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  2. 大宮 直木

大宮 直木

オオミヤ ナオキ  (Naoki Ohmiya)

基本情報

所属
藤田医科大学 医学部 医学科 先端光学診療学講座
学位
博士(医学）
J-GLOBAL ID
200901011108502975
researchmap会員ID
6000005568
患者さんの立場にたって、安全かつ最高の医療を提供できるよう努力します。

研究キーワード

 8

研究分野

 1

委員歴

 28
もっとみる

受賞

 4

論文

 266
  • Edouard Louis, Stefan Schreiber, Remo Panaccione, Peter Bossuyt, Luc Biedermann, Jean-Frederic Colombel, Gareth Parkes, Laurent Peyrin-Biroulet, Geert D’Haens, Tadakazu Hisamatsu, Britta Siegmund, Kaichun Wu, Brigid S. Boland, Gil Y. Melmed, Alessandro Armuzzi, Phillip Levine, Jasmina Kalabic, Su Chen, Ling Cheng, Lei Shu, W. Rachel Duan, Valerie Pivorunas, Yuri Sanchez Gonzalez, Ronilda D’Cunha, Ezequiel Neimark, Kori Wallace, Raja Atreya, Marc Ferrante, Edward V. Loftus, Domingo Balderramo, Silvina Goncalves, Juan Lasa, Abel Novillo, Orlando Ruffinengo, Sonja Heeren, Walter Reinisch, Filip Baert, Peter Bossuyt, Arnaud Colard, Olivier Dewit, Marc Ferrante, Denis Franchimont, Edouard Louis, Jean-Francois Rahier, Carlos Francesconi, Roberto Kaiser Junior, Rogerio Parra, Ligia Sassaki, Plamen Penchev, Desislav Stanchev, Kenneth Atkinson, Melanie Beaton, Talat Bessissow, Susan Greenbloom, Jean-Rene Lachance, Allen Lim, Remo Panaccione, Jean- Michel Samson, Scott Shulman, Jesse Siffledeen, Ignacio Alfaro, Carlos Valenzuela, Gustavo Walsen, Ping An, Qian Cao, Yan Chen, Youxiang Chen, Xiang Gao, Xiaohua Hou, Naizhong Hu, YAN Li, Fei Liu, Mei Liu, Lu Lungen, Zhihua Ran, Tongyu Tang, Xin Wang, Shaoqi Yang, Qiang Zhan, Guoxin Zhang, Hu Zhang, Jie Zhang, Xiaolan Zhang, Jie Zhong, Xiaoping Zou, Eligio Alvarez, Juan Ricaurte, Vladimir Borzan, Zeljko Krznaric, Zeljko Puljiz, Martin Bortlik, Pavel Svoboda, Jan Ulbrych, Tomas Vanasek, Jens Kjeldsen, Lars Munck, Anja Poulsen, Ezzat Ali, Osama Salem, Hisham Sawah, Imam Waked, Romain Altwegg, Mathurin FLAMANT, Mathurin Fumery, Xavier Hebuterne, David Laharie, Laurent Peyrin-Biroulet, Xavier Roblin, Xavier Treton, Raja Atreya, Herbert Deppe, Peter Hasselblatt, Arne Kandulski, Jochen Klaus, Thomas Krause, Torsten Kucharzik, Jessica Mertens, Michael Mross, Axel Naumann, Wolfgang Reindl, Ingolf Schiefke, Stefan Schreiber, Stefan Schubert, Britta Siegmund, Andreas Sturm, Georgios Bamias, Ioannis Koutroubakis, Spilios Manolakopoulos, Gerassimos Mantzaris, Maria Tzouvala, Irit Avni-Biron, Eran Goldin, Lior Katz, Adi Lahat-Zok, Arik Segal, Sandro Ardizzone, Alessandro Armuzzi, Michele Cicala, Antonio Colecchia, Rocco Cosintino, Antonio Gasbarrini, Andrea Geccherle, Edoardo Giovanni Giannini, Paolo Gionchetti, Francesco Luzza, Giovanni Monteleone, Antonino Privitera, Simone Saibeni, Marcello Vangeli, Yasuhiko Abe, Nobuo Aoyama, Kunio Asonuma, Yutaka Endo, Motohiro Esaki, Toshimitsu Fujii, Katsuyuki Fukuda, Fumihito Hirai, Yasuhiro Hisanaga, Noriyuki Horiki, Mikitaka Iguchi, Keisuke Ishigami, Yoh Ishiguro, Hiroaki Ito, Yoichi Kakuta, Koji Kamikozuru, Jun Kato, Teruki Kawanishi, Taku Kobayashi, Hiroyuki Kuge, Atsuo Maemoto, Tomoyuki Masuda, Katsuyoshi Matsuoka, Kayoko Matsushima, Masashi Matsushima, Satoshi Motoya, Katsuhiko Nakai, Koichi Nakajima, Masanao Nakamura, Atsushi Nishida, Takahiro Nishikawa, Nobuaki Nishimata, Toshiaki Ochiai, Naoki Ohmiya, Yoshifumi Ohnishi, Shiro Oka, Keiji Ozeki, Daisuke Saito, Masayuki Saruta, Makoto Sasaki, Masahito Shimizu, Ken Sugimoto, Tomohisa Sujino, Takayoshi Suzuki, Hajime Takatori, Noritaka Takatsu, Hidetoshi Takedatsu, Ken Takeuchi, Hiroki Tanaka, Satoki Tokito, Tatsuya Toyokawa, Yoshito Uenoyama, Takatsugu Yamamoto, Takayuki Yamamoto, Hiroshi Yasuda, Kaoru Yokoyama, Aleksejs Derovs, Aldis Pukitis, Laimas Jonaitis, Edita Kazenaite, Lourdes Lol-be Pinzon Te, Geert D'Haens, Maurice Lutgens, James Brooker, Richard Gearry, Ben Griffiths, Stephen Inns, Michael Schultz, Jerzy Eszyk, Jaroslaw Kierkus, Dariusz Kleczkowski, Adam Kopon, Robert Petryka, Jaroslaw Regula, Tomasz Romanczyk, Grazyna Rydzewska-Wyszkowska, Piotr Sikorski, Michal Talarek, Rute Cerqueira, Tiago Goncalves, Susana Lopes, Paula Ministro, Francisco Portela, Helena Tavares, Mihai-Mircea Diculescu, Adrian Goldis, Andrada Seicean, Alina Agafina, Anton Edin, Evgenia Gerasimova, Maryana Gettueva, Vladimir Kashnikov, Vladimir Rafalskiy, Ksenia Sharapova, Elena Smolyarchuk, Daria Varganova, Sasa Grgov, Igor Jovanovic, Petar Svorcan, Dino Tarabar, Khoon Lin Ling, Jozef Balaz, Juraj Durina, Milos Gregus, Martin Laclav, David Drobne, Eduan Deetlefs, Jonny Peter, Muhammad Rajabally, Jennifer Rosa, Jan van Zyl, John Wright, Jae Hee Cheon, Byung Ik Jang, Sang-Bum Kang, Dukhwan Kim, Tae Oh Kim, Young-Ho Kim, Jonghun Lee, Kang-Moon Lee, Dong Il