65 results on '"Teppei Omori"'
Search Results
2. A case of incorrect evaluation of intestinal patency by early dissolution of a patency capsule
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Teppei Omori, Toshifumi Hara, Shun Murasugi, Harutaka Kambayashi, Yu Sasaki, Miki Koroku, Maria Yonezawa, Keiichi Morishita, Shinichi Nakamura, and Katsutoshi Tokushige
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capsule endoscopy ,patency capsule ,radiography ,stenosis ,small intestine ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract A 60‐year‐old man presented with a suspected small intestinal tumor on positron‐emission tomography‐computed tomography. Small bowel capsule endoscopy (SBCE) was planned for close examination of the small intestine. To avoid retention of the SBCE due to strictures, a patency capsule (PC) was first used to evaluate patency. However, PC discharge was not visually confirmed during the 24‐h period. No obvious PC was observed on plain abdominal radiography performed in the standing position. The patient underwent SBCE, assuming that the PC had been shed inconspicuously. SBCE revealed a neoplastic lesion with stenosis at a site thought to be the upper small intestine and remained stagnant at the same site for the duration of the battery. In addition, in the SBCE image, a PC shell was captured in the intestinal tract on the oral side of the stenosis. When the pre‐SBCE plain abdominal radiograph was enlarged to confirm the details, PC was observed in the lateral and decubitus views as a dissolved shell only. To the best of our knowledge, no previous report has described the complete dissolution of a PC leaving only its shell during a 30‐hour patency evaluation period. This case illustrates that, in the absence of visual confirmation of a PC discharge, PC may have remained in the body due to premature dissolution. Additional examinations or plain X‐ray imaging should be performed to confirm this, with no preconceived notions that the PC will not dissolve within 30 hours of administration.
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- 2024
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3. Predicting Therapeutic Intervention for Patients with Quiescent Crohn’s Disease Using the Small Bowel Capsule Endoscopy Score
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Teppei Omori, Miki Koroku, Shun Murasugi, Ayumi Ito, Maria Yonezawa, Shinichi Nakamura, and Katsutoshi Tokushige
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Introduction: Small bowel (SB) capsule endoscopy (SBCE) is a sensitive modality for screening the entire SB of patients with Crohn’s diseases (CD); however, the prognostic impact of the results is unclear. We evaluated the ability of the SBCE score to predict therapeutic intervention for patients with CD and SB lesions without clinical symptoms as well as negative C-reactive protein (CRP) levels. Methods: Fifty-six patients who underwent a patency evaluation and had a CD activity index (CDAI) score
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- 2024
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4. A Patient with Crohn’s Disease Who Gave Birth Despite Sigmoid Volvulus, Venous Thrombosis, Nontraumatic Fracture of the Rib, and Sepsis during Pregnancy
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Ayumi Ito, Maria Yonezawa, Shun Murasugi, Teppei Omori, Shinichi Nakamura, and Katsutoshi Tokushige
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bowel obstruction ,nontraumatic fracture ,thrombosis ,sepsis ,refractory crohn’s disease ,pregnancy ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
The patient was a woman in her 40s who was diagnosed with Crohn’s disease (CD) of the large and small intestines in 1996. In 2005, she was referred to our hospital for treatment. We treated her for 17 years with corticosteroids, biologics, immunosuppressive agents, 5-aminosalicylic acid, and nutrition care. However, her Crohn’s Disease Activity Index remained between 200 and 250, indicating refractory CD. During her medical treatment, the patient also underwent 3 operations. One year ago, the patient became pregnant through in vitro fertilization. Even after pregnancy was confirmed, the patient continued her treatment for refractory CD with ustekinumab, granulocyte apheresis, and budesonide. Nonetheless, her CD was highly active during pregnancy, and she experienced various complications: sigmoid volvulus at gestational week 15, venous thrombosis at gestational week 17, nontraumatic rib fracture due to fetal movement at gestational week 32, and sepsis from central venous catheter infection at gestational week 37. At gestational week 38, the patient gave birth by emergency cesarian delivery. This paper reports details of the case in which delivery was achieved after various complications were overcome and discusses previous relevant reports.
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- 2023
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5. Multiple Small Bowel Gastrointestinal Stromal Tumors Associated with Neurofibromatosis Type 1 that Were Not Detected by Endoscopy: A Case Report
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Satomi Saito, Teppei Omori, Shun Murasugi, Maria Yonezawa, Yukiko Takayama, Takeshi Ohki, Hiromi Onizuka, Yoji Nagashima, and Katsutoshi Tokushige
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gastrointestinal stromal tumors ,neurofibromatosis ,neurofibrome type 1 ,small bowel tumor ,balloon-assisted enteroscopy ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
We treated a 39-year-old Japanese man who was admitted for an abdominal mass. He had had neurofibroma-like skin lesions since childhood. Computed tomography and endoscopic ultrasound results were consistent with a tumor in the small intestine. Although the tumor was undetectable by single-balloon endoscopy, the patient’s background and imaging results led us to suspect a gastrointestinal stromal tumor (GIST). He also met the diagnostic criteria for neurofibroma type 1 (NF1). We performed a surgical removal of the tumor, and the biopsy results led to a definitive diagnosis of GIST. Small bowel GISTs should be considered in cases of NF1.
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- 2023
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6. Multiple intestinal lymphangiomas with episodic hemorrhage requiring partial laparoscopic resection: a case report
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Hiroka Kondo, Takeshi Ohki, Shimpei Ogawa, Teppei Omori, Hiromi Onizuka, Yoji Nagashima, and Shigeki Yamaguchi
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Lymphangioma ,Mesenteric ,Intestinal ,Anemia ,Laparoscopic-assisted surgery ,Surgery ,RD1-811 - Abstract
Abstract Background Lymphangioma is a non-epithelial tumor marked by aggregates of abnormally dilated lymphatics. Mesenteric occurrences account for
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- 2022
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7. Granulocyte and monocyte apheresis therapy for patients with active ulcerative colitis associated with COVID-19: a case report
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Miki Koroku, Teppei Omori, Harutaka Kambayashi, Shun Murasugi, Tomoko Kuriyama, Yuichi Ikarashi, Maria Yonezawa, Ken Arimura, Kazunori Karasawa, Norio Hanafusa, Masatoshi Kawana, and Katsutoshi Tokushige
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covid-19 ,granulocyte and monocyte adsorptive apheresis ,ulcerative colitis ,case reports ,Medicine ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Coronavirus disease 2019 (COVID-19), caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is now a pandemic. Although several treatment guidelines have been proposed for patients who have both inflammatory bowel disease and COVID-19, immunosuppressive therapy is essentially not recommended, and the treatment options are limited. Even in the COVID-19 pandemic, adjuvant adsorptive granulocyte and monocyte apheresis may safely bring ulcerative colitis (UC) into remission by removing activated myeloid cells without the use of immunosuppressive therapy. Our patient was a 25-year-old Japanese male with UC and COVID-19. This is the first case report of the induction of UC remission with granulocyte and monocyte apheresis treatment for active UC associated with COVID-19.
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- 2022
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8. Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study
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Ayumi Ito, Syun Murasugi, Teppei Omori, Shinichi Nakamura, and Katsutoshi Tokushige
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Ulcerative colitis ,Tacrolimus ,Mucosal healing ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Tacrolimus (TAC) is a powerful remission-inducing drug for refractory ulcerative colitis (UC). However, it is unclear whether mucosal healing (MH) influences relapse after completion of TAC.We investigated whether MH is related to relapse after TAC. Patients: Among 109 patients treated with TAC, 86 patients achieved clinical remission and 55 of them underwent colonoscopy at the end of TAC. These 55 patients were investigated. Methods Patients with MH at the end of TAC were classified into the MH group (n = 41), while patients without MH were classified into the non-MH group (n = 14). These groups were compared with respect to 1) clinical characteristics before treatment, 2) clinical characteristics on completion of treatment, and 3) the relapse rate and adverse events rates. This is a retrospective study conducted at a single institution. Results 1) There was a significant difference in baseline age between the two groups before TAC therapy, but there were no significant differences in other clinical characteristics. The NMH group was younger (MH group: 48.1 (23–79) years, NMH group: 36.3 (18–58) years, P = 0.007). Endoscopic scores showed significant differences between the 2 groups at the end of TAC. There were also significant differences in the steroid-free rate after 24 weeks (MH group: 85.3%, NMH group 50%, P = 0.012). There was no significant difference in the relapse rate between the 2 groups at 100 days after remission, but a significant difference was noted at 300 days (17% vs. 43%), 500 days (17% vs. 75%), and 1000 days (17% vs. 81%) (all P
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- 2020
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9. The Influence of Obesity on Small Bowel Capsule Endoscopy
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Teppei Omori, Yu Sasaki, Miki Koroku, Harutaka Kambayashi, Shun Murasugi, Maria Yonezawa, Shinichi Nakamura, and Katsutoshi Tokushige
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Objective. Intestinal motility may be different in obese and nonobese patients, but this has not been determined. Here, we sought to evaluate the effect of obesity on small bowel capsule endoscopy (SBCE). Patients and Methods. We retrospectively analyzed the cases of the 340 patients who underwent SBCE for small intestinal disease (excluding cases of unobservable total small bowel, small bowel stenosis, and bowel resection) at our hospital during the period January 2014 to December 2020 to extract patient background factors and the bowel transit times of SBCE according to the presence/absence of obesity (defined as a body mass index BMI≥25 kg/m2). Results. The obese group was 54 patients (nonobese, n=286). The small bowel transit time (SBTT) was significantly shorter in the obese patients compared to the nonobese patients (p=0.0026), and when we divided the patients by their short/long SBTTs using 216.5 min as the cutoff, we observed significant between-group differences in the patients’ age (≥60 years) and in the patients’ hospitalization status at the time of the SBCE examination. A multivariate analysis revealed that hospitalized status at the examination is a factor contributing significantly to a long SBTT (OR 0.25, 95% CI: 0.15–0.42, p
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- 2022
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10. Retrospective investigation of tacrolimus combined with an anti‐tumor necrosis factorα antibody as remission induction therapy for refractory ulcerative colitis: Efficacy, safety, and relapse rate
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Ayumi Ito, Teppei Omori, Shinichi Nakamura, and Katsutoshi Tokushige
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refractory ulcerative colitis ,remission induction therapy ,combined therapy with tacrolimus and an anti‐TNFα antibody ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and Aim Combined therapy with tacrolimus (TAC) and an anti‐tumor necrosis factorα (TNFα) antibody is used to induce remission in ulcerative colitis (UC) patients who have not responded to monotherapy with either drug. We evaluated the efficacy and safety of combined therapy, as well as the relapse rate. Methods Combined therapy was performed to induce remission in UC patients showing an inadequate response to monotherapy with TAC or an anti‐TNFα antibody. The following items were assessed retrospectively: (i) clinical characteristics, (ii) the remission induction rate, (iii) the relapse rate, and (iv) adverse events. Results Combined therapy induced remission in 7 of the 12 patients (58.3%). There were no significant differences in clinical characteristics between the patients with and without the successful induction of remission. However, the number of female patients tended to be higher in the remission group than in the nonremission group. The remission group also showed trends of a lower clinical activity index (Lichtiger index; CAI) on admission and before combined therapy and a lower total dose of prednisolone during hospitalization. The 1‐year relapse rate was 33.3%. Adverse events due to combined therapy included renal impairment (n = 2), tremors (n = 2), influenza (n = 1), and a positive cytomegalovirus antibody test (n = 3). None of these events were serious. Conclusions Combined therapy was effective in more than half of the patients with refractory UC who had not responded to monotherapy. Our findings suggest that combination therapy may be a new, third option for the treatment of refractory UC.
