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Nakase H, Wagatsuma K, Nojima M, Matsumoto T, Matsuura M, Iijima H, Matsuoka K, Ohmiya N, Ishihara S, Hirai F, Takeuchi K, Tamura S, Kinjo F, Ueno N, Naganuma M, Watanabe K, Moroi R, Nishimata N, Motoya S, Kurahara K, Takahashi S, Maemoto A, Sakuraba H, Saruta M, Tominaga K, Hisabe T, Tanaka H, Terai S, Hiraoka S, Takedomi H, Narimatsu K, Endo K, Nakamura M, Hisamatsu T. Anxiety and behavioral changes in Japanese patients with inflammatory bowel disease due to COVID-19 pandemic: a national survey. J Gastroenterol 2023; 58:205-216. [PMID: 36607399 PMCID: PMC9821342 DOI: 10.1007/s00535-022-01949-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/26/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Given the increasing health concerns for patients with inflammatory bowel disease (IBD), amidst the COVID-19 pandemic, we investigated the impact of the pandemic on the anxiety and behavioral changes in Japanese patients with IBD. METHODS We analyzed 3032 questionnaires from patients with IBD, aged 16 years or older visiting 30 hospitals and 1 clinic between March 2020 and June 2021. The primary outcome was the score of the anxiety experienced by patients with IBD during the pandemic. RESULTS Participants reported a median age of 44 years; 43.3% of the patients were women. Moreover, 60.6% and 39.4% were diagnosed with ulcerative colitis and Crohn's disease, respectively, with a median disease duration of 10 years. Participants indicated an average of disease-related anxiety score of 5.1 ± 2.5 on a ten-point scale, with a tendency to increase, 1 month after the number of infected persons per population increased. The top three causes for anxiety were the risk of contracting COVID-19 during hospital visits, SARS-CoV-2 infection due to IBD, and infection by IBD medication. Factors associated with anxiety were gender (women), being a homemaker, hospital visit timings, mode of transportation (train), use of immunosuppressive drugs, and nutritional therapy. Most patients continued attending their scheduled hospital visits, taking their medications, experienced the need for a family doctor, and sought guidance and information regarding COVID-19 from primary doctors, television, and Internet news. CONCLUSIONS Patients with IBD experienced moderate disease-related anxiety due to the pandemic and should be proactively informed about infectious diseases to relieve their anxiety.
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Affiliation(s)
- Hiroshi Nakase
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-Ku, Sapporo, Hokkaido, 060-8543, Japan.
| | - Kohei Wagatsuma
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-Ku, Sapporo, Hokkaido, 060-8543, Japan
| | - Masanori Nojima
- Center for Translational Research, The Institute of Medical Science, The University of Tokyo, Minato-Ku, Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Shiwa, Japan
| | - Minoru Matsuura
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka, Japan
| | - Hideki Iijima
- Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Katsuyoshi Matsuoka
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan
| | - Naoki Ohmiya
- Departments of Gastroenterology and Advanced Endoscopy, Fujita Health University School of Medicine, Toyoake, Japan
| | - Shunji Ishihara
- Department of Internal Medicine II, Faculty of Medicine, Shimane University, Izumo, Japan
| | - Fumihito Hirai
- Department of Gastroenterology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Ken Takeuchi
- Department of Gastroenterology, IBD Center, Tsujinaka Hospital Kashiwanoha, Kashiwa, Japan
| | - Satoshi Tamura
- First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Fukunori Kinjo
- Center for Gastroenterology, Urasoe General Hospital, Urasoe, Japan
| | - Nobuhiro Ueno
- Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Asahikawa Medical University, Asahikawa, Japan
- Department of Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Makoto Naganuma
- The Third Department of Internal Medicine, Kansai Medical University Hirakata, Hirakata, Japan
| | - Kenji Watanabe
- Center for Inflammatory Bowel Disease, Division of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Rintaro Moroi
- Division of Gastroenterology, Tohoku University Hospital, Sendai, Japan
| | - Nobuaki Nishimata
- Department of Gastroenterology, Sameshima Hospital, Kagoshima, Japan
| | - Satoshi Motoya
- IBD Center, Sapporo Kosei General Hospital, Sapporo, Japan
| | - Koichi Kurahara
- Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Sakuma Takahashi
- Department of Gastroenterology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - Atsuo Maemoto
- Inflammatory Bowel Disease Center, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Hirotake Sakuraba
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masayuki Saruta
- Department of Gastroenterology and Hepatology, Division of Internal Medicine, The Jikei University School of Medicine, Minato-Ku, Japan
| | - Keiichi Tominaga
- Department of Gastroenterology, Dokkyo Medical University, Shimotsuga, Japan
| | - Takashi Hisabe
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | | | - Shuji Terai
- Division of Gastroenterology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Sakiko Hiraoka
- Department of Gastroenterology and Hepatology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Hironobu Takedomi
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Kazuyuki Narimatsu
- Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan
| | - Katsuya Endo
- Division of Gastroenterology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tadakazu Hisamatsu
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Mitaka, Japan
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Suzuki R, Saitou N, Matsuari O, Shiota S, Matsumoto T, Akada J, Kinjo N, Kinjo F, Teruya K, Shimoji M, Shiroma A, Kato M, Satou K, Hirano T, Asaka M, Kryukov K, Moodley Y, Yamaoka Y. Helicobacter pylori genomes reveal Paleolithic human migration to the east end of Asia. iScience 2022; 25:104477. [PMID: 35720267 PMCID: PMC9204748 DOI: 10.1016/j.isci.2022.104477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/29/2021] [Accepted: 04/28/2022] [Indexed: 11/25/2022] Open
Abstract
A virulence bacterium, Helicobacter pylori, evolved parallel to its host human, therefore, can work as a marker for tracing the human migration. We found H. pylori strains indigenous in the southernmost islands of Japanese Archipelago, Okinawa, and defined them as hspOkinawa and hpRyukyu. Genome data of the strains revealed that hspOkinawa diverged from other East Asian strains about 20,000 years ago, and that hpRyukyu diverged about 45,000 years ago. The closest strains of hpRyukyu were found from Afghanistan, Punjab, and Nepal, which suggest this strain originated in the central Asia and traveled across the Eurasian continent during Paleolithic era. The divergence date of hpRyukyu corresponds with human fossil records in Okinawa. Although it is controversial from human DNA analyses whether descendants of the Paleolithic migrants remain in the modern Japanese population, this study reveals that the bacterium of Paleolithic origin remains in the stomachs of current Japanese. H. pylori strains in Okinawa, Japan, have a different origin from the main island One of the Okinawa-specific strains originate in Western Asia in the Paleolithic era Our results suggest ancient human migration from west to the east end of Eurasia
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Affiliation(s)
- Rumiko Suzuki
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu City, Oita Prefecture 879-5593, Japan
| | - Naruya Saitou
- Population Genetics Laboratory, National Institute of Genetics, 1111 Yata, Mishima 411-8540, Japan
| | - Osamu Matsuari
- Department of Gastroenterology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu 879-5593, Japan
