Fecal interventions were significantly correlated with aging (r = 0.55) and female (r = 0.59), and inversely correlated with population density (r = − 0.41) and total crime rate (r = − 0.38). MLR analysis identified aging as the only significant risk factor for magnesium laxative use (partial slope [β] = 1241.0). Female sex and antihypertensives were independent risk factors for stimulant laxative prescriptions (β = 44,547.0 and 0.2) and average outside temperature and 30-min of vigorous exercise were independent preventive factors (β = − 616.8 and − 219.1). We identified associations of magnesium laxatives with aging, stimulant laxatives with female sex, antihypertensives, low outside temperature and less 30 min of vigorous exercise.

DOI PubMed

Small intestinal mucosal injury and its risk factors in patients with gastrointestinal cancer who developed complicated fluoropyrimidine-induced diarrhea

Miho Sakumura, Takayuki Ando, Ayumu Hosokawa, Takahiko Nakajima, Iori Motoo, Hiroshi Mihara, Akira Ueda, Shinya Kajiura, Sohachi Nanjo, Haruka Fujinami, Kohei Ogawa, Ichiro Yasuda

BMC Gastroenterology ( Springer Science and Business Media LLC )  20 ( 1 ) 355 - 355  2020.12  [International journal]

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Diarrhea is a common adverse event of fluoropyrimidine-based chemotherapy. However, limited data are available on the frequency and risk factors of complicated chemotherapy-induced diarrhea (CID) and small intestinal mucosal damage. In this current study, we aimed to determine the incidence of complicated CID and mucosal injury among patients with complicated CID receiving fluoropyrimidine via small bowel capsule endoscopy (CE) and determined baseline risk factors associated with complicated CID. In total, 536 patients with advanced or recurrent gastrointestinal cancer who received fluoropyrimidine-based chemotherapy were retrospectively analyzed. Diarrhea was evaluated using the Common Terminology Criteria for Adverse Events version 4. Complicated CID was defined according to the American Society of Clinical Oncology guidelines. To evaluate small intestinal mucosal injury in patients with complicated CID, CE was performed. Multivariate analysis was performed to identify risk factors for complicated CID. Total number of 32 (6%) patients developed complicated CID. Complicating symptoms were noted in 25 (78%) patients, with cramping, vomiting, and sepsis being observed in 15 (60%), 8 (32%), and 3 (12%) patients, respectively. Among the 13 patients who underwent CE, 11 (85%) showed abnormal findings. Multivariate analysis revealed that oral fluoropyrimidine administration was a risk factor for complicated CID (odds ratio 2.95; 95% confidence interval 1.06–8.19). Despite the relatively low incidence of complicated CID, mucosal injury of small intestine was common in patients with complicated fluoropyrimidine-induced diarrhea and oral fluoropyrimidine was an independent risk factor.

