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Autofluorescence imaging endoscopy for identifi cation and assessment of inflammatory ulcerative colitis

World Journal of Gastroenterology 2011年第46期17卷 5110-5116页

作者： taro osada Atsushi Arakawa Naoto Sakamoto Hiroya Ueyama Tomoyoshi Shibuya Tatsuo Ogihara Takashi Yao Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine Department of Human Pathology Juntendo University School of Medicine

AIM:To validate the clinical relevance of autofluores-cence imaging(AFI)endoscopy for the assessment of inflammatory ulcerative colitis(UC).METHODS:A total of 572 endoscopic images were se-lected from 42 UC patients:286 taken with white light imaging(WLI)and 286 with AFI from the same *** images were assessed for overall mucosal inflammation according to Mayo endoscopic subscore(MES),and for seven characteristic endoscopic ***,AFI photographs were scored according to relative abundance of red,green and blue color com-ponents within each image based on an RGB additive color *** and AFI endoscopic scores from the same sites were *** evaluation of biopsies was according to the Riley ***:Relative to red(r=0.52,P<0.01)or blue(r=0.56,P<0.01)color component,the green color component of AFI(r=-0.62,P<0.01)corresponded more closely with mucosal inflammation *** were signif icant differences in green color components between MES-0(0.396±0.043)and MES-1(0.340± 0.035)(P<0.01),and between MES-1 and ≥ MES-2(0.318±0.037)(P<0.01).The WLI scores for "vascu-lar patterns"(r=-0.65,P<0.01),"edema"(r=-0.62,P<0.01),histology scores for "polymorphonuclear cells in the lamina propria"(r=-0.51,P<0.01)and "crypt architectural irregularities"(r=-0.51,P<0.01)showed correlation with the green color component of *** were significant differences in green color components between limited(0.399± 0.042)and extensive(0.375±0.044)(P=0.014)polymorpho-nuclear cell inf iltration within *** the severity of the mucosal inflammation increased,the green color component of AFI *** AFI green color com-ponent was well correlated with the characteristic en-doscopic and histological inflammatory features of ***:AFI has application in detecting inflammatory lesions,including microscopic activity in the co-lonic mucosa of UC patients,based on the green color component of images.

关键词： Autofluorescence imaging endoscopy En-doscopic activity Histological activity Microscopic in-flammation Green color component

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Gastrointestinal stromal tumor of the stomach with a giant abscess penetrating the gastric lumen

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World Journal of Gastroenterology 2007年第16期13卷 2385-2387页

作者： taro osada Akihito Nagahara Tomohiro Kodani Akihiro Namihisa Masato Kawabe Takashi Yoshizawa Toshifumi Ohkusa Sumio Watanabe Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine 2-1-1 Hongo Bunkyo-ku Tokyo 113-8421 Japan

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. In large GISTs, cystic degeneration, necrosis and focal hemorrhage that occur inside the tumor can result in gastrointestinal bleeding. We describe a case of a 74-year old male with GIST of the stomach accompanied with a giant abscess that penetrated the gastric lumen. The patient experienced undiagnosed fever for two months prior to hospitalization. Gastrointestinal endoscopy, X-ray series and computed tomography of the patient’s abdomen revealed a gastric submucosal tumor in the fornix, with a fistula to the gastric lumen that was inundated with a great deal of pus. The mass was diagnosed as a GIST from biopsy specimens. The patient was treated by endoscopic drainage of the abscess and intravenous administration of antibiotics. Eventually, a partial gastrectomy was performed. He was also administered Imanitib mesylate as adjuvant therapy. He was followed up for 2 years and no metastasis or recurrence was recognized at the follow- up examinations. This is the first report of a patient with clearly diagnosed GIST with endoscopic evidence of an abscess penetrating into the gastric lumen.