| | - Seiji Shiota
- Department of General Medicine, OIta University Faculty of Medicine, Japan
| | - Takashi Matsumoto
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu City, Oita Prefecture 879-5593, Japan
| | - Junko Akada
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu City, Oita Prefecture 879-5593, Japan
| | | | - Fukunori Kinjo
- Center for Gastroenterology, Urasoe General Hospital, Urasoe 901-2132, Japan
| | - Kuniko Teruya
- Okinawa Institute of Advanced Sciences, 5-1 Suzaki, Uruma 904-2234, Japan
| | - Makiko Shimoji
- Okinawa Institute of Advanced Sciences, 5-1 Suzaki, Uruma 904-2234, Japan
| | - Akino Shiroma
- Okinawa Institute of Advanced Sciences, 5-1 Suzaki, Uruma 904-2234, Japan
| | - Mototsugu Kato
- Hakodate National Hospital, 18-16 Kawahara, Hakodate 041-8512, Japan
| | - Kazuhito Satou
- Okinawa Institute of Advanced Sciences, 5-1 Suzaki, Uruma 904-2234, Japan
| | - Takashi Hirano
- Okinawa Institute of Advanced Sciences, 5-1 Suzaki, Uruma 904-2234, Japan
| | - Masahiro Asaka
- Health Sciences University of Hokkaido, Ishikari-gun 061-0293, Japan
| | - Kirill Kryukov
- Population Genetics Laboratory, National Institute of Genetics, 1111 Yata, Mishima 411-8540, Japan
| | - Yoshan Moodley
- Department of Zoology, University of Venda, 2002 University Road, Thohoyandou 0950, Republic of South Africa
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu City, Oita Prefecture 879-5593, Japan.,Department of Medicine-Gastroenterology, Baylor College of Medicine and Michael E. Debakey Veterans Affairs Medical Center, 2002 Holcombe Blvd., Houston, TX 77030, USA
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Tajiri H, Motoya S, Kinjo F, Maemoto A, Matsumoto T, Sato N, Yamada H, Nagano M, Susuta Y, Ozaki K, Kondo K, Hibi T. Correction: Infliximab for pediatric patients with Crohn’s disease: A Phase 3, open-label, uncontrolled, multicenter trial in Japan. PLoS One 2022; 17:e0261932. [PMID: 35439252 PMCID: PMC9017882 DOI: 10.1371/journal.pone.0261932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Esaki M, Matsumoto T, Ohmiya N, Washio E, Morishita T, Sakamoto K, Abe H, Yamamoto S, Kinjo T, Togashi K, Watanabe K, Hirai F, Nakamura M, Nouda S, Ashizuka S, Omori T, Kochi S, Yanai S, Fuyuno Y, Hirano A, Umeno J, Kitazono T, Kinjo F, Watanabe M, Matsui T, Suzuki Y. Capsule endoscopy findings for the diagnosis of Crohn's disease: a nationwide case-control study. J Gastroenterol 2019; 54:249-260. [PMID: 30219994 PMCID: PMC6394710 DOI: 10.1007/s00535-018-1507-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 09/04/2018] [Indexed: 02/04/2023]
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 < 0.0001), longitudinal ulcers (78% vs. 20%, p < 0.0001), and irregular ulcers (84% vs. 60%, p < 0.01) were more frequently found in patients with CD. Linear erosion (90% vs. 38%, p < 0.0001) and irregular erosion (89% vs. 64%, p < 0.005) were also more frequent in patients with CD. Furthermore, circumferential (75% vs. 9%, p < 0.0001) and longitudinal (56% vs. 7%, p < 0.0001) alignment of diminutive lesions, mainly observed in the 1st tertile of the small bowel, was more frequent in patients with CD. Good intra-observer agreement was found for ulcers, cobblestone appearance, and lesion alignment. However, inter-observer agreement of SBCE findings differed among observers. CONCLUSIONS Circumferential or longitudinal alignment of diminutive lesions, especially in the upper small bowel, may be a diagnostic clue for CD under SBCE, while inter-observer variations should be cautiously considered when using SBCE.
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Affiliation(s)
- Motohiro Esaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Naoki Ohmiya
- Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Ema Washio
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Toshifumi Morishita
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Kei Sakamoto
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Hiroo Abe
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Shojiro Yamamoto
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Tetsu Kinjo
- Department of Endoscopy, University of Ryukyus Hospital, Nishihara, Okinawa Japan
| | - Kazutomo Togashi
- Department of Coloproctology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu-City, Japan
| | - Kenji Watanabe
- Department of Intestinal Inflammation Research, Hyogo College of Medicine, Nishinomiya, Hyogo Japan
| | - Fumihito Hirai
- Inflammatory Bowel Disease Center, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sadaharu Nouda
- Second Department of Internal Medicine, Osaka Medical College, Takatsuki, Japan
| | - Shinya Ashizuka
- Department of Circulatory and Body Fluid Regulation, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Teppei Omori
- Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo, Japan
| | - Shuji Kochi
- Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan
| | - Shunichi Yanai
- Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Yuta Fuyuno
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Atsushi Hirano
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Junji Umeno
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582 Japan
| | - Fukunori Kinjo
- Center for Gastroenterology, Urasoe General Hospital, Urasoe, Japan
| | - Mamoru Watanabe
- Department of Gastroenterology, School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshiyuki Matsui
- Inflammatory Bowel Disease Center, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | - Yasuo Suzuki
- Department of Internal Medicine, Toho University, Sakura Medical Centre, Sakura, Chiba Japan
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Tajiri H, Motoya S, Kinjo F, Maemoto A, Matsumoto T, Sato N, Yamada H, Nagano M, Susuta Y, Ozaki K, Kondo K, Hibi T. Infliximab for pediatric patients with Crohn's disease: A Phase 3, open-label, uncontrolled, multicenter trial in Japan. PLoS One 2018; 13:e0201956. [PMID: 30114224 PMCID: PMC6095542 DOI: 10.1371/journal.pone.0201956] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 07/24/2018] [Indexed: 12/13/2022] Open
Abstract
Objectives The prevalence of pediatric Crohn’s disease (CD) is increasing in Japan and other countries, and many patients are unresponsive to or do not tolerate current treatment options. This study aimed to investigate the efficacy, safety, and pharmacokinetic profile of infliximab (IFX) in pediatric patients with moderate-to-severe CD and inadequate response to existing treatment. Study design This was an open-label, uncontrolled, multicenter Phase 3 study conducted at nine sites in Japan between April 2012 and March 2015. Pediatric patients (aged 6–17 years) with moderate-to-severe CD were treated with IFX 5 mg/kg at Weeks 0, 2, and 6, and at 8-week intervals thereafter until Week 46, with final evaluation at Week 54. IFX dose was increased to 10 mg/kg in patients who showed loss of response to IFX from Week 14 onwards. Results A total of 14 patients fulfilled eligibility criteria and were treated. Dose-escalation criteria were met by five patients who then received 10 mg/kg IFX. The remaining nine patients continued to receive an IFX dose of 5 mg/kg. IFX rapidly improved clinical symptoms and its effect was maintained for up to 54 weeks. Overall Pediatric Crohn’s Disease Activity Index (PCDAI) response rate was 85.7%, and overall PCDAI remission rate was 64.3%. Three out of five patients who increased IFX dose regained PCDAI remission by retrieval of serum IFX concentration. Adverse events and serious adverse events occurred in 100.0% and 14.3% of patients, respectively. There was no substantial difference in the safety profiles of patients taking a constant dose of 5 mg/kg and those taking an increased dose of 10 mg/kg. Conclusions These findings support the effective use of IFX in the treatment of pediatric patients with CD where other treatments have proven ineffective.