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- 2019
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11. Clinical Characterization of Ulcerative Colitis in Patients with Primary Sclerosing Cholangitis
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Shun Murasugi, Ayumi Ito, Teppei Omori, Shinichi Nakamura, and Katsutoshi Tokushige
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Objectives. The clinical/colonoscopic features of ulcerative colitis (UC) associated with primary sclerosing cholangitis (PSC), the prognostic impact of UC, and the utility of UC screening in PSC patients are unknown. We characterized UC associated with PSC and assessed UC’s impact on the prognosis of PSC and the importance of colonoscopic UC screening in PSC patients. Methods. We retrospectively analyzed the cases of 77 patients treated for PSC at a single center (April 2000–July 2019). We reviewed the clinical/colonoscopic profiles of the concurrent UC patients and compared the clinical profiles, survival, and primary causes of death between the patients with/without UC (n=35/n=42). The details of all patients’ colonoscopies were reviewed. Results. The concurrent UC group: 17 men, 18 women, diagnosed with PSC at the mean (SD) age of 36 (17) years; 21 patients (60%) had no UC symptoms. Colonoscopy revealed pancolitis in all patients, predominantly affecting the right-sided colon in 30 patients (86%). Lesions were scattered. Backwash ileitis (n=13, 37%) and rectal sparing (n=18, 51%) were observed. Most patients had mild UC; some had moderate or more severe UC (median Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score 2; range, 1–5). Ludwig’s stage determined by liver biopsy did not correlate with the Mayo endoscopic score for UC. The patients with UC were diagnosed with PSC at a significantly younger age than those without UC (mean (SD), 36 [17] years vs. 55 [19] years, p
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- 2020
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12. Development and Improvement of Simple Colonic Mucosal Ulcer during Treatment of Severe Ulcerative Colitis with Tacrolimus
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Ayumi Ito, Bunei Iizuka, Teppei Omori, Shinichi Nakamura, and Katsutoshi Tokushige
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Simple ulcer ,Behçet’s disease ,Ulcerative colitis ,Tacrolimus ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Diarrhea, melena, and lower abdominal pain developed in a male in his 20s and colonoscopy showed pancolitis-type severe ulcerative colitis (UC). Treatment was initiated with 4,000 mg of 5-aminosalicylic acid and 60 mg/day of prednisolone, but the symptoms and inflammatory reaction worsened with prednisolone dose reduction. Tacrolimus was added to the treatment, which subsequently induced remission. Serial colonoscopies during the treatment showed improvement in ulcer and mucosal edema throughout the entire large intestine, but a new solitary round ulcer appeared at the end of the ileum. Since no signs of Behçet’s disease were noted, it was considered as a simple ulcer, a complication of UC. Tacrolimus treatment was continued based on continued improvement in clinical features and colonic mucosa, excluding the end of the ileum. Colonoscopy at 6 months after initiation of tacrolimus showed healing of the large intestinal mucosa, although mild congestion was still noted. The solitary round ulcer at the end of the ileum improved to a small erosion. We report the improvement of a simple ulcer that developed during tacrolimus treatment.
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- 2017
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13. Does the PillCam SB3 capsule endoscopy system improve image reading efficiency irrespective of experience? A pilot study
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Teppei Omori, Toshifumi Hara, Sachiyo Sakasai, Harutaka Kambayashi, Shun Murasugi, Ayumi Ito, Shinichi Nakamura, and Katsutoshi Tokushige
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and study aims The aim of this study was tp compare the diagnostic efficiency of the PillCam SB3 capsule endoscopy (CE) system with the older system, PillCam SB2, taking into consideration the experience of the image reader. Patients and methods Small intestinal CE was conducted on 64 patients around May 2014 when the SB3 was introduced in our hospital. Data obtained from 20 patients (SB2: 10 and SB3: 10) based on transit time were assessed by junior (experience: 20 images), intermediate (> 50), and expert readers (> 600). Results Reading time with the CE down to the end of the small intestine was shorter in the SB3 group for each reader (SB2 vs. SB3: junior, 40.2 ± 10.1 vs. 23.7 ± 6.7 [P = 0.0009]; intermediate, 21.4 ± 4.9 vs. 10.3 ± 2.9 [P = 0.0003]; expert, 23.2 ± 5.6 vs. 11.1 ± 2.9 min [P = 0.0002]). Interpretation agreement rates between the findings by junior and intermediate readers and those by the expert reader were 84.6 % and 92.3 %, respectively. For the junior reader, rates of agreement using the SB2 and SB3 systems with those by the expert reader were 85.7 % and 83.3 %, respectively; no significant difference was noted between the two systems. Similarly, for the intermediate reader, the respective agreement rates using the SB2 and SB3 systems were 85.7 % and 100 %, respectively. Conclusions The PillCam SB3 reduces the time burden on readers irrespective of their experience.
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- 2018
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14. Tacrolimus for Remission Induction and Maintenance Therapy in Patients with Ulcerative Colitis: A Retrospective Evaluation Study
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Ayumi Ito, Bunei Iizuka, Teppei Omori, Shinichi Nakamura, and Katsutoshi Tokushige
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background. In this retrospective study, we compared the efficacy of tacrolimus (TAC) or prednisolone (PSL) for maintenance therapy in patients with ulcerative colitis (UC) at remission. Methods. The study patients were followed up for at least one year after induction of remission with either PSL (n=55, between April 2004 and March 2014) or TAC (n=40, between April 2009 and March 2014). The clinical features and relapse rates were compared in the two groups. Maintenance therapy in the TAC group included TAC alone, AZA alone, and TAC plus AZA. Results. The recurrence rates at 1500 days after remission were 61% and 46% for the PSL and TAC groups, respectively (P
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- 2016
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15. Differences in regions of interest to identify deeply invasive colorectal cancers: Computer-aided diagnosis vs expert endoscopists
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Yuki Nakajima, Daiki Nemoto, Zhe Guo, Peng Boyuan, Zhang Ruiyao, Shinichi Katsuki, Takahito Takezawa, Ryo Maemoto, Keisuke Kawasaki, Ken Inoue, Takashi Akutagawa, Hirohito Tanaka, Koichiro Sato, Teppei Omori, Yoshikazu Hayashi, Yasuyuki Miyakura, Takayuki Matsumoto, Naohisa Yoshida, Motohiro Esaki, Toshio Uraoka, Hiroyuki Kato, Yuji Inoue, Hironori Yamamoto, Xin Zhu, and Kazutomo Togashi
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and study aims: Diagnostic performance of a computer-aided diagnosis (CAD) system for deep submucosally invasive (T1b) colorectal cancer was excellent, but the “regions of interest” (ROI) within images are not obvious. Class activation mapping (CAM) enables identification of the ROI that CAD utilizes for diagnosis. The purpose of this study was a quantitative investigation of the difference between CAD and endoscopists. Patients and methods: Endoscopic images collected for validation of a previous study were used, including histologically proven T1b colorectal cancers (n = 82; morphology: flat 36, polypoid 46; median maximum diameter 20 mm, interquartile range 15-25 mm; histological subtype: papillary 5, well 51, moderate 24, poor 2; location: proximal colon 26, distal colon 27, rectum 29). Application of CAM was limited to one white light endoscopic image (per lesion) to demonstrate findings of T1b cancers. The CAM images were generated from the weights of the previously fine-tuned ResNet50. Two expert endoscopists depicted the ROI in identical images. Concordance of the ROI was rated by intersection over union (IoU) analysis. Results: Pixel counts of ROIs were significantly lower using CAD (188.9K[x103] ± 109.1K) than by endoscopists (354.5K ± 223.6K; P < 0.0001) and mean ± standard deviation of the IoU was 0.203 ± 0.170. IoU was significantly higher in correctly identified lesions (n = 54, 0.234 ± 0.172) than incorrect ones (n=28, 0.144 ± 0.153, P = 0.0215). Concusions: IoU was larger in correctly diagnosed T1b colorectal cancers. Optimal annotation of the ROI may be the key to improving diagnostic sensitivity of CAD for T1b colorectal cancers.
