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Wang S, Guo J, Liu X, Ge N, Wang G, Hu J, Zhang K, Sun S. Evaluation of a novel radial echoendosonoscope with a piezoelectric-composite transducer: An open-label, multicenter, randomized, parallel-group, noninferiority clinical trial. Endosc Ultrasound 2021; 10:431-439. [PMID: 34975041 PMCID: PMC8785674 DOI: 10.4103/eus-d-21-00100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES EUS is widely used in the clinical practice. This study aimed to evaluate the efficacy of a novel echoendoscope regarding image quality, maneuverability, stability of the entire machine system, and safety. SETTING AND DESIGN We conducted this open-label, multicenter, randomized, parallel-group, noninferiority clinical trial in three tertiary hospitals between November 2018 and April 2019. SUBJECTS AND METHODS One hundred and thirty patients were included. The stratified segment randomization method was employed. Sixty-five patients in the test group received an EUS examination using the new material radial echoendoscope, and 65 patients in the control group received an EUS examination using the existing endoscope. We recorded the image quality, maneuverability, stability of the entire machine system, and safety. For the main outcome, comprehensive image quality, the groups were compared with the noninferiority test, using the confidence interval method and 10% as the noninferiority threshold. The Pearson Chi-square test was used to compare the incidence of adverse events between the groups. RESULTS Sixty-five patients in the test group and 63 patients in the control group were analyzed. Two patients in control group did not complete an EUS examination due to machine problems. There were no significant differences in image quality, maneuverability of the echoendoscope, stability of the entire machine system, and safety between the groups. CONCLUSIONS This new material radial echoendoscope showed good capabilities for image quality, maneuverability, stability of the entire machine system, and safety. Our data suggest that the new echoendoscope may provide an additional option for endoscopic physicians.
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Affiliation(s)
- Sheng Wang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Jintao Guo
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Xiang Liu
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Nan Ge
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Guoxin Wang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Jinlong Hu
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Kai Zhang
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Siyu Sun
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
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Ishikawa-Kakiya Y, Maruyama H, Yamamoto K, Yamamura M, Tanoue K, Higashimori A, Ominami M, Nadatani Y, Fukunaga S, Otani K, Hosomi S, Tanaka F, Kamata N, Nagami Y, Taira K, Shiba M, Watanabe T, Fujiwara Y. Comparison of the Diagnostic Efficiency of Radial- and Convex-Arrayed Echoendoscopes for Indirect Findings of Pancreatic Cancer: A Retrospective Comparative Study Using Propensity Score Method. Cancers (Basel) 2021; 13:cancers13061217. [PMID: 33799500 PMCID: PMC8001660 DOI: 10.3390/cancers13061217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Pancreatic cancer (PC) has a poor prognosis; however, diagnosing PC at an earlier stage could improve long-term patient outcomes. Endoscopic ultrasonography (EUS) plays an important role in PC detection, and the indirect findings (caliber change, retention cysts, and dilatation of the branch duct) that are detected by EUS are especially important for the early detection of PC. The aim of this retrospective study was to compare the diagnostic efficacy of radial- and convex-arrayed echoendoscope for the detection rate of indirect findings. As a result, the radial-arrayed echoendoscope was found to be an independent detection factor of indirect findings by multivariate analysis. The radial-arrayed echoendoscope is useful for the detection of indirect findings. Abstract Endoscopic ultrasonography (EUS) is useful for detecting early-stage pancreatic cancer. Because the detection of small lesions is difficult, it is important to detect indirect findings, namely caliber change, retention cysts, and dilatation of the branch duct, during the procedure. Although two types of EUS endoscopes are frequently used, there is no comparative study on their efficacy for detecting indirect findings. Therefore, we aimed to compare the diagnostic efficacy of these two types for indirect findings. We retrospectively analyzed 316 consecutive patients who had undergone EUS for pancreaticobiliary disease at a single center between January 2017 and December 2018. The main outcome was the detection rate of indirect findings and its comparison between the two echoendoscope types. This outcome was achieved using the inverse probability of treatment weighting (IPTW) analysis. The detection rate of indirect findings was higher for the radial-arrayed endoscope than for the convex-arrayed echoendoscope (9.2% vs. 2.3% (p = 0.02)). The univariate analysis also revealed that the radial-arrayed echoendoscope was significantly superior to the convex-arrayed echoendoscope in terms of the detection of indirect findings (odds ratio, 5.94; 95% confidence interval, 1.68–21.10; p = 0.01) after IPTW. After adjustment for magnetic resonance imaging (MRI) and computed tomography (CT), radial-arrayed echoendoscope remained an independent factor for indirect finding detection (odds ratio, 6.04; 95% confidence interval, 1.74–21.00; p = 0.01). Finally, five patients who had indirect EUS findings were diagnosed with pancreatic cancer. Our results indicate that the radial-arrayed echoendoscope is useful for the detection of indirect findings.
