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Efficacy of mosapride citrate with polyethylene glycol solution for colonoscopy preparation

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World Journal of Gastroenterology 2012年第20期18卷 2517-2525页

作者： Masahiro Tajika Yasumasa Niwa Vikram Bhatia Hiroki Kawai Shinya Kondo Akira Sawaki Nobumasa Mizuno kazuo hara Susumu Hijioka Kazuya Matsumoto Yuji Kobayashi Akira Saeki Asana Akabane Koji Komori Kenji Yamao Department of Endoscopy Aichi Cancer Center Hospital Nagoya 464-8681Japan Department of Medical Hepatology Institute of Liver and Biliary SciencesNew Delhi 110070India Department of Gastroenterology Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Gastroenterological Surgery Aichi Cancer Center HospitalNagoya 464-8681Japan

AIM:To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy. METHODS:We conducted a randomized,double-blind, placebo-controlled study with mosapride in addition to polyethylene glycol(PEG)-electrolyte *** 250 patients undergoing colonoscopy,124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate (mosapride group),and 126 received 2 L PEG plus placebo(placebo group).Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation *** efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick's *** primary end point was optimal bowel preparation rates(scores of excellent/good/fair vs poor/inadequate). RESULTS:A total of 249 patients were included in the *** the mosapride group,optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group(78.2%vs 65.6%,P<0.05),but not in the right colon(76.5%vs 66.4%,P=0.08).After excluding patients with severe constipation,there was a significant difference in bowel preparation in both the left and right colon(82.4%vs 66.7%,80.8%vs 67.5%,P<0.05,P<0.01).The incidence of adverse events was similar in both groups. Among the subgroup who had previous colonoscopy experience,a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group(34/72 patients vs 24/74 patients,P<0.05). CONCLUSION:Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation,especially in patients without severe constipation.

关键词：枸橼酸莫沙必利结肠镜乙二醇溶液检查疗效电解质溶液聚乙二醇 PEG

Different Magnetic Resonance Imaging Manifestations of Diabetic Chorea in a Case with Hyperglycemia and Another One with Hypoglycemia

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Case Reports in Clinical Medicine 2018年第3期7卷 220-224页

作者： Hodaka Yamada Rika Saikawa Suzuki Daisuke Yuko Matsumoto Masashi Yoshida kazuo hara Department of Medicine Division of Endocrinology and Metabolism Jichi Medical University Saitama Medical Center Saitama Japan

Diabetic chorea (DC) is a rare complication of diabetes. Here we describe two cases of DC;patient 1 was an 87-year-old woman with chronic kidney disease and was administered with sulphonylurea and dipeptidylpeptodase-4 inhibitor. She showed right side hemiballismus and head magnetic resonance imaging T1-weighted images revealed a high intensity area in the putamen and caudate nucleus. Patient 2 was a 51-year-old woman who was diagnosed with diabetic ketoacidosis. She showed right side hemiballism and multiple, small hyperintense regions in both the periventricular sides in diffusion weighted images. Based on the hemiballism, we concluded a diagnosis of DC in the diabetic patient, although the case presentation is rare or has atypical MRI findings.

关键词： Diabetes Mellitus Hyperglycemia Magnetic Resonance Imaging Hemi-ballism

Clinical relevance of fluorodeoxyglucose positron emission tomography/computed tomography and magnifying endoscopy with narrow band imaging in decision-making regarding the treatment strategy for esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2019年第46期25卷 6767-6780页

作者： Kazuhiro Toriyama Masahiro Tajika Tsutomu Tanaka Makoto Ishihara Yutaka Hirayama Sachiyo Onishi Nobumasa Mizuno Takamichi Kuwahara Nozomi Okuno Shinpei Matsumoto Eiichi Sasaki Tetsuya Abe Yasushi Yatabe kazuo hara Keitaro Matsuo Tsuneo Tamaki Yasumasa Niwa Department of Gastroenterology Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Endoscopy Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Gastroenterology Anjo Kosei HospitalAnjo 446-8602Japan Department of Pathology and Molecular Diagnostics Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Gastroenterological Surgery Aichi Cancer Center HospitalNagoya 464-8681Japan Division of Cancer Epidemiology and Prevention Aichi Cancer Center Research InstituteNagoya 464-8681Japan East Nagoya Imaging Diagnosis Center Nagoya 464-0044Japan

