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Efficacy of endoluminal gastroplication in Japanese patients with proton pump inhibitor-resistant,non-erosive esophagitis

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World Journal of Gastroenterology 2012年第41期18卷 5940-5947页

作者： Kentaro Tokudome Yasushi Funaki Makoto Sasaki Shinya Izawa Yasuhiro Tamura akihito iida Naotaka Ogasawara Toshihiro Konagaya Yoshifumi Tokura Kunio Kasugai Division of Gastroenterology Department of Internal MedicineAichi Medical University School of MedicineAichi 480-1195Japan Department of Clinical Laboratory Aichi Medical University School of MedicineAichi 480-1195Japan Marine Clinic NagoyaAichi 460-0002Japan Tokura Yoshifumi Stomach and Intestines Internal Medicine Clinic Kyoto 615-8256Japan

AIM:To evaluate the efficacy,safety,and long-term outcomes of endoluminal gastroplication(ELGP) in patients with proton pump inhibitor(PPI)-resistant,nonerosive reflux disease(NERD).METHODS:The subjects were NERD patients,diagnosed by upper endoscopy before PPI use,who had symptoms such as heartburn or reflux sensations two or more times a week even after 8 wk of full-dose PPI *** to ELGP,while continuing full-dose PPI medication,patients' symptoms and quality of life(QOL) were assessed using the questionnaire for the diagnosis of reflux disease,the frequency scale for symptoms of gastro-esophageal reflux disease(FSSG),gastrointestinal symptoms rating scale,a 36-item *** addition,24-h esophageal pH monitoring or 24-h intraesophageal pH/impedance(MII-pH) monitoring was *** Bard EndoCinch TM was used for ELGP,and 2 or 3 plications were *** ELGP,all acid reducers were temporarily discontinued,and medication was resumed depending on the development and severity of *** mo after ELGP,symptoms,QOL,pH or MII-pH monitoring,number of plications,and PPI medication were ***,symptoms,number of plications,and PPI medication were evaluated 12 mo after ELGP to investigate long-term ***:The mean FSSG score decreased significantly from before ELGP to 3 and 12 mo after ELGP(19.1 ± 10.5 to 10.3 ± 7.4 and 9.3 ± 9.9,P < 0.05,respectively).The total number of plications decreased gradually at 3 and 12 mo after ELGP(2.4 ± 0.8 to 1.2 ± 0.8 and 0.8 ± 1.0,P < 0.05,respectively).The FSSG scores in cases with no remaining plications and in cases with one or more remaining plications were 4.4 and 2.7,respectively,after 3 mo,and 2.0 and 2.8,respectively,after 12 mo,showing no correlation to plication *** pH monitoring,there was no difference in the percent time pH < 4 from before ELGP to 3 mo *** monitoring revealed no changes in the number of reflux episodes or the symptom index for reflux events from bef

关键词：质子泵抑制剂患者食管腔内糜烂药物治疗耐药日本

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Inhibition of gastric perception of mild distention by omeprazole in volunteers

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World Journal of Gastroenterology 2012年第39期18卷 5576-5580页

作者： akihito iida Hiroshi Kaneko Toshihiro Konagaya Yasushi Funaki Kentaro Tokudome Shinya Izawa Yasuhiro Tamura Mari Mizuno Naotaka Ogasawara Makoto Sasaki Kunio Kasugai Division of Gastroen-terology Department of Internal MedicineSchool of MedicineAichi Medical UniversityAichi 480-1195Japan Department of Internal Medicine Hoshigaoka Maternity HospitalAichi 464-0026Japan Marine Clinic NagoyaAichi 460-0002Japan

