17 results on '"Iwamuro, Masaya"'
Search Results
2. Review of the diagnosis of gastrointestinal lanthanum deposition.
- Author
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Iwamuro M, Urata H, Tanaka T, and Okada H
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- Atrophy, Gastrointestinal Tract drug effects, Humans, Hyperphosphatemia complications, Kidney Failure, Chronic complications, Gastric Mucosa pathology, Gastrointestinal Diseases chemically induced, Hyperphosphatemia drug therapy, Kidney Failure, Chronic drug therapy, Lanthanum adverse effects
- Abstract
Lanthanum carbonate is used for treatment of hyperphosphatemia mostly in patients with chronic renal failure. Although lanthanum carbonate is safe, recently, lanthanum deposition in the gastrointestinal mucosa of patients has been reported in the literature. This review provides an overview of gastroduodenal lanthanum deposition and focuses on disease's endoscopic, radiological, and histological features, prevalence, and outcome, by reviewing relevant clinical studies, case reports, and basic research findings, to better understand the endoscopic manifestation of gastrointestinal lanthanum deposition. The possible relationship between gastric lanthanum deposition pattern and gastric mucosal atrophy is also illustrated; in patients without gastric mucosal atrophy, gastric lanthanum deposition appears as diffuse white lesions in the posterior wall and lesser curvature of the gastric body. In the gastric mucosa with atrophy, lanthanum-related lesions likely appear as annular or granular whitish lesions. Moreover, these white lesions are probably more frequently observed in the lower part of the stomach, where intestinal metaplasia begins., Competing Interests: Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)
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- 2020
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3. Frequent Involvement of the Duodenum with Lanthanum Deposition: A Retrospective Observational Study.
- Author
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Iwamuro M, Urata H, Tanaka T, Kawano S, Kawahara Y, and Okada H
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- Aged, Endoscopy, Digestive System, Female, Humans, Japan, Male, Middle Aged, Retrospective Studies, Duodenum physiopathology, Gastric Mucosa physiopathology, Intestinal Mucosa physiopathology, Lanthanum adverse effects
- Abstract
Objective This study aimed to investigate the endoscopic features of lanthanum-associated duodenal lesions and the prevalence of duodenal involvement among patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Methods We retrospectively reviewed 24 patients with pathologically proven lanthanum deposition in the gastrointestinal tract. Patients were subdivided into three groups: Group A, patients with pathologically-proven lanthanum deposition in the duodenum; Group B, patients without lanthanum deposition in the duodenum; and Group C, patients without a biopsy of the duodenum. Results A biopsy examination of the duodenum was performed in 19 patients, and lanthanum deposition was detected in 17 patients (17/19, 89.5%). In group A (n=17), whitish duodenal villi were detected in 15 patients during esophagogastroduodenoscopy (15/17, 88.2%). While the other two patients showed no whitish villi, a biopsy of the duodenal mucosa revealed lanthanum deposition. The deposition of a white substance showing a clear margin was visible within multiple villi under magnified observation in some patients of group A. Group B patients (n=2) also showed whitish villi. However, the whitish color was faint in one case and sparse in the other case. Conclusion Lanthanum deposits in the duodenum may resemble white villi. However, in some cases, these deposits may be unrecognizable during esophagogastroduodenoscopy due to the subtle degree of deposition. Endoscopists should biopsy the duodenum as well as the stomach, regardless of the presence or absence of white villi, for an accurate determination of lanthanum deposition in the gastrointestinal tract.
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- 2019
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4. Gastric lanthanum phosphate deposition masquerading as white globe appearance.
- Author
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Iwamuro M, Urata H, Tanaka T, and Okada H
- Subjects
- Aged, Biopsy, Gastric Mucosa ultrastructure, Humans, Hyperphosphatemia drug therapy, Hyperphosphatemia etiology, Male, Microscopy, Electron, Scanning, Gastric Mucosa drug effects, Lanthanum adverse effects
- Published
- 2019
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5. Lanthanum deposition corresponds to white lesions in the stomach.