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Affiliation(s)
- Hitoshi Tajiri
- Department of Pediatrics, Osaka General Medical Center, Osaka, Japan
- * E-mail:
| | - Satoshi Motoya
- Inflammatory Bowel Diseases Center, Sapporo-Kosei General Hospital, Sapporo, Japan
| | - Fukunori Kinjo
- Department of Endoscopy, University of the Ryukyus Hospital, Okinawa, Japan
| | - Atsuo Maemoto
- Inflammatory Bowel Disease Center, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Takayuki Matsumoto
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noriko Sato
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Hiroshi Yamada
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Mieko Nagano
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Yutaka Susuta
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Kunihiko Ozaki
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Kazuoki Kondo
- Ikuyaku. Integrated Value Development Division, Mitsubishi Tanabe Pharma Corporation, Tokyo, Japan
| | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato Institute Hospital, Kitasato University, Tokyo, Japan
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Hokama A, Uechi K, Takeshima E, Kobashigawa C, Iraha A, Kinjo T, Kishimoto K, Kinjo F, Fujita J. A fish bone perforation of the esophagus. Endoscopy 2014; 46 Suppl 1 UCTN:E216-7. [PMID: 24806364 DOI: 10.1055/s-0034-1364952] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Akira Hokama
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| | - Kayoko Uechi
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| | - Eriko Takeshima
- Department of Endoscopy, University of the Ryukyus, Okinawa, Japan
| | - Chiharu Kobashigawa
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| | - Atsushi Iraha
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| | - Tetsu Kinjo
- Department of Endoscopy, University of the Ryukyus, Okinawa, Japan
| | - Kazuto Kishimoto
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
| | - Fukunori Kinjo
- Department of Endoscopy, University of the Ryukyus, Okinawa, Japan
| | - Jiro Fujita
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
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Tamura J, Kuniyoshi N, Maruwaka S, Shiroma J, Miyagi S, Orita H, Sakugawa H, Hokama A, Kinjo F, Fujita J. "Whirl sign" of primary small bowel volvulus. West J Emerg Med 2014; 15:359-60. [PMID: 25035728 PMCID: PMC4100828 DOI: 10.5811/westjem.2014.4.20679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Revised: 01/21/2014] [Accepted: 04/02/2014] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jiro Tamura
- University of the Ryukyus, Department of Infectious, Respiratory, and Digestive Medicine, Okinawa, Japan
| | | | | | - Joji Shiroma
- Heart Life Hospital, Digestive Division, Okinawa, Japan
| | - Sunao Miyagi
- Heart Life Hospital, Digestive Division, Okinawa, Japan
| | - Hitoshi Orita
- Heart Life Hospital, Digestive Division, Okinawa, Japan
| | | | - Akira Hokama
- University of the Ryukyus, Department of Infectious, Respiratory, and Digestive Medicine, Okinawa, Japan
| | - Fukunori Kinjo
- University of the Ryukyus Hospital, Department of Endoscopy, Okinawa, Japan
| | - Jiro Fujita
- University of the Ryukyus, Department of Infectious, Respiratory, and Digestive Medicine, Okinawa, Japan
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Tamura J, Maruwaka S, Shiroma J, Miyagi S, Orita H, Sakugawa H, Hokama A, Kinjo F, Fujita J. An inflammatory polyp in the colon caused by the migration of a Kirschner wire following fixation of a pelvic fracture. Intern Med 2014; 53:699-701. [PMID: 24694479 DOI: 10.2169/internalmedicine.53.1407] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The migration of Kirschner wires (K-wires) is a rare complication. We herein present a case of an inflammatory polyp in the colon caused by the migration of a K-wire following fixation of a pelvic fracture. Surgery was carried out to remove the K-wire through an incision at the level of the left iliac bone. Simultaneous endoscopic clipping of the colonic wound was also performed. The patient's postoperative course was uneventful. Although very rare, migration of devices should be considered in patients with a previous history of orthopedic surgery.
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Affiliation(s)
- Jiro Tamura
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Japan
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Iraha A, Chinen H, Hokama A, Yonashiro T, Kinjo T, Kishimoto K, Nakamoto M, Hirata T, Kinjo N, Higa F, Tateyama M, Kinjo F, Fujita J. Fucoidan enhances intestinal barrier function by upregulating the expression of claudin-1. World J Gastroenterol 2013; 19:5500-5507. [PMID: 24023493 PMCID: PMC3761103 DOI: 10.3748/wjg.v19.i33.5500] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 07/07/2013] [Accepted: 07/25/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the protective effects of fucoidan on oxidative stress-induced barrier disruption in human intestinal epithelial cells.
METHODS: In Caco-2 cell monolayer models, the disruption of barrier function by oxidative stress is mediated by H2O2. The integrity of polarized Caco-2 cell monolayers was determined by measuring the transepithelial resistance (TER) and permeability was estimated by measuring the paracellular transport of FITC-labeled 4-kDa dextran (FD4). The protective effects of fucoidan on epithelial barrier functions on polarized Caco-2 cell monolayers were evaluated by TER and FD4 flux. The expression of tight junction (TJ) proteins was assessed using reverse-transcription polymerase chain reaction (RT-PCR) and immunofluorescence staining.
RESULTS: Without H2O2 treatment, fucoidan significantly increased the TER compared to control (P < 0.05), indicating a direct enhancement of intestinal epithelial barrier function. Next, H2O2 disrupted the epithelial barrier function in a time-dependent manner. Fucoidan prevented the H2O2-induced destruction in a dose-dependent manner. Fucoidan significantly decreased H2O2-induced FD4 flux (P < 0.01), indicating the prevention of disruption in paracellular permeability. RT-PCR showed that Caco-2 cells endogenously expressed claudin-1 and -2, and occludin and that H2O2 reduced the mRNA expression of these TJ proteins. Treatment with fucoidan attenuated the reduction in the expressions of claudin-1 and claudin-2 but not occludin. Immunofluorescence staining revealed that the expression of claudin-1 was intact and high on the cell surface. H2O2 disrupted the integrity of claudin-1. Treatment with fucoidan dramatically attenuated the expression of claudin-1.
CONCLUSION: Fucoidan enhanced intestinal epithelial barrier function by upregulating the expression of claudin-1. Thus, fucoidan may be an appropriate therapy for the treatment of inflammatory bowel diseases.
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Watanabe D, Kakimoto T, Kodama K, Ikehara N, Ohtsuka K, Mikogami T, Kimura S, Fukuchi K, Kinjo F, Kudo SE. [Whipple's disease]. Nihon Shokakibyo Gakkai Zasshi 2013; 110:998-1006. [PMID: 23739732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A 36-year-old woman presented with fever, diarrhea, and weight loss in April 2011. Upper GI endoscopy and colonoscopy showed a diffuse yellow-white shaggy mucosa in the second part of the duodenum and the ileum end, respectively. These lesions in these 2 locations were biopsied, and both specimens showed distended epithelial villi and massive infiltration of foamy macrophages in the lamina propria. PCR was performed to identify causative bacilli. DNA extracted from the duodenal mucosa showed a specific PCR product, confirming the diagnosis of Whipple's disease. The patient was treated with a 2-week course of ceftriaxone, followed by sulfamethoxazole/trimethoprim. After we started the treatment, the patient developed complications of infective endocarditis and meningitis. The patient was relieved of her symptoms using a combination of gentamicin, penicillin G, ampicillin, meropenem, and vancomycin.
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Ohira T, Hokama A, Kinjo N, Nakamoto M, Kobashigawa C, Kise Y, Yamashiro S, Kinjo F, Kuniyoshi Y, Fujita J. Detection of active bleeding from gastric antral vascular ectasia by capsule endoscopy. World J Gastrointest Endosc 2013; 5:138-140. [PMID: 23515703 PMCID: PMC3600552 DOI: 10.4253/wjge.v5.i3.138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 10/29/2012] [Accepted: 01/07/2013] [Indexed: 02/05/2023] Open
Abstract
Gastric antral vascular ectasia (GAVE) has been recognized as one of the important causes of occult and obscure gastrointestinal bleeding. The diagnosis is typically made based on the characteristic endoscopic features, including longitudinal row of flat, reddish stripes radiating from the pylorus into the antrum that resemble the stripes on a watermelon. These appearances, however, can easily be misinterpreted as moderate to severe gastritis. Although it is believed that capsule endoscopy (CE) is not helpful for the study of the stomach with its large lumen, GAVE can be more likely to be detected at CE rather than conventional endoscopy. CE can be regarded as “physiologic” endoscopy, without the need for gastric inflation and subsequent compression of the vasculature. The blood flow of the ecstatic vessels may be diminished in an inflated stomach. Therefore, GAVE may be prominent in CE. We herein describe a case of active bleeding from GAVE detected by CE and would like to emphasize a possibility that CE can improve diagnostic yields for GAVE.