关键词： Gastrointestinal stromal tumor Abscess Drainage

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Characteristic pathological findings and effects of ecabet sodium in rat reflux esophagitis

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World Journal of Gastroenterology 2009年第28期15卷 3480-3485页

作者： Daisuke Asaoka Akihito Nagahara Masako Oguro Yuko Izumi Akihiko Kurosawa taro osada Masato Kawabe Mariko Hojo Michiro Otaka Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine

AIM： To explore the pathological findings in the entire esophagus in rats with reflux esophagitis, and the effects of ecabet sodium （ES）. METHODS： A rat model of chronic acid reflux esophagitis was used. In the treatment group, ES was administered after surgery （n = 16）. No drug was administered postoperatively to the esophagitis group （n = 9）. Shamoperated rats were used as a control group （n = 5）. Rats were sacrificed on day 7 after the operation. The epithelial thickness and leukocyte infiltration were examined in the upper, middle and lower areas of the esophagus. The survival rate, incidence of esophageal ulcer, and mean surface area and number of esophageal ulcers were determined in the esophagitis and ES groups. Esophageal histology was assessed in all three groups. RESULTS： Leukocyte infiltration in the esophagitis group was 26.3 ± 22.0 in the middle esophagus and 8.2 ± 4.9 in the upper esophagus, which was significantly greater than that in the controls （1.3 ± 1.1 and 1.4 ±1.0, respectively）（P 〈 0.05）. The thickness of the epithelium in the esophagitis group was 210.8 ± 47.7 μm in the lower esophagus and 204.2 ± 60.1 μm in the middle esophagus, which was significantly greater than that in the controls （26.0 ± 5.5 and 21.0 ± 6.5 μm, respectively）（P 〈 0.05）. The mean number of ulcers per animal in the ES group in the entire esophagus was 5.4 =1= 2.5, which was significantly less than that in the esophagitis group （9.0 ± 3.5）（P 〈 0.05）. The epithelial thickness in the ES group was 97.5 ± 32.2 μm in the lower esophagus, which was decreased compared with that in the esophagitis group （210.8 ± 47.7 μm）（P 〈 0.05）. CONCLUSION： Mucosal inflammation extended to the upper esophagus close to the hypopharynx. Our study suggested that ES may have a useful defensive role in reflux esophagitis.

关键词： Gastroesophageal reflux disease Upperesophagus Laryngopharyngeal reflux disease Extraesophageal syndrome

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Factors associated with incomplete colonoscopy at a Japanese academic hospital

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World Journal of Gastroenterology 2014年第22期20卷 6961-6967页

作者： Shigeo Koido Toshifumi Ohkusa Kosaburo Nakae Tetsuji Yokoyama Tomoyoshi Shibuya Naoto Sakamoto Kan Uchiyama Hiroshi Arakawa taro osada Akihito Nagahara Sumio Watanabe Hisao Tajiri Division of Gastroenterology and Hepatology Department of Internal MedicineThe Jikei University School of MedicineChiba 277-8567Japan Department of Gastroenterology Juntendo University School of MedicineTokyo 113-8421Japan Department of Technology Assessment and Biostatistics National Institute of Public HealthSaitama 351-0197Japan

AIM: To evaluate significant risk factors for incomplete colonoscopy at a Japanese academic hospital.

关键词： Colonoscopy Incomplete Intubation rates Japanese academic hospital Risk factors Inflammatory bowel disease

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Malignant lymphoma in the ileum diagnosed by double-balloon enteroscopy

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World Journal of Gastroenterology 2007年第24期13卷 3388-3391页

作者： Kazuko Beppu taro osada Akihito Nagahara Naoto Sakamoto Tomoyoshi Shibuya Masato Kawabe Takeshi Terai Toshifumi Ohkusa Tatsuo Ogihara Nobuhiro Sato Toshiki Kamano Yasuo Hayashida Sumio Watanabe Department of Gastroenterology Juntendo University School of Medicine 2-1-1 Hongo Bunkyo-ku Tokyo 113-8421 Japan Department of Coloproctological Surgery Juntendo University School of Medicine dicine 2-1-1 Hongo Bunkyo-ku Tokyo 113-8421 Japan Department of General Medicine Juntendo University School of Medicine 2-1-1 Hongo Bunkyo-ku Tokyo 113-8421 Japan

A 73-year old man presented with abdominal pain. A tumor with central ulceration was observed in the ileum using double-balloon enteroscopy. Histological findings of the biopsy specimens were consistent with malignant lymphoma. Double-balloon enteroscopy confirmed the diagnosis of a malignant lymphoma tumor which was surgically resected. The patient is still in complete remission now.