- Author
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Iwamuro M, Urata H, Tanaka T, Kawano S, Kawahara Y, Kimoto K, and Okada H
- Subjects
- Adult, Aged, Biopsy, Endoscopy, Digestive System methods, Humans, Kidney Failure, Chronic therapy, Lanthanum metabolism, Male, Middle Aged, Renal Dialysis methods, Stomach pathology, Stomach Diseases etiology, Stomach Diseases pathology, Gastric Mucosa pathology, Kidney Failure, Chronic etiology, Lanthanum pharmacology, Stomach drug effects
- Abstract
Objective: Although lanthanum deposition in the stomach has been most frequently reported to occur as white lesions, no study has investigated whether the white lesions observed during esophagogastroduodenoscopy are truly lanthanum-related. Here, we retrospectively investigated the amount of lanthanum in endoscopic biopsy specimens., Methods: We reviewed four patients showing gastric white spots or annular whitish mucosa in the gastric white lesions (Bw) and peripheral mucosa where the white substance was not endoscopically observed (Bp) during biopsy. We also reviewed three patients with diffuse whitish mucosa and three patients with no whitish lesions. We performed scanning electron microscopy and energy dispersive X-ray spectrometry to quantify the lanthanum elements (wt%) in the biopsy specimens., Results: The amount of lanthanum in the Bw ranged from 0.15-0.31 wt%, whereas that of Bp was 0.00-0.13 wt%. The difference was statistically significant (P < 0.05). The amount of lanthanum in the Bw, endoscopically presented with white spots or annular whitish mucosa, was significantly higher than that of no whitish lesions (0.05-0.14 wt%, P < 0.05). The amount of lanthanum was also higher in the diffuse whitish mucosa (0.21-0.23 wt%) compared with no whitish lesions (P < 0.01)., Conclusions: This study is the first to reveal that pathological lanthanum deposition corresponds to the endoscopically observed white lesions in the gastric mucosa. Therefore, during esophagogastroduodenoscopy, physicians should pay attention to possible presence of white lesions in patients treated with oral lanthanum carbonate to ensure prompt identification of associated issues., (Copyright © 2018 Elsevier GmbH. All rights reserved.)
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- 2018
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6. Lanthanum Deposition in the Stomach in the Absence of Helicobacter pylori Infection.
- Author
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Iwamuro M, Urata H, Tanaka T, Kawano S, Kawahara Y, Kimoto K, and Okada H
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- Adult, Aged, Asian People, Gastric Mucosa diagnostic imaging, Helicobacter Infections, Helicobacter pylori, Humans, Male, Stomach Diseases diagnostic imaging, Stomach Neoplasms diagnosis, Stomach Neoplasms diagnostic imaging, Gastric Mucosa pathology, Lanthanum isolation & purification, Stomach Diseases pathology, Stomach Neoplasms pathology
- Abstract
In this case report, we describe two patients who showed a diffusely whitish mucosa in the posterior wall and the lesser curvature of the gastric body. The patients were serologically- and histopathologically-negative for Helicobacter pylori. Random biopsy specimens from the stomach revealed no regenerative changes, intestinal metaplasia, and/or foveolar hyperplasia in either of the patients. Although lanthanum deposition in the gastric mucosa has been reported to occur in close association with H. pylori-associated gastritis, our patients tested negative for H. pylori. These cases suggest that lanthanum deposition presents as whitish lesions in the gastric body in H. pylori-negative patients.
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- 2018
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7. Postoperative bleeding risk after gastric endoscopic submucosal dissection during antithrombotic drug therapy.