Park, Geun Am Song, Luisa Castro Laria, Ana Echarri Piudo, Santiago Garcia Lopez, Vincent Hernandez Ramirez, Maria Dolores Martin Arranz, Pilar Varela Trastoy, Maria Vera Mendoza, Mikael Lordal, Luc Biedermann, Benjamin Misselwitz, Chung-Hsin Chang, Jen-Wei Chou, Chia-Jung Kuo, Ching-Pin Lin, Chia-Hung Tu, Huseyin Alkim, Yusuf Erzin, Irfan Soykan, Tetiana Kravchenko, Nataliia Tsarynna, Vira Vyshyvanyuk, Tariq Ahmad, Fraser Cummings, Kapil Kapur, Arthur Kaser, Alexandra Kent, Gareth Parkes, Kamal Patel, Richard Speight, Alan Steel, Faten Aberra, Humberto Aguilar, Badr Al Bawardy, Ashwin Ananthakrishnan, Matthew Barnes, Kendall Beck, Charles Berkelhammer, Brigid Boland, Jeff Bullock, Adeeti Chiplunker, Robin Dalal, Sushila Dalal, Belkis Delgado, Michael DiGiovanna, George Aaron DuVall, Curtis Freedland, Keith Friedenberg, Philip Ginsburg, Tarek Hassanein, Peter Higgins, John Hong, Jason Hou, Vivek Huilgol, Nikhil Inamdar, Saurabh Kapur, David Kerman, Henry Levine, Nilesh Lodhia, Edward Loftus, Jaime Mayoral, Donald McNeil, Gil Melmed, Andria Mushahwar, Harry Ojeas, Bhaktasharan Patel, Raymond Phillips, Joe Pouzar, Harry Sarles Jr., Joel Schock, Shahriar Sedghi, Nirav Shah, Junaid Siddiqui, David Stokesberry, Le-Chu Su, Arun Swaminath, Dharmendra Verma, John Weber, Ziad Younes, Timothy Zisman
    JAMA 2024年7月22日  査読有り
    Importance The clinical effects of risankizumab (a monoclonal antibody that selectively targets the p19 subunit of IL-23) for the treatment of ulcerative colitis are unknown. Objective To evaluate the efficacy and safety of risankizumab when administered as an induction and a maintenance therapy for patients with ulcerative colitis. Design, Setting, and Participants Two phase 3 randomized clinical trials were conducted. The induction trial was conducted at 261 clinical centers (in 41 countries) and enrolled 977 patients from November 5, 2020, to August 4, 2022 (final follow-up on May 16, 2023). The maintenance trial was conducted at 238 clinical centers (in 37 countries) and enrolled 754 patients from August 28, 2018, to March 30, 2022 (final follow-up on April 11, 2023). Eligible patients had moderately to severely active ulcerative colitis; a history of intolerance or inadequate response to 1 or more conventional therapies, advanced therapies, or both types of therapies; and no prior exposure to risankizumab. Interventions For the induction trial, patients were randomized 2:1 to receive 1200 mg of risankizumab or placebo administered intravenously at weeks 0, 4, and 8. For the maintenance trial, patients with a clinical response (determined using the adapted Mayo score) after intravenous treatment with risankizumab were randomized 1:1:1 to receive subcutaneous treatment with 180 mg or 360 mg of risankizumab or placebo (no longer receiving risankizumab) every 8 weeks for 52 weeks. Main Outcomes and Measures The primary outcome was clinical remission (stool frequency score ≤1 and not greater than baseline, rectal bleeding score of 0, and endoscopic subscore ≤1 without friability) at week 12 for the induction trial and at week 52 for the maintenance trial. Results Among the 975 patients analyzed in the induction trial (aged 42.1 [SD, 13.8] years; 586/973 [60.1%] were male; and 677 [69.6%] were White), the clinical remission rates at week 12 were 132/650 (20.3%) for 1200 mg of risankizumab and 20/325 (6.2%) for placebo (adjusted between-group difference, 14.0% [95% CI, 10.0%-18.0%], P < .001). Among the 548 patients analyzed in the maintenance trial (aged 40.9 [SD, 14.0] years; 313 [57.1%] were male; and 407 [74.3%] were White), the clinical remission rates at week 52 were 72/179 (40.2%) for 180 mg of risankizumab, 70/186 (37.6%) for 360 mg of risankizumab, and 46/183 (25.1%) for placebo (adjusted between-group difference for 180 mg of risankizumab vs placebo, 16.3% [97.5% CI, 6.1%-26.6%], P < .001; adjusted between-group difference for 360 mg of risankizumab vs placebo, 14.2% [97.5% CI, 4.0%-24.5%], P = .002). No adverse event signals were detected in the treatment groups. Conclusion and Relevance Compared with placebo, risankizumab improved clinical remission rates in an induction trial and in a maintenance trial for patients with moderately to severely active ulcerative colitis. Further study is needed to identify benefits beyond the 52-week follow-up. Trial Registration ClinicalTrials.gov Identifiers: NCT03398148 and NCT03398135
  • Tomomitsu Tahara, Noriyuki Horiguchi, Hyuga Yamada, Tsuyoshi Terada, Dai Yoshida, Masaaki Okubo, Kohei Funasaka, Yoshihito Nakagawa, Tomoyuki Shibata, Naoki Ohmiya