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16. Computer-aided diagnosis of early-stage colorectal cancer using nonmagnified endoscopic white-light images (with videos)
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Daiki Nemoto, Zhe Guo, Shinichi Katsuki, Takahito Takezawa, Ryo Maemoto, Keisuke Kawasaki, Ken Inoue, Takashi Akutagawa, Hirohito Tanaka, Koichiro Sato, Teppei Omori, Kunihiro Takanashi, Yoshikazu Hayashi, Yuki Nakajima, Yasuyuki Miyakura, Takayuki Matsumoto, Naohisa Yoshida, Motohiro Esaki, Toshio Uraoka, Hiroyuki Kato, Yuji Inoue, Boyuan Peng, Ruiyao Zhang, Takashi Hisabe, Tomoki Matsuda, Hironori Yamamoto, Noriko Tanaka, Alan Kawarai Lefor, Xin Zhu, and Kazutomo Togashi
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Gastroenterology ,Radiology, Nuclear Medicine and imaging - Published
- 2023
17. Efficacy of Calcineurin Inhibitors for Induction of Remission in Intestinal Behçet’s Disease
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Takaaki Kawaguchi, Masayuki Fukata, Teppei Omori, Hiroki Kiyohara, Shinya Sugimoto, Kosaku Nanki, Tomohisa Sujino, Yohei Mikami, and Takanori Kanai
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Gastroenterology - Abstract
Background The efficacy of calcineurin inhibitors (CNIs) for induction of remission in intestinal Behçet’s disease (intestinal BD) has not been explored. Methods A multicenter retrospective case series study of patients with active intestinal BD treated with CNIs (cyclosporin and tacrolimus) was conducted. Results Of 16 patients, 12 (75%) showed a clinical response and 5 (31.3%) achieved clinical remission after 2 weeks of CNI treatment. Similar efficacy of CNIs was observed even in 7 patients refractory to antitumor necrosis factor-alpha therapies. Endoscopic improvement was observed in 11 of 12 patients. Conclusions CNIs may be promising treatment options for refractory intestinal BD.
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- 2022
18. Real-world safety and efficacy of twice-daily budesonide 2-mg foam in patients with ulcerative colitis: interim analysis of post-marketing surveillance
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Yasuo Suzuki, Akira Nagaki, Akira Ohta, Masayuki Saruta, Kiyotoshi Kuramoto, Teppei Omori, and Yuki Arai
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Budesonide ,medicine.medical_specialty ,Pancolitis ,Phases of clinical research ,Postmarketing surveillance ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Product Surveillance, Postmarketing ,medicine ,Humans ,Pharmacology (medical) ,Glucocorticoids ,Proctitis ,Pharmacology ,business.industry ,Remission Induction ,General Medicine ,medicine.disease ,Interim analysis ,Ulcerative colitis ,Treatment Outcome ,030220 oncology & carcinogenesis ,Colitis, Ulcerative ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Adverse drug reaction ,medicine.drug - Abstract
Background: Budesonide foam 2 mg twice daily induced complete mucosal healing in patients with mild-to-moderate ulcerative colitis (UC) in a phase 3 study. Post-marketing surveillance is underway to assess the real-world outcomes in UC patients.Research design and methods: The authors performed an interim analysis of post-marketing surveillance in 182 patients with mild-to-moderate UC who received 2 mg budesonide foam rectally.Results: Budesonide foam was prescribed twice daily to 76.4% of patients for 7.6 ± 3.8 weeks (mean ± standard deviation). Seven patients (3.8%) had at least one adverse drug reaction (ADR). A serious ADR of enteritis infectious and glucocorticoid-related ADRs of acne and hypertrichosis were observed in one patient (0.5%) each. The partial Mayo scores significantly decreased from baseline to week 2 in patients with proctitis, left-sided colitis, and pancolitis (p < 0.01 versus baseline each). Clinical response and remission at week 6 were 75.9% (60/79) and 68.4% (54/79), respectively. At week 6, 72.6% (77/106) of the patients reported as 'good compliance' and 54.7% (58/106) of the patients as 'very easy' for administration, using a self-administered questionnaire.Conclusions: Budesonide foam appeared to be safe, efficacious, and well-accepted in a real-world cohort of patients with UC. Trial registration: JapicCTI-183858.
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- 2021
19. Serum Leucine-Rich Alpha-2 Glycoprotein in Quiescent Crohn's Disease as a Potential Surrogate Marker for Small-Bowel Capsule Endoscopy
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Teppei Omori
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InformationSystems_INFORMATIONSTORAGEANDRETRIEVAL ,education ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,ComputingMilieux_COMPUTERSANDEDUCATION ,Data_FILES ,ComputerApplications_COMPUTERSINOTHERSYSTEMS ,health care economics and organizations ,humanities - Abstract
Journal of Clinical Medicine Supplement files.
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- 2022
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20. Tag‐less patency capsule for suspected small bowel stenosis: Nationwide multicenter prospective study in Japan
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Kenji Watanabe, Sadaharu Nouda, Daisuke Tokuhara, Yukinori Sameshima, Teppei Omori, Konosuke Nakaji, Hisao Tajiri, Akira Terano, Naoki Ohmiya, Toshiyuki Matsui, Fumihito Hirai, Masanao Nakamura, Hidemi Goto, and Motohiro Esaki
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medicine.medical_specialty ,Constriction, Pathologic ,Capsule Endoscopy ,Gastroenterology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Capsule endoscopy ,law ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,Crohn's disease ,business.industry ,Odds ratio ,medicine.disease ,Confidence interval ,Bowel obstruction ,Stenosis ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,Intestinal Obstruction - Abstract
STUDY AIMS The PillCam patency capsule (PPC) is an Agile tag-less patency capsule used to evaluate gastrointestinal (GI) patency. We determined the appropriate use of PPC to preclude subsequent small bowel capsule endoscopy (SBCE) retention. METHODS This prospective multicenter study consecutively enrolled patients indicated for SBCE with suspected or established small bowel stenosis. Excretion of an intact PPC or its radiologic visualization in the large bowel was considered GI patency. Primary and secondary study endpoints were SBCE retention rates in patients with confirmed patency and identification of factors associated with patency and SBCE retention, respectively. RESULTS Of 1096 patients enrolled in the study, patency was confirmed in 976 (89.1%). PPC excretion occurred in 579 patients. Of the remaining 517 patients, patency was confirmed using imaging modalities in 401 (77.5%). SBCE retention occurred in five (0.51%) of 963 patients who underwent SBCE: 1.0% in established Crohn's disease (CD) patients, 0% in suspected CD, 0% in tumors, and 1.6% in patients with obscure GI bleeding, for which PPC localization had been radiographically misinterpreted. The non-confirmation of patency was associated with established CD, stenosis identified using imaging modalities, abdominal fullness, serum albumin levels
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- 2020
21. Efficacy of apheresis as maintenance therapy for patients with ulcerative colitis in an open-label prospective multicenter randomised controlled trial
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Makoto, Naganuma, Yoko, Yokoyama, Satoshi, Motoya, Kenji, Watanabe, Koji, Sawada, Fumito, Hirai, Takayuki, Yamamoto, Hiroyuki, Hanai, Teppei, Omori, Takanori, Kanai, Toshifumi, Hibi, and Tadashi, Teramoto
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Severity of Illness Index ,Monocytes ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,Maintenance therapy ,law ,Internal medicine ,Clinical endpoint ,Humans ,Medicine ,Leukapheresis ,Prospective Studies ,Adverse effect ,business.industry ,Remission Induction ,Gastroenterology ,Colonoscopy ,Middle Aged ,medicine.disease ,Ulcerative colitis ,Colorectal surgery ,Treatment Outcome ,Apheresis ,030220 oncology & carcinogenesis ,Colitis, Ulcerative ,Female ,030211 gastroenterology & hepatology ,business ,Granulocytes ,Abdominal surgery - Abstract
Apheresis therapy involves the selective removal of leukocytes and is used to induce remission in ulcerative colitis (UC) patients. The aim of this study was to demonstrate the efficacy and safety of apheresis therapy for maintaining UC remission. We conducted a multicenter, prospective, randomised-control trial of patients with remitting UC induced by granulocyte and monocyte adsorption apheresis or leukocytapheresis. Patients were randomly assigned to the apheresis group (twice per month for 12 months) or the control group (no apheresis treatment) using a 1:1 allocation ratio. The primary endpoint was the rate of cumulative clinical remission (Mayo score ≤ 2) at 12 months. The secondary endpoints were the rates of clinical remission, endoscopic remission, and complete endoscopic remission at 12 months. Between March 2013 and March 2017, 164 patients were enrolled. The cumulative remission rate at 12 months was 46.6% in the apheresis group and 36.4% in the control group (p = 0.1621). The rate of endoscopic remission at 12 months was significantly higher in the apheresis group than in the control group (42.5% vs. 25.9%) p = 0.0480). The rate of clinical remission (47.5% vs.32.1%, p = 0.0540) and complete endoscopic remission (33.8% vs.19.8%, p = 0.0513) tended to be higher in the apheresis than in the control group; however, the difference was not significant. No severe adverse events were observed in either group. Apheresis was well tolerated as maintenance therapy for UC although the cumulative clinical remission rate at 12 months was comparable between the apheresis and control groups.
- Published
- 2019
22. Retrospective investigation of tacrolimus combined with an anti‐tumor necrosis factorα antibody as remission induction therapy for refractory ulcerative colitis: Efficacy, safety, and relapse rate
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Shinichi Nakamura, Katsutoshi Tokushige, Teppei Omori, and Ayumi Ito
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remission induction therapy ,medicine.medical_specialty ,Necrosis ,Combination therapy ,RC799-869 ,Gastroenterology ,combined therapy with tacrolimus and an anti‐TNFα antibody ,Refractory ,Internal medicine ,Remission Induction Therapy ,refractory ulcerative colitis ,medicine ,Adverse effect ,Hepatology ,business.industry ,Original Articles ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,Ulcerative colitis ,Tacrolimus ,Prednisolone ,Original Article ,medicine.symptom ,business ,medicine.drug - Abstract
Background and Aim Combined therapy with tacrolimus (TAC) and an anti‐tumor necrosis factorα (TNFα) antibody is used to induce remission in ulcerative colitis (UC) patients who have not responded to monotherapy with either drug. We evaluated the efficacy and safety of combined therapy, as well as the relapse rate. Methods Combined therapy was performed to induce remission in UC patients showing an inadequate response to monotherapy with TAC or an anti‐TNFα antibody. The following items were assessed retrospectively: (i) clinical characteristics, (ii) the remission induction rate, (iii) the relapse rate, and (iv) adverse events. Results Combined therapy induced remission in 7 of the 12 patients (58.3%). There were no significant differences in clinical characteristics between the patients with and without the successful induction of remission. However, the number of female patients tended to be higher in the remission group than in the nonremission group. The remission group also showed trends of a lower clinical activity index (Lichtiger index; CAI) on admission and before combined therapy and a lower total dose of prednisolone during hospitalization. The 1‐year relapse rate was 33.3%. Adverse events due to combined therapy included renal impairment (n = 2), tremors (n = 2), influenza (n = 1), and a positive cytomegalovirus antibody test (n = 3). None of these events were serious. Conclusions Combined therapy was effective in more than half of the patients with refractory UC who had not responded to monotherapy. Our findings suggest that combination therapy may be a new, third option for the treatment of refractory UC., Combined therapy with tacrolimus and an anti‐TNFa antibody is used to induce remission in ulcerative colitis patients who have not responded to monotherapy with either drug. We evaluated the efficacy and safety of this combination therapy, as well as the relapse rate.
