Curriculum Vitaes
Profile Information
- Affiliation
- School of Medicine Faculty of Medicine, Department of Advanced Endoscopy (formerly Department of Gastroenterology), Fujita Health University
- Degree
- 博士(医学）
- J-GLOBAL ID
- 200901011108502975
- researchmap Member 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。
Research Interests
8Research Areas
1Committee Memberships
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Jul, 2023 - Present
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- Present
Awards
4-
May, 2000
Papers
270-
The Journal of dermatology, Sep 30, 2024 Peer-reviewed
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JAMA, Jul 22, 2024 Peer-reviewedImportance 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
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Journal of gastrointestinal and liver diseases : JGLD, 33(2) 164-169, Jun 29, 2024 Peer-reviewedBACKGROUND 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.
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Journal of gastroenterology, 59(5) 376-388, May, 2024 Peer-reviewedBACKGROUND: 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.
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日本消化器病学会雑誌, 121(臨増総会) A190-A190, Mar, 2024
Misc.
1258-
消化器内視鏡, 19(6) 795-801, 2007小腸内視鏡の分野は、2001年におけるダブルバルーン内視鏡(DBE)、カプセル内視鏡(VCE)の臨床導入により一気に飛躍した。それらは術後の消化管においても対応が可能である。特にDBEにおいては、blind loop挿入などによる術後腸管におけるtotal enteroscopyや、術後吻合部狭窄に対してのバルーン拡張術、術後出血の検索、内視鏡的止血術などの処置までカバーできるといった特徴を有する。一方、VCEは術後腸管への施行は躊躇される面もあるが、術後すぐの患者に対しても施行ができ、またDBEが癒着で深部挿入できなかった際に、補助的に用いるといった役割が担える。DBEとVCEはともに補足的な検査といわれるが、術後消化管においても同様であり、両者を上手に活用されると臨床効果は高い。(著者抄録)
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消化器の臨床, 10(5) 491-496, 2007十二指腸乳頭部腫瘍に対する内視鏡的乳頭切除術はいまだ確立した治療手技ではないが、胆膵管内進展を伴わない腺腫または腺腫内癌を適応とすることでおおむね同意が得られている。切除に際しては、十二指腸スコープを用いた切開波による一括切除を基本とし、出血のコントロールと膵管ステントによる膵炎予防が術後処置として重要である。切除断端陰性が得られれば良好な長期予後が得られ、乳頭部腫瘍に対する根治術として評価できる。(著者抄録)
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消化器内視鏡, 19(6) 795-801, 2007小腸内視鏡の分野は、2001年におけるダブルバルーン内視鏡(DBE)、カプセル内視鏡(VCE)の臨床導入により一気に飛躍した。それらは術後の消化管においても対応が可能である。特にDBEにおいては、blind loop挿入などによる術後腸管におけるtotal enteroscopyや、術後吻合部狭窄に対してのバルーン拡張術、術後出血の検索、内視鏡的止血術などの処置までカバーできるといった特徴を有する。一方、VCEは術後腸管への施行は躊躇される面もあるが、術後すぐの患者に対しても施行ができ、またDBEが癒着で深部挿入できなかった際に、補助的に用いるといった役割が担える。DBEとVCEはともに補足的な検査といわれるが、術後消化管においても同様であり、両者を上手に活用されると臨床効果は高い。(著者抄録)
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Journal of biomedical materials research. Part A, 79(4) 771-8, Dec 15, 2006 Peer-reviewedRecently, decellularized tissue has been reported to have the potential to regenerate a variety of tissues. However, the optimal protocol for a decellularized esophagus has not been studied. Here, we investigated the effect of different decellularization protocols on the histology and biocompatibility of decellularized esophagi in view of future applications to tissue engineering. The esophageal mucosal epithelium (EP) from 4-week-old Wistar rats was enzymatically dissociated and cultured with growth-arrested feeder cells. Two methods for decellularization using deoxycholic acid (DEOX) or Triton X-100 (TRITON) were compared on esophagi from adult Wistar rats. Those treated with DEOX showed superior mechanical properties, maintenance of extracellular matrix, and lower DNA content than those treated with TRITON. To evaluate the biocompatibility of the scaffold, cultured (passage 3) esophageal epithelial cells were seeded inside the decellularized esophagus and cultured for 7 days. The cells seeded onto the decellularized esophagus were examined histologically and immunocytochemically. Esophageal epithelial cells were stratified into three to four cellular layers in vitro inside the decellularized esophagus, to show polarity. The results from immunocytochemistry indicated that the seeded epithelial cells expressed characteristic marker proteins for native esophageal EP. Decellularized esophagus showed suitable compatibility as a scaffold material for esophageal tissue engineering. (c) 2006 Wiley Periodicals, Inc.