    Journal of gastrointestinal and liver diseases : JGLD 33(2) 164-169 2024年6月29日  査読有り
    BACKGROUND AND AIMS: Early gastric cancers (EGCs) after Helicobacter pylori (H. pylori) eradication often appear as reddish depressed lesions (RDLs); the same features are also appeared in benign stomachs after eradication. We compared clinic-pathological and endoscopic features of benign and neoplastic RDLs after H. pylori eradication. METHODS: 228 neoplastic RDLs after H. pylori eradication were studied. All lesions were divided into neoplastic RDLs (differentiated carcinoma or adenoma, n=114) and benign RDLs (n=114) according to the histology. Clinical and pathological characteristics were compared in neoplastic and benign groups. Endoscopic diagnostic yields using the white light (WL) endoscopy, chromoendoscopy (CE) using indigo carmine dye and the magnifying endoscopy with narrow-band imaging (ME-NBI) were also evaluated in relation to the pathological diagnosis. RESULTS: Size of neoplastic RDLs was larger than that of benign RDLs (p<0.01). Sensitivity, specificity and accuracy for predicting pathological types of RDLs was 70.1%, 52.6% and 61.4% for the WL, 65.8%, 63.1% and 65.4% for the CE, while the ME-NBI scored better with the 88.6%, 88.6%, 99.1% and 93.9% of sensitivity, specificity and accuracy. The accuracy of the ME-NBI was 99.9% (113/114) in the benign RDLs and 89.4% (101/114) for the neoplastic RDLs. Undiagnosed neoplastic RDLs using the ME-NBI were associated with more differentiated tumors such as adenoma and well-differentiated adenocarcinoma (tub1) and the presence of an unclear demarcation line. CONCLUSIONS: ME-NBI is useful to diagnose RDLs after H. pylori eradiation, while some of neoplastic lesions are difficult to diagnose using the ME-NBI.
  • Ken Yamashita, Shiro Oka, Takeshi Yamada, Keigo Mitsui, Hironori Yamamoto, Keiichi Takahashi, Akio Shiomi, Kinichi Hotta, Yoji Takeuchi, Toshio Kuwai, Fumio Ishida, Shin-Ei Kudo, Shoichi Saito, Masashi Ueno, Eiji Sunami, Tomoki Yamano, Michio Itabashi, Kazuo Ohtsuka, Yusuke Kinugasa, Takayuki Matsumoto, Tamotsu Sugai, Toshio Uraoka, Koichi Kurahara, Shigeki Yamaguchi, Tomohiro Kato, Masazumi Okajima, Hiroshi Kashida, Yoshito Akagi, Hiroaki Ikematsu, Masaaki Ito, Motohiro Esaki, Masaya Kawai, Takashi Yao, Madoka Hamada, Takahiro Horimatsu, Keiji Koda, Yasumori Fukai, Koji Komori, Yusuke Saitoh, Yukihide Kanemitsu, Hiroyuki Takamaru, Kazutaka Yamada, Hiroaki Nozawa, Tetsuji Takayama, Kazutomo Togashi, Eiji Shinto, Takehiro Torisu, Akira Toyoshima, Naoki Ohmiya, Takeshi Kato, Eigo Otsuji, Shinji Nagata, Yojiro Hashiguchi, Kenichi Sugihara, Yoichi Ajioka, Shinji Tanaka
    Journal of gastroenterology 59(5) 376-388 2024年5月  査読有り
    BACKGROUND: The clinicopathological features and prognosis of primary small bowel adenocarcinoma (PSBA), excluding duodenal cancer, remain undetermined due to its rarity in Japan. METHODS: We analyzed 354 patients with 358 PSBAs, between January 2008 and December 2017, at 44 institutions affiliated with the Japanese Society for Cancer of the Colon and Rectum. RESULTS: The median age was 67 years (218 males, 61.6%). The average tumor size was 49.9 (7-100) mm. PSBA sites consisted of jejunum (66.2%) and ileum (30.4%). A total of 219 patients (61.9%) underwent diagnostic small bowel endoscopy, including single-balloon endoscopy, double-balloon endoscopy, and capsule endoscopy before treatment. Nineteen patients (5.4%) had Lynch syndrome, and 272 patients (76.8%) had symptoms at the initial diagnosis. The rates for stages 0, I, II, III, and IV were 5.4%, 2.5%, 27.1%, 26.0%, and 35.6%, respectively. The 5-year overall survival rates at each stage were 92.3%, 60.0%, 75.9%, 61.4%, and 25.5%, respectively, and the 5-year disease-specific survival (DSS) rates were 100%, 75.0%, 84.1%, 59.3%, and 25.6%, respectively. Patients with the PSBA located in the jejunum, with symptoms at the initial diagnosis or advanced clinical stage had a worse prognosis. However, multivariate analysis using Cox-hazard model revealed that clinical stage was the only significant predictor of DSS for patients with PSBA. CONCLUSIONS: Of the patients with PSBA, 76.8% had symptoms at the initial diagnosis, which were often detected at an advanced stage. Detection during the early stages of PSBA is important to ensure a good prognosis.