BACKGROUND Recent advances in endoscopic technology,especially magnifying endoscopy with narrow band imaging(ME-NBI)enable us to detect superficial esophageal squamous cell carcinoma(ESCC),but determining the appropriate method of resection,endoscopic resection(ER)vs surgical resection,is often ***,several studies have reported that 18F-fluorodeoxyglucose positron emission tomography(FDG-PET)is a useful indicator for decision-making regarding treatment for superficial ***,there are not enough reports on association between FDG-PET uptake and clinicopathological characteristics of superficial ***,there are not enough reports on evaluating the usefulness of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial *** study evaluated clinical relevance of FDG-PET and ME-NBI in decision-making regarding the treatment strategy for *** To investigate the association between FDG uptake and the clinicopathological characteristics of superficial ESCC and its usefulness of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial *** A database of all patients with superficial ESCC who had undergone both MENBI and FDG-PET for pre-treatment staging at Aichi Cancer Center Hospital between January 2008 and November 2018 was retrospectively *** uptake was defined positive or negative whether the primary lesion was visualized or could be distinguished from the background,or *** invasion depth of ESCC was classified according to the Japan Esophageal *** endpoint is to evaluate the association between FDG uptake and clinicopathological characteristics of superficial *** endpoint is to investigate the efficacy of combination of FDG-PET and ME-NBI for determining the treatment strategy for superficial *** A total of 82 lesions in 82 patients were ***-PET showed positive uptake in 29(35.4%)*** analysis sh

关键词： ^18F-fluorodeoxyglucose positron emission tomography Magnifying endoscopy Narrow band imaging Superficial esophageal cancer Squamous cell carcinoma Treatment strategy

Use of color Doppler ultrasonography in the diagnosis of anomalous connection in pancreatobiliary disease

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World Journal of Gastroenterology 2005年第7期11卷 1018-1022页

作者： Hiroki Kawashima Yoshiki Hirooka Akihiro Itoh Senju Hashimoto Terutomo Itoh kazuo hara Akira Kanamori Naoki Ohmiya Yasumasa Niwa Hidemi Goto Department of Gastroenterology Department of Endoscopy

AIM: To estimate the detectability of anomalous connection in pancreatobiliary disease (ACPBD) cases, measuring gallbladder wall blood flow (GWBF).METHODS: In the retrospective study, we enrolled 42subjects with gallbladder wall thickening. GWBF velocity was determined as an average value of the peak velocity of color signals on the gallbladder wall, three times in each case. Based on the findings on endoscopic ultrasonography (EUS) or endoscopic retrograde cholangiopancreatography (ERCP), the 42 subjects were divided into 11 cases with ACPBD and 31 cases without ACPBD. In the prospective study, the subjects were 92 cases with gallbladder wall thickening. Using the cut-off level of the flow velocity obtained in the retrospective study, the usefulness of measuring GWBF velocity in diagnosing ACPBD was ***: In the retrospective study, imaging of GWBF was obtained in 40 of the 42 subjects. The mean GWBF velocity of the ACPBD cases was 29.4±3.9 cm/s(mean±SD), which was significantly different (P＜0.0001;95% CI 5.48-13.2) from that of the without ACPBD cases(20.1±5.9 cm/s). Based on this result, we prepared a receiver operating characteristic curve, and the cut-off level appropriate for diagnosing ACPBD was estimated to be 25 cm/s. In the prospective study, GWBF was detected in 86 of the 92 subjects. Based on the EUS or ERCP findings, the 92 subjects were divided into 15 cases with ACPBD and 77 cases without ACPBD. When a cut-off level of 25 cm/s was employed, ACPBD could be diagnosed with a sensitivity of 87.0% (13/15) and a specificity of87.3% (62/71).CONCLUSION: Measurement of GWBF velocity, which is less invasive and provides objective values, is very useful for diagnosing ACPBD prior to the development of malignant tumors in cases with gallbladder wall thickening.