- Published
- 2019
23. Multiple intestinal lymphangiomas with episodic hemorrhage requiring partial laparoscopic resection: a case report
- Author
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Hiroka Kondo, Takeshi Ohki, Shimpei Ogawa, Teppei Omori, Hiromi Onizuka, Yoji Nagashima, and Shigeki Yamaguchi
- Abstract
Background Lymphangioma is a non-epithelial tumor marked by aggregates of abnormally dilated lymphatics. Mesenteric occurrences account for Case presentation Herein, we describe an elderly Japanese woman with anemia, hypoalbuminemia, and episodic bleeding due to multiple intestinal lymphangiomas. Abdominal computed tomography revealed multiple low-density defects of mesentery, with areas of intermediate (T1 images) or high (T2 images) signal intensity similarly dispersed in magnetic resonance scanning sequences. Single-balloon enteroscopy was undertaken, enabling identification and tattooing of a small intestinal bleeding source. Laparoscopy-assisted resection at this site served to control related hemorrhage, removing a histologically confirmed hemolymphangioma. Having recovered uneventfully, the patient remained stable 2 months postoperatively. Conclusions Although rare in adults, mesenteric or gastrointestinal lymphangiomas must be considered in a setting of anemia and hypoalbuminemia. Complete resection is advantageous to improve patient symptoms, but limited resection of multiple lesions may be equally effective.
- Published
- 2021
24. Multiple Intestinal Lymphangiomas with Episodic Hemorrhage Requiring Partial Laparoscopic Resection: A Case Report
- Author
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Shigeki Yamaguchi, Fumiaki Tokito, Fumi Maeda, Hiroka Kondo, Kimitaka Tani, Hisako Aihara, Yuka Kaneko, Kurodo Koshino, Ryosuke Nakagawa, Yuji Inoue, Yoji Nagashima, Hiromi Onizuka, Shuji Fujikawa, Takeshi Ohki, Shimpei Ogawa, Yoshiko Bamba, Michio Itabashi, and Teppei Omori
- Subjects
medicine.medical_specialty ,business.industry ,Medicine ,Laparoscopic resection ,business ,Surgery - Abstract
Background:Lymphangioma is a non-epithelial tumor marked by aggregates of abnormally dilated lymphatics. Mesenteric occurrences account for Case presentation:Herein, we describe an elderly Japanese woman with anemia, hypoalbuminemia, and episodic bleeding due to multiple intestinal lymphangiomas. Abdominal computed tomography revealed multiple low-density defects of mesentery, with areas of intermediate (T1 images) or high (T2 images) signal intensity similarly dispersed in magnetic resonance scanning sequences. Single-balloon enteroscopy was undertaken, enabling identification and tattooing of a small intestinal bleeding source. Laparoscopy-assisted resection at this site served to control related hemorrhage, removing a histologically confirmed hemolymphangioma. Having recovered uneventfully, the patient remained stable 2 months postoperatively. Conclusions:Although rare in adults, mesenteric or gastrointestinal lymphangiomas must be considered in a setting of anemia and hypoalbuminemia. Complete resection is advantageous to improve patient symptoms, but limited resection of multiple lesions may be equally effective.
- Published
- 2021
25. Management of elderly ulcerative colitis in Japan
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Toshiyuki Sakurai, Satohiro Matsumoto, Shigeki Bamba, Ken Sugimoto, Makoto Naganuma, Kazutaka Koganei, Yasuo Suzuki, Teppei Omori, Masayuki Saruta, Noritaka Takatsu, Shingo Kato, Kenji Wanatabe, Mitsuo Nagasaka, Shiro Nakamura, Kazuya Kitamura, Motoi Uchino, Masaaki Higashiyama, Takehiko Katsurada, Yoko Yokoyama, Ken Takeuchi, Shintaro Sagami, Tomohisa Takagi, Akira Sugita, Masakazu Nagahori, Kazuhiro Watanabe, and Ryota Hokari
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medicine.medical_specialty ,health care facilities, manpower, and services ,Population ,Review ,Inflammatory bowel disease ,03 medical and health sciences ,Elderly ,0302 clinical medicine ,Internal medicine ,Epidemiology ,medicine ,Intensive care medicine ,education ,Polypharmacy ,education.field_of_study ,business.industry ,Gastroenterology ,social sciences ,Hepatology ,medicine.disease ,Ulcerative colitis ,humanities ,Colorectal surgery ,Management ,Natural history ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business - Abstract
Japan has the largest aging society, where many elderly people have intractable diseases including ulcerative colitis (UC). Along with the increasing total number of UC patients, the number of elderly UC patients has also been increasing and will continue to do so in the future. Although the clinical features and natural history of UC in the elderly have many similarities with UC in the non-elderly population, age-specific concerns including comorbidities, immunological dysfunction, and polypharmacy make the diagnosis and management of elderly UC challenging compared to UC in non-elderly patients. Based on increasing data related to elderly UC patients from Japan, as well as other countries, we reviewed the epidemiology, clinical course, differential diagnosis, management of comorbidities, surveillance, medical therapy, and surgery of UC in the elderly.
- Published
- 2019
26. Tu1546: JAPAN PROSPECTIVE MULTICENTER STUDY FOR OPTIMIZATION OF COVID-19 VACCINATIONS BASED ON THE IMMUNE RESPONSE AND SAFETY PROFILE IN INFLAMMATORY BOWEL DISEASE PATIENTS: INTERIM ANALYSES
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Kenji Watanabe, Tadakazu Hisamatsu, Hiroshi Nakase, Kazuko Nagase, Minoru Matsuura, Nobuo Aoyama, Taku Kobayashi, Hirotake Sakuraba, Kaoru Yokoyama, Masakazu Nishishita, Motohiro Esaki, Fumihito Hirai, Masakazu Nagahori, Sohachi Nanjo, Teppei Omori, Satoshi Tanida, Yoshihiro Yokoyama, Kei Moriya, Atsuo Maemoto, Osamu Handa, Naoki Ohmiya, Shinichiro Shinzaki, Shingo Kato, Hiroki Tanaka, Toshio Uraoka, Noritaka Takatsu, Hideo Suzuki, Kenichiro Takahashi, Junji Umeno, Yoshiyuki Mishima, Kenji Tsuchida, Mikihiro Fujiya, Sakiko Hiraoka, Shuji Yamamoto, Masayuki Saruta, Masanori Nojima, and Akira Andoh
- Subjects
Hepatology ,Gastroenterology - Published
- 2022
27. Serum Leucine-Rich Alpha-2 Glycoprotein in Quiescent Crohn’s Disease as a Potential Surrogate Marker for Small-Bowel Ulceration detected by Capsule Endoscopy
- Author
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Teppei Omori, Yu Sasaki, Miki Koroku, Shun Murasugi, Maria Yonezawa, Shinichi Nakamura, and Katsutoshi Tokushige
- Subjects
small bowel capsule endoscopy ,leucine-rich alpha-2 glycoprotein ,Lewis score ,quiescent ,Crohn’s disease ,General Medicine ,digestive system diseases - Abstract
Background: Small bowel (SB) lesions in quiescent Crohn’s disease (CD) are sometimes not identified by clinical activity or existing markers. We investigated the usefulness of a novel biomarker, leucine-rich α2-glycoprotein (LRG), for screening for the presence of SB ulcerative lesions detected by small-bowel capsule endoscopy (SBCE). Methods: We examined patients with a Crohn’s Disease Activity Index (CDAI) value < 150 and a C-reactive protein (CRP) value < 0.5 mg/dL with SB or SB colonic CD. The presence of small-bowel ulcerative lesions (≥0.5 cm) was grouped by SBCE results, and we then compared the groups’ LRG value to establish a cutoff value for screening for the presence of lesions. Results: In 40 patients with CD, the LRG values differed significantly between the patients with and without SB ulcerative lesions (Ul + 14.1 (2.1–16.5) μg/mL vs. Ul − 12.3 (9.3–13.5) μg/mL; p = 0.0105). The respective cutoff LRG values for the presence of SB ulcerative lesions was 14 μg/mL (areas under the ROC curve 0.77), with sensitivity 63.6%, specificity 82.8%, positive predictive values 58.3%, negative predictive values 85.7%, and accuracy 78%. Conclusion: These results indicate that LRG may be useful in predicting the presence of SB inflammation associated in patients with CD with CRP < 0.5 mg/dL and CDAI < 150, and in selecting patients for SBCE.