  • Yoshitaka Nishikawa, Takahiro Horimatsu, Shiro Oka, Takeshi Yamada, Keigo Mitsui, Hironori Yamamoto, Keiichi Takahashi, Akio Shiomi, Kinichi Hotta, Yoji Takeuchi, Toshio Kuwai, Fumio Ishida, Shin-Ei Kudo, Shoichi Saito, Masashi Ueno, Eiji Sunami, Tomoki Yamano, Michio Itabashi, Kazuo Ohtsuka, Yusuke Kinugasa, Takayuki Matsumoto, Tamotsu Sugai, Toshio Uraoka, Koichi Kurahara, Shigeki Yamaguchi, Tomohiro Kato, Masazumi Okajima, Hiroshi Kashida, Fumihiko Fujita, Hiroaki Ikematsu, Masaaki Ito, Motohiro Esaki, Masaya Kawai, Takashi Yao, Madoka Hamada, Keiji Koda, Yasumori Fukai, Koji Komori, Yusuke Saitoh, Yukihide Kanemitsu, Hiroyuki Takamaru, Kazutaka Yamada, Hiroaki Nozawa, Tetsuji Takayama, Kazutomo Togashi, Eiji Shinto, Takehiro Torisu, Akira Toyoshima, Naoki Ohmiya, Takeshi Kato, Eigo Otsuji, Shinji Nagata, Yojiro Hashiguchi, Kenichi Sugihara, Yoichi Ajioka, Shinji Tanaka
    JCO global oncology 10 e2300392 2024年2月  
    PURPOSE: Limited information is available regarding the characteristics and outcomes of stage IV small bowel adenocarcinoma (SBA) in Japan. This study examined the clinical and pathological characteristics and outcomes according to the treatment strategies in patients with stage IV SBA. METHODS: This retrospective observational study used the data of patients with jejunal or ileal adenocarcinoma collected by the Small Bowel Malignant Tumor Project of the Japanese Society for Cancer of the Colon and Rectum. Descriptive statistics were expressed as the mean (standard deviation) or median (range). Survival analysis was performed using Kaplan-Meier curves and pairwise log-rank tests. RESULTS: Data from 128 patients were analyzed. The treatment strategies were chemotherapy alone (26 of 128, 20.3%), surgery alone (including palliative surgery; 21 of 128, 16.4%), surgery + chemotherapy (74 of 128, 57.8%), and best supportive care (7 of 128, 5.5%). The median (range) overall survival was 16 (0-125) months overall, and 11 (1-38) months, 8 (0-80) months, 18 (0-125) months, and 0 (0-1) months for the chemotherapy, surgery, surgery + chemotherapy, and best supportive care groups, respectively. Three main categories of chemotherapeutic regimen were used: a combination of fluoropyrimidine and oxaliplatin (F + Ox), fluoropyrimidine and irinotecan (F + Iri), and single-agent fluoropyrimidine. Among patients treated with chemotherapy, the median (range) OS was 16 (1-106) months overall, and 17 (1-87) months, 29 (7-39) months, and 16 (1-106) months in patients treated with fluoropyrimidine, F + Iri, and F + Ox, respectively. CONCLUSION: Patients treated with surgery, chemotherapy, or both had a better prognosis than those who received best supportive care. Among patients who received chemotherapy, survival did not differ according to the chemotherapeutic regimen.
  • Takafumi Omori, Yasutaka Jodai, Kohei Maeda, Naoki Ohmiya
    Gastrointestinal endoscopy 99(2) 245-253 2024年2月  
    BACKGROUND AND AIMS: We prospectively determined the efficacy of flexible spectral imaging color enhancement (FICE) used with second-generation colon capsule endoscopy (CCE) for colorectal polyps and tumors (CRTs). METHODS: This study included optical colonoscopy within 4 months after CCE. Two colonoscopists independently reviewed CCE using white-light images (CCE-WL) and CCE using FICE images (CCE-FICE), respectively. Based on colonoscopic findings as the criterion standard, the diagnostic accuracy for CRTs was compared between CCE-WL and CCE-FICE. RESULTS: Of 89 enrolled patients (65 men and 24 women; 75 with CRTs including 36 with serrated lesions, 63 with adenomas, and 9 with adenocarcinomas), the per-patient detectability of CCE-FICE for the representative CRTs was significantly higher than that of CCE-WL: overall CRTs (CCE-WL, 79%; CCE-FICE, 88%; P = .0001), 6- to 9-mm CRTs (CCE-WL, 63%; CCE-FICE, 94%; P = .0055), and ≥6-mm CRTs (CCE-WL, 78%; CCE-FICE, 93%; P = .0159). The per-lesion sensitivity of CCE-FICE was significantly higher than that of CCE-WL for CRTs: overall (CCE-WL, 61%; CCE-FICE, 79%; P < .0001), <6 mm (CCE-WL, 53%; CCE-FICE, 69%; P < .0001), 6- to 9-mm CRTs (CCE-WL, 65%; CCE-FICE, 93%; P = .0007), slightly elevated CRTs (CCE-WL, 53%; CCE-FICE, 75%; P < .0001), tubular adenomas (CCE-WL, 61%; CCE-FICE, 79%; P < .0001), and serrated polyps (CCE-WL, 57%; CCE-FICE, 74%; P = .0022). Both modes detected all adenocarcinomas. No significant differences were found between CCE-WL and CCE-FICE of the per-lesion sensitivity for ≥10-mm CRTs (CCE-WL, 81%; CCE-FICE, 94%; P = .1138) or protruding CRTs (CCE-WL, 77%; CCE-FICE, 86%; P = .0614). Kappa coefficients for overall CRTs for CCE-WL and CCE-FICE were .66 and .64, respectively, which indicated substantial agreement. CONCLUSIONS: CCE-FICE improved the detection rates for all CRTs except adenocarcinomas, ≥10-mm polyps, and protruding polyps when compared with CCE-WL. (Clinical trial registration number: UMIN 000021125.).
もっとみる