关键词：彩色多普勒超声胰腺疾病超声诊断胆囊壁血液流动学

Can mosapride citrate reduce the volume of lavage solution for colonoscopy preparation?

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World Journal of Gastroenterology 2013年第5期19卷 727-735页

作者： Masahiro Tajika Yasumasa Niwa Vikram Bhatia Shinya Kondo Tsutomu Tanaka Nobumasa Mizuno kazuo hara Susumu Hijioka Hiroshi Imaoka Koji Komori Kenji Yamao Department of Endoscopy Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Medical Hepatology Institute of Liver and Biliary SciencesNew Delhi 110070India Department of Gastroenterology Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Gastroenterological surgery Aichi Cancer Center HospitalNagoya 464-8681Japan

AIM:To evaluate the possibility of reducing the volume of polyethylene glycol(PEG)-electrolyte solution using adjunctive mosapride citrate for colonoscopy preparation. METHODS:This was a single-center,prospective, randomized,investigator-blinded,non-inferiority study involving 252 patients of both sexes,aged from 20 to 80 years,scheduled for screening or diagnostic colonoscopy in our department.A total of 126 patients was randomized to receive 1.5 L PEG-electrolyte solution plus 15 mg of mosapride(1.5 L group),and 126 received 2 L PEG-electrolyte solution plus 15 mg of mosapride(2 L group).Patients completed a questionnaire on the acceptability and tolerability of the bowel preparation *** efficacy of bowel preparation was assessed using a 5-point scale based on the Aronchick *** primary end point was adequate bowel preparation rates(score of excellent/good/fair) vs(poor/inadequate).Acceptability and tolerability,as well as disease detection,were secondary end points. RESULTS:A total of 244 patients was included in the *** were no significant differences between the 2 L and 1.5 L groups in age,sex,body mass index, number of previous colonoscopies,and the preparation method used *** adequate bowel preparation rates were 88.5%in the 2 L group and 82.8%in the 1.5 L group[95%lower confidence limit(LCL)for the difference=-14.5%,non-inferiority P=0.019]in the right *** the left colon,the adequate bowel preparation rates were 89.3%in the 2 L group and 81.1%in the 1.5 L group(95%LCL=-17.0%,non-inferiority P=0.066).Compliance,defined as complete (100%)intake of the PEG solution,was significantly higher in the 1.5 L group than in the 2 L group(96.8% vs 85.7%,P=0.002).The proportion of abdominal distension(none/mild/moderate/severe)was significantly lower in the 1.5 L group than in the 2 L group (36/65/22/3 vs 58/48/18/2,P=0.040).Within the subgroup who had undergone colonoscopy previously, a significantly higher number of patients in t

关键词： Mosapride citrate Bowel preparation Polyethylene glycol-electrolyte solution Prokinetics Colonoscopy

endoscopic ultrasonography-guided biliary drainage:Who,when,which,and how?

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World Journal of Gastroenterology 2016年第3期22卷 1297-1303页

作者： kazuo hara Kenji Yamao Nobumasa Mizuno Susumu Hijioka Hiroshi Imaoka Masahiro Tajika Tutomu Tanaka Makoto Ishihara Nozomi Okuno Nobuhiro Hieda Tukasa Yoshida Yasumasa Niwa Department of Gastroenterology Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Endoscopy Aichi Cancer Center HospitalNagoya 464-8681Japan