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12
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Takahashi A, Shiota S, Matsunari O, Watada M, Suzuki R, Nakachi S, Kinjo N, Kinjo F, Yamaoka Y. Intact long-type dupA as a marker for gastroduodenal diseases in Okinawan subpopulation, Japan. Helicobacter 2013; 18:66-72. [PMID: 23067336 PMCID: PMC3545078 DOI: 10.1111/j.1523-5378.2012.00994.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Helicobacter pylori dupA can be divided into two types according to the presence or absence of the mutation. In addition, full-sequenced data revealed that dupA has two types with different lengths depend on the presence of approximately 600 bp in the putative 5' region (presence; long-type and absence; short-type), which has not been taken into account in previous studies. METHODS A total of 319 strains isolated from Okinawa, the south islands of Japan, were included. The status of dupA and cagA was determined by polymerase chain reaction. The presence of mutations in long-type dupA was determined by DNA sequencing. RESULTS The prevalence of long-type dupA was 26.3% (84/319). Sequence analysis showed that there were only six cases (7.1%) with point mutations lead to stop codon among 84 long-type dupA strains studied. Interestingly, intact long-type dupA without frameshift mutation, but not short-type dupA, was significantly associated with gastric ulcer and gastric cancer than gastritis (p = .001 and p = .019, respectively). After adjustment by age, gender, and cagA, the presence of intact long-type dupA was significantly associated with gastric ulcer and gastric cancer compared with gastritis (odds ratio [OR] = 3.35, 95% confidence interval [CI] = 1.55-7.24 and OR = 4.14, 95% CI = 1.23-13.94, respectively). CONCLUSIONS Intact long-type dupA is a real virulence marker for severe outcomes in Okinawa, Japan. The previous information gained from PCR-based methods without taking long-type dupA into account must be interpreted with caution.
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Affiliation(s)
- Ayaka Takahashi
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, 879-5569, Japan
| | - Seiji Shiota
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, 879-5569, Japan
| | - Osamu Matsunari
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, 879-5569, Japan
| | - Masahide Watada
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, 879-5569, Japan
| | - Rumiko Suzuki
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, 879-5569, Japan
| | - Saori Nakachi
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, 879-5569, Japan
| | - Nagisa Kinjo
- Department of Endoscopy, University Hospital, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Fukunori Kinjo
- Department of Endoscopy, University Hospital, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, 879-5569, Japan,Department of Medicine-Gastroenterology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, 77030 USA,Corresponding author: Yoshio YamaokaMD, PhD, Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan, Tel: +81-97-586-5740; Fax: +81-97-586-5749,
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Matsuo Y, Shiota S, Matsunari O, Suzuki R, Watada M, Binh TT, Kinjo N, Kinjo F, Yamaoka Y. Helicobacter pylori cagA 12-bp insertion can be a marker for duodenal ulcer in Okinawa, Japan. J Gastroenterol Hepatol 2013; 28. [PMID: 23190390 PMCID: PMC3734362 DOI: 10.1111/jgh.12067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIM Helicobacter pylori cagA can be classified into mainly two types (East-Asian-type and Western-type cagA) according to the repeat regions located in the 3' region. Recent studies showed that the Western-type cagA in strains from Okinawa, Japan formed a different cluster (J-Western-type cagA subtype). It has also been reported that J-Western-type cagA possesses a 12-bp insertion located in the 5' region of cagA sequence. METHODS The prevalence of 12-bp insertion in cagA in Okinawa and the United States (U.S.) was examined by DNA sequencing. The primer pair that can detect the 12-bp insertion only by polymerase chain reaction was then designed. The prevalence of strains with 12-bp insertion was examined in 336 strains isolated from Okinawa by polymerase chain reaction. RESULTS In case of Western-type cagA/vacA s1m2 strains, the prevalence of 12-bp insertion was significantly higher in strains isolated from Okinawa than that from the U.S. (P = 0.002). Phylogenetic tree showed that strains with 12-bp insertion formed two individual clusters within J-Western-type cagA subtype; one is from Okinawa and another is from the U.S. The designed primer set showed high sensitivity (100%) and specificity (90.8%) in Okinawa. The 12-bp insertion was found in 23.7%, 14.3%, 4.2%, and 4.0% of strains with duodenal ulcer (DU), gastritis, gastric cancer, and gastric ulcer (GU), respectively (P < 0.001 for DU vs GU) in Okinawa. CONCLUSIONS Although the mechanisms are unknown, the presence of 12-bp insertion was associated with the presence of DU and might have a suppressive action on GU and gastric cancer.
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Affiliation(s)
- Yuichi Matsuo
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan
| | - Seiji Shiota
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan,Department of General Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan
| | - Osamu Matsunari
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan,Department of Gastroenterology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan
| | - Rumiko Suzuki
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan
| | - Masahide Watada
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan,Department of Gastroenterology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan
| | - Tran Thanh Binh
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan
| | - Nagisa Kinjo
- Department of Endoscopy, University Hospital, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Fukunori Kinjo
- Department of Endoscopy, University Hospital, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - Yoshio Yamaoka
- Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan,Department of Medicine-Gastroenterology, Baylor College of Medicine and Michael E. Debakey Veterans Affairs Medical Center, 2002 Holcombe Blvd. Houston, Texas 77030 USA,Corresponding author: Yoshio Yamaoka MD, PhD Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu-City, Oita 879-5593, Japan, Tel: +81-97-586-5740; Fax: +81-97-586-5749,
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Ihama Y, Hokama A, Hibiya K, Kishimoto K, Nakamoto M, Hirata T, Kinjo N, Cash HL, Higa F, Tateyama M, Kinjo F, Fujita J. Diagnosis of intestinal tuberculosis using a monoclonal antibody to Mycobacterium tuberculosis. World J Gastroenterol 2012; 18:6974-80. [PMID: 23322996 PMCID: PMC3531682 DOI: 10.3748/wjg.v18.i47.6974] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 07/19/2012] [Accepted: 07/28/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the utility of immunohistochemical (IHC) staining with an antibody to Mycobacterium tuberculosis (M. tuberculosis) for the diagnosis of intestinal tuberculosis (TB).
METHODS: We retrospectively identified 10 patients (4 males and 6 females; mean age = 65.1 ± 13.6 years) with intestinal TB. Clinical characteristics, including age, gender, underlying disease, and symptoms were obtained. Chest radiograph and laboratory tests, including sputum Ziehl-Neelsen (ZN) staining, M. tuberculosis culture, and sputum polymerase chain reaction (PCR) for tubercle bacilli DNA, as well as Tuberculin skin test (TST) and QuantiFERON-TB gold test (QFT), were examined. Colonoscopic records recorded on the basis of Sato’s classification were also reviewed, in addition to data from intestinal biopsies examined for histopathological findings, including hematoxylin and eosin staining, and ZN staining, as well as M. tuberculosis culture, and PCR for tubercle bacilli DNA. For the present study, archived formalin-fixed paraffin-embedded (FFPE) intestinal tissue samples were immunohistochemically stained using a commercially available species-specific monoclonal antibody to the 38-kDa antigen of the M. tuberculosis complex. These sections were also stained with the pan-macrophage marker CD68 antibody.
RESULTS: From the clinical data, we found that no patients were immunocompromised, and that the main symptoms were diarrhea and weight loss. Three patients displayed active pulmonary TB, six patients (60%) had a positive TST, and 4 patients (40%) had a positive QFT. Colonoscopic findings revealed that all patients had type 1 findings (linear ulcers in a circumferential arrangement or linear ulcers arranged circumferentially with mucosa showing multiple nodules), all of which were located in the right hemicolon and/or terminal ileum. Seven patients (70%) had concomitant healed lesions in the ileocecal area. No acid-fast bacilli were detected with ZN staining of the intestinal tissue samples, and both M. tuberculosis culture and PCR for tubercle bacilli DNA were negative in all samples. The histopathological data revealed that tuberculous granulomas were present in 4 cases (40%). IHC staining in archived FFPE samples with anti-M. tuberculosis monoclonal antibody revealed positive findings in 4 patients (40%); the same patients in which granulomas were detected by hematoxylin and eosin staining. M. tuberculosis antigens were found to be mostly intracellular, granular in pattern, and primarily located in the CD68+ macrophages of the granulomas.