MISC

 1256
  • 田口 歩, 大宮 直木, 神谷 健司, 大山 格, 松浦 哲生, 白井 健之助, 尾関 雅靖, 馬渕 信行, 伊藤 彰浩, 丹羽 康正, 後藤 秀実
    日本消化器病学会雑誌 100(臨増大会) A640-A640 2003年9月  
  • 神岡 諭郎, 丹羽 康正, 大宮 直木, 伊藤 彰浩, 橋本 千樹, 安藤 伸浩, 佐々木 洋治, 宮原 良二, 大橋 暁, 山田 雅弘, 廣岡 芳樹, 後藤 秀実
    日本消化器病学会雑誌 100(臨増大会) A683-A683 2003年9月  
  • Ohyama, I, C Niimi, K Shirai, A Taguchi, N Ohmiya, Y Hirooka, Y Niwa, H Goto
    GASTROENTEROLOGY 124(4) A551-A551 2003年4月  
  • 佐々木 洋治, 丹羽 康正, 大宮 直木, 安藤 伸浩, 宮原 良二, 大橋 暁, 神岡 嗣郎, 山田 雅弘, 後藤 秀実
    Gastroenterological Endoscopy 45(Suppl.1) 636-636 2003年4月  
  • 大橋 暁, 丹羽 康正, 大宮 直木, 安藤 伸浩, 佐々木 洋治, 宮原 良二, 神岡 諭郎, 山田 雅弘, 後藤 秀実
    Gastroenterological Endoscopy 45(Suppl.1) 697-697 2003年4月  
  • 杉浦 一充, 岡本 都子, 室 慶直, 富田 靖, 大宮 直木
    日本皮膚科学会雑誌 113(5) 795-795 2003年4月  
  • 大山 格, 丹羽 康正, 大宮 直木, 松浦 哲生, 白井 健之助, 田口 歩, 尾関 雅靖, 馬淵 信行, 後藤 秀実
    日本消化器病学会雑誌 100(臨増総会) A168-A168 2003年3月  
  • 白井 健之助, 大宮 直木, 神谷 健司, 大山 格, 松浦 哲生, 田口 歩, 尾関 雅靖, 馬渕 信行, 丹羽 康正, 後藤 秀実
    日本消化器病学会雑誌 100(臨増総会) A169-A169 2003年3月  
  • 大宮 直木, 大山 格, 松浦 哲生, 白井 健之助, 田口 歩, 馬渕 信行, 尾関 雅靖, 神谷 健司, 丹羽 康正, 後藤 秀実
    日本消化器病学会雑誌 100(臨増総会) A169-A169 2003年3月  
  • 神岡 諭郎, 後藤 秀実, 丹羽 康正, 廣岡 芳樹, 大宮 直木, 伊藤 彰浩, 神谷 健司, 橋本 千樹, 安藤 伸浩, 佐々木 洋治, 宮原 良二, 大橋 暁, 山田 雅弘
    日本消化器病学会雑誌 100(臨増総会) A240-A240 2003年3月  
  • 石崎高志, 大宮直木, 古田隆久
    消化器診療 61 1-9 2003年  
  • Shimako Furuta, Hidemi Goto, Yasumasa Niwa, Naoki Ohmiya, Kenji Kamiya, Akihiko Oguri, Tetsuo Hayakawa, Naoyoshi Mori
    Journal of gastroenterology and hepatology 17(12) 1283-90 2002年12月  査読有り
    Background and Aims: Interferon (IFN)-gamma and tumor necrosis factor (TNF) are predominant cytokines produced in the gastric mucosa of patients with Helicobacter pylori-infected gastritis. Several studies reported that IFN-gamma and TNF induced the synergistic effect on many cell lines. We attempted to clarify the apoptotic activity and the synergistic effect of IFN-gamma and TNF on the gastric epithelial cell, and whether IFN-gamma relates to soluble TNF receptors (sTNF-R) release from the gastric epithelial cell. Methods: On the gastric epithelial cell line MKN45, cytotoxic and apoptotic effects of IFN-gamma and TNF were examined. Next, sTNF-R released in response to IFN-gamma and the protective effect of sTNF-R against the cytotoxic activity of TNF and IFN-gamma were examined by blocking the release of sTNF-R with a serine protease inhibitor such as phenylmethylsulfonyl fluoride. Results: Interferon-gamma significantly decreased cell viability, but TNF decreased it only slightly. Interferon-gamma and TNF did not make a synergistic effect on cell viability and apoptosis. Interferon-gamma and TNF induced sTNF-R release from gastric epithelial cells. Phenylmethylsulfonyl fluoride significantly inhibited shedding of sTNF-R and a synergistic effect of TNF and IFN-gamma on apoptosis was observed. Conclusion: These results suggest that sTNF-R released by IFN-gamma regulate the injury on the gastric epithelial cell line induced by TNF. (C) 2002 Blackwell Publishing Asia Pty Ltd.
  • Chikanori Niimi, Hidemi Goto, Naoki Ohmiya, Yasumasa Niwa, Tetsuo Hayakawa, Tetsuro Nagasaka, Nobuo Nakashima
    American journal of clinical pathology 118(5) 683-92 2002年11月  査読有り
    Of 987 cases of gastric adenocarcinoma seen at Nagoya University School of Medicine, we found 6 rare, extremely well-differentiated advanced gastric adenocarcinomas that could not be diagnosed as malignant tumors with only H&E staining, even with repeated biopsies under preoperative endoscopy. The aim of this study was to determine whether an immunohistochemical method using p53 and Ki-67 antibody would be helpful for preoperative pathologic diagnosis. The cancer control cases were 16 cases of ordinary well-differentiated advanced gastric adenocarcinoma, while the gastritis control cases were 22 cases of Helicobacter pylori positive chronic gastritis. The p53 labeling index and the localization of Ki-67+ cells showed that the special adenocarcinomas in biopsy specimens were distinct from the surrounding normal mucosa and chronic gastritis, but not from the cancer control cases. These methods are useful markers for preoperative pathologic diagnosis of extremely well-differentiated gastric adenocarcinoma, which sometimes is confused with regenerative atypical glands before operation.
  • 宮原 良二, 後藤 秀実, 丹羽 康正, 廣岡 芳樹, 大宮 直木, 伊藤 彰浩, 神谷 健司, 安藤 伸浩, 伊藤 文一, 佐々木 洋治, 大橋 暁, 神岡 諭郎
    Gastroenterological Endoscopy 44(Suppl.2) 1498-1498 2002年9月  
  • 大橋 暁, 丹羽 康正, 大宮 直木, 神谷 健司, 安藤 伸浩, 伊藤 文一, 佐々木 洋治, 宮原 良二, 神岡 諭郎, 後藤 秀実
    Gastroenterological Endoscopy 44(Suppl.2) 1538-1538 2002年9月  
  • 神岡 諭郎, 後藤 秀実, 丹羽 康正, 廣岡 芳樹, 大宮 直木, 伊藤 彰浩, 神谷 健司, 安藤 伸浩, 佐々木 洋治, 宮原 良二, 大橋 暁
    Gastroenterological Endoscopy 44(Suppl.2) 1643-1643 2002年9月  
  • N Ando, Y Niwa, N Ohmiya, B Ito, Y Sasaki, H Goto
    ENDOSCOPY 34(8) 667-669 2002年8月  査読有り
    Endoscopic mucosal resection (EMR) has been accepted as a completely curative treatment of gastrointestinal mucosal cancers. With advances in diagnostic techniques, the tendency to detect simultaneous multiple primary cancers is increasing. Patients with another cancer coexisting with esophageal cancer have had a poor prognosis, but if both cancers are detected in the early stage, complete treatment consisting only of endoscopic surgery, with a good prognosis, is expected. We describe two cases of simultaneous multiple early cancers of the stomach and esophagus, treated by EMR.
