医学部 消化器内科学
Profile Information
- Affiliation
- Associate Professor, School of Medicine Faculty of Medicine, Fujita Health University
- Degree
- 博士(医学)
- Other name(s) (e.g. nickname)
- 許可する
- J-GLOBAL ID
- 201501016495969959
- researchmap Member ID
- 7000013246
Research Areas
1Research History
6-
2022 - Present
-
2013 - 2022
-
2008 - 2013
-
2006 - 2008
Education
3-
Apr, 2024 - Present
-
2008 - 2012
-
1998 - 2004
Committee Memberships
8-
Aug, 2023 - Present
-
2023 - Present
-
2023 - Present
-
2023 - Present
-
2020 - Present
Awards
3Papers
37-
Immunological Medicine, 1-11, Nov 28, 2024 Peer-reviewed
-
Pathology international, Sep 11, 2024 Peer-reviewedThis study aimed to validate the DFS (direct fast scarlet) staining in the diagnosis of EC (eosinophilic colitis). The study included 50 patients with EC and 60 with control colons. Among the 60 control samples, 39 and 21 were collected from the ascending and descending colons, respectively. We compared the median number of eosinophils and frequency of eosinophil degranulation by HE (hematoxylin and eosin) and DFS staining between the EC and control groups. In the right hemi-colon, eosinophil count by HE was useful in distinguishing between EC and control (41.5 vs. 26.0 cells/HPF, p < 0.001), but the ideal cutoff value is 27.5 cells/HPF (high-power field). However, this method is not useful in the left hemi-colon (12.5 vs. 13.0 cells/HPF, p = 0.990). The presence of degranulation by DFS allows us to distinguish between the groups even in the left hemi-colon (58% vs. 5%, p < 0.001). DFS staining also enabled a more accurate determination of degranulation than HE. According to the current standard to diagnose EC (count by HE staining ≥20 cells/HPF), mucosal sampling from left hemi-colon is problematic since the number of eosinophils could not be increased even in EC. Determination of degranulated eosinophils by DFS may potentiate the diagnostic performance even in such conditions.
-
Pancreas, Feb 12, 2024 Peer-reviewedLead authorOBJECTIVES: We set out to predict whether nonsurgical treatment is likely to succeed in removing pancreatic stones in a given patient and also to determine an optimal maximal number of extracorporeal shock wave lithotripsy (ESWL) sessions for treatment of pancreatolithiasis in that patient. MATERIALS AND METHODS: We ascertained the number of ESWL sessions for each of 164 patients undergoing that treatment for pancreatolithiasis between 1992 and 2020. Median follow-up duration was 31 months (range, 0-239), median age was 58 years (22-83), and the male to female ratio was 5.1:1.0. Patients were divided into 2 groups based upon an optimal maximal number of ESWL sessions determined by receiver operating characteristic analysis. RESULTS: Total stone clearance was achieved in 130 of 164 patients (79%). The median number of ESWL sessions was 3 (1-61). Receiver operating characteristic analysis determined 7 to be the optimal maximal number of sessions. Complete clearance was more frequent (87%) among the 131 patients requiring 7 or fewer ESWL sessions than among the 33 undergoing more (48%, P < 0.001). Seventeen patients (52%) undergoing 8 or more sessions still had residual stones. CONCLUSIONS: If any pancreatic stones persist after 7 ESWL sessions, we recommend transition to medical or surgical treatments.
-
Fujita medical journal, 9(2) 154-159, May, 2023 Peer-reviewedLead authorA 69-year-old woman suspected to have IgG4-related sclerosing cholangitis causing bile duct stenosis was transferred from another hospital after diarrhea, eosinophilia, and eosinophilic infiltration were detected and prednisolone was prescribed. Additional biliary imaging suggested primary sclerosing cholangitis, but the IgG4 level and inferior bile duct stenosis were alleviated by steroid therapy, suggesting IgG4-related sclerosing cholangitis. Therefore, prednisolone was continued. Bile duct biopsy findings suggesting adenocarcinoma led to a diagnosis of pancreatoduodenectomy. The latter specimen only displayed evidence of primary sclerosing cholangitis, and prednisolone was discontinued. Intractable cholangitis necessitated left hepatectomy, after which serum alkaline phosphatase levels increased and eosinophilic colitis recurred. The reintroduction of prednisolone effectively managed the diarrhea but only temporarily reversed the alkaline phosphatase elevation. When histologic sections from resection specimens were compared, the hepatectomy specimen exhibited greater eosinophil infiltration than the earlier pancreatoduodenectomy specimen, suggesting eosinophilic cholangiopathy superimposed on primary sclerosing cholangitis.
