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Disease trends after Helicobacter pylori eradication based on Japanese nationwide claims and the health check-up database

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World Journal of Gastroenterology 2023年第4期29卷 692-705页

作者： Kazuhiro Mizukami kentaro sugano Tomomi Takeshima Kazunari Murakami Department of Gastroenterology Oita UniversityOita 8795593Japan Department of Medicine Jichi Medical UniversityTochigi 3290498Japan Milliman Inc. Tokyo 1020083Japan

BACKGROUND Helicobacter pylori(***)infection is a risk factor for many diseases,including peptic ulcer disease and gastric *** *** eradication therapy can prevent these diseases,potentially unfavorable effects of eradication therapy have also been reported in some diseases,such as gastroesophageal reflux disease(GERD),Barrett’s esophagus(BE),inflammatory bowel disease(IBD),allergic diseases,and metabolic ***,both positive and negative impacts should be considered when assessing the effects of *** eradication *** To compare the incidence of these diseases before and after *** eradication and to comprehensively assess its *** This retrospective cohort study used a Japanese nationwide health claims database(April 2009-March 2020),developed by the Japanese Ministry of Health,Labour and *** database contained almost all health insurance claims data issued in Japan,and specific health check-up data for individuals who took the *** statistics were used for the *** who received primary eradication therapy were defined as those prescribed medication for *** *** diagnoses,defined as incidence of upper gastrointestinal diseases and IBD,and prevalence of allergic diseases were compared before and after *** incidence and prevalence of each disease were also compared between the 3-year period before eradication(from the 4th to the 2nd year prior to the year of eradication)and the 3-year period after eradication(from the 1st to the 3rd year after the year of eradication)based on the age category and calendar year and *** in body mass index and proportion of patients with metabolic syndrome(MS)were examined before and after *** We identified 5219731 patients who received primary eradication *** 65-69 years age group had the greatest number of patients in both *** was no significant increase in the incidence

关键词： Administrative claims Healthcare Allergy Eradication therapy Gastroesophageal reflux disease Helicobacter pylori Inflammatory bowel disease

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Prevention of gastrointestinal adverse events from anti-thrombotic drugs

Prevention of gastrointestinal adverse events from anti-thro...

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2012中国消化系疾病学术大会

作者： kentaro sugano Jichi Medical University

Anti-thrombotic drugs including anti-platelet drugs and anti-coagulants have been widely used all over the world as the benefits from using anti-thrombotic drugs to prevent cardiovascular events were ***, they are associated with increased risks such as major bleedings,most frequently from the gastrointestinal(GI) *** we need to carefully evaluate the balance between the risk and benefit of an individual patient when

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Clinical outcomes of enteroscopy using the double-balloon method for strictures of the small intestine

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World Journal of Gastroenterology 2005年第7期11卷 1087-1089页

作者： Keijiro Sunada Hironori Yamamoto Hiroto Kita Tomonori Yano Hiroyuki Sato Yoshikazu Hayashi Tomohiko Miyata Yutaka Sekine Akiko Kuno Michiko Iwamoto Hirohide Ohnishi Kenichi Ido kentaro sugano Department of Internal Medicine

AIM:To evaluate the clinical outcome of enteroscopy, using the double-balloon method, focusing on the involvement of neoplasms in strictures of the small intestine. METHODS: Enteroscopy, using the double-balloon method, was performed between December 1999 and December 2002 at Jichi Medical School Hospital, 3apan and strictures of the small intestine were found in 17 out of 62 patients. These 17 consecutive patients were subjected to analysis. RESULTS: The double-balloon enteroscopy contributed to the diagnosis of small intestinal neoplasms found in 3 out of 17 patients by direct observation of the strictures as well as biopsy sampling. Surgical procedures were chosen for these three patients, while balloon dilation was chosen for the strictures in four patients diagnosed with inflammation without involvement of neoplasm. CONCLUSION: Double-balloon enteroscopy is a useful method for the diagnosis and treatment of strictures in the small bowel.