AIM:To evaluate the effects of omeprazole on gastric mechanosensitivity in humans. METHODS:A double lumen polyvinyl tube with a plastic bag was introduced into the stomach of healthy volunteers under fluorography and connected to a barostat device. Subjects were then positioned so they were sitting comfortably, and the minimal distending pressure (MDP) was determined after a 30-min adaptation period. Isobaric distensions were performed in stepwise increments of 2 mmHg (2 min each) starting from the MDP. Subjects were instructed to score feel-ings at the end of every step using a graphic rating scale:0, no perception; 1, weak/vague; 2, weak but significant; 3, moderate/vague; 4, moderate but signifi-cant; 5, severe discomfort; and 6, unbearable pain. After this first test, subjects received omeprazole (20 mg, after dinner) once daily for 1 wk. A second test was performed on the last day of treatment. RESULTS:No adverse effects were observed. Mean MDP before and after treatment was 6.3 ± 0.3 mmHg and 6.2 ± 0.5 mmHg, respectively. One subject before and 2 after treatment did not reach a score of 6 at the maximum bag volume of 750 mL. After omeprazole, there was a significant increase in the distension pres-sure required to reach scores of 1 (P = 0.019) and 2 (P = 0.017) as compared to baseline. There were no changes in pressure required to reach the other scores after treatment. Two subjects before and one after omeprazole rated their abdominal feeling < 1 at MDP, and mean (± SE) abdominal discomfort scores at MDP were 0.13 ± 0.09 and 0.04 ± 0.04, respectively. Mean scores induced by each MDP + 2, 4, 6, 8, 10, 12, 14, 16, 18 and 20 (mmHg) were 1.1 ± 0.3, 2.0 ± 0.4, 2.9 ± 0.5, 3.3 ± 0.4, 4.6 ± 0.3, 5.2 ± 0.3, 5.5 ± 0.2, 5.5 ± 0.3, 5.7 ± 0.3, and 5.4, respectively. After omepra-zole, abdominal feeling scores for the same incremental pressures over MDP were 0.3 ± 0.1, 0.8 ± 0.1, 2.0 ± 0.4, 2.8 ± 0.4, 3.8 ± 0.4, 4.6 ± 0.4, 4.9 ± 0.3, 5.4 ± 0.4, 5.2 ± 0.6, and 5.0 ± 1.0, re

关键词：奥美拉唑志愿者胃癌毫米汞柱 MDP 评价等级聚乙烯醇不良反应

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Pathophysiology of functional heartburn based on Rome Ⅲ criteria in Japanese patients

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World Journal of Gastroenterology 2015年第16期21卷 5009-5016页

作者： Yasuhiro Tamura Yasushi Funaki Shinya Izawa akihito iida Yoshiharu Yamaguchi Kazunori Adachi Naotaka Ogasawara Makoto Sasaki Hiroshi Kaneko Kunio Kasugai Department of Gastroenterology Division of Internal MedicineAichi Medical University School of Medicine Department of Clinical Laboratory Aichi Medical University School of Medicine Department of Internal Medicine Hoshigaoka Maternity Hospital

AIM:To investigate the pathophysiology of functional heartburn(FH) in Japanese ***:A total of 111 patients with proton pump inhibitor(PPI)-refractory non-erosive gastroesophageal reflux disease underwent intraesophageal pressure testing and 24-h multichannel intraluminal impedancep H(24MII-p H) *** patients also completed several questionnaires while they were receiving the PPI treatment, including the questionnaire for the diagnosis of reflux disease(QUEST), the frequency scale for the symptoms of gastroesophageal reflux disease(FSSG), the gastrointestinal symptoms rating scale(GSRS), SF-36, and the Cornell Medical Index(CMI).The subjects were classified into FH and endoscopy-negative reflux disease(ENRD) groups based on the Rome Ⅲ ***:Thirty-three patients with esophageal motility disorder were excluded from this study, while 22 patients with abnormal esophageal acid exposure time(p H-POS) and 34 with hypersensitive esophagus(HE) were included in the ENRD *** FH group included 22 patients with no reflux ***, age, and body mass index did not differ significantly between the *** mean SF-36 values were < 50(normal) for all scales in these groups, with no significant *** GSRS scores in these groups were not different and showed overlap with other gastrointestinal *** QUEST and the FSSG scores did not differ significantly between the *** was diagnosed using the CMI questionnaire in 17 of the 78 included subjects within the p H-POS(n=4),HE(n=8),and FH(n=5)groups,with no significant ***:Clinical characteristics of the FH and PPI-refractory ENRD groups were ***,esophageal function should be examined via manometry and 24MII-p H testing to differentiate between them.

关键词： Functional heartburn endoscopy-negativereflux disease proton pump inhibitor-resistant RomeⅢ criteria 24-h multichannel intraluminal impedancepHtesting

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Cerebral Infarction after Spine Surgery: Report of Two Cases

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Open Journal of Orthopedics 2013年第4期3卷 204-207页

作者： Katsunori Fukutake Hiroshi Takahashi Yuichiro Yokoyma Yasuaki iida Ryo Takamatsu Kazumasa Nakamura akihito Wada Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan.