- Published
- 2022
28. The Efficacy of Medium- to Long-term Anti-TNF-α Antibody-based Maintenance Therapy in Behçet's Disease Patients with Intestinal Lesions
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Harutaka Kambayashi, Ayumi Ito, Shinichi Nakamura, Satomi Saito, Teppei Omori, Maria Yonezawa, Katsutoshi Tokushige, Hiroyuki Kashiwagi, and Shun Murasugi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Necrosis ,intestinal Behçet's disease ,Prednisolone ,anti-TNF-α antibody-based therapy ,Disease ,Behcet's disease ,030204 cardiovascular system & hematology ,Gastroenterology ,Antibodies ,03 medical and health sciences ,0302 clinical medicine ,Maintenance therapy ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Retrospective Studies ,biology ,Behçet's disease ,business.industry ,Tumor Necrosis Factor-alpha ,Behcet Syndrome ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Intestines ,medium- to long-term maintenance therapy ,biology.protein ,030211 gastroenterology & hepatology ,Tumor necrosis factor alpha ,Female ,Original Article ,Immunotherapy ,Antibody ,medicine.symptom ,business ,medicine.drug ,steroids - Abstract
Objective Anti-tumor necrosis factor (TNF)-α antibody-based regimens are effective in Behcet's disease (BD) with intestinal lesions. We therefore evaluated the efficacy of medium- to long-term anti-TNF-α antibody-based maintenance therapy of BD intestinal and non-intestinal lesions. Methods In this retrospective study, the response to the treatment was assessed endoscopically and clinically. Treatment responders were transferred to maintenance therapy. We evaluated the sustain rate of maintenance therapy, reductions in the dose of prednisolone (PSL), and the presence of non-intestinal BD involvement before and after the start of anti-TNF-α antibody-based the maintenance therapy. Patients We assessed 20 BD patients with intestinal lesions who underwent anti-TNF-α antibody-based therapy. Results Treatment was discontinued in 3 patients (18%). Loss of response was noted in 1 (5.9%) patient. Maintenance therapy was continued in 13 (76%) patients. The cumulative sustain rates to maintenance therapy after 2, 4, and 6 years were 94%, 87%, and 72%, respectively. In the 13 patients with remission of intestinal lesions, the mean PSL dose decreased from 13.4±2.16 mg/day before treatment to 0.92±0.47 after treatment (p
- Published
- 2020
29. Relationship between mucosal healing by tacrolimus and relapse of refractory ulcerative colitis: a retrospective study
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Syun Murasugi, Katsutoshi Tokushige, Shinichi Nakamura, Ayumi Ito, and Teppei Omori
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0301 basic medicine ,medicine.medical_specialty ,Colonoscopy ,Gastroenterology ,Tacrolimus ,03 medical and health sciences ,0302 clinical medicine ,Refractory ,Recurrence ,Internal medicine ,Medicine ,Humans ,lcsh:RC799-869 ,Intestinal Mucosa ,Adverse effect ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Mucosal healing ,Remission Induction ,Retrospective cohort study ,General Medicine ,Hepatology ,medicine.disease ,Ulcerative colitis ,stomatognathic diseases ,030104 developmental biology ,Treatment Outcome ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,Colitis, Ulcerative ,business ,Research Article - Abstract
Background Tacrolimus (TAC) is a powerful remission-inducing drug for refractory ulcerative colitis (UC). However, it is unclear whether mucosal healing (MH) influences relapse after completion of TAC.We investigated whether MH is related to relapse after TAC. Patients: Among 109 patients treated with TAC, 86 patients achieved clinical remission and 55 of them underwent colonoscopy at the end of TAC. These 55 patients were investigated. Methods Patients with MH at the end of TAC were classified into the MH group (n = 41), while patients without MH were classified into the non-MH group (n = 14). These groups were compared with respect to 1) clinical characteristics before treatment, 2) clinical characteristics on completion of treatment, and 3) the relapse rate and adverse events rates. This is a retrospective study conducted at a single institution. Results 1) There was a significant difference in baseline age between the two groups before TAC therapy, but there were no significant differences in other clinical characteristics. The NMH group was younger (MH group: 48.1 (23–79) years, NMH group: 36.3 (18–58) years, P = 0.007). Endoscopic scores showed significant differences between the 2 groups at the end of TAC. There were also significant differences in the steroid-free rate after 24 weeks (MH group: 85.3%, NMH group 50%, P = 0.012). There was no significant difference in the relapse rate between the 2 groups at 100 days after remission, but a significant difference was noted at 300 days (17% vs. 43%), 500 days (17% vs. 75%), and 1000 days (17% vs. 81%) (all P Conclusions TAC is effective for refractory ulcerative colitis. However, even if clinical remission is achieved, relapse is frequent when colonoscopy shows that MH has not been achieved. It is important to evaluate the mucosal response by colonoscopy on completion of TAC.
- Published
- 2020
30. Capsule endoscopy findings for the diagnosis of Crohn’s disease: a nationwide case–control study
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Toshiyuki Matsui, Kazutomo Togashi, Masanao Nakamura, Fukunori Kinjo, Motohiro Esaki, Atsushi Hirano, Fumihito Hirai, Ema Washio, Hiroo Abe, Takayuki Matsumoto, Junji Umeno, Kenji Watanabe, Shojiro Yamamoto, Shinya Ashizuka, Shunichi Yanai, Shuji Kochi, Naoki Ohmiya, Takanari Kitazono, Teppei Omori, Kei Sakamoto, Toshifumi Morishita, Mamoru Watanabe, Sadaharu Nouda, Yasuo Suzuki, Yuta Fuyuno, and Tetsu Kinjo
- Subjects
Original Article—Alimentary Tract ,Crohn’s disease ,Adult ,Male ,medicine.medical_specialty ,Video Recording ,Diagnostic accuracy ,Capsule Endoscopy ,Sensitivity and Specificity ,Gastroenterology ,law.invention ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,Crohn Disease ,Japan ,Capsule endoscopy ,law ,Internal medicine ,Humans ,Medicine ,Intestinal Mucosa ,Stage (cooking) ,Aged ,Retrospective Studies ,Observer Variation ,Crohn's disease ,business.industry ,Case-control study ,Middle Aged ,Hepatology ,medicine.disease ,Colorectal surgery ,Case-Control Studies ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Abdominal surgery - Abstract
Background Capsule endoscopy can be used to identify the early stage of small bowel Crohn’s disease (CD). We evaluated significant small bowel capsule endoscopy (SBCE) findings that can lead to early diagnosis of CD. Methods We retrospectively accumulated clinical and SBCE data of 108 patients (63 with and 45 without CD). Types of small bowel mucosal injuries, including erosion, ulceration, and cobblestone appearance, and the alignment of diminutive lesions were compared between patients with and without CD. Inter- and intra-observer agreement in the determination of lesions was assessed in 25 pairs of SBCE from the two groups. Results Under SBCE, cobblestone appearance (33% vs. 2%, p
- Published
- 2018
31. Two cases of accidental ingestion of a press-through package (PTP) sheet, diagnosed by tomosynthesis prior to endoscopy
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Kana Yamamoto, Yukiko Himukai, Ayako Kobayashi, Yu Sasaki, Shinichi Nakamura, Maiko Kishino, Teppei Omori, Katsutoshi Tokushige, Hiroki Nitta, and Rie Kure
- Subjects
Male ,medicine.medical_specialty ,High radiation ,Computed tomography ,Gastrointestinal Injury ,Eating ,Esophagus ,medicine ,Humans ,Aged ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Endoscopy ,General Medicine ,Middle Aged ,Colorectal surgery ,Tomosynthesis ,Radiography ,Accidental ingestion ,Female ,Radiology ,business ,Tomography, X-Ray Computed ,Abdominal surgery - Abstract
The accidental ingestion of a press-through package (PTP) sheet is associated with the risk of gastrointestinal injury and puncture. When pain occurs in the laryngeal pharynx, the PTP may already be stuck in the upper esophageal region, and urgent endoscopic treatment is necessary. A plain chest X-ray image should be performed first to identify the ingested PTP, but this was not successful in the present two patients. As a next step, a CT scan (which involves high radiation exposure) is commonly used. In our patients (a 76-year-old woman and a 59-year-old man), tomosynthesis was used to confirm the presence and location of a PTP sheet as a pre-endoscopic diagnosis. With tomosynthesis, the level of radiation exposure was reduced to approx. 1/10 of that of simple CT; the imaging time is also shorter at ~ 5 s. Tomosynthesis can be performed at approx. 1/3–1/4 the cost of simple CT. The usefulness of tomosynthesis as a pre-endoscopic diagnostic tool was demonstrated in our patients, and its further utilization is expected.
- Published
- 2019
32. Safety protocol of endoscopic examinations
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Yukiko Takayama, Shinichi Nakamura, Teppei Omori, Katsutoshi Tokushige, and Maiko Kishino
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Protocol (science) ,medicine.medical_specialty ,business.industry ,Mechanical Engineering ,Energy Engineering and Power Technology ,Medicine ,Medical physics ,Management Science and Operations Research ,business - Published
- 2018
33. Relationship between the Clinical Course of Ulcerative Colitis during Pregnancy and the Outcomes of Pregnancy: A Retrospective Evaluation
- Author
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Shinichi Nakamura, Teppei Omori, Bunei Iizuka, Ayumi Ito, and Katsutoshi Tokushige
- Subjects
Adult ,medicine.medical_specialty ,Time Factors ,Adolescent ,Exacerbation ,Remission, Spontaneous ,Abnormal Pregnancy ,childbirth ,Abnormal delivery ,Severity of Illness Index ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Pregnancy ,Recurrence ,clinical course [clinical activity index (CAI) ,Lichtiger index] ,maintenance of remission ,Internal Medicine ,Humans ,Medicine ,Childbirth ,ulcerative colitis ,Retrospective Studies ,business.industry ,Obstetrics ,Pregnancy Outcome ,Retrospective cohort study ,General Medicine ,Odds ratio ,Delivery, Obstetric ,medicine.disease ,Ulcerative colitis ,Surgery ,Pregnancy Complications ,030220 oncology & carcinogenesis ,Original Article ,Colitis, Ulcerative ,Female ,030211 gastroenterology & hepatology ,Pregnancy Trimesters ,business - Abstract
Objective Little information is available on the relationship between the clinical course of ulcerative colitis (UC) and the outcomes of pregnancy and delivery in pregnant Japanese women. The aim of this retrospective study was to determine the factors that influence pregnancy and childbirth in middle-aged UC patients. Methods We studied 53 pregnancies in 45 pregnant women with UC who delivered at our department. They included 41 pregnancies that started while in UC remission and 12 pregnancies that started in the UC active phase. The following factors were evaluated: 1) the clinical course of UC; 2) the frequency and details of abnormal pregnancy/abnormal delivery; and 3) the course of pregnancy/delivery. We compared the clinical features, course of UC, and details of treatment between women with a normal pregnancy/delivery and those with an abnormal delivery. Results A comparison of the remission and acute groups showed lower clinical activity indices (CAIs) during pregnancy in the remission group and significantly higher rates of recurrence/exacerbation in the active group (75%) than in the remission group (7.3%). The respective CAIs in the first, second, and third trimesters were 3 and 6, 3 and 5, and 3 and 4, in the remission and active groups, respectively. Live infants were delivered in 51 (96%) pregnancies, with 7 (17%) abnormal pregnancies in the remission group and 4 (33.3%) in the active group (p>0.05). Abnormal delivery occurred in 16 of 53 (30.1%) pregnancies, and the rate was higher in the remission group than in the active group (p>0.05). In both groups, the most common abnormal event during pregnancy was delivery of low-birth-weight infants. Delivery was normal in 37 cases and abnormal in 16 cases. A multivariate analysis showed that a shorter UC disease duration (odds ratio=1.16) and higher CAI in the first trimester (odds ratio=1.49) were associated with an increased risk of abnormal pregnancy. Conclusion Our findings demonstrated that the clinical course of UC, as evaluated by the CAI, during pregnancy influenced the outcome of pregnancy and delivery.