CONCLUSION: IHC staining with a monoclonal antibody to M. tuberculosis may be an efficient and simple diagnostic tool in addition to classic examination methods for the diagnosis of intestinal TB.
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Komatsu-Tanaka M, Iwakiri R, Fujimoto K, Fujiwara Y, Inamori M, Tanaka J, Shimatani T, Akiyama J, Ando T, Manabe N, Kinjo F, Deguchi R, Kusano M. Clinical symptoms of FSSG in gastroesophageal reflux disease are critical for PPI treatment: Japanese multi-centers with 185 patients. Dig Endosc 2012; 24:407-11. [PMID: 23078431 DOI: 10.1111/j.1443-1661.2012.01301.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIM The main aim of this study was to determine whether questionnaire evaluations of clinical symptoms in gastroesophageal reflux disease were useful to assess proton pump inhibitor therapy. METHODS A total of 185 Japanese patients (men, 88; women, 97; age: 55.7 ± 16.1 years) with gastroesophageal reflux disease were enrolled. The patients were divided based on the frequency scale for symptoms of gastroesophageal reflux disease: severe symptoms with scores ≥8 and mild symptoms with scores ≤7. Quality of life was evaluated with the Medical Outcomes Study 8-Item Short-Form Health Survey. All patients were treated with a proton pump inhibitor, rabeprazole (10 mg/day), for 8 weeks. RESULTS Patients were classified into four groups: reflux esophagitis with severe symptoms (n = 92, 49.7%); reflux esophagitis with mild symptoms (n = 17, 9.2%); non-erosive reflux disease with severe symptoms (n = 66, 35.7%); and non-erosive reflux disease with mild symptoms (n = 10, 5.4%). The dysmotility score was high in non-erosive reflux disease with severe symptoms compared with reflux esophagitis with severe symptoms (9.1 ± 0.5 vs 6.8 ± 0.5, P < 0.05). The symptom score and quality of life in the severe symptoms groups for both reflux esophagitis and non-erosive reflux disease were significantly improved by rabeprazole treatment. Only the reflux score was improved by rabeprazole in the reflux esophagitis with mild symptoms group; no therapeutic effect was observed for the non-erosive reflux disease with mild symptoms group. CONCLUSIONS Low scores on the frequency scale for the symptoms of gastroesophageal reflux disease indicate poor responsiveness to proton pump inhibitor treatment, and high scores indicate good responsiveness.
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Affiliation(s)
- Mio Komatsu-Tanaka
- Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan
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Hokama A, Ohira T, Kishimoto K, Kinjo F, Fujita J. Impending megacolon: small bowel distension as a predictor of toxic megacolon in ulcerative colitis. Intern Emerg Med 2012; 7:487-8. [PMID: 22843318 DOI: 10.1007/s11739-012-0834-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 07/14/2012] [Indexed: 12/17/2022]
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17
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Hokama A, Kishimoto K, Ihama Y, Kobashigawa C, Nakamoto M, Hirata T, Kinjo N, Higa F, Tateyama M, Kinjo F, Iseki K, Kato S, Fujita J. Endoscopic and radiographic features of gastrointestinal involvement in vasculitis. World J Gastrointest Endosc 2012; 4:50-6. [PMID: 22442741 PMCID: PMC3309893 DOI: 10.4253/wjge.v4.i3.50] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 11/04/2011] [Accepted: 03/01/2012] [Indexed: 02/05/2023] Open
Abstract
Vasculitis is an inflammation of vessel walls, followed by alteration of the blood flow and damage to the dependent organ. Vasculitis can cause local or diffuse pathologic changes in the gastrointestinal (GI) tract. The variety of GI lesions includes ulcer, submucosal edema, hemorrhage, paralytic ileus, mesenteric ischemia, bowel obstruction, and life-threatening perforation.The endoscopic and radiographic features of GI involvement in vasculitisare reviewed with the emphasis on small-vessel vasculitis by presenting our typical cases, including Churg-Strauss syndrome, Henoch-Schönlein purpura, systemic lupus erythematosus, and Behçet’s disease. Important endoscopic features are ischemic enterocolitis and ulcer. Characteristic computed tomographic findings include bowel wall thickening with the target sign and engorgement of mesenteric vessels with comb sign. Knowledge of endoscopic and radiographic GI manifestations can help make an early diagnosis and establish treatment strategy.
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Affiliation(s)
- Akira Hokama
- Akira Hokama, Kazuto Kishimoto, Yasushi Ihama, Tetsuo Hirata, Futoshi Higa, Masao Tateyama, Jiro Fujita, Department of Infectious, Respiratory and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0125, Japan
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18
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Hoshino K, Shibata D, Miyagi T, Yamamoto Y, Arakaki S, Maeshiro T, Hokama A, Kinjo F, Takahashi K, Fujita J. Cytomegalovirus-associated gastric ulcers in a patient with dermatomyositis treated with steroid and cyclophosphamide pulse therapy. Endoscopy 2012; 43 Suppl 2 UCTN:E277-8. [PMID: 21915824 DOI: 10.1055/s-0030-1256422] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- K Hoshino
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan.
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Kinjo F, Iraha A, Chinen H, Ihama Y, Kishimoto K, Hokama A. [Extraintestinal complications of inflammatory bowel disease]. Nihon Rinsho 2012; 70 Suppl 1:261-265. [PMID: 23126101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Fukunori Kinjo
- Department of Endoscopy, University Hospital of the Ryukyus
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20
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Hokama A, Arakaki S, Shibata D, Maeshiro T, Kinjo F, Fujita J. "Playboy bunny" sign of congestive heart failure. West J Emerg Med 2012; 12:433-4. [PMID: 22224133 PMCID: PMC3236167 DOI: 10.5811/westjem.2011.2.2226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 02/28/2011] [Indexed: 11/11/2022] Open
Abstract
In emergency, ultrasound has been widely used as a noninvasive and effective examination to evaluate congestive heart failure. We highlight "Playboy Bunny" sign as a reliable marker and an important clue to the diagnosis of passive hepatic congestion, caused by congestive heart failure.
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Affiliation(s)
- Akira Hokama
- University of the Ryukyus, Department of Infectious, Respiratory, and Digestive Medicine, Nishihara, Okinawa, Japan
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Takeshima E, Tomimori K, Kawakami H, Ishikawa C, Sawada S, Tomita M, Senba M, Kinjo F, Mimuro H, Sasakawa C, Fujita J, Mori N. Retraction Note: NF-κB activation by Helicobacter pylorirequires Akt-mediated phosphorylation of p65. BMC Microbiol 2011; 11:128. [PMID: 21635758 PMCID: PMC3123716 DOI: 10.1186/1471-2180-11-128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Accepted: 06/02/2011] [Indexed: 11/22/2022] Open
Abstract
Article retracted
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Ihama Y, Hokama A, Iraha A, Kaida M, Kinjo F, Fujita J. Esophageal perforation by fish bone ingestion. Gastrointest Endosc 2011; 74:921; discussion 921. [PMID: 21821251 DOI: 10.1016/j.gie.2011.05.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2010] [Accepted: 05/26/2011] [Indexed: 12/11/2022]
Affiliation(s)
- Yasushi Ihama
- Department of Infectious, Respiratory and Digestive Medicine, University of the Ryukyus, Okinawa Japan
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Hokama A, Kishimoto K, Nakamoto M, Kobashigawa C, Hirata T, Kinjo N, Kinjo F, Kato S, Fujita J. Endoscopic and histopathological features of gastrointestinal amyloidosis. World J Gastrointest Endosc 2011; 3:157-61. [PMID: 21954412 PMCID: PMC3180620 DOI: 10.4253/wjge.v3.i8.157] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 07/18/2011] [Accepted: 08/06/2011] [Indexed: 02/05/2023] Open
Abstract
Amyloidosis is a rare disorder, characterized by the extracellular deposition of an abnormal fibrillar protein, which disrupts tissue structure and function. Amyloidosis can be acquired or hereditary, and systemic or localized to a single organ, such as the gastrointestinal (GI) tract. Clinical manifestations may vary from asymptomatic to fatal forms. Primary amyloidosis (monoclonal immunoglobulin light chains, AL) is the most common form of amyloidosis. AL amyloidosis has been associated with plasma cell dyscrasias, such as, multiple myeloma. Secondary amyloidosis is caused by the deposition of fragments of the circulating acute-phase reactant, serum amyloid A protein (SAA). Common causes of AA amyloidosis are chronic inflammatory disorders. Although GI symptoms are usually nonspecific, histopathological patterns of amyloid deposition are associated with clinical and endoscopic features. Amyloid deposition in the muscularis mucosae, submucosa, and muscularis propria has been dominant in AL amyloidosis, leading to polypoid protrusions and thickening of the valvulae conniventes, whereas granular amyloid deposition mainly in the propria mucosae has been related to AA amyloidosis, resulting in the fine granular appearance, mucosal friability, and erosions. As a result, AL amyloidosis usually presents with constipation, mechanical obstruction, or chronic intestinal pseudo-obstruction while AA amyloidosis presents with diarrhea and malabsorption Amyloidotic GI symptoms are mostly refractory and have a negative impact on quality of life and survival. Diagnosing GI amyloidosis requires high suspicion of evaluating endoscopists. Because of the absence of specific treatments for reducing the abundance of the amyloidogenic precursor protein, we should be aware of certain associations between patterns of amyloid deposition and clinical and endoscopic features.
