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Endoscopic diagnosis of Barrett's esophagus

World Journal of Gastroenterology 2012年第26期18卷 3477-3478页

作者： Tomoyuki Akiyama Yusuke Sekino Hiroshi Iida Shigeru Koyama eiji gotoh Shin Maeda Atsushi Nakajima Masahiko Inamori Department of Gastroenterology Tokyo Metropolitan Hiroo HospitalTokyo 150-0013Japan Gastroenterology Division Yokohama City University HospitalYokohama 2360004Japan Department of Medical Education Yokohama City University School of MedicineYokohama 2360004Japan Office of Postgraduate Medical Education Yokohama City University HospitalYokohama 2360004Japan

The Prague C and M Criteria have been developed for the objective endoscopic diagnosis of Barrett's esophagus(BE).BE arises between the squamocolumnar junction and the gastroesophageal junction at the proximal margin of the gastric *** this study,we reported that 43.0% of the subjects examined were diagnosed with BE based on the Prague C and M *** criticism by John Dent proposed that our data should be considered invalid because the prevalence of BE reported in our study was extraordinarily high and discordant with previous *** predicted that the position of the gastroesophageal junction in our study was judged to be lower than the actual position due to the effacement of the proximal ends of the gastric folds because of the routine use of a high degree of air distension during typical Japanese endoscopic *** endoscopic evaluation of the superior gastric folds is certainly influenced by the degree of air distension of the ***,in our study,the proximal limit of the gastric mucosal folds was prospectively imaged while the oesophagus was minimally ***,under a high level of air distension,the distal ends of the palisade-shaped longitudinal vessels were imaged because they are more easily observed when *** the majority of patients,the distal ends of the palisade-shaped longitudinal vessels correspond to the proximal limit of the gastric mucosal *** endoscopic evaluation was appropriately performed according to the Prague C and M *** suspect that the high prevalence of BE in our study may be due to the inclusion of ultrashort-segment BE,which defines BE with an affected mucosal length under 5 mm,in our positive results.

关键词： Barrett's esophagus Gastroesophagealjunction Squamocolumnar junction Digital endoscopicimages Endoscopy

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characteristics of intestinal pseudo-obstruction in patients with mitochondrial diseases

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World Journal of Gastroenterology 2012年第33期18卷 4557-4562页

作者： Yusuke Sekino Masahiko Inamori eiji Yamada Hidenori Ohkubo eiji Sakai Takuma Higurashi Hiroshi Iida Kunihiro Hosono Hiroki Endo Takashi Nonaka Hirokazu Takahashi Tomoko Koide Yasunobu Abe eiji gotoh Shigeru Koyano Yoshiyuki Kuroiwa Shin Maeda Atsushi Nakajima Gastroenterology Division Yokohama City University School of Medicine Yokohama 236-0004 Japan Department of Medical Education Yokohama City University School of Medicine Yokohama 236-0004 Japan Department of Neurology Yokohama City University School of Medicine Yokohama 236-0004 Japan

AIM: To reveal the frequency, characteristics and prognosis of chronic intestinal pseudo-obstruction (CIP) in mitochondrial disease patients. METHODS: Between January 2000 and December 2010, 31 patients (13 males and 18 females) were di-agnosed with mitochondrial diseases at our hospital. We conducted a retrospective review of the patients' sex, subclass of mitochondrial disease, age at onset of mitochondrial disease, frequency of CIP and the age at its onset, and the duration of survival. The age at onset or at the first diagnosis of the disorder that led to the clinical suspicion of mitochondrial disease was also examined. RESULTS: Twenty patients were sub-classified with mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS), 8 with chronic progressive external ophthalmoplegia (CPEO), and 3 with myoclonus epilepsy associated with ragged-red fibers (MERRF). Nine patients were diagnosed with CIP, 8 of the 20 (40.0%) patients with MELAS, 0 of the 8 (0.0%) patients with CPEO, and 1 of the 3 (33.3%) patients with MERRF. The median age (range) at the diagnosis and the median age at onset of mitochondrial disease were 40 (17-69) and 25 (12-63) years in patients with CIP, and 49 (17-81) and 40 (11-71) years in patients without CIP. During the survey period, 5 patients (4 patients with MELAS and 1 with CPEO) died. The cause of death was cardiomyopathy in 2 patients with MELAS, cerebral infarction in 1 patient with MELAS, epilepsy and aspiration pneumonia in 1 patient with MELAS, and multiple metastases from gastric cancer and aspiration pneumonia in 1 patient with CPEO. CONCLUSION: Patients with CIP tend to have disorders that are suspected to be related to mitochondrial diseases at younger ages than are patients without CIP.