- Published
- 2018
34. Risk Factors for Mortality in Pneumocystis jirovecii Pneumonia in Patients with Inflammatory Bowel Disease
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Akira Matsui, Teppei Omori, Katsuya Endo, Hiroki Tanaka, Shinichiro Shinzaki, Atsushi Yoshida, Shuji Kanmura, Tetsu Kinjo, Norimasa Fukata, Makoto Ooi, Ryohei Hayashi, Taku Kobayashi, Ryosuke Sakemi, Yoko Yokoyama, Toshio Morizane, Takuya Yoshino, Akihiro Yamada, Shigeki Bamba, Sakuma Takahashi, Noriko Kamata, Shinya Ashizuka, Toshimitsu Fujii, and Noriyuki Ogata
- Subjects
Crohn's disease ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Mortality rate ,Gastroenterology ,Retrospective cohort study ,medicine.disease ,Inflammatory bowel disease ,Ulcerative colitis ,chemistry.chemical_compound ,chemistry ,Internal medicine ,Medicine ,Blood test ,Risk factor ,business ,Sulfamethoxazole/Trimethoprim - Abstract
Background: Pneumocystis jirovecii pneumonia (PJP) is highly fatal once infection is established. In this study, we investigated the risk of PJP mortality in patients with inflammatory bowel disease (IBD). Methods: We conducted a retrospective observational study of case data from IBD patients who developed PJP, compiled from 17 collaborating institutions. Parameters such as age, sex, medications used, and blood test results were analyzed to identify risk factors for mortality. Results: The mortality rate among the 28 IBD patients who developed PJP was 17.9%. A low serum albumin level at the start of IBD treatment was identified as a risk factor for mortality and showed the following association with probability of death (P): P = 1/[1 + exp(–5.5 + 2.4 × Alb). The probability of death exceeded 0.5 when serum albumin was 2.2 g/dL or lower. Conclusion: Patients with IBD who develop PJP have a high mortality rate and often cannot continue treatment with medication alone. Therefore, it is necessary to pay attention to albumin levels at the start of immunosuppressive therapy when creating a treatment plan.
- Published
- 2018
35. ID: 3523068 COMPUTER-AIDED DIAGNOSIS OF COLORECTAL CANCER WITH DEEP SUBMUCOSAL INVASION USING NON-MAGNIFIED WHITE LIGHT ENDOSCOPIC IMAGES COMPARED WITH ENDOSCOPISTS
- Author
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Takayuki Matsumoto, Yasuyuki Miyakura, Daiki Nemoto, Toshio Uraoka, Tomoki Matsuda, Ryo Maemoto, Ruiyao Zhang, Xin Zhu, Hiroyuki Kato, Ken Inoue, Hirohito Tanaka, Koichiro Sato, Takashi Akutagawa, Shinichi Katsuki, Takahito Takezawa, Keisuke Kawasaki, Noriko Tanaka, Hironori Yamamoto, Naohisa Yoshida, Alan Kawarai Lefor, Kunihiro Takanashi, Yuji Inoue, Takashi Hisabe, Boyuan Peng, Yoshikazu Hayashi, Teppei Omori, Yuki Nakajima, Zhe Guo, Kazutomo Togashi, and Motohiro Esaki
- Subjects
medicine.medical_specialty ,business.industry ,Colorectal cancer ,Computer-aided diagnosis ,Gastroenterology ,White light ,Medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business ,medicine.disease - Published
- 2021
36. Development and Improvement of Simple Colonic Mucosal Ulcer during Treatment of Severe Ulcerative Colitis with Tacrolimus
- Author
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Shinichi Nakamura, Teppei Omori, Ayumi Ito, Katsutoshi Tokushige, and Bunei Iizuka
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Single Case ,Colonoscopy ,Ileum ,Gastroenterology ,Tacrolimus ,Behçet’s disease ,03 medical and health sciences ,0302 clinical medicine ,Melena ,Simple ulcer ,Internal medicine ,medicine ,Mucosal Ulcer ,lcsh:RC799-869 ,medicine.diagnostic_test ,Behçet's disease ,business.industry ,medicine.disease ,Ulcerative colitis ,030104 developmental biology ,medicine.anatomical_structure ,Prednisolone ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Complication ,medicine.drug - Abstract
Diarrhea, melena, and lower abdominal pain developed in a male in his 20s and colonoscopy showed pancolitis-type severe ulcerative colitis (UC). Treatment was initiated with 4,000 mg of 5-aminosalicylic acid and 60 mg/day of prednisolone, but the symptoms and inflammatory reaction worsened with prednisolone dose reduction. Tacrolimus was added to the treatment, which subsequently induced remission. Serial colonoscopies during the treatment showed improvement in ulcer and mucosal edema throughout the entire large intestine, but a new solitary round ulcer appeared at the end of the ileum. Since no signs of Behçet’s disease were noted, it was considered as a simple ulcer, a complication of UC. Tacrolimus treatment was continued based on continued improvement in clinical features and colonic mucosa, excluding the end of the ileum. Colonoscopy at 6 months after initiation of tacrolimus showed healing of the large intestinal mucosa, although mild congestion was still noted. The solitary round ulcer at the end of the ileum improved to a small erosion. We report the improvement of a simple ulcer that developed during tacrolimus treatment.
- Published
- 2017
37. A case of gastrojejunocolic fistula with steatohepatitis
- Author
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Masakazu Yamamoto, Bunei Iizuka, Teppei Omori, Fukiko Kinoshita, Mikiko Taneichi, Makiko Taniai, Shinichi Nakamura, Yoji Nagashima, Ayumi Ito, Katsutoshi Tokushige, Etsuko Hashimoto, and Michio Itabashi
- Subjects
Adult ,Gastric Fistula ,Male ,Enteroscopy ,medicine.medical_specialty ,Balloon Enteroscopy ,Biopsy ,Fistula ,medicine.medical_treatment ,Anastomosis ,Gastroenterology ,Colonic Diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Intestinal Fistula ,medicine ,Humans ,Ultrasonography ,Barium enema ,Billroth II ,Gastrojejunocolic fistula ,business.industry ,Transverse colon ,Jejunal Diseases ,General Medicine ,medicine.disease ,Surgery ,Fatty Liver ,Liver ,Duodenal Ulcer ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Steatohepatitis ,Gastroenterostomy ,Tomography, X-Ray Computed ,business - Abstract
A man in his 30s, who had undergone retrocolic Billroth II reconstruction for perforated duodenal ulcer, presented with watery diarrhea for 2 years and suspected fatty liver. He was referred to our hospital for management of chronic diarrhea, weight loss, hepatopathy and hypoalbuminemia. Initial upper and lower gastrointestinal endoscopies were negative. Since a small bowel lesion was suspected, peroral single-balloon enteroscopy was performed, which identified feces-like residue near the Billroth II anastomotic site and a connection to the colon separate from the afferent and efferent loops. Transanal single-balloon enteroscopy identified a fistula between the gastrojejunal anastomosis and transverse colon, with the scope reaching the stomach transanally. Barium enema confirmed flow of contrast medium from the transverse colon through the fistula to the anastomotic site, allowing the diagnosis of gastrojejunocolic fistula. Liver biopsy showed relatively severe steatohepatitis (Brunt's classification: stage 2-3, grade 3). Resection of the anastomotic site and partial transverse colectomy were performed to remove the fistula, followed by Roux-en-Y reconstruction. Postoperatively, watery diarrhea resolved and the stools became normal. Hepatopathy and hypoproteinemia improved. One year later, liver biopsy showed marked improvement of steatosis. This case demonstrated marked improvement of both diarrhea/nutritional status and steatohepatitis after treatment of gastrojejunocolic fistula, suggesting that the fistula caused non-alcoholic steatohepatitis.
- Published
- 2016
38. Comparison of Lewis Score and Capsule Endoscopy Crohn's Disease Activity Index in Patients with Crohn's Disease
- Author
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Harutaka Kambayashi, Shinichi Nakamura, Katsutoshi Tokushige, Teppei Omori, Ayumi Ito, Maria Yonezawa, and Shun Murasugi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Physiology ,Gastroenterology ,Capsule Endoscopy ,Severity of Illness Index ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Crohn Disease ,Intestinal inflammation ,Capsule endoscopy ,law ,Internal medicine ,medicine ,Humans ,In patient ,Rank correlation ,Retrospective Studies ,Crohn's disease ,business.industry ,Hepatology ,Middle Aged ,medicine.disease ,Crohn's Disease Activity Index ,030220 oncology & carcinogenesis ,Biomarker (medicine) ,030211 gastroenterology & hepatology ,Female ,Inflammation Mediators ,business ,Biomarkers - Abstract
Small bowel capsule endoscopy (SBCE) is used to visualize mucosal inflammatory changes in the small intestine of patients with Crohn’s disease (CD). The Lewis score (LS) and Capsule Endoscopy Crohn’s Disease Activity Index (CECDAI) are used to evaluate the visualized images. We determined the score disagreement between LS and CECDAI in patients with CD. We evaluated 184 SBCE procedures in 102 CD patients with small bowel lesions. Patients were classified according to the Montreal classification. LS and CECDAI were calculated, and cases with disagreement between the two scores were identified. We investigated the characteristics of disagreement, and analyzed the relationships with the Crohn’s Disease Activity Index (CDAI) and C-reactive protein. LS (504 ± 1160) correlated strongly with CECDAI (6 ± 5.4) (Spearman’s rank correlation coefficient ρ = 0.81, p
- Published
- 2019
39. Tacrolimus for Remission Induction and Maintenance Therapy in Patients with Ulcerative Colitis: A Retrospective Evaluation Study
- Author
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Katsutoshi Tokushige, Teppei Omori, Ayumi Ito, Shinichi Nakamura, and Bunei Iizuka
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Article Subject ,chemical and pharmacologic phenomena ,Gastroenterology ,Nephrotoxicity ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,Maintenance therapy ,Internal medicine ,medicine ,In patient ,lcsh:RC799-869 ,Adverse effect ,Hepatology ,business.industry ,Retrospective cohort study ,medicine.disease ,Ulcerative colitis ,Tacrolimus ,Surgery ,stomatognathic diseases ,030104 developmental biology ,Clinical Study ,Prednisolone ,lcsh:Diseases of the digestive system. Gastroenterology ,030211 gastroenterology & hepatology ,business ,medicine.drug - Abstract
Background. In this retrospective study, we compared the efficacy of tacrolimus (TAC) or prednisolone (PSL) for maintenance therapy in patients with ulcerative colitis (UC) at remission.Methods. The study patients were followed up for at least one year after induction of remission with either PSL (n=55, between April 2004 and March 2014) or TAC (n=40, between April 2009 and March 2014). The clinical features and relapse rates were compared in the two groups. Maintenance therapy in the TAC group included TAC alone, AZA alone, and TAC plus AZA.Results. The recurrence rates at 1500 days after remission were 61% and 46% for the PSL and TAC groups, respectively (P<0.05). The recurrence rates at 600 days for TAC, AZA, and TAC + AZA maintenance groups were 24%, 49%, and 55%, respectively. Nephrotoxicity developed in 16 patients on TAC maintenance therapy.Conclusions. TAC monotherapy is a potential alternative especially for PSL nonresponders or those intolerant to AZA. However, patients on TAC therapy should be regularly monitored for adverse effects including nephrotoxicity.