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GUT, 55(12) 1768-1773, Dec, 2006 Peer-reviewedBackground: Relapse of ulcerative colitis is difficult to predict by routine colonoscopy. A high-resolution video-magnifying colonoscope with chromoscopy enables the observation of colorectal mucosal pit patterns. Aims: To investigate the association of pit patterns as assessed by magnifying colonoscopy (MCS) with histological inflammation and mucosal chemokine activity in patients with quiescent ulcerative colitis, and to prospectively analyse the prognostic factors that may predict exacerbations. Methods: MCS was performed in 113 patients with ulcerative colitis in remission. Pit patterns in the rectal mucosa were classified into four MCS grades on the basis of size, shape and arrangement. Mucosal interleukin (IL) 8 activity was measured in biopsy specimens of rectal mucosa and the specimens were assessed for histological disease activity. The patients were then followed until relapse or for a maximum of 12 months. Multivariate survival analysis was carried out to determine the independent predictors of clinical relapse. Results: A positive correlation was identified between MCS grade, histological grade (p = 0.001) and mucosal IL8 activity (p < 0.001). Multivariate proportional hazard model analysis showed that MCS grade was a significant predictor of relapse (relative risk 2.06, p = 0.001). Kaplan - Meier estimate of relapse during 12 months of follow-up was found to increase with increasing MCS grade, with values of 0% for grade 1, 21% for grade 2, 43% for grade 3 and 60% for grade 4. Conclusion: MCS grading is associated with the degree of histological inflammation and mucosal IL8 activity in patients with quiescent ulcerative colitis, and may predict the probability of subsequent disease relapse in patients with ulcerative colitis in remission.
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Toxicology and applied pharmacology, 217(1) 35-42, Nov 15, 2006 Peer-reviewedPaeonol, a major phenolic component of Moutan Cortex, is known to have anti-inflammatory activity. However, the effect of Paeonol on colitis has not been evaluated and the molecular mechanism of its anti-inflammatory action remains unknown. The aim of this study was to determine if Paeonol enema attenuates trinitrobenzene sulfonic acid (TNBS)-induced colitis in mice. We also investigated the effects of Paeonol in colon cancer-derived CW-2 cells and T cell leukemia-derived Jurkat cells treated with tumor necrosis factor alpha (TNF alpha) and/or interferon gamma (IFN gamma), which play critical roles in TNBS-induced colitis. Paeonol enema attenuated TNBS-induced colitis judging by body weigh reduction, colon length and histological score. Myeloperoxidase activity and inducible nitric oxide synthase (iNOS) production in the colon were also reduced with Paeonol enema. In CW-2 cells, Paeonol inhibited NOS protein and mRNA expression induced by costimulation of TNF alpha and IFN gamma. Furthermore, Paeonol reduced TNF alpha-induced NF-kappa B transactivation and IFN-gamma-induced STAT1 transactivation in CW-2 cells and also in Jurkat cells. These findings suggest that Paeonol enema may be useful for the treatment of colitis. (c) 2006 Elsevier Inc. All rights reserved.