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Affiliation(s)
- Yuki Ishikawa-Kakiya
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Hirotsugu Maruyama
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
- Correspondence: ; Tel.: +81-6-6645-3811
| | - Kei Yamamoto
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Masafumi Yamamura
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Kojiro Tanoue
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Akira Higashimori
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Masaki Ominami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Yuji Nadatani
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Shusei Fukunaga
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Koji Otani
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Shuhei Hosomi
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Fumio Tanaka
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Noriko Kamata
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Yasuaki Nagami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Koichi Taira
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Masatsugu Shiba
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan;
| | - Toshio Watanabe
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
| | - Yasuhiro Fujiwara
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan; (Y.I.-K.); (K.Y.); (M.Y.); (K.T.); (A.H.); (M.O.); (Y.N.); (S.F.); (K.O.); (S.H.); (F.T.); (N.K.); (Y.N.); (K.T.); (T.W.); (Y.F.)
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Ishii T, Katanuma A, Toyonaga H, Chikugo K, Nasuno H, Kin T, Hayashi T, Takahashi K. Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms. Diagnostics (Basel) 2021; 11:diagnostics11020316. [PMID: 33672085 PMCID: PMC7919683 DOI: 10.3390/diagnostics11020316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 12/16/2022] Open
Abstract
Although pancreatic neuroendocrine neoplasms (PNENs) are relatively rare tumors, their number is increasing with advances in diagnostic imaging modalities. Even small lesions that are difficult to detect using computed tomography or magnetic resonance imaging can now be detected with endoscopic ultrasound (EUS). Contrast-enhanced EUS is useful, and not only diagnosis but also malignancy detection has become possible by evaluating the vascularity of tumors. Pathological diagnosis using EUS with fine-needle aspiration (EUS-FNA) is useful when diagnostic imaging is difficult. EUS-FNA can also be used to evaluate the grade of malignancy. Pooling the data of the studies that compared the PNENs grading between EUS-FNA samples and surgical specimens showed a concordance rate of 77.5% (κ-statistic = 0.65, 95% confidence interval = 0.59–0.71, p < 0.01). Stratified analysis for small tumor size (2 cm) showed that the concordance rate was 84.5% and the kappa correlation index was 0.59 (95% confidence interval = 0.43–0.74, p < 0.01). The evolution of ultrasound imaging technologies such as contrast-enhanced and elastography and the artificial intelligence that analyzes them, the evolution of needles, and genetic analysis, will further develop the diagnosis and treatment of PNENs in the future.
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Affiliation(s)
- Tatsuya Ishii
- Correspondence: ; Tel.: +81-11-681-8111; Fax: +81-11-685-2967
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Kanno Y, Ito K, Koshita S, Ogawa T, Kusunose H, Masu K, Sakai T, Murabayashi T, Hasegawa S, Kozakai F, Kawakami Y, Fujii Y, Noda Y. Capability of Radial- and Convex-Arrayed Echoendoscopes for Visualization of the Pancreatobiliary Junction. Clin Endosc 2017; 51:274-278. [PMID: 28942626 PMCID: PMC5997075 DOI: 10.5946/ce.2017.098] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/20/2017] [Indexed: 01/04/2023] Open
Abstract
Background/Aims Although both radial- and convex-arrayed endoscopic ultrasonography (EUS) scopes are widely used for observational EUS examinations, there have been few comparative studies on their power of visualization. The aim of this study was to evaluate the capability of these EUS scopes for observation of the pancreatobiliary junction. METHODS The rate of successful visualization of the pancreatobiliary junction was retrospectively compared between a radial-arrayed and a convex-arrayed echoendoscope, from a prospectively maintained database. Study periods were defined as January 2010 to December 2012 for the radial group, and February 2015 to October 2016 for the convex group because the respective scope was mainly used during those periods. RESULTS During the study period, 1,660 cases with radial EUS and 1,984 cases with convex EUS were recruited. The success rates of observation of the pancreatobiliary junction were 80.0% and 89.5%, respectively (p<0.0001). Conclusions The capability of visualization of the pancreatobiliary junction in observational EUS was found to be better with a convex-arrayed than with a radial-arrayed echoendoscope.