DOI PubMed

特集 進化するEUS 治療的EUS WONに対する治療戦略

高橋 孝輔, 花岡 辰行, 荒木 康宏, 南條 宗八, 三原 弘, 梶浦 新也, 安藤 孝将, 藤浪 斗, 田尻 和人, 安田 一朗

消化器内視鏡 ( (株)東京医学社 )  32 ( 11 ) 1708 - 1713  2020.11

DOI

【進化するEUS】治療的EUS WONに対する治療戦略

高橋 孝輔, 花岡 辰行, 荒木 康宏, 南條 宗八, 三原 弘, 梶浦 新也, 安藤 孝将, 藤浪 斗, 田尻 和人, 安田 一朗

消化器内視鏡 ( (株)東京医学社 )  32 ( 11 ) 1708 - 1713  2020.11

BRAF変異大腸癌に対してDabrafenib+Trametinib+Panitumumabを導入した一例

後藤 柚乃, 元尾 伊織, 安藤 孝将, 三原 弘, 作村 美穂, 南條 宗八, 藤浪 斗, 梶浦 新也, 安田 一朗

日本消化器病学会北陸支部例会プログラム・抄録集 ( 日本消化器病学会-北陸支部 )  130回   43 - 43  2020.11

小腸難治性疾患の診断と治療の新知見 好酸球性胃腸炎における好酸球浸潤の部位・程度と臨床的病態・治療反応性との関連についての検討

渕野 真代, 三原 弘, 作村 美穂, 元尾 伊織, 南條 宗八, 安藤 孝将, 梶浦 新也, 藤浪 斗, 安田 一朗

日本小腸学会学術集会プログラム・抄録集 ( 日本小腸学会 )  58回   54 - 54  2020.10

進行胃癌に対するNivolumab療法における転移臓器別の治療効果に関する検討

村山 愛子, 安藤 孝将, 植田 亮, 元尾 伊織, 渕野 真代, 作村 美穂, 南條 宗八, 三原 弘, 梶浦 新也, 藤浪 斗, 安田 一朗

日本消化器病学会雑誌 ( (一財)日本消化器病学会 )  117 ( 臨増大会 ) A775 - A775  2020.10

白血球数、リンパ球数減少が潰瘍性大腸炎患者におけるトファシチニブ減量後の非再燃を予測する

渕野 真代, 南條 宗八, 高嶋 祐介, 元尾 伊織, 三原 弘, 梶浦 新也, 安藤 孝将, 藤浪 斗, 安田 一朗

日本消化器病学会雑誌 ( (一財)日本消化器病学会 )  117 ( 臨増大会 ) A760 - A760  2020.10

消化器癌に対するMSI検査の実際と今後の課題

圓谷 俊貴, 安藤 孝将, 大屋 柚乃, 渕野 真代, 小林 才人, 元尾 伊織, 高橋 孝輔, 南條 宗八, 三原 弘, 藤浪 斗, 梶浦 新也, 田尻 和人, 安田 一朗

日本消化器病学会雑誌 ( (一財)日本消化器病学会 )  117 ( 臨増大会 ) A757 - A757  2020.10

【肝胆膵における結石診療のベストプラクティス】肝外/肝内胆管結石症 ERCPによる総胆管結石治療のベストプラクティス

安田 一朗, 花岡 辰行, 高橋 孝輔, 荒木 康宏, 南條 宗八, 三原 弘, 梶浦 新也, 安藤 孝将, 藤浪 斗, 田尻 和人

肝胆膵 ( (株)アークメディア )  81 ( 2 ) 221 - 227  2020.08

【消化器疾患とステント治療】良性胆道狭窄に対するステント治療

高橋 孝輔, 安田 一朗, 圓谷 俊貴, 二日市 有花, 小林 才人, 高嶋 祐介, 元尾 伊織, 南條 宗八, 三原 弘, 梶浦 新也, 安藤 孝将, 藤浪 斗, 田尻 和人, 小松 直広, 小澤 栄介, 中尾 一彦

消化器・肝臓内科 ( (有)科学評論社 )  8 ( 1 ) 42 - 49  2020.07

クローン病におけるインフリキシマブ・バイオシミラーの有効性と安全性の検討

高嶋 祐介, 三原 弘, 元尾 伊織, 南條 宗八, 梶浦 新也, 安藤 孝将, 藤浪 斗, 安田 一朗

日本消化器病学会雑誌 ( (一財)日本消化器病学会 )  117 ( 臨増総会 ) A282 - A282  2020.07

特集 胆膵内視鏡治療におけるトラブルシューティング ERCP関連治療における偶発症予防とトラブルシューティング ERCP関連治療における留意点と偶発症

安田 一朗, 小林 才人, 高橋 孝輔, 南條 宗八, 三原 弘, 梶浦 新也, 安藤 孝将, 田尻 和人, 藤浪 斗

消化器内視鏡 ( (株)東京医学社 )  32 ( 3 ) 314 - 322  2020.03

DOI

下痢と便秘の診断:問題点と対策 ナルデメジンの使用は経口オキシコドンの最高用量を増加させるか

梶浦 新也, 近岡 伸悟, 横田 朋学, 高嶋 祐介, 南條 宗八, 三原 弘, 安藤 孝将, 藤浪 斗, 安田 一朗, 林 龍二, 富山大学附属病院緩和ケアチーム

日本消化管学会雑誌 ( (一社)日本消化管学会 )  4 ( Suppl. ) 184 - 184  2020.01

[Approaching Upper Gastrointestinal Diseases-A New Approach from Morphology and Function].