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Affiliation(s)
- Akira Hokama
- Akira Hokama, Kazuto Kishimoto, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0125, Japan
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Minematsu H, Hokama A, Makishi T, Arakaki K, Kinjo F, Fujita J. Colonoscopic findings and pathologic characteristics of Strongyloides colitis: a case series. Digestion 2011; 83:210-4. [PMID: 21266818 DOI: 10.1159/000321812] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS Strongyloidiasis, which is caused by Strongyloides stercoralis, is one of the prevalent infections in the tropical and subtropical regions worldwide. The larvae mainly infect the small intestine and cause serious disseminated strongyloidiasis. Although upper gastrointestinal features in strongyloidiasis are well known, colonoscopic evaluation has not been established yet. The aim of this study is to clarify the characteristic findings on colonic lesions in strongyloidiasis. METHOD From January 2005 to December 2009, 10 cases with strongyloidiasis underwent colonoscopy at a single center on an endemic island of Japan. The clinical and colonoscopic findings were analyzed retrospectively. RESULTS Six (60%) cases had an immunocompromised condition, including human T lymphotropic virus type 1 infection, corticosteroids, and chemotherapy. Hyperinfection or disseminated strongyloidiasis was not presented. Endoscopic features included yellowish-white nodules, erythema, and loss of vascular pattern, which were mainly observed in the right colon. Pathological examination revealed the filariform Strongyloides larvae and the eosinophilic infiltration of the lamina propria. CONCLUSION This study demonstrates that colonoscopic observation and biopsies are very useful to diagnose strongyloidiasis. Asymptomatic cases with strongyloidiasis can have colonic involvement. Yellowish-white nodules may be a characteristic finding of colonic lesions in strongyloidiasis and can be a cautious marker to prevent fatal disseminated strongyloidiasis in endemic regions.
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Affiliation(s)
- Hideki Minematsu
- Gastroenterology Unit, Tomishiro Central Hospital, Tomigusuku, Japan.
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Hokama A, Kishimoto K, Ihama Y, Chinen H, Kinjo F, Fujita J. Gallbladder dysfunction diagnosed by cholescintigraphy with a Fatty meal. Gut Liver 2011; 4:556-7. [PMID: 21253309 DOI: 10.5009/gnl.2010.4.4.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 07/06/2010] [Indexed: 11/04/2022] Open
Affiliation(s)
- Akira Hokama
- Department of Infectious, Respiratory, and Digestive Medicine, University of the Ryukyus, Okinawa, Japan
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Hokama A, Taira K, Yamamoto YI, Kinjo N, Kinjo F, Takahashi K, Fujita J. Cytomegalovirus gastritis. World J Gastrointest Endosc 2010; 2:379-80. [PMID: 21173917 PMCID: PMC3004046 DOI: 10.4253/wjge.v2.i11.379] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 08/21/2010] [Accepted: 08/28/2010] [Indexed: 02/05/2023] Open
Abstract
Cytomegalovirus (CMV) has been increasingly recognized as an important common pathogen in an immunocompromised state. The colon and stomach are the most common sites of its gastrointestinal infection. Symptoms of CMV gastritis are usually nonspecific and include epigastric pain, fever, nausea and bleeding. Endoscopic features are quite variable and include macroscopically normal mucosa, diffuse erythema, nodules, pseudotumors, erosions and ulcers. The bioptic detection of intranuclear inclusions is the hallmark of CMV infection. Most gastrointestinal CMV infection responds well to ganciclovir. We present endoscopic and histopathological features of CMV gastritis in a 71 year old woman receiving long-term prednisolone for pemphigus vulgaris.
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Affiliation(s)
- Akira Hokama
- Akira Hokama, Jiro Fujita, Department of Infectious, Respiratory, and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0125, Japan
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Hokama A, Yamamoto YI, Taira K, Nakamura M, Kobashigawa C, Nakamoto M, Hirata T, Kinjo N, Kinjo F, Takahashi K, Fujita J. Esophagitis dissecans superficialis and autoimmune bullous dermatoses: A review. World J Gastrointest Endosc 2010; 2:252-6. [PMID: 21160615 PMCID: PMC2999143 DOI: 10.4253/wjge.v2.i7.252] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 06/23/2010] [Accepted: 06/30/2010] [Indexed: 02/05/2023] Open
Abstract
Esophagitis dissecans superficialis (EDS) is a rare and severe endoscopic finding characterized by sloughing of large fragments of esophageal mucosal lining. Although EDS has been reported in association with serious illnesses and certain medications, the pathophysiological association of autoimmune bullous dermatoses with EDS has gained remarkable attention. Among these dermatoses, pemphigus vulgaris and pemphigoid frequently present with various types of esophageal involvement including EDS. We review the pathophysiology and clinical features of this involvement with the presentation of our experiences. The importance of endoscopic evaluation of this entity is discussed.
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Affiliation(s)
- Akira Hokama
- Akira Hokama, Tetsuo Hirata, Jiro Fujita, Department of Infectious, Respiratory and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0125, Japan
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Affiliation(s)
- A Hokama
- First Department of Internal Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215,
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Hokama A, Ihama Y, Chinen H, Kishimoto K, Kinjo F, Fujita J. Appendiceal orifice inflammation in ulcerative colitis. Dig Dis Sci 2010; 55:1189. [PMID: 19504186 DOI: 10.1007/s10620-009-0840-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Accepted: 05/04/2009] [Indexed: 12/09/2022]
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Hokama A, Kishimoto K, Ihama Y, Chinen H, Kinjo F, Fujita J. A food impaction in Crohn's ileal stricture. West J Emerg Med 2010; 11:106. [PMID: 20411097 PMCID: PMC2850839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Revised: 08/28/2009] [Accepted: 09/14/2009] [Indexed: 11/24/2022] Open
Affiliation(s)
- Akira Hokama
- Address for Correspondence: Akira Hokama, MD, PhD. First Department of Internal Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
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Hokama A, Inamine M, Kishimoto K, Kinjo F, Aoki Y, Fujita J. Telescope sign of intussusception in Peutz-Jeghers syndrome. Dig Liver Dis 2010; 42:153. [PMID: 19168406 DOI: 10.1016/j.dld.2008.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2008] [Accepted: 11/17/2008] [Indexed: 12/11/2022]
Affiliation(s)
- A Hokama
- First Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan.