关键词： Chronic intestinal pseudo-obstruction Criteria Mitochondrial disease Mitochondrial encephalopathy Lactic acidosis Stroke-like episodes Chronic progressive external ophthalmoplegia

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Effect of sumatriptan on gastric emptying:A crossover study using the BreathID system

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World Journal of Gastroenterology 2012年第26期18卷 3415-3419页

作者： Yasunari Sakamoto Yusuke Sekino eiji Yamada Takuma Higurashi Hidenori Ohkubo eiji Sakai Hiroki Endo Hiroshi Iida Takashi Nonaka Koji Fujita Masato Yoneda Tomoko Koide Hirokazu Takahashi Ayumu Goto Yasunobu Abe eiji gotoh Shin Maeda Atsushi Nakajima Masahiko Inamori Gastroenterology Division Yokohama City University Hospital3-9 FukuuraKanazawa-kuYokohamaKanagawa 236-0004Japan Department of Medical Education Yokohama City University School of Medicine3-9 FukuuraKanazawa-kuYokohamaKanagawa 236-0004Japan Office of Postgraduate Medical Education Yokohama City University Hospital3-9 FukuuraKanazawakuYokohamaKanagawa 236-0004Japan

AIM:To determine the effect of oral sumatriptan on gastric emptying using a continuous 13 C breath test(BreathID system).METHODS:Ten healthy male volunteers participated in this randomized,2-way crossover *** subjects fasted overnight and were randomly assigned to receive a test meal(200 kcal/200 mL) 30 min after pre-medication with sumatriptan 50 mg(sumatriptan condition),or the test meal alone(control condition).Gastric emptying was monitored for 4 h after administration of the test meal by the 13 C-acetic acid breath test performed continually using the BreathID ***,using Oridion Research Software(β version),the time taken for emptying of 50% of the labeled meal(T 1/2) similar to the scintigraphy lag time for 10% emptying of the labeled meal(T lag),the gastric emptying coefficient(GEC),and the regression-estimated constants(β and κ) were *** statistical significance of any differences in the parameters were analyzed using Wilcoxon's signed-rank ***:In the sumatriptan condition,significant differences compared with the control condition were found in T 1/2 [median 131.84 min(range,103.13-168.70) vs 120.27 min(89.61-138.25);P = 0.0016],T lag [median 80.085 min(59.23-125.89) vs 61.11 min(39.86-87.05);P = 0.0125],and β [median 2.3374(1.6407-3.8209) vs 2.0847(1.4755-2.9269);P = 0.0284].There were no significant differences in the GEC or κ between the 2 ***:This study showed that oral sumatriptan significantly delayed gastric emptying of a liquid meal.

关键词： Sumatriptan Gastric emptying Breath test Liquid meal BreathID system

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Early effects of oral administration of omeprazole and roxatidine on intragastric pH

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2012年第1期13卷 29-34页

作者： Hiroshi IIDA Shingo KATO Yusuke SEKINO eiji SAKAI Takashi UCHIYAMA Hiroki ENDO Kunihiro HOSONO Yasunari SAKAMOTO Koji FUJITA Masato YONEDA Tomoko KOIDE Hirokazu TAKAHASHI Chikako TOKORO Ayumu GOTO Yasunobu ABE Noritoshi KOBAYASHI Kensuke KUBOTA eiji gotoh Shin MAEDA Atsushi NAKAJIMA Masahiko INAMORI Gastroenterology Division Yokohama City University School of Medicine Department of Medical Education Yokohama City University School of Medicine Office of Postgraduate Medical Education Yokohama City University Hospital