  • Naoki Ohmiya, Nobuhiko Emi, Yasumasa Niwa, Hidemi Goto, Tetsuo Hayakawa
    Clinical and experimental pharmacology & physiology 29(7) 544-8 2002年7月  査読有り
    1. Liposome-mediated transfection is useful due to no DNA constraints, lower immunogenicity and easy preparation. However, it has the disadvantage of low transfection efficiency. We aimed to test whether lipofection efficiency could be enhanced in gastrointestinal cell lines by the growth-promoting effect of insulin. 2. To assess the effect of insulin on lipofection efficiency and the cell cycle, expression of green fluorescent protein (GFP) and DNA distribution in gastric (MKN1), colonic (HT29) and pancreatic (BxPC3) carcinoma cell lines was analysed using flow cytometry. 3. The percentage of positive cells with GFP was significantly higher in MKN1 cells in culture medium with 5 mg/mL insulin than without insulin, whereas the percentage was the same in HT29 and BxPC3 cells with insulin as without insulin. The percentage of S phase fraction MKN1 cells with insulin was greater than without insulin, whereas the percentage of S phase fractions of HT29 and BxPC3 cells was the same with or without insulin. Lipofection efficiency correlated with the percentage of S phase fraction. 4. Insulin has the potential to enhance efficiency of lipofection into a sensitive cell line by increasing cellular proliferation.
  • 大塚 泰郎, 後藤 秀実, 丹羽 康正, 大宮 直木, 神谷 健司, 安藤 伸浩, 伊藤 文一, 佐々木 洋治, 宮原 良二, 早川 哲夫
    Gastroenterological Endoscopy 44(Suppl.1) 507-507 2002年3月  
  • 安藤 伸浩, 後藤 秀実, 丹羽 康正, 大宮 直木, 伊藤 彰浩, 早川 哲夫, 飯沼 雅朗, 附柴 達
    日本消化器集団検診学会雑誌 40(2) 170-170 2002年3月  
  • 岡田 直人, 後藤 秀実, 丹羽 康正, 廣岡 芳樹, 大宮 直木, 伊藤 彰浩, 橋本 千樹, 丹羽 克司, 佐々木 洋治, 石川 英樹
    Gastroenterological Endoscopy 44(Suppl.1) 524-524 2002年3月  
  • 大宮 直木, 後藤 秀実, 丹羽 康正
    日本消化器病学会雑誌 99(臨増総会) A22-A22 2002年3月  
  • 伊藤 文一, 後藤 秀実, 丹羽 康正, 大宮 直木, 神谷 健司, 安藤 伸浩, 大塚 泰郎, 佐々木 洋治, 宮原 良二, 早川 哲夫
    日本消化器病学会雑誌 99(臨増総会) 170-170 2002年3月  
  • 宮原 良二, 後藤 秀実, 丹羽 康正, 廣岡 芳樹, 大宮 直木, 伊藤 彰浩, 神谷 健司, 安藤 伸浩, 大塚 泰郎, 伊藤 文一, 佐々木 洋治
    日本消化器病学会雑誌 99(臨増総会) A173-A173 2002年3月  
  • 大山 格, 後藤 秀実, 丹羽 康正, 大宮 直木, 神谷 健司, 加藤 徹哉, 古田 しま子, 新美 親紀, 小栗 彰彦, 松浦 哲生, 白井 健之助, 田口 歩, 早川 哲夫
    日本消化器病学会雑誌 99(臨増総会) A206-A206 2002年3月  
  • 大宮 直木, 後藤 秀実, 丹羽 康正
    日本消化器病学会雑誌 99(臨増総会) A369-A369 2002年3月  
  • 丹羽 克司, 後藤 秀実, 丹羽 康正, 廣岡 芳樹, 大宮 直木, 伊藤 彰浩, 橋本 千樹, 石川 英樹, 岡田 直人
    日本内科学会雑誌 91(臨増) 178-178 2002年2月  
  • 安藤 伸浩, 後藤 秀実, 丹羽 康正, 廣岡 芳樹, 大宮 直木, 伊藤 彰浩, 神谷 健司, 大塚 泰郎, 佐々木 洋治, 早川 哲夫
    日本内科学会雑誌 91(臨増) 179-179 2002年2月  
  • Nobuhiro Ando, Hidemi Goto, Yasumasa Niwa, Yoshiki Hirooka, Naoki Ohmiya, Tetsuo Nagasaka, Tetsuo Hayakawa
    Gastrointestinal endoscopy 55(1) 37-43 2002年1月  査読有り
    Background: With the advent of immunohistochemical analysis, the term "gastrointestinal stromal tumor" (GIST) was proposed to designate the largest category of primary nonepithelial neoplasms. EUS-guided fine needle aspiration (EUS-FNA) is useful for diagnosis of GISTs. The aim of this study was to evaluate the phenotyping of GISTs and diagnosis of malignant GISTs by using EUS-FNA with immunohistochemical analysis. Methods: A diagnosis of GIST was made in 23 patients by using EUS-FNA with immunohistochemical analysis. The accuracy of EUS-FNA diagnosis compared with the EUS imaging alone was analyzed. Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens was compared. Factors that were diagnostic for malignant GISTs were also analyzed. Results: The overall accuracy for the diagnosis of malignant GIST was 78% (18/23) by EUS imaging alone and 91% (21/23) by histopathologic evaluation (H&E staining) of specimens obtained by EUS-FNA. In 21 of 23 cases (91%) the immunohistochemical expressions of c-kit, CD34, muscle actin, and S-100 coincided for the FNA and surgical specimens. The presence of mitotic cells (p = 0.011) and the Ki-67 labeling Index (p &lt; 0.0001) with respect to the FNA specimens were significant predictive factors for malignant GIST. For the diagnosis of malignant GIST, the accuracy, sensitivity, and specificity of EUS-FNA with the addition of Ki-67 immunohistochemical staining were 100%. Conclusions. EUS-FNA with immunohistochemical analysis is useful in the preoperative diagnosis of GIST. It provides abundant information on immunohistochemical subtyping and on the capacity of the tumor for cellular progression.
  • 大宮直木, 後藤秀実
    Helicobacter Research 6 331-334 2002年  
  • 大宮直木, 後藤秀実, 丹羽康正, 神谷健司, 加藤徹哉, 古田しま子, 新美親紀, 小栗彰彦, 大山 格, 松浦哲生, 白井健之助, 田口 歩
    Progress in Medicine 22(8) 1985-1991 2002年  
    Interleukin(IL)-1多型と慢性萎縮性胃炎,胃癌の関係を明らかにする目的で,胃癌患者116名と,非胃癌の450名を対象に,血漿ペプシノーゲン(PG)I,II,ガストリン値,抗H.pylori IgG抗体を測定した.IL-1β-31,-511,+3954の多型はTaqMan PCR assay,IL-1RNのVNTRはPCR後に電気泳動にて検討した.その結果,IL-1β-31T/T型は,H.pylori感染により慢性萎縮性胃炎,高ガストリン血症を生じやすく,遠位側に発生するペプシノーゲン法陽性胃癌との関連が示唆され,IL-1β-31C/C型は,近位側に発生するペプシノーゲン法陰性胃癌との関連が示唆された
  • 佐々木 洋治, 後藤 秀実, 丹羽 康正, 大宮 直木, 神谷 健司, 安藤 伸浩, 大塚 泰郎, 伊藤 文一, 宮原 良二, 早川 哲夫
    Gastroenterological Endoscopy 43(Suppl.2) 1725-1725 2001年9月  
  • 伊藤 文一, 後藤 秀実, 丹羽 康正, 大宮 直木, 神谷 健司, 安藤 伸浩, 大塚 泰郎, 佐々木 洋治, 宮原 良二, 早川 哲夫
    Gastroenterological Endoscopy 43(Suppl.2) 1656-1656 2001年9月  
  • 大宮 直木, 後藤 秀実, 丹羽 康正
    日本消化器病学会雑誌 98(臨増大会) A403-A403 2001年9月  
  • 大宮 直木, 後藤 秀実, 早川 哲夫
    日本癌学会総会記事 60回 410-410 2001年9月  