- Published
- 2016
40. The Timing of Endoscopic Evaluation of Anti-TNFα Therapy Patients with Ulcerative Colitis
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Maria Yonezawa, Teppei Omori, Shinichi Nakamura, Harutaka Kambayashi, Katsutoshi Tokushige, Ayumi Ito, Hiroyuki Kashiwagi, and Shun Murasugi
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Colonoscopy ,medicine.disease ,Ulcerative colitis ,Gastroenterology ,Infliximab ,Maintenance therapy ,Refractory ,Internal medicine ,medicine ,Adalimumab ,Blood test ,Tumor necrosis factor alpha ,business ,medicine.drug - Abstract
Anti-TNFα Therapy are used to induce remission and as maintenance therapy in refractory ulcerative colitis (UC) to achieve mucosal healing (MH). However, the time at which mucosal healing should be assessed is unclear. We retrospectively examined the optimal timing for colonoscopy and the criteria to determine the need for the continuation of treatment. We evaluated 44 UC patients that were treated with anti-TNFα Therapy and categorized them into the following groups according to the degree of MH within 12 months: MH and non-MH/NMH, early-MH (EMH, healing within three months), and slow MH/SMH (healing between 4-12 months). We compared the Mayo Endoscopic Subscore (MES) between the MH vs. NMH and SMH vs. NMH groups. The Lichtiger index and blood test results were investigated as predictive factors of MH. MH was defined as an MES of ≤ 1. The MES was significantly lower in the MH group at 3, 6, and 12 months, compared to the NMH group. Significant changes were observed in the platelet counts, the Lichtiger index, the levels of C-reactive protein (lower), and hemoglobin (higher) in the MH group at 3- and 6-months following treatment. However, the only significant difference between the SMH and NMH groups was in the endoscopic findings at 6- or 12-months post-treatment. Colonoscopy should be performed three months after treatment with anti-TNFα Therapy. The treatment should be continued in patients who do not achieve mucosal healing at 3-months, and colonoscopy should be repeated at 6- or 12-months to assess the outcomes.
- Published
- 2020
41. Risk Factors for Mortality in
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Atsushi, Yoshida, Noriko, Kamata, Akihiro, Yamada, Yoko, Yokoyama, Teppei, Omori, Toshimitsu, Fujii, Ryohei, Hayashi, Tetsu, Kinjo, Akira, Matsui, Norimasa, Fukata, Sakuma, Takahashi, Ryosuke, Sakemi, Noriyuki, Ogata, Shinya, Ashizuka, Shigeki, Bamba, Makoto, Ooi, Shuji, Kanmura, Katsuya, Endo, Takuya, Yoshino, Hiroki, Tanaka, Toshio, Morizane, Shinichiro, Shinzaki, and Taku, Kobayashi
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Original Paper - Abstract
BACKGROUND: Pneumocystis jirovecii pneumonia (PJP) is highly fatal once infection is established. In this study, we investigated the risk of PJP mortality in patients with inflammatory bowel disease (IBD). METHODS: We conducted a retrospective observational study of case data from IBD patients who developed PJP, compiled from 17 collaborating institutions. Parameters such as age, sex, medications used, and blood test results were analyzed to identify risk factors for mortality. RESULTS: The mortality rate among the 28 IBD patients who developed PJP was 17.9%. A low serum albumin level at the start of IBD treatment was identified as a risk factor for mortality and showed the following association with probability of death (P): P = 1/[1 + exp(−5.5 + 2.4 × Alb). The probability of death exceeded 0.5 when serum albumin was 2.2 g/dL or lower. CONCLUSION: Patients with IBD who develop PJP have a high mortality rate and often cannot continue treatment with medication alone. Therefore, it is necessary to pay attention to albumin levels at the start of immunosuppressive therapy when creating a treatment plan.
- Published
- 2018
42. Evaluation of Intestinal Patency with the Patency Capsule: The Twenty-Four Hour Assessment Method
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Shinichi Nakamura, Ayumi Ito, Maria Yonezawa, Shun Murasugi, Teppei Omori, Katsutoshi Tokushige, and Harutaka Kambayashi
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Patency capsule ,Urology ,Capsules ,Extracorporeal ,law.invention ,Capsule endoscopy ,law ,medicine ,Humans ,Large intestine ,Gastrointestinal Transit ,Retrospective Studies ,business.industry ,Gastroenterology ,Capsule ,Middle Aged ,Intestines ,medicine.anatomical_structure ,Assessment methods ,Female ,business ,Intestinal Obstruction - Abstract
Introduction: Confirmation of intestinal patency using the patency capsule (PC) in 30–33 h may result in a complex testing schedule. The aim of this study was to perform and evaluate a 24-h PC procedure for potential use as a simple and easy-to-apply intestinal patency assessment method. Subject and Methods: The study included 342 patients who were assessed 24 h after ingesting a PC for assessment of intestinal patency. The PC elimination rate and the distribution of elimination time were evaluated. Results: Assessment of intestinal patency was conducted in 308 (90%) patients. Self-confirmed PC elimination within 24 h was possible in 104 (30.4%) patients. The PC was considered to have been already eliminated in 38 (11.1%) patients. Thus, the extracorporeal elimination rate was 41.5%. Among 200 patients with non-extracorporeal elimination, the PC reached the large intestine in 166 patients (48.5% of the total patients). Small-bowel capsule endoscopy (CE) was performed in all 308 patients, and the entire small bowel could be observed in 98.4%. Capsule retention was not observed in any of the patients. Conclusion: The 24-h assessment method, in which the PC can be ingested using the same procedure as that for CE capsule, can be handled more easily and is more useful clinically.
- Published
- 2018
43. A novel MLH1 mutation in a Japanese family with Lynch syndrome associated with small bowel cancer
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Kayoko Saito, Toshiyuki Kanno, Yoshika Akizawa, Teppei Omori, Kazuo Tamura, Katsutoshi Tokushige, Takeshi Ohki, Toshiyuki Yamamoto, Masakazu Yamamoto, and Nobuko Takahashi
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0301 basic medicine ,Oncology ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,lcsh:QH426-470 ,Colorectal cancer ,lcsh:Life ,Biochemistry ,03 medical and health sciences ,0302 clinical medicine ,Germline mutation ,Internal medicine ,Data Report ,Genetics ,medicine ,neoplasms ,Molecular Biology ,business.industry ,Endometrial cancer ,nutritional and metabolic diseases ,Cancer ,medicine.disease ,digestive system diseases ,Lynch syndrome ,MSH6 ,lcsh:Genetics ,lcsh:QH501-531 ,030104 developmental biology ,MSH2 ,030220 oncology & carcinogenesis ,business ,Ovarian cancer - Abstract
Lynch syndrome is a genetic disorder related to cancer predisposition, including colorectal cancer, endometrial cancer, and ovarian cancer. Germline mutations in mismatch repair genes, including MLH1, MSH2, MSH6, and PMS2, are responsible for this condition. Cancer tissue specimens resected from small bowel adenocarcinoma in a Japanese patient showed decreased expression of MLH1 and PMS2 by immunohistochemistry testing. Finally, a novel MLH1 mutation, c.1833dup, was identified in this patient.
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- 2018
44. Does the PillCam SB3 capsule endoscopy system improve image reading efficiency irrespective of experience? A pilot study
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Ayumi Ito, Toshifumi Hara, Katsutoshi Tokushige, Shun Murasugi, Teppei Omori, Sachiyo Sakasai, Shinichi Nakamura, and Harutaka Kambayashi
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medicine.medical_specialty ,Original article ,business.industry ,media_common.quotation_subject ,Significant difference ,Transit time ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Capsule endoscopy ,law ,030220 oncology & carcinogenesis ,Reading (process) ,Medicine ,030211 gastroenterology & hepatology ,Pharmacology (medical) ,Medical physics ,lcsh:Diseases of the digestive system. Gastroenterology ,lcsh:RC799-869 ,business ,media_common - Abstract
Background and study aims The aim of this study was tp compare the diagnostic efficiency of the PillCam SB3 capsule endoscopy (CE) system with the older system, PillCam SB2, taking into consideration the experience of the image reader. Patients and methods Small intestinal CE was conducted on 64 patients around May 2014 when the SB3 was introduced in our hospital. Data obtained from 20 patients (SB2: 10 and SB3: 10) based on transit time were assessed by junior (experience: 20 images), intermediate (> 50), and expert readers (> 600). Results Reading time with the CE down to the end of the small intestine was shorter in the SB3 group for each reader (SB2 vs. SB3: junior, 40.2 ± 10.1 vs. 23.7 ± 6.7 [P = 0.0009]; intermediate, 21.4 ± 4.9 vs. 10.3 ± 2.9 [P = 0.0003]; expert, 23.2 ± 5.6 vs. 11.1 ± 2.9 min [P = 0.0002]). Interpretation agreement rates between the findings by junior and intermediate readers and those by the expert reader were 84.6 % and 92.3 %, respectively. For the junior reader, rates of agreement using the SB2 and SB3 systems with those by the expert reader were 85.7 % and 83.3 %, respectively; no significant difference was noted between the two systems. Similarly, for the intermediate reader, the respective agreement rates using the SB2 and SB3 systems were 85.7 % and 100 %, respectively. Conclusions The PillCam SB3 reduces the time burden on readers irrespective of their experience.