- Author
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Kono Y, Obayashi Y, Baba Y, Sakae H, Gotoda T, Miura K, Kanzaki H, Iwamuro M, Kawano S, Kawahara Y, Tanaka T, and Okada H
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- Aged, Case-Control Studies, Female, Heparin adverse effects, Humans, Male, Retrospective Studies, Risk, Fibrinolytic Agents adverse effects, Gastrectomy methods, Gastric Mucosa surgery, Gastrointestinal Hemorrhage etiology, Gastroscopy methods, Postoperative Complications etiology, Stomach Neoplasms surgery
- Abstract
Background and Aim: The safety of gastric endoscopic submucosal dissection (ESD) in the antithrombotic drug users remains controversial., Methods: Patients who underwent gastric ESD at Okayama University Hospital between March 2006 and February 2016 were enrolled. This study investigated the risk of post-ESD bleeding according to the management of the antithrombotic drugs., Results: One thousand twenty lesions (872 patients) were enrolled. In a multivariate analysis, heparin replacement (odds ratio [OR] 5.0, 95% confidence interval [CI] 1.8-14), multiple antithrombotic drug use (OR 2.9, 95% CI 1.1-6.9), a resected specimen of ≥ 33 mm in diameter (OR 2.7, 95% CI 1.5-5.4), Helicobacter pylori negativity (OR 2.2, 95% CI 1.3-3.7), and tumors located in the lower third of the stomach (OR 1.7, 95% CI 1.0-2.9) were significant risk factors for post-ESD bleeding, while the continuation of aspirin or cilostazol was not (OR 2.6, 95% CI 0.72-7.8). The bleeding rate of the continuation group was comparable with that of the all cessation group among single antithrombotic drug users (4.5% vs 4.4%, P = 1.0); however, the rate of the continuation group was significantly higher than that of the all cessation group among multiple antithrombotic drug users (67% vs 15%, P = 0.020)., Conclusions: The risk of post-ESD bleeding differed according to the management of the antithrombotic drugs. The gastric ESD under the cessation or continuation of aspirin or cilostazol monotherapy was acceptable. However, multiple antithrombotic drug use or heparin replacement was associated with a higher risk of post-ESD bleeding., (© 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)
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- 2018
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8. Lanthanum phosphate deposition in the duodenum.
- Author
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Iwamuro M, Tanaka T, Urata H, Kimoto K, and Okada H
- Subjects
- Aged, Duodenum diagnostic imaging, Duodenum pathology, Endoscopy, Gastrointestinal, Gastric Mucosa diagnostic imaging, Gastric Mucosa pathology, Humans, Hyperphosphatemia prevention & control, Intestinal Mucosa diagnostic imaging, Intestinal Mucosa pathology, Lanthanum therapeutic use, Male, Microscopy, Electron, Scanning, Renal Dialysis, Duodenum metabolism, Gastric Mucosa metabolism, Intestinal Mucosa metabolism, Lanthanum metabolism
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- 2017
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9. Lanthanum Deposition in the Stomach: Usefulness of Scanning Electron Microscopy for Its Detection.
- Author
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Iwamuro M, Urata H, Tanaka T, Ando A, Nada T, Kimura K, Yamauchi K, Kusumoto C, Otsuka F, and Okada H
- Subjects
- Aged, Endoscopy, Digestive System, Female, Humans, Hyperphosphatemia drug therapy, Kidney Failure, Chronic therapy, Lanthanum chemistry, Gastric Mucosa diagnostic imaging, Lanthanum analysis, Microscopy, Electron, Scanning methods
- Abstract
After having been treated with lanthanum carbonate administration for 4 years for hyperphosphatemia, a 75-year-old Japanese woman undergoing hemodialysis was diagnosed with lanthanum phosphate deposition in the stomach. The deposition, seen as white microgranules, was observed using esophagogastroduodenoscopy with magnifying observation. To the best of our knowledge, these are the minutest endoscopy images of lanthanum phosphate deposition in the gastric mucosa. Scanning electron microscopy (SEM) observation enabled easier identification of the deposited material, which was visible as bright areas. The present case suggests the usefulness of SEM observation in the detection of lanthanum phosphate deposition in the gastrointestinal tract., Competing Interests: No potential conflict of interest relevant to this article was reported.
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- 2017
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10. Intravascular lymphoma with a gastric submucosal tumor.