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Affiliation(s)
| | - Kei Ito
- Sendai City Medical Center, Sendai, Japan
| | | | | | | | - Kaori Masu
- Sendai City Medical Center, Sendai, Japan
| | | | | | | | | | | | - Yuki Fujii
- Sendai City Medical Center, Sendai, Japan
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Matsubayashi H, Takaori K, Morizane C, Maguchi H, Mizuma M, Takahashi H, Wada K, Hosoi H, Yachida S, Suzuki M, Usui R, Furukawa T, Furuse J, Sato T, Ueno M, Kiyozumi Y, Hijioka S, Mizuno N, Terashima T, Mizumoto M, Kodama Y, Torishima M, Kawaguchi T, Ashida R, Kitano M, Hanada K, Furukawa M, Kawabe K, Majima Y, Shimosegawa T. Familial pancreatic cancer: Concept, management and issues. World J Gastroenterol 2017; 23:935-948. [PMID: 28246467 PMCID: PMC5311103 DOI: 10.3748/wjg.v23.i6.935] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 09/07/2016] [Accepted: 01/18/2017] [Indexed: 02/06/2023] Open
Abstract
Familial pancreatic cancer (FPC) is broadly defined as two first-degree-relatives with pancreatic cancer (PC) and accounts for 4%-10% of PC. Several genetic syndromes, including Peutz-Jeghers syndrome, hereditary pancreatitis, hereditary breast-ovarian cancer syndrome (HBOC), Lynch syndrome, and familial adenomatous polyposis (FAP), also have increased risks of PC, but the narrowest definition of FPC excludes these known syndromes. When compared with other familial tumors, proven genetic alterations are limited to a small proportion (< 20%) and the familial aggregation is usually modest. However, an ethnic deviation (Ashkenazi Jewish > Caucasian) and a younger onset are common also in FPC. In European countries, “anticipation” is reported in FPC families, as with other hereditary syndromes; a trend toward younger age and worse prognosis is recognized in the late years. The resected pancreases of FPC kindred often show multiple pancreatic intraepithelial neoplasia (PanIN) foci, with various K-ras mutations, similar to colorectal polyposis seen in the FAP patients. As with HBOC patients, a patient who is a BRCA mutation carrier with unresectable pancreatic cancer (accounting for 0%-19% of FPC patients) demonstrated better outcome following platinum and Poly (ADP-ribose) polymerase inhibitor treatment. Western countries have established FPC registries since the 1990s and several surveillance projects for high-risk individuals are now ongoing to detect early PCs. Improvement in lifestyle habits, including non-smoking, is recommended for individuals at risk. In Japan, the FPC study group was initiated in 2013 and the Japanese FPC registry was established in 2014 by the Japan Pancreas Society.
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Kaneko M, Katanuma A, Maguchi H, Takahashi K, Osanai M, Yane K, Hashigo S, Harada R, Kato S, Kato R, Nojima M. Prospective, randomized, comparative study of delineation capability of radial scanning and curved linear array endoscopic ultrasound for the pancreaticobiliary region. Endosc Int Open 2014; 2:E160-70. [PMID: 26134963 PMCID: PMC4423251 DOI: 10.1055/s-0034-1377384] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 05/26/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND STUDY AIMS There are two types of endoscopic ultrasound (EUS) endoscope, the radial scanning (RS) and the curved linear array (CL). The type of EUS endoscope used at a first intent depends on local expertise, local habits and sometimes on how the examination is reimbursed. In Japan, RS is mainly used for observation, whereas CL is primarily used for histopathological diagnosis and treatment. We compared the imaging capabilities of RS and CL in evaluating the pancreaticobiliary region, a study which has not been performed previously. PATIENTS AND METHODS This prospective and randomized trial included 200 patients undergoing endoscopic ultrasonography of the pancreaticobiliary region by RS (n = 99) or CL (n = 101). The primary end point was the basal imaging capability of each technique. Eleven pancreaticobiliary areas were assessed and scored (range, 0 - 2). Endoscopists evaluated each criterion, and a transcriber recorded the decisions in real time. RESULTS The mean imaging scores in the RS and CL groups were 18.39 and 19.62, respectively (significantly higher in CL, 95 %CI: 0.82 - 1.64). Although no significant difference in imaging capability for the pancreatic head, body, or tail was observed between CL and RS, the imaging capability of CL for the pancreatic head - body transition region was superior to that of RS. Although no significant difference in imaging capability for the middle and inferior bile duct or the cystic duct was observed between CL and RS, the imaging capability of RS for the major duodenal papilla and gallbladder was superior to that of CL. For the area from the hepatic portal region to the superior bile duct, the imaging capability of CL was superior. In the delineation of the branch area of the celiac and superior mesenteric arteries, CL was also superior to RS. CONCLUSIONS The non-inferiority of the overall imaging capability of CL to that of RS was demonstrated. CL was superior in the delineation of the pancreatic head - body transition region, the area from the hepatic portal region to the superior bile duct, and the vascular bifurcation, whereas RS was superior in the delineation of the major duodenal papilla and gallbladder. Thus, for detailed evaluations of specific areas, the choice of scope should probably be considered.
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Affiliation(s)
- Maki Kaneko
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan,Corresponding author Maki Kaneko, MD Center for
GastroenterologyTeine-Keijinkai
Hospital1-40-1-12 Maeda,
Teine-kuSapporoHokkaido
006-8555Japan+81-11-6852967
| | - Akio Katanuma
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan
| | - Hiroyuki Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan
| | - Kuniyuki Takahashi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan
| | - Manabu Osanai
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan
| | - Kei Yane
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan
| | - Syunpei Hashigo
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan
| | - Ryo Harada
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan
| | - Shin Kato
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan
| | - Ryusuke Kato
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo,
Hokkaido 006-8555, Japan
| | - Masanori Nojima
- Department of Public Health, Sapporo Medical University School of
Medicine, Sapporo, Hokkaido 006-8555, Japan,Division of Advanced Medicine Promotion, The Advanced Clinical Research
Center, The Institute of Medical Science, The University of Tokyo, Tokyo,
Japan
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