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- 2018
45. Correction to: Management of elderly ulcerative colitis in Japan
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Masayuki Saruta, Masakazu Nagahori, Kazuhiro Watanabe, Ryota Hokari, Kenji Wanatabe, Akira Sugita, Ken Takeuchi, Shigeki Bamba, Satohiro Matsumoto, Tomohisa Takagi, Noritaka Takatsu, Makoto Naganuma, Ken Sugimoto, Toshiyuki Sakurai, Yoko Yokoyama, Mitsuo Nagasaka, Yasuo Suzuki, Shingo Kato, Shiro Nakamura, Takehiko Katsurada, Kazuya Kitamura, Shintaro Sagami, Motoi Uchino, Kazutaka Koganei, Teppei Omori, and Masaaki Higashiyama
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medicine.medical_specialty ,business.industry ,General surgery ,Gastroenterology ,MEDLINE ,Correction ,Hepatology ,medicine.disease ,Ulcerative colitis ,Colorectal surgery ,Diagnosis, Differential ,Japan ,Surgical oncology ,Internal medicine ,Humans ,Medicine ,Colitis, Ulcerative ,business ,Aged ,Abdominal surgery - Abstract
Japan has the largest aging society, where many elderly people have intractable diseases including ulcerative colitis (UC). Along with the increasing total number of UC patients, the number of elderly UC patients has also been increasing and will continue to do so in the future. Although the clinical features and natural history of UC in the elderly have many similarities with UC in the non-elderly population, age-specific concerns including comorbidities, immunological dysfunction, and polypharmacy make the diagnosis and management of elderly UC challenging compared to UC in non-elderly patients. Based on increasing data related to elderly UC patients from Japan, as well as other countries, we reviewed the epidemiology, clinical course, differential diagnosis, management of comorbidities, surveillance, medical therapy, and surgery of UC in the elderly.
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- 2019
46. Establishment of a Novel Scoring System for Colon Capsule Endoscopy to Assess the Severity of Ulcerative Colitis-Capsule Scoring of Ulcerative Colitis
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Mamoru Watanabe, Yoshihiro Nakazato, Yutaka Endo, Yasuo Suzuki, Takanori Kanai, Ken Takeuchi, Toshifumi Hibi, Haruhiko Ogata, Naoki Hosoe, Mari Hayashida, Masaru Nakano, Makoto Naganuma, Teppei Omori, Atsushi Yoshida, Katsuyoshi Matsuoka, Fumiaki Ueno, Takayuki Abe, Shinta Mizuno, and Taku Kobayashi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Visual analogue scale ,Video Recording ,Colonoscopy ,Inflammatory bowel disease ,Gastroenterology ,Capsule Endoscopy ,Severity of Illness Index ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Capsule endoscopy ,law ,Internal medicine ,medicine ,Immunology and Allergy ,Humans ,Prospective Studies ,Colitis ,Sigmoidoscopy ,Splenic flexure ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Ulcerative colitis ,030220 oncology & carcinogenesis ,Linear Models ,030211 gastroenterology & hepatology ,Colitis, Ulcerative ,Female ,Calprotectin ,business - Abstract
Background The usefulness of second-generation colon capsule endoscopy (CCE-2) for ulcerative colitis (UC) has not been fully demonstrated. This study aimed to develop an endoscopic severity score of UC for CCE-2. Methods Patients diagnosed with UC were enrolled prospectively and underwent colonoscopy and CCE-2 on the same day. The collected CCE-2 videos were adopted for the development of the score. These videos were scored by 4 blinded inflammatory bowel disease experts. The items validated with the Ulcerative Colitis Endoscopic Index of Severity (UCEIS) were used as the candidate items, some of which were automatically assessed using the workstation. Each item was divided into proximal and distal parts at the splenic flexure and then individually assessed. The image readers simultaneously evaluated the inflammation severity using the visual analog scale (VAS). The descriptors that contribute to this scale were evaluated, and a model to predict the VAS was constructed. The UCEIS was scored by other endoscopists using colonoscopy videos. The correlation coefficients with fecal calprotectin, blood tests, and Lichtiger index were calculated. Results The final scoring system was fixed as "vascular pattern sum (proximal + distal) + bleeding sum + erosions and ulcers sum (minimum-maximum, 0-14)" and was named Capsule Scoring of Ulcerative Colitis (CSUC). The correlation coefficient of CSUC with biomarkers and clinical score was similar to that of the UCEIS. Conclusions We developed a new simple score using the 3 descriptors of CCE-2.
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- 2017
47. Localization of the Patency Capsule by Abdominal Tomosynthesis
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Teppei Omori, Shinichi Nakamura, and Keiko Shiratori
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Adult ,Male ,medicine.medical_specialty ,Patency capsule ,Constriction, Pathologic ,Capsule Endoscopy ,Sensitivity and Specificity ,law.invention ,Feces ,Foreign-Body Migration ,Predictive Value of Tests ,Capsule endoscopy ,law ,Intestine, Small ,Humans ,Medicine ,In patient ,Prospective Studies ,Vascular Patency ,Aged ,business.industry ,Gastroenterology ,Gold standard (test) ,Middle Aged ,Predictive value ,Tomosynthesis ,Gastrointestinal Tract ,Capsule Endoscopes ,Female ,Radiology ,Abdominal computed tomography ,Tomography, X-Ray Computed ,business - Abstract
Background/Aims: A patency capsule (PC) is used to assess intestinal patency in patients with known or suspected stricture, but PC localization by plain abdominal X-ray (AXR) is difficult in those patients in whom the PC is not detected in the feces. Tomosynthesis is a promising, cost-effective, and low-radiation digital tomographic technique. This prospective study evaluated its use for PC localization in the intestinal tract. Methods: The study subjects were 49 patients in whom the PC was not detected in the feces and was identified intra-abdominally on AXR films. PC localization in the small or large intestines by AXR alone or by tomosynthesis with AXR was compared with abdominal computed tomography (CT), which is the gold standard. Results: The PC was judged in the large and small intestines in 22 and 27 patients by AXR alone versus 34 and 15 patients, respectively, by tomosynthesis combined with AXR. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for PC detection by AXR alone were 52.9, 53.3, 56.2, 50.0, and 53.1%, respectively. The same parameters were 100, 100, 100, 100, and 100%, respectively, for tomosynthesis with AXR, which were identical to those of CT. Conclusions: Tomosynthesis with AXR is superior to AXR alone, though similar to CT, with respect to localization of the PC.
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- 2015
48. Induction of Remission and Maintenance Therapy with Tacrolimus in Refractory Ulcerative Colitis with Adverse Events from 5-ASA and Thiopurine
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Katsutoshi Tokushige, Tomomi Kogiso, Shinichi Nakamura, Teppei Omori, and Ayumi Ito
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medicine.medical_specialty ,Abdominal pain ,business.industry ,Azathioprine ,medicine.disease ,Gastroenterology ,Ulcerative colitis ,Surgery ,Discontinuation ,03 medical and health sciences ,0302 clinical medicine ,Maintenance therapy ,Melena ,030220 oncology & carcinogenesis ,Internal medicine ,medicine ,Prednisolone ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Adverse effect ,medicine.drug - Abstract
A 58-year-old Japanese woman was admitted to the hospital with fever, diarrhea, melena and lower abdominal pain. Colonoscopy showed moderate left-sided Ulcerative Colitis (UC). Administration of 5-aminosalicylic acid (5- ASA) (3600 mg) was started, but skin eruptions and hepatic dysfunction occurred. The drug lymphocyte stimulation test (DLST) was positive for 5-ASA, so this medication was discontinued. Prednisolone (PSL, initially 10 mg/day) was started, and remission was achieved. However, relapse occurred 5 months later after the discontinuation of PSL, and hospitalization was required again. Remission was achieved again by PSL, and azathioprine (AZA) (initially 25 mg/day) was started as maintenance therapy. Hepatic dysfunction was detected at 1 month after starting AZA and was judged to represent drug-induced hepatitis. Following the discontinuation of AZA, PSL (2 mg/day) monotherapy was continued. At 11 months after discharge from hospital, the patient developed diarrhea, melena, and abdominal pain, requiring hospitalization for the third time. Colonoscopy showed extensive ulceration and spontaneous bleeding, indicating a relapse of severe UC. Administration of tacrolimus (TAC) led to remission and the patient was discharged from hospital. Because she experienced adverse effects with 5-ASA and AZA, TAC alone was continued as maintenance therapy for ≥ 2 years after the discontinuation of PSL. Relapse did not occur during this period and repeat colonoscopy showed mucosal healing. During the TAC maintenance therapy, slight deterioration of renal function was observed, but there were no other adverse events. In conclusion, we experienced a rare patient who responded to TAC maintenance monotherapy for severe UC.
- Published
- 2017
49. Tomosynthesis for colonic localization of patency capsules
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Ayumi Ito, Katsutoshi Tokushige, Teppei Omori, and Shinichi Nakamura
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Adult ,Colon ,business.industry ,Gastroenterology ,Humans ,Medicine ,Female ,Tomography, X-Ray Computed ,Nuclear medicine ,business ,Capsule Endoscopy ,Tomosynthesis - Published
- 2018
50. A patient with syphilis who had concomitant gastric and large intestinal lesions
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Maiko Kishino, Yukiko Himukai, Shun Murasugi, Shinichi Nakamura, Tomoko Yamamoto, Kana Yamamoto, Teppei Omori, Yoji Nagashima, Hiroki Nitta, Rie Kure, Katsutoshi Tokushige, Hirotaka Yamamoto, and Ayako Kobayashi
- Subjects
medicine.medical_specialty ,business.industry ,Mechanical Engineering ,Internal medicine ,Concomitant ,medicine ,Energy Engineering and Power Technology ,Syphilis ,Large intestinal ,Management Science and Operations Research ,medicine.disease ,business ,Gastroenterology - Published
- 2018
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