- Author
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Sawahara H, Iwamuro M, Ito M, Nose S, Nishimura M, and Okada H
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- Aged, Biopsy, Gastric Mucosa blood supply, Gastric Mucosa diagnostic imaging, Humans, Lymphoma diagnostic imaging, Male, Positron-Emission Tomography, Stomach Neoplasms blood supply, Stomach Neoplasms diagnostic imaging, Stomach Neoplasms pathology, Tomography, X-Ray Computed, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Gastric Mucosa pathology, Lymphoma drug therapy, Stomach Neoplasms drug therapy
- Abstract
A 75-year-old man was admitted to our hospital for further examination of swollen lymph nodes and a possible gastric submucosal tumor. He had persistent fever and anorexia. Blood examination showed anemia, thrombocytopenia, and elevated lactate dehydrogenase and soluble interleukin 2 receptor levels. Swollen lymph nodes and splenomegaly were evident on computed tomography, and the submucosal tumor was revealed by esophagogastric endoscopy. Cervical lymph node biopsy and endoscopic biopsy were performed, which revealed a diagnosis of intravascular lymphoma. In Asian countries, patients with intravascular lymphoma often have hemophagocytic syndrome without lesions of the central nervous system or skin, which is called the Asian variant of intravascular lymphoma. In this case, the patient had no indicative lesions and had no evidence of the hemophagocytic syndrome. He also had lymph node swelling and a gastric submucosal tumor, which are rare in intravascular lymphoma. The patient was treated with chemotherapy (R-CHOP;rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisolone), and complete response was demonstrated (based on the Response Evaluation Criteria for Solid Tumours [RECIST] guideline). In cases of possible intravascular lymphoma, gastrointestinal endoscopy and biopsy should be considered because they are a useful diagnostic strategy.
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- 2017
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11. Lanthanum phosphate deposition in the gastric mucosa of patients with chronic renal failure.
- Author
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Iwamuro M, Kanzaki H, Tanaka T, Kawano S, Kawahara Y, and Okada H
- Subjects
- Aged, Biopsy, Endoscopy, Digestive System, Humans, Lanthanum therapeutic use, Male, Renal Dialysis, Gastric Mucosa drug effects, Kidney Failure, Chronic therapy, Lanthanum adverse effects
- Abstract
A 77-year-old Japanese man underwent endoscopic submucosal dissection twice over a 5-year period for the treatment of two separate early gastric cancers. He had been taking lanthanum carbonate, an orally administered phosphate binder, for 3 years. Esophagogastroduodenoscopy revealed reddish mucosa in the greater curvature and anterior wall of the gastric angle, while granular, white deposits were also observed in some areas of this reddish mucosa. Additionally, biopsy specimens from the gastric mucosa revealed the deposition of fine, amorphous, eosinophilic material, which appeared bright on scanning electron microscopy. Energy dispersive X-ray spectroscopy revealed the presence of lanthanum and phosphate in these bright areas, and elemental mapping confirmed that their distribution was identical to that seen in the bright areas. Based on these findings, the diagnosis of lanthanum phosphate deposition in the gastric mucosa was determined.
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- 2016
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12. Propofol sedation with a target-controlled infusion pump and bispectral index monitoring system in elderly patients during a complex upper endoscopy procedure.