Both endoscopic ultrasonography(EUS)-guided choledochoduodenostomy( EUS- CDS) and EUS-guided hepaticogastrostomy(EUS-HGS) are relatively well established as alternatives to percutaneous transhepatic biliary drainage(PTBD). Both EUSCDS and EUS-HGS have high technical and clinical success rates(more than 90%) in high-volume centers. Complications for both procedures remain high at 10%-30%. Procedures performed by endoscopists who have done fewer than 20 cases sometimes result in severe or fatal complications. When learning EUSguided biliary drainage(EUS-BD), we recommend a mentor's supervision during at least the first 20 cases. For inoperable malignant lower biliary obstruction, a skillful endoscopist should perform EUS-BD before EUS-guided rendezvous technique(EUS-RV) and PTBD. We should be select EUS-BD for patients having altered anatomy from malignant tumors before balloon-enteroscope-assisted endoscopic retrograde cholangiopancreatography, EUS-RV, and PTBD. If both EUS-CDS and EUS-HGS are available, we should select EUS-CDS, according to published data. EUSBD will potentially become a first-line biliary drainage procedure in the near future.

关键词： endoscopic ultrasonography endoscopicultrasonography-guided biliary drainage Interventionalendoscopic ultrasonography endoscopic ultrasonography-guided choledochoduodenostomy endoscopicultrasonography-guided rendezvous technique

Interventional endoscopic ultrasonography for pancreatic cancer

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World Journal of Clinical Oncology 2011年第2期2卷 108-114页

作者： kazuo hara Kenji Yamao Nobumasa Mizuno Susumu Hijioka Akira Sawaki Masahiro Tajika Hiroki Kawai Shinya Kondo Yasuhiro Shimizu Yasumasa Niwa Department of Gastroenterology Aichi Cancer Center HospitalNagoya 464-8681Japan Department of Gastrointestinal Surgery Aichi Cancer Center HospitalNagoya 464-8681Japan

Endoscopic ultrasonography(EUS)represents the combination of endoscopy and intraluminal *** allows use of a high-frequency transducer(5-20 MHz)that,due to the short distance to the target lesion,provides ultrasonographic images of higher resolution than those obtained from other imaging modalities,including multiple-detector-row-computed tomography,magnetic resonance imaging,and positron emission *** is now a widely accepted modality for diagnosing pancreatic ***,the most important limitation of EUS has been the lack of specificity in differentiating between benign and malignant *** 1992,EUS-guided fine needle aspiration(FNA)of lesions in the pancreas head was introduced into clinical practice,using a curved linear-array *** then,EUS has evolved from EUS imaging to EUSFNA and wider *** EUS for pancreatic cancer includes EUS-FNA,EUS-guided fine needle injection,EUS-guided biliary drainage and anastomosis,EUS-guided celiac neurolysis,radiofrequency ablation,brachytherapy,and delivery of a growing number of anti-tumor *** review focuses on interventional EUS,including EUS-FNA and therapeutic EUS for pancreatic cancer.

关键词： Endoscopic ultrasonography-biliary drainage Endoscopic ultrasonography-choledochoduodenostomy Endoscopic ultrasonography-fine needle aspiration Endoscopic ultrasonography-guided biliary drainage Interventional endoscopic ultrasonography

A case of EGFR mutation-positive lung adenocarcinoma in which the T790M allele fraction was increased by repeated EGFR-TKI treatment

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Cancer Communications 2019年第1期39卷 593-597页

作者： Hideharu Kimura Yoshiaki Amino Hayato Koba Yuichi Tambo Noriyuki Ohkura Johsuke hara Takashi Sone kazuo Kasahara Department of Respiratory Medicine Kanazawa University HospitalTakara-machi 13-1KanazawaIshikawa 920-8641Japan Regional Respiratory Symptomatology Kanazawa University Graduate School of Medical ScienceKanazawaIshikawa 920-8641Japan Respiratory Medicine Institute of MedicalPharmaceutical and Health SciencesKanazawa University Faculty of MedicineKanazawaIshikawa 920-8641Japan