关键词： Malignant lymphoma Double-balloon enteroscopy

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Quit smoking improves gastroesophageal reflux symptoms and quality of life

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Health 2011年第11期3卷 677-683页

作者： Kou Nakajima Akihito Nagahara Akihiko Kurosawa Kuniaki Seyama Daisuke Asaoka taro osada Mariko Hojo Sumio Watanabe 不详

Background: Smoking is considered to be risk factors of gastroesophageal reflux disease (GERD). The present study aimed to reveal whether quit smoking improves GERD symptoms and QOL of patients. Methods: In this prospective study, 33 patients who participated in a 12-week quit smoking program filled out the Frequency Scale for the Symptoms of GERD (FSSG) questionnaire, and SF8 QOL questionnaire. Patients filled out the questionnaires at baseline and during the program at 2 weeks, 4 weeks, 8 weeks and 12 weeks. In the FSSG, the responses were scored and the reflux score (RS), dysmotility score (DS) and total score (TS) were calculated. Results: There were 22 males and 11 females. Their mean age was 54.8 ± 13.0 (mean ± SD) yr, BMI was 22.9 ± 4.0, and duration of smoking was 33.5 ± 12.5 years. Ten patients belonged to GERD subgroup (baselineFSSGscore ≥ 8). All patients were successful at quit smoking. Scores of TS/RS/DS are 8.6 ± 1.8 (mean ± SE)/4.2 ± 0.9/4.5 ± 0.9 at baseline, 4.7 ± 1.6**/2.5 ± 0.9**/2.3 ± 0.7** at 2 w, 5.7 ± 1.3**/2.6 ± 0.6*/3.0 ± 0.7* at 4 w, 4.5 ± 1.4*/2.2 ± 0.8*/2.3 ± 0.8* at 8 w and 3.7 ± 1.2**/1.7 ± 0.6**/2.0 ± 0.7** at 12 w, respectively (**p < 0.01, *p < 0.05 vs. baseline). Among GERD subgroup, Scores of TS/RS/DS are 18.0 ± 2.9/8.9 ± 1.6/9.1 ± 1.5 at baseline, 8.8 ± 3.0/5.1 ± 1.7/3.7 ± 1.6 at 2 w, 10.8 ± 2.9/5.4 ± 1.6/5.4 ± 1.5 at 4 w, 7.6 ± 2.9*/4.1 ± 1.6/3.5 ± 1.5* at 8 w and 7.1 ± 2.9*/3.2 ± 1.6*/3.9 ± 1.5* at 12w, respectively. Regarding QOL, physical component score has significantly improved at 2, 4, 8 and 12 w and mental component score at 4w, respectively. Conclusions: Quit smoking significantly improved not only GERD symptoms but also QOL, indicating that quit smoking might be an option in the treatment strategy of GERD symptoms.

关键词： Quit Smoking FSSG GERD SF8

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Seasonal variations in the onset of ulcerative colitis in Japan

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World Journal of Gastroenterology 2013年第47期19卷 9063-9068页

作者： Shigeo Koido Toshifumi Ohkusa Hiroaki Saito Tetsuji Yokoyama Tomoyoshi Shibuya Naoto Sakamoto Kan Uchiyama Hiroshi Arakawa taro osada Akihito Nagahara Sumio Watanabe Hisao Tajiri Division of Gastroenterology and Hepatology Department of Internal Medicinethe Jikei University School of MedicineChiba 277-8567Japan Department of Gastroenterology Juntendo University School of MedicineTokyo 113-8421Japan Department of Health Promotion National Institute of Public HealthSaitama 351-0197Japan

AIM:To investigate seasonal variations in the onset and relapse of ulcerative colitis(UC)in Japanese ***:Between 1994 and 2006,198 Japanese patients diagnosed with UC according to conventional criteria in an academic hospital were enrolled for onset *** 265 Japanese patients with UC who were observed for more than 12 mo,165 patients relapsed(239 times)and were enrolled for relapse *** patients’symptoms were recorded each month for 12 consecutive ***:There was monthly seasonality in symptom onset during October and March for *** onset of symptoms in UC patients frequently occurred during the *** in UC onset was observed according to both month(P=0.015)and season(P=0.048).Relapse commonly occurred in October,and variations in relapse were not significant either in month(P=0.52)or season(P=0.12).Upper respiratory inflammation was the main factor responsible for ***:Our results suggest that environmental factors associated with winter and spring seasonality may be responsible for triggering the clinical onset of UC in Japan.

关键词： Japanese population Onset Relapse Seasonal variations Ulcerative colitis

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