- Author
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Gotoda T, Okada H, Hori K, Kawahara Y, Iwamuro M, Abe M, Kono Y, Miura K, Kanzaki H, Kita M, Kawano S, and Yamamoto K
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- Adult, Age Factors, Aged, Aged, 80 and over, Blood Pressure, Dissection, Drug Monitoring instrumentation, Female, Humans, Hypnotics and Sedatives adverse effects, Hypnotics and Sedatives blood, Hypotension chemically induced, Hypoxia chemically induced, Infusion Pumps, Lung physiopathology, Male, Middle Aged, Monitoring, Intraoperative instrumentation, Propofol adverse effects, Propofol blood, Systole, Deep Sedation adverse effects, Deep Sedation instrumentation, Endoscopy, Gastrointestinal methods, Gastric Mucosa surgery, Hypnotics and Sedatives administration & dosage, Propofol administration & dosage, Stomach Neoplasms surgery
- Abstract
Background and Aims: Although the usefulness of propofol sedation during endoscopic submucosal dissection (ESD) for gastric neoplasms was reported previously, information is limited on its use in elderly patients. We investigated the safety and efficacy of propofol sedation with a target-controlled infusion (TCI) pump and bispectral index (BIS) monitoring system (TCI/BIS system) in elderly patients during gastric ESD., Methods: Included were 413 consecutive gastric ESD procedures involving 455 lesions (379 patients) performed in patients under propofol sedation with a TCI/BIS system between October 2009 and September 2013. Patients were divided into 3 groups: group A, age <70 years (n = 162); group B, age ≥70 and <80 years (n = 171); and group C, age ≥80 years (n = 80). We compared the propofol dose and adverse events (eg, hypotension and hypoxemia) during ESD., Results: Older groups required a lower target concentration of propofol (group A: median 2.1 μg/mL [interquartile range (IQR), 1.9-2.3]; group B: median 1.6 μg/mL [IQR, 1.3-1.8]; and group C: median 1.4 μg/mL [IQR, 1.2-1.6]; P < .0001). Hypotension tended to occur in the younger group, and hypoxemia occurred at a significantly higher rate in the older groups, although the number of cases was small. Low preoperative systolic blood pressure (≤125 mm Hg) was associated with hypotension (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.12-2.70; P = .013) and abnormal pulmonary function was associated with hypoxemia in groups B and C (OR, 4.54; 95% CI, 1.01-31.5; P = .048)., Conclusions: Elderly patients required lower doses of propofol with the TCI/BIS system than younger patients. Attention to hypoxemia is necessary in elderly patients, particularly patients with abnormal pulmonary function., (Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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13. White Gastric Mucosa in a Dialysis Patient.
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Iwamuro M, Sakae H, and Okada H
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- Administration, Oral, Aged, Biopsy, Chelating Agents analysis, Endoscopy, Digestive System, Gastric Mucosa ultrastructure, Humans, Hyperphosphatemia diagnosis, Hyperphosphatemia etiology, Kidney Failure, Chronic complications, Kidney Failure, Chronic diagnosis, Lanthanum analysis, Male, Microscopy, Electron, Scanning, Spectrometry, X-Ray Emission, Chelating Agents administration & dosage, Gastric Mucosa chemistry, Hyperphosphatemia drug therapy, Kidney Failure, Chronic therapy, Lanthanum administration & dosage, Renal Dialysis
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- 2016
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14. Endoscopic findings of gastric neoplasms in familial adenomatous polyposis are associated with the phenotypic variations and grades of dysplasia
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Kobashi, Mayu, Iwamuro, Masaya, Kuraoka, Sakiko, Inoo, Shoko, Okanoue, Shotaro, Satomi, Takuya, Hamada, Kenta, Abe, Makoto, Kono, Yoshiyasu, Kanzaki, Hiromitsu, Kawano, Seiji, Tanaka, Takehiro, Kawahara, Yoshiro, and Okada, Hiroyuki
- Subjects
Hyperplasia ,gastric cancer ,General Medicine ,gastric adenoma ,Adenomatous Polyps ,phenotypic variations ,Polyps ,Adenomatous Polyposis Coli ,Biological Variation, Population ,Gastric Mucosa ,Stomach Neoplasms ,familial adenomatous polyposis ,Humans ,Atrophy - Abstract