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ENDOSCOPY, 38(11) 1110-1114, Nov, 2006 Peer-reviewedBackground and study aims: Advances in endoscopy have led to imaging of the details of the gastric mucosa, but the histological diagnosis usually has to be confirmed by endoscopic biopsy. A method of confocal endomicroscopy that has recently been developed allows the observation of living cells in vivo. Several investigators have reported that the technique is of value, but there have as yet been no studies describing its application in gastric cancer. Patients and methods: Twenty-seven patients with early gastric cancer underwent confocal endomicroscopy (Pentax EG3870CIK; Pentax, Tokyo,japan). After intravenous administration of fluorescein sodium, confocal images obtained from the normal mucosa and from cancerous lesions were interpreted by two pathologists independently and compared with the histological findings, including CD34 immunostaining of biopsy specimens or resected specimens from the same sites. Results: Fluorescein yielded high-quality confocal images of the gastric mucosa; if cancer could be targeted (59%) images were mostly graded good. The images corresponded to the hematoxylin-eosin staining of transverse sections of specimens from the same sites. In the results for the interpretation by the two pathologists, the accuracy for the diagnosis of gastric cancer was 94.2% (pathologist A), and 96.2% (pathologist B), respectively. The accuracy decreased substantially when poor images and inaccessible lesions were included. Conclusions: Confocal endomicroscopy is useful in the diagnosis of gastric cancer but good quality images cannot always be obtained. In the future, it may allow virtual biopsy and help reduce unnecessary biopsies.
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Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 24(27) 4434-40, Sep 20, 2006 Peer-reviewedPurpose Recently, a single-nucleotide polymorphism in the MDM2 promoter (SNP309) has been found to lower the age of onset of tumors and increase the occurrence of multiple primary tumors in Li-Fraumeni syndrome, and accelerate the development of sporadic adult soft tissue sarcoma. The aim of this study was to determine whether SNP309 is associated with susceptibility to gastric carcinoma and its prognosis. Patients and Methods In a case-control study including 438 controls and 410 patients with sporadic gastric carcinoma, MDM2 SNP309 was genotyped. Serum pepsinogens (PGs) I and II were measured in 438 control subjects and 253 cases selected from 410 patients. Tumor tissue was immunostained with p53 and examined for mutations in exons 5 to 8 of p53 using polymerase chain reaction-based single strand conformational polymorphism analysis and direct sequencing. Results The risk of overall gastric carcinoma for SNP309 (G/G) was significantly increased when compared with T carriers (P =.039), especially carcinomas with extragastric tumors (P =.005), carcinoma with severe atrophic gastritis positive for PG assay (PG I level < 70 ng/mL and PG I/II < 3.0; P =.005), antral carcinoma (P =.020), intestinal-type carcinoma (P =.023), p53-immunopositive carcinoma (P =.007), and carcinoma with p53 mutations (P =.007). No significant difference in age at diagnosis was observed among genotypes. SNP309 (G/G) was an independent marker of poor overall survival in advanced carcinoma (hazard ratio, 3.16; 95% Cl, 1.22 to 8.20; P =.018). Conclusion This study provides evidence supporting the association of SNP309 with gastric carcinogenesis via p53 tumor suppressor pathway, extragastric tumorigenesis, and poor prognosis.