Ikuji Nigami, Tomohiro Tada, Yoshiyuki Watanabe, Hiroshi Mihara, Yamawaki

Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology   117 ( 10 ) 876 - 887  2020  [Domestic journal]

DOI PubMed

好酸球性胃腸炎における好酸球浸潤の部位・程度と臨床的病態・治療反応性との関連についての検討

渕野 真代, 三原 弘, 作村 美穂, 元尾 伊織, 南條 宗八, 安藤 孝将, 梶浦 新也, 藤浪 斗, 安田 一朗

日本小腸学会学術集会プログラム・抄録集 ( 日本小腸学会 )  4   54 - 54  2020

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【目的】好酸球性胃腸炎症例における、病理組織学的所見と臨床的病態・治療反応性との関連性について検討した。 【方法】2006年11月から2020年6月に富山大学附属病院で好酸球性胃腸炎と診断された患者33例を対象とし、臨床的・病理組織学的所見を後方視的に検討した。検討項目は患者背景（性別、年齢）、臨床症状（腹痛、嘔気、下痢、食欲不振、腹部不快感）、血液検査所見（好酸球数、CRP、IgE）、病理所見（好酸球浸潤部位・程度）及び、治療経過（治療内容、臨床的寛解の有無）であり、電子カルテから情報を抽出した。臨床的寛解の定義は症状消失とした。 【結果】男性17例、女性16例、年齢中央値35歳（10-69歳）であり、治療内容は抗アレルギー薬28例、ステロイド15例、臨床的寛解に至った症例は25例（75.7%）、自然寛解は4例（12.1％）であった。各臨床症状と好酸球浸潤部位・程度には有意な相関はみられなかった。小腸・大腸に好酸球浸潤を認める場合は有意にCRPが高かった（P=0.032、0.019）。胃好酸球浸潤数20未満/HPF群は40以上/HPF群に比べ臨床的寛解率が高く（P=0.025）、また男性で臨床的寛解率が高かった（P=0.006）。 【結論】今回の検討より男性・胃好酸球浸潤の程度は臨床的寛解予測因子になり得ること、CRP高値は小腸大腸病変を示唆する可能性があることが示唆された。

DOI CiNii

Transient Receptor Potential Vanilloid 4 Regulation of Adenosine Triphosphate Release by the Adenosine Triphosphate Transporter Vesicular Nucleotide Transporter, a Novel Therapeutic Target for Gastrointestinal Baroreception and Chronic Inflammation.

Mihara H, Boudaka A, Tominaga M, Sugiyama T

Digestion   101 ( 1 ) 6 - 11  2020  [Refereed]  [International journal]

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BACKGROUND: Transient receptor potential vanilloid 4 (TRPV4) is activated by stretch (mechanical), warm temperature, some epoxyeicosatrienoic acids, and lipopolysaccharide. TRPV4 is expressed throughout the gastrointestinal epithelia and its activation induces adenosine triphosphate (ATP) exocytosis that is involved in visceral hypersensitivity. As an ATP transporter, vesicular nucleotide transporter (VNUT) mediates ATP storage in secretory vesicles and ATP release via exocytosis upon stimulation. SUMMARY: TRPV4 is sensitized under inflammatory conditions by a variety of factors, including proteases and serotonin, whereas methylation-dependent silencing of TRPV4 expression is associated with various pathophysiological conditions. Gastrointestinal epithelia also release ATP in response to hypo-osmolality or acid through molecular mechanisms that remain unclear. These synergistically released ATP could be involved in visceral hypersensitivity. Low concentrations of the first generation bisphosphate, clodronate, were recently reported to inhibit VNUT activity and thus clodronate may be a safe and potent therapeutic option to treat visceral pain. Key Messages: This review focuses on: (1) ATP and TRPV4 activities in gastrointestinal epithelia; (2) factors that could modulate TRPV4 activity in gastrointestinal epithelia; and (3) the inhibition of VNUT as a potential novel therapeutic strategy for functional gastrointestinal disorders.