Patients with familial adenomatous polyposis (FAP) are at increased risk of developing gastric neoplasms. However, endoscopic findings have not been sufficiently investigated. We investigated the phenotypic expression of gastric adenoma (low-grade dysplasia) and gastric cancer (high-grade dysplasia or carcinoma) in patients with FAP and clarified their relationships to endoscopic findings. Of 29 patients with FAP who underwent esophagogastroduodenoscopy between 2005 and 2020, 11 (38%) had histologically confirmed gastric neoplasms, including 23 lesions of gastric adenoma and 9 lesions of gastric cancer. The gastric neoplasms were classified into 3 phenotypes (gastric, mixed, or intestinal type) according to the immunostaining results and evaluated for location (U or M region: upper or middle third of the stomach or L region: lower third of the stomach), color (same as the background mucosa, whitish, or reddish), macroscopic type (elevated, flat, or depressed), background mucosal atrophy (present or absent), fundic gland polyps in the surrounding mucosa (present or absent), and morphologic changes in tumor size. Elevated whitish gastric adenomas were further subdivided by macroscopic type (flat elevated, protruded, or elevated with a central depression) and color (milky- or pinkish-white). The gastric adenomas included gastric (11/23, 48%), mixed (4/23, 17%), and intestinal (8/23, 35%) phenotypes. In contrast, no lesions of gastric cancers showed a gastric phenotype (0/9, 0%), while 5 (56%) and 4 (44%) lesions were intestinal and mixed phenotypes, respectively. Gastric cancers were significantly more likely than gastric adenomas to present as reddish depressed lesions with gastric atrophy. All gastric-type adenomas occurred in non-atrophic mucosa, in mucosa with fundic gland polyps in the periphery, in the U or M region, and as flat elevated or protruded lesions with a milky-white color. Half of the lesions increased in size. Meanwhile, the typical endoscopic features of intestinal-type adenomas included occurrence in the L region and elevated pinkish-white lesions with central depression. None of the intestinal-type adenomas increased in size during the observation period. We believe that these endoscopic features will be useful for the prompt diagnosis and appropriate management of gastric neoplasms in patients with FAP.
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- 2022
15. Endoscopic features of oxyntic gland adenoma and gastric adenocarcinoma of the fundic gland type differ between patients with and without Helicobacter pylori infection: a retrospective observational study.
- Author
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Iwamuro, Masaya, Kusumoto, Chiaki, Nakagawa, Masahiro, Matsueda, Kazuhiro, Kobayashi, Sayo, Yoshioka, Masao, Inaba, Tomoki, Toyokawa, Tatsuya, Sakaguchi, Chihiro, Tanaka, Shouichi, Tanaka, Takehiro, and Okada, Hiroyuki
- Subjects
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HELICOBACTER pylori infections , *GASTRIC mucosa , *GLANDS , *HELICOBACTER pylori , *ADENOCARCINOMA , *SCIENTIFIC observation - Abstract
Background: The endoscopic features of oxyntic gland adenoma and gastric adenocarcinoma of the fundic gland type have not been fully investigated in relation to Helicobacter pylori infection status. We compared the morphology, color, and location of these lesions between patients with and without H. pylori infection. Methods: We retrospectively enrolled 165 patients (180 lesions) from 10 institutions. We divided the patients into the (i) Hp group (patients with current H. pylori infection [active gastritis, n = 13] and those with past infection [inactive gastritis, n = 76]) and (ii) uninfected group (H. pylori-uninfected patients, n = 52). We compared the clinical and endoscopic features of the two groups. We also performed an analysis between (i) lesions with atrophy of the surrounding gastric mucosa (atrophy group) and (ii) lesions without atrophy of the surrounding gastric mucosa (non-atrophy group). Results: The average age was older in the Hp group than in the uninfected group (68.1 ± 8.1 vs. 63.4 ± 8.7 years, p < 0.01). Although the difference was not statistically significant (p = 0.09), multiple lesions were observed in 9 of 89 patients (10.1%) in the Hp group and in only 1 of 52 patients (1.9%) in the uninfected group. Meanwhile, significant differences were