There has been an increase in spinal surgery for the elderly, with a corresponding potential increase in perioperative complications. In our department, 1833 patients underwent spinal surgery under general anesthesia from April 2001 to October 2012, and 2 of 260 patients aged ≥75 years old had postoperative cerebral infarction. An analysis of the pathogenic mechanism and potential risk factors showed that a history of cerebral infarction was a significant risk factor. Blood pressure rapidly increased on arousal from anesthesia, and particularly on extubation. The change in blood pressure was examined as a potential risk factor for cerebral infarction, but no significant relationship was observed. This result requires further examination in more patients with cerebral infarction after spinal surgery.

关键词： Cerebral infarction Spine surgery Complication

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A Case of Thoracic Disc Herniation Extruded to the Dorsal Epidural Space

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Open Journal of Orthopedics 2015年第8期5卷 229-234页

作者： Shigeta Takeuchi Yuichirou Yokoyama Yasuaki iida Keiji Hasegawa akihito Wada Ryoichi Fukano Kazutoshi Shibiuya Hiroshi Takahashi Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan Department of Pathology Toho University School of Medicine Tokyo Japan

We encountered a patient with thoracic disc herniation that extruded to the dorsal epidural space. The patient was a 78-year-old man in whom listlessness of the lower limbs developed without an inducer and walking became difficult. The patient was diagnosed as having a thoracic spinal cord tumor on MRI by a physician, and was referred to our hospital. Since ring enhancement was observed on contrast MRI performed at our hospital, the patient was diagnosed with disc herniation and surgery was performed. A hernia continuous with the intervertebral space that extruded to the dorsal epidural space was excised. At the final follow up, 1 year and 4 months after surgery, the patient could walk with a cane. Among thoracic disc herniation cases, hernia extruded to the dorsal epidural space is rare and difficult to diagnose by imaging before surgery, but evaluation using contrast MRI is useful in the diagnosis. When a space-occupying lesion is observed in the spinal canal in the lower thoracic spinal region, it is necessary to evaluate it by contrast MRI in consideration of thoracic disc herniation.

关键词： Disc Hernia Dorsal Epidural Space Thoracic Spine

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Spinal Epidural Cavernous Hemangioma of the Thoracic Spine: A Case Report

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Open Journal of Orthopedics 2015年第10期5卷 311-318页

作者： Ryoichi Fukano Yasuaki iida Keiji Hasegawa Yuichirou Yokoyama akihito Wada Shigeta Takeuchi Kazutoshi Shibuya Hiroshi Takahashi Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan Department of Pathology Toho University School of Medicine Tokyo Japan

Cavernous hemangiomas can arise in any region of the body, including the central nervous system. Spinal cavernous hemangiomas account for 5% - 12% of all cases of vertebral vascular malformation. Most of these are of vertebral origin, and cases that are non-vertebral in origin are rare. We encountered a patient with a relatively rare spinal epidural cavernous hemangioma of the thoracic spine that was non-vertebral in origin. The patient was a 63-year-old man. He had become aware of bilateral leg pain and numbness about 2 months earlier, and gait disturbance appeared gradually thereafter. On MRI, a lesion showing iso-intensity on T1-weighted imaging and high intensity on T2-weighted imaging was detected at the 7th thoracic vertebra. On gadolinium contrast-imaging, the lesion was found to be a homogenously-enhanced dumbbell-shaped extradural spinal neoplasm protruding from the left 7th/8th thoracic intervertebral foramen. A neurogenic tumor was suspected based on myelography and MRI findings, and complete tumorectomy was performed, which improved the lower limb symptoms and gait disturbance. The histopathological diagnosis was cavernous hemangioma. Epidural hemangiomas arise from the vertebra in many cases, and pure spinal epidural cavernous hemangiomas are rare. It is difficult to make a preoperative diagnosis because there are no specific imaging findings that can differentiate these tumors. It may be important to consider this disease before surgery in the differential diagnosis of epidural tumors.

关键词： Epidural Cavernous Hemangioma Thoracic Spine Myelopathy

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A Case of Acute Cauda Equina Syndrome for Combined Lumbar Ossification of the Posterior Longitudinal and Yellow Ligament

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Open Journal of Orthopedics 2014年第6期4卷 145-149页

作者： Kazumasa Nakamura Yuichirou Yokoyama akihito Wada Yasuhiro Inoue Keiji Hasegawa Shintaro Tsuge Hiroshi Takahashi Yasuaki iida Department of Orthopaedic Surgery School of Medicine Toho University Tokyo Japan

Acute cauda equina syndrome is known as a symptom of lumbar disc herniation, but to date, there have been no reports of cases caused by lumbar vertebral ligament ossification. We encountered a 61-year-old female patient with acute cauda equina syndrome associated with lumbar vertebral OPLL and OLF. The symptoms were improved by emergency laminectomy. One year after the surgery, the disturbances of gait and urination have been resolved.