DOI PubMed

Management of Remnant or Recurrent Lesions after Endoscopic Papillectomy.

Yasuda I, Kobayashi S, Takahashi K, Nanjo S, Mihara H, Kajiura S, Ando T, Tajiri K, Fujinami H

Clinical endoscopy   53 ( 6 ) 659 - 662  2019.12  [Refereed]  [International journal]

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Endoscopic papillectomy (EP) for ampullary adenomas achieves cure rates ranging from 76% to 90%, and recurrence rates are as high as 33%. If remnant or recurrent lesions after prior EP are endoscopically visible and are not suspected of intraductal extension into the biliary or pancreatic duct, repeated snaring and cutting can be performed until all visible lesions are completely resected. However, endoscopic ablative therapies, particularly argon plasma coagulation, can be attempted for tiny or uncertain remnant and recurrent lesions. In addition, intraductal radiofrequency ablation has recently been attempted for residual intraductal lesions after EP at several institutions. Although still under investigation, it has shown some promise. It might be offered as an alternative to surgery, particularly in patients who are unfit for surgery or those who refuse to undergo surgery.

DOI PubMed

特集 結石除去を極める 総胆管結石の画像診断と標準的治療戦略

安田 一朗, 小林 才人, 高橋 孝輔, 南條 宗八, 三原 弘, 梶浦 新也, 安藤 孝将, 田尻 和人, 藤浪 斗

消化器内視鏡 ( (株)東京医学社 )  31 ( 11 ) 1601 - 1607  2019.11

DOI

Serum soluble interleukin-2 receptor levels for screening for malignant lymphomas and differential diagnosis from other conditions.

Murakami J, Arita K, Wada A, Mihara H, Origasa H, Kigawa M, Yasuda I, Sato T

Molecular and clinical oncology   11 ( 5 ) 474 - 482  2019.11  [Refereed]  [International journal]

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The serum soluble interleukin 2 receptor (sIL2R) level is elevated in patients with most types of lymphoid neoplasms, and is also elevated in patients with solid tumors or reactive conditions, such as severe inflammation. To evaluate the diagnostic significance of sIL2R levels for the screening and differential diagnosis of lymphomas, data from 248 consecutive adult patients with suspected lymphoma were retrospectively analyzed in order to determine its diagnostic characteristics and the clinical parameters that affect diagnosis. In 133 patients with aggressive or indolent lymphomas or related neoplasms, the sIL2R level was higher (median: 920 U/ml, standard deviation: 7,312 U/ml) compared with that of 115 patients with other diagnoses (median: 520 U/ml, standard deviation: 727 U/ml), including solid tumors, infection, inflammation, and others. When the cutoff value of sIL2R was 1,104 U/ml, the specificity was 80%, at which point lymphoma was suspected. When the threshold levels were increased from 1,500 to 2,000 U/ml, the specificity increased from 87 to 93%, with the positive likelihood ratio increasing from 2.99 to 4.97, strongly suggesting the diagnosis of lymphoma. The receiver operating characteristic curve for prediction of lymphoma by sIL2R revealed that the area under the curve was 0.695. The curve was nearest to the left corner of the plot when the threshold was 1,946 U/ml; at this point, the sensitivity, specificity and positive likelihood ratio were 35%, 93% and 5.06, respectively. Multivariate analysis demonstrated that an age >46 years and lactate dehydrogenase level >173 U/l appeared to increase the risk of malignant lymphoma diagnosis. Although sIL2R appears to be a less specific marker for the screening of lymphomas, its detection at higher levels strongly suggests the diagnosis of lymphomas. Therefore, sIL2R may be more useful compared with any other parameter for lymphoma diagnosis, provided other false-positive conditions are taken into consideration.

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