observed in the prevalence of lesions located in the gastric fornix or cardia (uninfected group: 67.3% vs. Hp group: 38.0%, p < 0.01), with an elevated morphology (80.0% vs. 56.0%, p < 0.01), with a subepithelial-like appearance (78.2% vs. 42.0%, p < 0.01), and with a color similar to that of the peripheral mucosa (43.6% vs. 25.0%, p = 0.02). The male-to-female ratio, lesion size, and presence or absence of vascular dilatation or black pigmentation on the surface were not different between the two groups. In the analysis comparing lesions with and without mucosal atrophy, the prevalence of multiple lesions was significantly higher (p = 0.02) in the atrophy group (5/25 patients, 20.0%) than in the non-atrophy group (7/141 patients, 5.0%). Conclusions: The endoscopic features of oxyntic gland adenoma and gastric adenocarcinoma of the fundic gland type differ between patients with and without H. pylori infection. [ABSTRACT FROM AUTHOR]
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- 2022
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16. Lanthanum Deposition in the Stomach in the Absence of Helicobacter pylori Infection
- Author
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Iwamuro, Masaya, Urata, Haruo, Tanaka, Takehiro, Kawano, Seiji, Kawahara, Yoshiro, Kimoto, Katsuhiko, and Okada, Hiroyuki
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Adult ,Male ,lanthanum carbonate ,scanning electron microscopy analysis ,Helicobacter pylori ,Stomach Diseases ,Case Report ,Helicobacter Infections ,Asian People ,Gastric Mucosa ,Lanthanum ,Stomach Neoplasms ,atrophic gastritis ,Humans ,hyperphosphatemia ,Aged - Abstract
In this case report, we describe two patients who showed a diffusely whitish mucosa in the posterior wall and the lesser curvature of the gastric body. The patients were serologically- and histopathologically-negative for Helicobacter pylori. Random biopsy specimens from the stomach revealed no regenerative changes, intestinal metaplasia, and/or foveolar hyperplasia in either of the patients. Although lanthanum deposition in the gastric mucosa has been reported to occur in close association with H. pylori-associated gastritis, our patients tested negative for H. pylori. These cases suggest that lanthanum deposition presents as whitish lesions in the gastric body in H. pylori-negative patients.
- Published
- 2017
17. Gastric ulcer after prophylactic balloon-occluded retrograde transvenous obliteration.
- Author
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Takuma, Yoshitaka, Nouso, Kazuhiro, Takayama, Hiroki, Makino, Yasuhiro, Saito, Shunsuke, Tanaka, Shouichi, Ogata, Masatoshi, Ohta, Takeyuki, Kubota, Junichi, and Iwamuro, Masaya
- Subjects
ULCERS ,CIRRHOSIS of the liver ,LIVER metastasis ,VARICOSE veins ,VEIN diseases ,GASTROINTESTINAL cancer ,ENDOSCOPY ,GASTRIC mucosa ,CANCER - Abstract
A 74-year-old man with compensated hepatitis C virus-related liver cirrhosis was admitted for the treatment of small hepatocellular carcinoma (HCC) by radiofrequency ablation therapy (RFA). As a routine pretreatment examination, gastrointestinal endoscopy was performed, and large nodular varices were observed in the gastric fornix, with telangiectasia on top of the varices. As soon as the RFA was completed, prophylactic balloon-occluded retrograde transvenous obliteration (B-RTO) was performed. Seven days after the B-RTO, the patient complicated of upper abdominal pain. Gastrointestinal endoscopy was performed, and a deep ulcer, located at the top of the tumor-shaped gastric varices, was found. The ulcer showed rapid healing after 1-week administration of a proton pump inhibitor (PPI). A severe ulcer after a B-RTO procedure, is extremely rare, because sclerosing agents rarely flow into the gastric mucosa. The ulcer in this patient was deep and large, and it may have been due to direct mucosal damage caused by the sclerosing agent, because mucosal telangiectasia on top of the varices was observed before the B-RTO. It is likely that, in this patient, the mucosal vessels communicated with the submucosal large varices, and ethanolamine oleate (EOI) flowed into the gastric mucosa via this communication. Based on our experience, we recommend periodic follow-up endoscopy. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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