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Shiroma J, Hokama A, Maeshiro T, Shibata D, Arakaki S, Kinjo F, Fujita J. Splenic infarction in pancreatic cancer. JOP 2009; 10:699-700. [PMID: 19890199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Hokama A, Kishimoto K, Kinjo F, Fujita J. Endoscopic clipping in the lower gastrointestinal tract. World J Gastrointest Endosc 2009; 1:7-11. [PMID: 21160644 PMCID: PMC2999077 DOI: 10.4253/wjge.v1.i1.7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 08/26/2009] [Accepted: 09/02/2009] [Indexed: 02/05/2023] Open
Abstract
Endoscopic clipping has been established as a safe and effective method for the treatment of nonvariceal upper gastrointestinal bleeding in numerous randomized studies. Recently, clipping has been applied to various lesions in the lower gastrointestinal tract, including diverticular bleeding, postpolypectomy bleeding, and repair of perforations with successful outcomes. We review the safety and efficacy of this maneuver for the management of diseases in the lower gastrointestinal tract.
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Affiliation(s)
- Akira Hokama
- Akira Hokama, Jiro Fujita, Department of Medicine and Therapeutics (First Department of Internal Medicine), Control and Prevention of Infectious Diseases, Faculty of Medicine, University of the Ryukyus, Okinawa 903-0125, Japan
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Takeshima E, Tomimori K, Takamatsu R, Ishikawa C, Kinjo F, Hirayama T, Fujita J, Mori N. Helicobacter pylori VacA activates NF-kappaB in T cells via the classical but not alternative pathway. Helicobacter 2009; 14:271-9. [PMID: 19674131 DOI: 10.1111/j.1523-5378.2009.00683.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Helicobacter pylori secretes vacuolating cytotoxin (VacA) that damages the gastric epithelium by erosion and loosening of tight junctions. VacA has also immunosuppressive effects, inhibiting interleukin (IL)-2 secretion by interference with the T cell receptor/IL-2 signaling pathway. This study investigated the effect of VacA on gene expression of T cells. MATERIALS AND METHODS Gene expression profile of a T cell line, Jurkat, was analyzed by the cDNA microarray technique after VacA challenge. The expression of specific mRNAs was assessed by reverse transcription-polymerase chain reaction. Interleukin (IL)-8 concentrations in culture supernatants and cell surface expression of CD69 were measured by enzyme-linked immunosorbent assay and flow cytometry, respectively. We evaluated nuclear factor-kappaB (NF-kappaB) activation in Jurkat cells challenged with VacA by luciferase assay, electrophoretic mobility shift assay, and Western blot analysis. RESULTS VacA produced two or greater fold up-regulation of expression of 60 genes. Most of these genes were associated with signal transduction, regulation of gene expression, apoptosis, and inflammation. Up-regulation of four genes (IL8, IL2RA, ICAM1, and CD69) was confirmed. The supernatants of cells incubated with VacA showed significantly higher secretion levels of IL-8 than those incubated without VacA. VacA also induced the cell surface expression of CD69. Since microarray analysis indicated NF-kappaB was involved in the transcriptional activation of the above genes, we examined NF-kappaB signaling pathway. VacA activated NF-kappaB via classical but not alternative pathway. CONCLUSIONS VacA has two paradoxical effects on T cells, immunosuppression, and proinflammatory effects. The latter is mediated by NF-kappaB activation.
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Affiliation(s)
- Eriko Takeshima
- Division of Molecular Virology and Oncology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan
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Hokama A, Kinjo F, Fujita J. Pneumatosis cystoides intestinalis: radiographic and endoscopic features. Clin Gastroenterol Hepatol 2009; 7:A32. [PMID: 19250985 DOI: 10.1016/j.cgh.2008.11.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Accepted: 11/19/2008] [Indexed: 02/07/2023]
Affiliation(s)
- Akira Hokama
- First Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan
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Toma S, Yamashiro T, Arakaki S, Shiroma J, Maeshiro T, Hibiya K, Sakamoto N, Kinjo F, Tateyama M, Fujita J. Inhibition of intracellular hepatitis C virus replication by nelfinavir and synergistic effect with interferon-alpha. J Viral Hepat 2009; 16:506-12. [PMID: 19302339 DOI: 10.1111/j.1365-2893.2009.01102.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Liver diseases associated with hepatitis C virus (HCV) infection have become the major cause of mortality in patients with human immunodeficiency virus (HIV) infection since the introduction of highly active anti-retroviral therapy. HCV-related liver disease is more severe in HIV-infected patients than in non-HIV-infected patients, but the standard therapies used to treat chronic hepatitis C in HCV/HIV coinfected patients are the same as those for patients infected with HCV alone. HIV protease inhibitors might have potential to down-regulate HCV load of HCV/HIV coinfected patients. In this study, we evaluated the effects of nelfinavir on intracellular HCV replication using the HCV replicon system. We constructed an HCV replicon expressing a neomycin-selectable chimeric firefly luciferase reporter protein. Cytotoxicity and apoptosis induced by nelfinavir were assessed and synergism between nelfinavir and interferon (IFN) was calculated using CalcuSyn analysis. Nelfinavir dose-dependently repressed HCV replication at low concentrations (IC(50), 9.88 micromol/L). Nelfinavir failed to induce cytotoxicity or apoptosis at concentrations that inhibited HCV replication. Clinical concentrations of nelfinavir (5 micromol/L) combined with IFN showed synergistic inhibition of HCV replication in our replicon model. Our results suggest that the direct effects of nelfinavir on the HCV subgenome and its synergism with IFN could improve clinical responses to IFN therapy in HCV/HIV coinfected patients.
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Affiliation(s)
- S Toma
- First Department of Internal Medicine, School of Medicine, University of the Ryukyus, Okinawa, Japan
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Hokama A, Samura H, Arakaki J, Murabayashi R, Shimoji K, Chinen H, Kishimoto K, Kinjo F, Nishimaki T, Fujita J. Epigastric pain in a woman with previous Behcet's disease. Gut 2009; 58:896, 948. [PMID: 19520883 DOI: 10.1136/gut.2008.172767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- A Hokama
- First Department of Internal Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
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Affiliation(s)
- A Hokama
- First Department of Internal Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
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Danjo A, Yamaguchi K, Fujimoto K, Saitoh T, Inamori M, Ando T, Shimatani T, Adachi K, Kinjo F, Kuribayashi S, Mitsufuji S, Fujiwara Y, Koyama S, Akiyama J, Takagi A, Manabe N, Miwa H, Shimoyama Y, Kusano M. Comparison of endoscopic findings with symptom assessment systems (FSSG and QUEST) for gastroesophageal reflux disease in Japanese centres. J Gastroenterol Hepatol 2009; 24:633-8. [PMID: 19220681 DOI: 10.1111/j.1440-1746.2008.05747.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIM We compared endoscopic findings of the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG), a written questionnaire developed in Japan, to that for the questionnaire for the diagnosis of reflux esophagitis (QUEST) for the diagnosis of reflux esophagitis. METHODS We registered 475 patients with untreated symptoms of upper abdominal pain (male/female: 252/223, average age 52.4 +/- 17.8 years). Subjects were assessed first with the FSSG and QUEST questionnaires, then by endoscopy, before allocation to a gastric ulcer (GU), duodenal ulcer (DU), gastroesophageal reflux disease (GERD) or functional dyspepsia (FD) group. RESULTS On the basis of the endoscopic findings the diagnoses for the 475 subjects were as follows: FD 52.2%, DU 7.6%, GU 7.8%, and GERD 32.4% (Grade M 10.1%, Grade A + B 20.2%, Grade C + D 2.3%). There was no difference between the FSSG and QUEST in sensitivity, specificity or accuracy for any condition. The FSSG score rose with increasing endoscopic severity of GERD, but there was no correlation between the QUEST score and endoscopic severity. The FSSG total score was inferior to QUEST in terms of distinguishing GERD from other conditions, but when only the questions relating to reflux symptoms were used, the FSSG was able to distinguish GERD from other conditions as well as QUEST. CONCLUSIONS The FSSG score reflects the severity of the endoscopic findings of GERD.