Dear editor,The current treatment strategy for advanced non-small cell lung cancer(NSCLC)patients harboring epider-mal growth factor receptor(EGFR)mutations involves EGFR-tyrosine kinase inhibitors(EGFR-TKIs).Several reports on EGFR-TKI resistance have shown that the T790M mutation within the EGFR gene is present in approximately half of the patients who develop resist-ance to a first-or second-generation EGFR-TKI[1,2].In Japan,osimertinib monotherapy is the standard therapy for patients harboring the EGFR T790M mutation arising after the development of resistance to a first-or second-generation EGFR-TKI[3,4].Herein,we report the case of a patient who underwent four tumor biopsies over the treatment *** no detection of this mutation after developing resistance to the first-line EGFR-TKI,in the fourth biopsy specimen,which was collected after progression following EGFR-TKI re-challenge,EGFR T790M mutation was detected using the cobas®EGFR mutation test(Roche Molecular Systems,Pleasanton,CA,USA).Additionally,we analyzed the T790M allele frequency(AF)in longitudinal biopsy samples obtained at four different time points using droplet digital PCR(ddPCR)(PrimePCR™,Bio-Rad Laboratories,Inc.,Her-cules,CA,USA).We discuss the clinical usefulness of longitudinal assessment of the EGFR T790M AF,espe-cially for deciding the appropriate treatment(e.g.,osi-mertinib)in patients with EGFR mutations.

关键词： TKI treatment Roche

Unresectable esophageal cancer treated with multiple chemotherapies in combination with chemoradiotherapy:A case report

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World Journal of Clinical Cases 2021年第12期9卷 2801-2810页

作者： Masahiro Yura kazuo Koyanagi Asuka hara Keita Hayashi Yuki Tajima Yasushi Kaneko Hiroto Fujisaki Akira Hirata Kiminori Takano Kumiko Hongo Kikuo Yo Kimiyasu Yoneyama Yoshifumi Tamai Reiko Dehari Motohito Nakagawa Department of Surgery Hiratsuka City HospitalKanagawa 2540065Japan Department of Gastroenterological Surgery Tokai University School of MedicineIsehara 2591193Japan Department of Radiology Hiratsuka City HospitalKanagawa 2540065Japan Department of Surgical Pathology Hiratsuka City HospitalKanagawa 2540065Japan

BACKGROUND Definitive chemoradiotherapy(dCRT)using cisplatin plus 5fluorouracil(CF)with radiation is considered the standard treatment for unresectable locally advanced T4 esophageal squamous cell carcinoma(ESCC).Recently,induction chemotherapy has received attention as an effective treatment *** SUMMARY We report a successful case of a 59-year-old female with unresectable locally advanced T4 ESCC treated by two additional courses of chemotherapy with CF after induction chemotherapy with docetaxel,cisplatin and fluorouracil(DCF)followed by *** esophagogastroduodenoscopy(EGD)detected a type 2 advanced lesion located on the middle part of the esophagus,with *** tomography detected the primary tumor with suspected invasion of the left bronchus and 90°of direct contact with the aorta,and upper mediastinal lymph node *** findings from biopsy revealed squamous cell *** initially performed induction chemotherapy using three courses of DCF,but the lesion was still evaluated unresectable after DCF ***,we subsequently performed dCRT treatment(CF and radiation).After dCRT,prominent reduction of the primary tumor was recognized but a residual tumor with ulceration was detected by *** the patient had some surgical risk,we performed two additional courses of CF and achieved a clinically complete *** 14 mo from last administration of CF chemotherapy,recurrence has not been detected by computed tomography and EGD,and biopsy from the scar formation has revealed no cancer *** We report successful case with tumor remnants even after DCF and subsequent dCRT,for whom a complete response was finally achieved with two additional courses of CF *** CF chemotherapy could be one radical treatment option for residual ESCC after treatment with induction DCF followed by dCRT to avoid salvage surgery,especially for high-risk patients.

关键词： Unresectable esophageal cancer Induction docetaxel,cisplatin and fluorouracil Chemoradiotherapy Complete response Additional chemotherapy Case report