  • H Goto, K Tachi, Y Hisanaga, K Kamiya, N Ohmiya, Y Niwa, T Hayakawa
    CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY 28(8) 659-662 2001年8月  査読有り
    1. The present study was designed to investigate whether or not ageing affects the development of water immersion stress-induced gastric lesions in rats. Effects of cetraxate, an anti-ulcer drug, were also examined. 2. Gastric lesions were induced by 6 h water immersion stress in rats. Gastric mucosal blood flow was determined by the hydrogen gas clearance technique and nitric oxide synthase (NOS) activity was measured enzymatically. 3. Early development of gastric lesions was observed in aged rats and exacerbation of gastric lesions was also found. Lowering of gastric mucosal blood flow and reduced NOS activity were observed in aged rats. 4. Cetraxate mitigated the development of gastric lesions in young rats and also increased gastric mucosal blood flow and NOS activity. However, these favourable effects were diminished in aged rats. 5. Decreased NOS activity may be an important exacerbatory factor to the development of gastric lesions in aged rats. 6. Effects of cetraxate differed between young rats and aged rats. 7. These results may explain the refractoriness and drug resistance in gastric ulcers encountered by elderly individuals.
  • N Ohmiya, S Matsumoto, H Yamamoto, S Baranovskaya, Malkhosyan, SR, M Perucho
    GENE 272(1-2) 301-313 2001年7月  査読有り
    Hereditary and sporadic gastrointestinal cancer of the microsatellite mutator phenotype (MMP) is characterized by a remarkable genomic instability at simple repeated sequences. The genomic instability is often caused by germline and somatic mutations in DNA mismatch repair (MMR) genes hMSH2 and hMLH1. The MMP can be also caused by epigenetic inactivation of hMLH1. The MMP generates many somatic frameshift mutations in genes containing mononucleotide repeats. We previously reported that in MMP tumors the hMSH6 and hMSH3 MMR genes often carry frameshift mutations in their (C)(8) and (A)(8) tracks. respectively. We proposed that these 'secondary mutator mutations' contribute to a gradual manifestation of the MMP. Here we report the detection of other frameshift. nonsense. and missense mutations in these genes in colon and gastric cancers of the MMP. A germline frameshift mutation was found in hMSH6 in a colon tumor harboring another somatic frameshift mutation. Several germline sequence variants and somatic missense mutations at conserved residues were detected in hMSH6 and only one was detected in hMSH3. Of the three hMSH6 germline variants in conserved residues, one coexisted with a somatic mutation at the (C)(8) track and another had a somatic missense mutation. We suggest that some of these germline and somatic missense variants are pathogenic. While biallelic hMSH6 and hMSH3 frameshift mutations were found in some tumors, many tumors seemed to contain only monoallelic mutations. In some tumors, these somatic monoallelic frameshift mutations at the (C)(8) and (A),., tracks were found to coexist with other somatic mutations in the other allele, supporting their functionality during tumorigenesis. However, the low incidence of these additional somatic mutations in hMSH6 and hMSH3 leaves many tumors with only monoallelic mutations. The impact of the frameshift mutations in gene expression was studied by comparative analysis of RNA and protein expression in different tumor cell clones with different genotypes. The results show that the hMSH6 (C)(8) frameshift mutation abolishes protein expression. ruling out a dominant negative effect by a truncated protein. We suggest the functionality of these secondary monoallelic mutator mutations in the context of an accumulative haploinsufficiency model. (C) 2001 Elsevier Science B.V. All rights reserved.
  • 丹羽 康正, 後藤 秀実, 大宮 直木
    日本消化器集団検診学会雑誌 39(2) 64-64 2001年3月  
  • 大塚 泰郎, 後藤 秀実, 丹羽 康正, 大宮 直木, 神谷 健司, 坂田 豊博, 安藤 伸浩, 伊藤 文一, 佐々木 洋治, 早川 哲夫
    Gastroenterological Endoscopy 43(Suppl.1) 634-634 2001年3月  
  • 丹羽 康正, 後藤 秀実, 大宮 直木, 神谷 健司, 安藤 伸浩, 坂田 豊博, 大塚 泰郎, 佐々木 洋治, 伊藤 文一, 早川 哲夫
    Gastroenterological Endoscopy 43(Suppl.1) 654-654 2001年3月  
  • 伊藤 文一, 後藤 秀実, 丹羽 康正, 大宮 直木, 神谷 健司, 坂田 豊博, 安藤 伸浩, 大塚 泰郎, 佐々木 洋司, 早川 哲夫
    Gastroenterological Endoscopy 43(Suppl.1) 703-703 2001年3月  
  • 坂田 豊博, 後藤 秀実, 丹羽 康正, 大宮 直木, 神谷 健司, 安藤 伸浩, 大塚 泰郎, 伊藤 文一, 佐々木 洋治, 早川 哲夫
    Gastroenterological Endoscopy 43(Suppl.1) 648-648 2001年3月  
  • 佐々木 洋治, 丹羽 康正, 後藤 秀実, 廣岡 芳樹, 大宮 直木, 伊藤 彰浩, 神谷 健司, 安藤 伸浩, 坂田 豊博, 大塚 泰郎
    Gastroenterological Endoscopy 43(Suppl.1) 639-639 2001年3月  
  • T Sakata, Y Niwa, H Goto, Y Hirooka, T Hayakawa, N Ohmiya, S Kobayashi
    AMERICAN JOURNAL OF GASTROENTEROLOGY 96(3) 735-739 2001年3月  査読有り