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日本消化器病学会雑誌, 103(臨増大会) A700-A700, Sep, 2006
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Gastroenterological Endoscopy, 48(Suppl.2) 1888-1888, Sep, 2006
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Gastroenterological Endoscopy, 48(Suppl.2) 1928-1928, Sep, 2006
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Gastroenterological Endoscopy, 48(Suppl.2) 2046-2046, Sep, 2006
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日本消化器病学会雑誌, 103(臨増大会) A828-A828, Sep, 2006
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肝胆膵治療研究会誌, 4(1) 51-55, Aug, 200657歳男.患者は背部痛を主訴とした.腹部超音波,超音波内視鏡,CTで,膵尾部に径30mm大の境界明瞭な腫瘍を認め,内部は嚢胞状の変化と乳頭状の充実を認めた.更にERCP-IDUSでは,主膵管は膵尾部で圧排狭窄し,尾側膵管の拡張を認めたが,乳頭開口部の開大や粘液の排出は認めず,膵管内に粘液を疑う所見は認められなかった.Solid pseudopapillary tumorを第一に考え,膵体尾部切除術を施行したところ,病理組織学的所見では,残存する嚢胞壁上皮に腫瘍レベルから上皮内癌レベルまでの異型を有し,低乳頭状に増殖するintraductal papillary mucinous tumor(IPMT)がみられ,最終病理診断はIPMT由来浸潤癌であった
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Journal of gastroenterology and hepatology, 21(7) 1129-35, Jul, 2006Background and Aim: Gastric carcinoma (GC) with microsatellite instability (MST) exhibits clinicopathological characteristics distinct from microsatellite- stable (MSS) GC. Both MST and MSS carcinomas are mostly associated with chronic gastritis infected by Helicobacter pylori (Hp). The relationship between Hp-induced inflammation and the mutator pathway of MST remains unclear. Recently, cytokine polymorphisms have been reported to affect the development of non-cardia GC. The objective of this study was to elucidate the relationship between cytokine polymorphisms and MST phenotypes. Methods: In a case-control study including 482 controls and 181 patients with GC, interleukin (IL)-8-25 1, IL-IB-511, IL-IRN, and tumor necrosis factor-A (TNFA)-857 polymorphisms were genotyped. The presence of MST and mutations in exons 5 to 8 of the p53 gene were examined in GC cases. All clinicopathrological data were collected from individual records. Results: High and low frequency of MST (MSI-H and MSI-L) and MSS were detected in 16 (8.8%), 14 (7.7%) and 151 (83.4%) GC cases, respectively. We found that IL-8-251 T/ T genotype was significantly associated with increased risk of MSI-H GC compared to MSI-L/MSS GC and controls. We found no association between other cytokine polymorphisms and MSI-H GC. The percentage of smokers and the frequency of p53 mutations were significantly lower in MSI-H than MSI-L/MSS GC. We found significant associations of MSI-H with synchronous or metachronous multiple occurrence, antral location and intestinal type. Conclusions: Our study shows that MSI-H GC is associated with IL-8-251 T/T (low expression genotype) and is inversely correlated with cigarette smoking.
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GASTROENTEROLOGY, 130(4) A573-A573, Apr, 2006
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GASTROINTESTINAL ENDOSCOPY, 63(5) AB167-AB167, Apr, 2006
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GASTROINTESTINAL ENDOSCOPY, 63(5) AB175-AB175, Apr, 2006
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GASTROINTESTINAL ENDOSCOPY, 63(5) AB307-AB307, Apr, 2006
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GASTROINTESTINAL ENDOSCOPY, 63(5) AB258-AB258, Apr, 2006
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GASTROENTEROLOGY, 130(4) A642-A643, Apr, 2006
Books and Other Publications
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羊土社, Oct 15, 2024 (ISBN: 9784758110853)
Presentations
430-
JDDW2024 第108回日本消化器内視鏡学会, Nov 1, 2024
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第62回日本小腸学会学術集会, Oct 19, 2024
Teaching Experience
7Professional Memberships
12Research Projects
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Grants-in-Aid for Scientific Research, Japan Society for the Promotion of Science, Apr, 2022 - Mar, 2025
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Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C), Japan Society for the Promotion of Science, Apr, 2022 - Mar, 2025
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Advanced medical care B, Ministry of Health, Labour and Welfare, Feb, 2021 - Jun, 2024
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令和6年度 医療機器等研究成果展開事業（開発実践タイプ）, 国立研究開発法人日本医療研究開発機構（AMED), Jun, 2024
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令和３年度難治性疾患実用化研究事業, 国立研究開発法人日本医療研究開発機構（AMED), May, 2021 - Mar, 2024