Objective： The ideal medication for the treatment of acid-related diseases, e.g., peptic ulcers, stress- related gastric bleeding, functional dyspepsia, and gastroesophageal reflux disease, should have a rapid onset of action to promote hemostasis and relieve the symptoms. The aim of our study was to investigate the inhibitory effects on gastric acid secretion of a single oral administration of a proton pump inhibitor, omeprazole 20 mg, and an H2-receptor antagonist, roxatidine 75 mg. Methods： Ten Heficobacterpylori-negative male subjects participated in this randomized, two-way crossover study. Intragastric pH was monitored continuously for 6 h after single oral admini- stration of omeprazole 20 mg and roxatidine 75 mg. Each administration was separated by a 7-d washout period. Results： During the 6-h study period, the average pH after administration of roxatidine was higher than that after administration of omeprazole （median： 4.45 vs. 2.65; P=0.0367）. Also during the 6-h study period, a longer duration of maintenance at pH above 2, 5, and 6 was observed after administration of roxatidine 75 mg than after administration of omeprazole 20 mg （median： 90.6% vs. 55.2%, P=-0.0284; 43.7% vs. 10.6%, P=0.0125; 40.3% vs. 3.3%, P=0.0125; respectively）. Conclusions： In Helicobacter pylori-negative healthy male subjects, oral administration of roxatidine 75 mg increased the intragastric pH more rapidly than that of omeprazole 20 mg.

关键词： Proton pump inhibitor H2-receptor antagonist Intragastric pH Omeprazole Roxatidine

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Salt Preference and the Incidence of Cardiovascular Disease in a Japanese General Population: The Jichi Medical School Cohort Study

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Health 2016年第1期8卷 105-115页

作者： Saki Tadenuma Hideyuki Kanda Shizukiyo Ishikawa Kazunori Kayaba Tadao gotoh Yosikazu Nakamura eiji Kajii Department of Environmental Health and Public Health Faculty of Medicine Shimane University Shimane Japan Department of Anesthesiology Faculty of Medicine Shimane University Shimane Japan Division of Community and Family Medicine Center for Community Medicine Jichi Medical University Tochigi Japan Graduate School of Saitama Prefectural University Saitama Japan Wara National Health Insurance Clinic Gifu Japan Department of Public Health Jichi Medical University Tochigi Japan

Dietary salt intake has been reported to be associated with cardiovascular disease (CVD). However, there were few studies that assessed the relationship of salt preference with CVD. We examined the association between salt preference and the incidence of CVD and its subtypes in a Japanese general population. Based on the prospective Jichi Medical School Cohort Study, data were analyzed from 11,394 eligible participants. A baseline survey of the preference for salt was obtained by questionnaire and health examinations from April 1992 through July 1995 in 12 communities in Japan. The participants were followed up until December 2005 (mean follow-up period, 10.7 ± 2.4 years). Subjects were divided into three categories according to their preference for salt: favor, so-so, and disfavor. A Cox proportional hazards model was used to calculate hazard ratios (HRs) of the incidence of CVD according to the preference categories. We observed 485 cardiovascular events (258 in men and 227 in women). Among the men, the multivariable adjusted HRs for incidence of myocardial infarction and subarachnoid hemorrhage for favor versus so-so salt preference were 0.34 (95% confidence interval, 0.17 - 0.71) and 7.10 (0.88 - 56.84), respectively. Among the women, age-adjusted HRs for the incidence of CVD, total stroke, cerebral hemorrhage, and cerebral infarction for the favor preference were 1.41 (1.02 - 1.95), 1.36 (0.97 - 1.91), 1.79 (0.87 - 3.71), and 1.40 (0.89 - 2.19), respectively. The data indicated that preference for salt may be associated with an increase in the incidence of CVD in women.

关键词： Salt Preference Cardiovascular Disease Cohort Study Japanese

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