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Affiliation(s)
- Akiko Danjo
- Department of Internal Medicine, Saga Medical School, Saga 849-8501, Japan
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Arakaki S, Iraha A, Shiroma J, Maeshiro T, Hokama A, Kinjo F, Fujita J. Acute haemorrhagic rectal ulcer in fulminant hepatitis. BMJ Case Rep 2009; 2009:bcr10.2008.1138. [PMID: 21691386 DOI: 10.1136/bcr.10.2008.1138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Shingo Arakaki
- University of the Ryukyus, First Department of Internal Medicine, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
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Hokama A, Nakamura M, Kobashigawa C, Chinen H, Kishimoto K, Nakamoto M, Hirata T, Kinjo N, Kinjo F, Samura H, Nishimaki T, Fujita J. Education and imaging. Gastrointestinal: Signs of pneumoperitoneum. J Gastroenterol Hepatol 2009; 24:497. [PMID: 19335789 DOI: 10.1111/j.1440-1746.2009.05835.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- A Hokama
- First Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan
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Takeshima E, Tomimori K, Kawakami H, Ishikawa C, Sawada S, Tomita M, Senba M, Kinjo F, Mimuro H, Sasakawa C, Fujita J, Mori N. NF-kappaB activation by Helicobacter pylori requires Akt-mediated phosphorylation of p65. BMC Microbiol 2009; 9:36. [PMID: 19216748 PMCID: PMC2653507 DOI: 10.1186/1471-2180-9-36] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2008] [Accepted: 02/12/2009] [Indexed: 02/08/2023] Open
Abstract
Background The inflammatory response in Helicobacter pylori-infected gastric tissue is mediated by cag pathogenicity island (PAI)-dependent activation of nuclear factor-κB (NF-κB). Phosphatidylinositol 3-kinase (PI3K)/Akt signaling is known to play a role in NF-κB activation, but little information is available on the relationship between H. pylori and PI3K/Akt signaling in gastric epithelial cells. We examined whether H. pylori activates Akt in gastric epithelial cells, the role of cag PAI in this process and the role of Akt in regulating H. pylori-induced NF-κB activation. Results Phosphorylated Akt was detected in epithelial cells of H. pylori-positive gastric tissues. Although Akt was activated in MKN45 and AGS cells by coculture with cag PAI-positive H. pylori strains, a cag PAI-negative mutant showed no activation of Akt. H. pylori also induced p65 phosphorylation. PI3K inhibitor suppressed H. pylori-induced p65 phosphorylation and NF-κB transactivation, as well as interleukin-8 expression. Furthermore, transfection with a dominant-negative Akt inhibited H. pylori-induced NF-κB transactivation. Transfection with small interference RNAs for p65 and Akt also inhibited H. pylori-induced interleukin-8 expression. Conclusion The results suggest that cag PAI-positive H. pylori activates Akt in gastric epithelial cells and this may contribute to H. pylori-mediated NF-κB activation associated with mucosal inflammation and carcinogenesis.
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Affiliation(s)
- Eriko Takeshima
- Division of Molecular Virology and Oncology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan.
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Affiliation(s)
- Masamoto Nakamura
- Department of Internal Medicine, Okinawa Red Cross Hospital, Okinawa.
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Affiliation(s)
- Masamoto Nakamura
- Department of Internal Medicine, Okinawa Red Cross Hospital, Okinawa.
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Hokama A, Tomoyose T, Yamamoto YI, Watanabe T, Hirata T, Kinjo F, Kato S, Ohshima K, Uezato H, Takasu N, Fujita J. Adult T-cell leukemia/lymphoma presenting multiple lymphomatous polyposis. World J Gastroenterol 2008; 14:6584-8. [PMID: 19030219 PMCID: PMC2773353 DOI: 10.3748/wjg.14.6584] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Multiple lymphomatous polyposis (MLP) is an unusual form of non-Hodgkin’s lymphoma characterized by polyps throughout the gastrointestinal tract. It has been reported that most MLP are observed in cases with mantle cell lymphoma of B-cell type. We herein present a case of a 66-year-old man with adult T-cell leukemia/lymphoma (ATLL). Colonoscopy revealed MLP throughout the colon and histopathological findings of ATLL cell infiltration. The patient died despite combination of chemotherapy. The literature of manifestations of colonic involvement of ATLL is reviewed and the importance of endoscopic evaluation to differentiate ATLL intestinal lesions from opportunistic infectious enterocolitis is discussed.
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Affiliation(s)
- A Hokama
- First Department of Internal Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
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Higa F, Haranaga S, Tateyama M, Hibiya K, Yamashiro T, Nakamatsu M, Tomoyose T, Nagahama M, Okamura T, Owan T, Kuda T, Kinjo F, Fujita J. Assessment of Serum Anti-<i>Bordetella pertussis</i> Antibody Titers among Medical Staff Members. Jpn J Infect Dis 2008. [DOI: 10.7883/yoken.jjid.2008.371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Affiliation(s)
- Futoshi Higa
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Syusaku Haranaga
- Department of Medicine and Therapeutics, Prevention and Control of Infectious Diseases, University of the Ryukyus, Japan
| | - Masao Tateyama
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Kenji Hibiya
- Department of Medicine and Therapeutics, Prevention and Control of Infectious Diseases, University of the Ryukyus, Japan
| | - Tsuyoshi Yamashiro
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Miyuki Nakamatsu
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Takeaki Tomoyose
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Masayoshi Nagahama
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Takayuki Okamura
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Tomoko Owan
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Tomoharu Kuda
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Fukunori Kinjo
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
| | - Jiro Fujita
- Infection Control Team, Ryukyu University Hospital, University of the Ryukyus, Japan
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Higa F, Haranaga S, Tateyama M, Hibiya K, Yamashiro T, Nakamatsu M, Tomoyose T, Nagahama M, Okamura T, Owan T, Kuda T, Kinjo F, Fujita J. Assessment of serum anti-Bordetella pertussis antibody titers among medical staff members. Jpn J Infect Dis 2008; 61:371-374. [PMID: 18806344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This study comparatively evaluated the titers of the bacterial agglutination (BA) antibody for Bordetella pertussis, anti-pertussis toxin (PT) antibody, and anti-filamentous hemagglutinin (FHA) antibody in the serum of medical staff members. The geometric means of the anti-PT and anti-FHA antibody titers were 5.83 and 17.17 EU/mL, respectively. The positive rates of the BA antibodies against Tohama and Yamaguchi strains (> or = 40x), and anti-PT and anti-FHA antibodies (>10 EU/mL) were 81.3, 72.9, 43.8, and 68.8%, respectively. A high anti-PT antibody titer (>94 EU/mL) was found in 1 staff member, but this individual had no recent respiratory symptoms. The titers of the BA antibody against the Yamaguchi strain were weakly associated with the anti-PT antibody titers, but the BA antibody titer was not useful for predicting anti-PT antibody positivity. The seroprevalence of anti-pertussis antibody among medical staff was heterogeneous, suggesting that this group could be at high risk for pertussis. Judgments made using BA antibody or anti-PA antibody results differ, and thus careful evaluation of anti-pertussis antibody titers is necessary. Prompt and accurate diagnostic tools are crucial for infection control in the hospital setting.
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Affiliation(s)
- Futoshi Higa
- Infection Control Team, Ryukyu University Hospital, Okinawa 903-0215, Japan.
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Hokama A, Nakamura M, Ihama Y, Chinen H, Kishimoto K, Kinjo F, Fujita J. Notched sign and bamboo-joint-like appearance in duodenal Crohn's disease. Endoscopy 2008; 40 Suppl 2:E151. [PMID: 18633874 DOI: 10.1055/s-2007-995774] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- A Hokama
- First Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan.
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