关键词： Double-balloon enteroscopy Strictures Small intestine

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Non-steroidal anti-inflammatory drug-induced small bowel injuries identified by double-balloon endoscopy

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World Journal of Gastroenterology 2005年第31期11卷 4861-4864页

作者： Yoshikazu Hayashi Hironori Yamamoto Hiroto Kita Keijiro Sunada Hiroyuki Sato Tomonori Yano Michiko Iwamoto Yutaka Sekine Tomohiko Miyata Akiko Kuno Takaaki Iwaki Yoshiyuki Kawamura Hironari Ajibe Kenichi Ido kentaro sugano Department of Internal Medicine

AIM： To clarify clinical features of the NSAID-induced sma bowel lesions using a new method of endoscopy. METHODS： This is a retrospective study and we analyzed seven patients with small bowel lesions while taking NSAIDs among 61 patients who had undergone doubleballoon endoscopy because of gastro-intestinal bleeding or anemia between September 2000 and March 2004, at .lichi Medical School Hospital in Japan. Neither conventional EGD nor colonoscopy revealed any lesions of potential bleeding sources including ulcerations. Double-balloon endoscopy was carried out from oral approach in three patients, from anal approach in three patients, and from both approaches in one patient. RESULTS： Ulcers or erosions were observed in the ileum in six patients and in the jejunum in one patient, respectively. The ulcers were multiple in all the patients with different features from tiny punched out ulcers to deep ulcerations with oozing hemorrhage or scar. All the patients recovered uneventfully and had full resolution of symptoms after suspension of the drug. CONCLUSION： NSAIDs can induce injuries in the small bowel even in patients without any lesions in both the stomach and colon.

关键词： Double-balloon endoscopy NSAIDS-inducedsmall bowel injuries

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Diagnosis of extent of early gastric cancer using flexible spectral imaging color enhancement

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World Journal of Gastrointestinal Endoscopy 2012年第8期4卷 356-361页

作者： Hiroyuki Osawa Hironori Yamamoto Yoshimasa Miura Mitsuyo Yoshizawa Keijiro Sunada Kiichi Satoh kentaro sugano Department of Internal Medicine Division of Gastroen- terology Jichi Medical University Tochigi 329-0498 Japan

The demarcation line between the cancerous lesion and the surrounding area could be easily recognized with flexible spectral imaging color enhancement (FICE) system compared with conventional white light images. The characteristic f inding of depressed-type early gastric cancer (EGC) in most cases was revealed as reddish lesions distinct from the surrounding yellowish non-cancerous area without magnification. Conventional endoscopic images provide little information regarding depressed lesions located in the tangential line, but FICE produces higher color contrast of such cancers. Histological f indings in depressed area with reddish col- or changes show a high density of glandular structure and an apparently irregular microvessel in intervening parts between crypts, resulting in the higher color con- trast of FICE image between cancer and surrounding area. Some depressed cancers are shown as whitish lesion by conventional endoscopy. FICE also can pro- duce higher color contrast between whitish cancerous lesions and surrounding atrophic mucosa. For nearly flat cancer, FICE can produce an irregular structuralpattern of cancer distinct from that of the surrounding mucosa, leading to a clear demarcation. Most elevated-type EGCs are detected easily as yellowish lesions with clearly contrasting demarcation. In some cases, a partially reddish change is accompanied on the tumor surface similar to depressed type cancer. In addition, the FICE system is quite useful for the detection of minute gastric cancer, even without magnif ication. These new contrasting images with the FICE system may have the potential to increase the rate of detection of gastric cancers and screen for them more effectively as well as to determine the extent of EGC.

关键词： Early gastric cancer Flexible spectral imag- ing color enhancement Nonmagnified image Magnified image Endoscopic submucosal dissection

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Endoscopic diagnosis of extrahepatic bile duct carcinoma:Advances and current limitations

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World Journal of Clinical Oncology 2011年第5期2卷 203-216页

作者： Kiichi Tamada Jun Ushio kentaro sugano Department of Gastroenterology and Hepatology Jichi Medical UniversityYakushijiTochigi 329-0498Japan