    OBJECTIVE: We examined cases of asymptomatic inflammatory bowel diseases, particularly asymptomatic ulcerative colitis, which were found in apparently healthy Japanese persons who underwent general health screening. METHODS: Patients with positive immunological fecal occult blood test (IFOBT) among approximately 236,000 persons participating in the health screening program at the Aichi Prefectural Center for Health Care for the past 9 yr underwent total colonoscopy. In patients with ulcerative colitis, we investigated the sex and age distributions, extent of lesion, endoscopic activity, incidence rate, and clinical course. RESULTS: In ail, 35 cases of inflammatory bowel disease were detected, and 274 cases of colorectal cancer (not discussed here) were detected in the same population. The 35 cases of inflammatory bowel disease consisted of 19 cases of ulcerative colitis (12 Of asymptomatic and minimally symptomatic ulcerative colitis, and seven of symptomatic or with past history of ulcerative colitis); five of intestinal tuberculosis; two of Crohn's disease; two of amebic colitis; and seven of endoscopic colitis. The 12 patients with asymptomatic and minimally symptomatic ulcerative colitis consisted of 11 men and one woman aged 36-63 yr (mean 46.2 yr). We classified these cases into three grades of severity according to endoscopic findings: four cases were mild, eight moderate, and none severe. Of these 12 cases, three were found endoscopically because of positive IFOBT, although barium enema was normal. Anatomic types of colitis cases included three of total colitis, three left-sided colitis, two proctitis, and four right-sided or segmental colitis. In one case, the disease extended proximally during the course of observation. CONCLUSIONS: We found 35 cases of inflammatory bowel disease because of positive IFOBT performed as part of a general health screening. Of these, 19 cases were ulcerative colitis. These included many asymptomatic and minimally symptomatic cases, which could be very important in helping to elucidate the natural history of ulcerative colitis; thus, long-term follow up is necessary. (C) 2001 by Am. Cell. of Gastroenterology.
  • T Hosoi, H Goto, T Arisawa, Y Niwa, N Okada, N Ohmiya, T Hayakawa
    CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY 28(1-2) 9-12 2001年1月  査読有り
    1. The present study was designed to investigate the role of nitric oxide (NO) in modulating 2,4,6-trinitrobenzene sulphonic acid (TNBS)-induced colitis in rats. 2. Damage scores and NO synthase (NOS) activity were measured. 3. The damage scores and NOS activity reached a peak on the 4th day after administration of TNBS solution (day 0), thereafter gradually decreasing, and were significantly higher than in the group treated with saline throughout the experimental period. 4. Subsequently, we divided the stage of colitis into two groups, one from day 0 to day 3 after induction of colitis, and the other from day 4 onwards, We evaluated the effects of the NOS inhibitor N-G-monotnethyl-L-arginine (L-NMMA), on TNBS-hapten-induced colitis and colonic mucosal blood flow. Two different methods of L-NMMA administration, from day 0 to day 3, and from day 4 onwards, were undertaken. 5. The damage score in the early L-NMMA treatment group was significantly higher than in the group without L-NMMA on day 14. In contrast, the damage score in the late L-NMMA treatment group was not significantly different from the group without L-NMMA. Colonic mucosal blood how in the early LMMA treatment group was not significantly different from that in the tate L-NMMA treatment group, 6. These data suggest that NO is important for inhibiting inflammation during the early stages.
  • T Odori, H Goto, T Arisawa, Y Niwa, N Ohmiya, T Hayakawa
    ENDOSCOPY 33(1) 65-69 2001年1月  査読有り
    Background and Study Aims: This study was designed to assess the usefulness of variable-stiffness video colonoscopes, compared with conventional videoscopes. Patients and Methods: The first prototype XCF-QAY1 and the latter prototype XCF-Q240AI used in this study can be varied to 4 levels of stiffness of tube insertion during examination. In 352 consecutive colonoscopic examinations performed using these and two conventional scopes, the following data were recorded: time for intubation to the cecum, frequency of changes in the patients' posture, frequency of abdominal pressure attempts, and pain score. The degree of stiffness of the insertion tube and the examiners' impressions score were recorded only in procedures where the variable-stiffness scopes were used. Results: There was no significant difference between colonoscopes in the pain score. Total colonoscopy rate was 97.4 %. The frequency of usage of the varying stiffness control in the colon according to site was as follows: descending colon, 57.3 %; transverse colon, 32.8 %, sigmoid colon, 7.6 %; and ascending colon, 2.3 %. A significant difference in the mean time for intubation to the cecum between the XCF-Q240AI and conventional scopes was observed. Moreover, there were significant differences in the frequency of abdominal pressure attempts and changes in the patient's posture between conventional scopes and the new scopes. Conclusions: These results suggest that only one scope, the XCF-Q240AI, is needed for any colonic examination by any examiner.
  • 古田しま子, 後藤秀実, 有沢富康, 丹羽康正, 大宮直木, 神谷健司, 早川哲夫
    Progress in Medicine 21(3) 633-635 2001年  
    胃癌培養細胞株MKN45において,IFN-γはsTNFRを放出することにより,TNFによる細胞傷害を制御している可能性があると考えられた
  • 大塚 泰郎, 後藤 秀実, 丹羽 康正, 有澤 富康, 大宮 直木, 神谷 健司, 坂田 豊博, 安藤 伸浩, 小栗 彰彦, 伊藤 文一
    Gastroenterological Endoscopy 42(Suppl.2) 1678-1678 2000年9月  
  • 伊藤 文一, 後藤 秀実, 丹羽 康正, 有沢 富康, 大宮 直木, 坂田 豊博, 安藤 伸浩, 大塚 泰郎, 小栗 彰彦, 早川 哲夫
    Gastroenterological Endoscopy 42(Suppl.2) 1687-1687 2000年9月  
  • 神谷 健司, 後藤 秀実, 丹羽 康正, 大宮 直木
    日本大腸肛門病学会雑誌 53(9) 649-649 2000年9月  

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