-
Fujita medical journal, 9(2) 113-120, May, 2023 Peer-reviewedLead authorOBJECTIVES: We aimed to determine when a coexisting pseudocyst was likely to complicate the nonsurgical treatment of pancreatolithiasis. METHODS: We treated 165 patients with pancreatolithiasis nonsurgically between 1992 and 2020, including 21 with pseudocysts. Twelve patients had a single pseudocyst less than 60 mm in diameter. Pseudocysts in the other nine patients had diameters of at least 60 mm or were multiple. The locations of pseudocysts along the length of the pancreas varied from the area with stone involvement to the pancreatic tail. We compared the outcomes in these groups. RESULTS: We found no significant differences in pain relief, stone clearance, stone recurrence, or the likelihood of adverse events between pseudocyst groups or between patients with vs without pseudocysts. However, 4 of 9 patients with large or multiple pseudocysts required transition to surgical treatment (44%) compared with 13 of 144 patients with pancreatolithiasis and no pseudocyst (9.0%) (P=0.006). CONCLUSIONS: Patients with smaller pseudocysts typically underwent nonsurgical stone clearance successfully with few adverse events, similar to findings in patients with pancreatolithiasis and no pseudocysts. Pancreatolithiasis complicated by large or multiple pseudocysts did not cause more adverse events but was more likely to require transition to surgery compared with pancreatolithiasis without pseudocysts. In patients with large or multiple pseudocysts, early transition to surgery should be considered when nonsurgical treatment is ineffective.
Misc.
106-
JOURNAL OF MEDICAL ULTRASONICS, 48(2) 175-186, Apr, 2021 Peer-reviewedDiseases associated with gallbladder wall thickening include benign entities such as adenomyomatosis of the gallbladder, acute and chronic cholecystitis, and hyperplasia associated with pancreaticobiliary maljunction, and also cancer. Unique conditions such as sclerosing cholecystitis and cholecystitis associated with immune checkpoint inhibitor treatment can also manifest as wall thickening, as in some systemic inflammatory conditions. Gallbladder cancer, the most serious disease that can show wall thickening, can be difficult to diagnose early and to distinguish from benign causes of wall thickening, contributing to a poor prognosis. Differentiating between xanthogranulomatous cholecystitis and gallbladder cancer with wall thickening can be particularly problematic. Cancers that thicken the wall while coexisting with benign lesions that cause wall thickening represent another potential pitfall. In contrast, some benign gallbladder lesions that can cause wall thickening, such as adenomyomatosis and acute cholecystitis, typically show characteristic ultrasonographic features that, together with clinical findings, permit easier diagnosis. In this review of the literature, we describe B-mode abdominal ultrasonographic diagnosis of gallbladder lesions showing wall thickening.
-
Ningen Dock International, 7(1) 14-18, Mar, 2020膵管内乳頭粘液性腫瘍(IPMN)に対する腹部超音波(US)と磁気共鳴胆道膵管造影(MRCP)の描出能を比較し、最終的なIPMNの外科的切除の必要性に関連する要因を特定した。IPMN患者170例(男性85例、女性85例、平均66±11歳)を対象に、USにより検出した病変を部位および嚢胞サイズにより評価した。さらに、フォローアップ期間中の手術の必要性に関連する臨床および画像の特徴を調べた。全嚢胞サイズに対して、MRCPと比較したUSによる検出率は膵頭部で60.8%、膵体部で79.8%、膵尾部で32.8%であった。170例の患者のうち、12例(7.1%)が追跡期間に外科的切除を実施した。主膵管の拡大(直径拡大≧0.2mm/年)および高齢(70歳以上)は外科的切除の必要性と独立して有意に関連することが示された。膵頭部および膵尾部におけるUSの嚢胞検出能は特に膵尾部において限定的であった。これらの領域では相対的に複数の嚢胞が頻発することから、USにより膵体部に嚢胞を検出した際はMRCPを実施すべきであることが示された。
-
消化器の臨床 = Clinics in gastroenterology, 22(3) 226-230, Aug, 2019
Books and Other Publications
2Presentations
81-
APA 2022 Annual Meeting, Nov, 2022
-
第26回国際膵臓学会/第53回日本膵臓学会, Jul, 2022
-
The 53 Annual Meeting of the Japan Pancreas Society and The 26 Meeting of the International Pancreas Society (Joint Meeting), Jul, 2022
-
APA&JPS 50th Joint Meeting, Nov, 2019