The accurate diagnosis of extrahepatic bile duct carcinoma is difficult,even *** ultrasonography(US)shows dilatation of the bile duct,magnetic resonance cholangiopancreatography followed by endoscopic US(EUS)is the next *** US or EUS shows localized bile duct wall thickening,endoscopic retrograde cholangiopancreatography should be conducted with intraductal US(IDUS)and forceps *** in situ hybridization increases the sensitivity of brush cytology with similar *** patients with papillary type bile duct carcinoma,three biopsies are *** patients with nodular or infiltrating-type bile duct carcinoma,multiple biopsies are warranted,and IDUS can compensate for the limitations of *** preoperative staging,the combination of dynamic multidetector low computed tomography(MDCT)and IDUS is useful for evaluating vascular invasion and cancer depth ***,assessment of lymph nodes metastases is *** resectable cases,assessment of longitudinal cancer spread is *** combination of IDUS and MDCT is useful for revealing submucosal cancer extension,which is common in hilar *** estimate the mucosal extenextension,which is common in extrahepatic bile duct carcinoma,the combination of IDUS and cholangioscopy is *** utility of current peroral cholangioscopy is limited by the maneuverability of the“baby scope”.A new baby scope(10 Fr),called“SpyGlass”has potential,if the image quality can be *** extrahepatic bile duct carcinoma is common in the Far East,many researchers in Japan and Korea contributed these studies,especially,in the evaluation of longitudinal cancer extension.

关键词： Bile duct cancer Bile duct carcinoma Cholangiocarcinoma Endoscopic retrograde cholangiopancreatography Intraductal ultrasonography

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胃癌预防亚太地区共识指南

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胃肠病学 2008年第4期13卷 231-240页

作者： Kwong Ming Fock Nick Talley Paul Moayyedi Richard Hunt Takeshi Azuma kentaro sugano Shu Dong Xiao Shiu Kum Lam Khean Lee Goh Tsutomu Chiba Naomi Uemura Jae G Kim Nayoung Kim Tiing Leong Ang Varocha Mahachai Hazel Mitchell Abdul Aziz Rani Jyh Ming Liou Ratha-korn Vilaichone Jose Sollanor 钱本余 Changi General Hospital Singapore Mayo Clinic College of Medicine Rochester USA McMaster University Medical Center Ontario Canada University of Fukui Fukui Jichi Medical University Tochigi Shanghai Institrte of Digestive Disease Shanghai University of Hong Kong Hong Kong University of Malaya Kuala Lumpur Malaysia Kyoto University Kyoto Kure Kyousai General Hospital Kure Japan Chung Ang University College of Medicine Seoul National University College of Medicine Seoul Korea Chulalongkorn University Hospital Bangkok University of New South Wales Sydney New South Wales Australia University of Indonesia Jakarta Indonesia National Taiwan University Hospital Taipei China Thammasat University Hospital Pathumthani Thailand University of Santo Tomas Manila Philippines

背景与目的:胃癌是亚太地区的主要健康负担之一,但对其预防策略尚缺乏共识。本共识会议旨在评价预防胃癌的策略。方法:多学科专家组应用德尔菲(Delphi)法制订共识条文,提呈相关数据,对证据等级、推荐强度以及共识水平予以分级。结果:幽... 详细信息

背景与目的:胃癌是亚太地区的主要健康负担之一,但对其预防策略尚缺乏共识。本共识会议旨在评价预防胃癌的策略。方法:多学科专家组应用德尔菲(Delphi)法制订共识条文,提呈相关数据,对证据等级、推荐强度以及共识水平予以分级。结果:幽门螺杆菌(***)感染是非贲门胃腺癌必要但非充分的致病因子。盐的高摄入与胃癌强烈相关。新鲜果蔬对胃癌具有预防作用,但维生素和其他饮食补充并不能预防胃癌。***感染中的宿主-细菌相互作用导致不同类型的胃炎和胃酸分泌,从而决定疾病结局。胃癌阳性家族史是一个重要的危险因素。低血清胃蛋白酶原反映胃萎缩程度,可作为检出胃癌高危人群的标志物。***筛查和治疗被推荐作为减少高危人群胃癌危险性的一种策略,该策略在萎缩性胃炎发生前实施最为有效,但并不排除对胃癌高危人群的内镜监测。对胃癌低危人群不推荐行***筛查。***感染的一线治疗应遵循国家治疗指南。结论:高危人群中***筛查和根除策略可能会减少胃癌的发生率,本共识根据现有证据予以推荐。

关键词：癌指南幽门螺杆菌预防

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