关键词： Lumbar Spine Ossification of the Yellow Ligament Ossification of the Posterior Longitudinal Ligament Cauda Equina Syndrome

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A Patient with Malignant Spinal Epidural Lymphoma with Initial Rapidly Aggravating Paraplegia

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Open Journal of Orthopedics 2017年第3期7卷 90-97页

作者： Taihei Go Yasuaki iida Hideyuki Aoki Shintaro Tsuge Keiji Hasegawa Yuichiro Yokoyama akihito Wada Yuri Akishima-Fukasawa Hiroshi Takahashi Department of Orthopedics Toho University Tokyo Japan

We report the case of a 51-year-old female with rapid neurological deterioration as an initial presentation of non-Hodgkin’s lymphoma. Paraplegia occurred suddenly after a 4-day history of weakness and numbness of the lower extremity. MRI revealed a dorsal epidural mass from T10 to T11 that compressed the spinal cord. There was neither bone destruction nor a paravertebral mass. Emergency decompressive laminectomy and tumor resection were performed. Histological analysis of the surgical specimen indicated diffuse large B cell lymphoma. The clinical stage was IV on CT and complete remission was achieved by subsequent chemotherapy. Spinal cord compression occurs in the course of non-Hodgkin’s lymphoma in 0.1% - 6.5% of cases, but this situation usually develops in the late phase with bone destruction and/or a paravertebral mass. Cord compression and especially the severe symptoms such as paraplegia are rare as the initial presentation of lymphoma.

关键词： Malignant Lymphoma Epidural Mass Paraplegia Thoracic Spine

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Evaluation of Conservative Treatment of Acute Fracture of the Odontoid Process of Axis with a Halo-Vest

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Open Journal of Orthopedics 2013年第7期3卷 296-299页

作者： Yuichiro Yokoyama Hiroshi Takahashi Yasuaki iida Yasuhiro Inoue Keiji Hasegawa Daisuke Suzuki Shintaro Tsuge Wataru Shishikura Katsunori Fukutake Ryo Takamatsu Kazumasa Nakamura akihito Wada Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan.

We fitted a halo-vest on patients with a fracture of the odontoid process of the axis and evaluated the effects of conservative treatment on cervical muscular atrophy and the number and type of patient complaints after bone union. Four patients had Anderson Type II fractures and 6 patients had Type III fractures. Bone union was observed in all patients within 3 months after injury. After halo-vest fitting, cervical muscular atrophy increased with time, however, it gradually improved after removal of the halo-vest. Patients fixed with a halo-vest for more than 10 weeks complained of cervical discomfort and limited range of motion. No patients with fixation for less than 10 weeks had problems in bone union or had cervical complaints. Thus, less than a 10-week fixation period was considered to be appropriate.

关键词： Fracture Odontoid Process of the Axis Halo-Vest Conservative Treatment

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Successful Treatment of Spine Fracture for Diffuse Idiopathic Skeletal Hyperostosis with Teriparatide—A Report of Two Cases

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Open Journal of Orthopedics 2013年第6期3卷 278-282页

作者： Yasuaki iida Hiroshi Takahashi Yuichiro Yokoyama Yasuhiro Inoue Daisuke Suzuki Keiji Hasegawa Shintaro Tsuge Wataru Shishikura Katsunori Fukutake Ryo Takamatsu Kazumasa Nakamura Masayuki Sekiguchi akihito Wada Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan Department of Orthopaedic Surgery Toho University School of Medicine Tokyo Japan.

We experienced 2 cases of spinal fracture in patients aged 80 years or older with diffuse idiopathic skeletal hyperostosis (DISH). Since they decided not to undergo surgical treatment, we provided conservative treatment with teriparatide. There has been no previous study on teriparatide for spine fracture in DISH. This is the first report of the successful use of teriparatide to treat spine fracture in DISH without surgical intervention. Our patients were treated with teriparatide for 8-9 months after diagnosis of the fracture. Union was obtained in two cases and no adverse events were observed during treatment. Our report showed that teriparatide could be an alternative to conventional intervention in spinal fracture of DISH.

关键词： Diffuse Idiopathic Skeletal Hyperostosis Teriparatide Spine Fracture

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