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Introduction
Publications
Publications (139)
Obesity, smoking and alcohol are modifiable putative risk factors for colorectal neoplasms (CRN) and hyperplastic polyps (HP). The aim of this study was to evaluate the strength of association between these modifiable risk factors and colorectal polyps.
These risk factors were assessed by using a questionnaire completed by the patient prior to colo...
Acute pancreatitis is a most serious complication following endoscopic retrograde cholangiopancreatography (ERCP). Previous meta-analyses and randomized controlled trials have shown conflicting results regarding the preventive efficacy of somatostatin or octreotide for this complication. The aim of this study was to resolve these conflicts.
A stand...
Objective:
Obesity (body mass index [BMI] ≥30) or overweight (25 ≤ BMI ≤29.9) has been reported to be a risk factor for colorectal adenoma (CRA). However, this association remains controversial. The aim of this study was to determine the association between overweight or obesity and CRA.
Design:
Systematic review and meta-analysis were conducted...
Background and aim:
Long-term cumulative incidence of and risk factors for metachronous advanced colorectal neoplasia, including both advanced colorectal adenoma (≥10 mm, or with villous or high-grade dysplasia) and colorectal cancer, are critical for surveillance strategies. The aim of this study was to determine the cumulative incidence of metac...
Background Antispasmodics, such as scopolamine, are widely used in several countries prior to diagnostic and screening esophagogastroduodenoscopy (EGD), with the goal of optimizing the detection of minute lesions, typically early gastric cancer (T1 lesions). The aim of this study was to determine whether scopolamine facilitates detection of gastric...
Objectives
No randomized controlled trials have compared endoscopic screening with no screening for gastric cancer on an intention‐to‐screen basis, and the population‐based evidence is insufficient. This study aimed to identify factors contributing to the population effectiveness of cancer screening, estimate the number needed to screen (NNS) to re...
Introduction:
This study aimed to reevaluate the effectiveness of fluoroscopy and endoscopy in reducing gastric cancer mortality at the population level.
Methods:
Crude and age-adjusted mortality rates of gastric cancer and the introduction rates of gastric cancer screening were extracted from the Cancer Registry and Statistics database. The pop...
Background and Aims
We aimed to determine the optimal timing of colonoscopy and factors that benefit patients who undergo early colonoscopy for acute lower gastrointestinal bleeding.
Methods
We identified 10,342 patients with acute hematochezia (CODE BLUE-J study) admitted to 49 hospitals in Japan. Of these, 6,270 patients who underwent a colonosc...
Gastric subepithelial lesions (SEL) are usually found incidentally during esophagogastroduodenoscopy. Most gastric SELs are benign lesions, such as leiomyoma and pancreatic rests. However, neoplastic lesions including neuroendocrine tumors, gastrointestinal stromal tumors, and certain types of gastric adenocarcinoma (GA), such as the recently WHO-c...
Outcomes of acute lower gastrointestinal bleeding have not been compared according to hospital capacity. We aimed to perform a propensity score-matched cohort study with path and mediation analyses for acute hematochezia patients. Hospitals were divided into high- versus low-volume hospitals for emergency medical services. Rebleeding and death with...
Background
Anti-tumour necrosis factor (TNF) agents are the mainstay of long-term treatment for refractory ulcerative colitis. However, long-term use of anti-TNF therapy might lead to an increased risk of malignancy or infection. To date, no randomised controlled trial has evaluated whether anti-TNF agents can be safely discontinued in patients wit...
Background and Aim
Either clipping or band ligation will become the most common endoscopic treatment for colonic diverticular bleeding (CDB). Rebleeding is a significant clinical outcome of CDB, but there is no cumulative evidence comparing reduction of short‐ and long‐term rebleeding between them. Thus, we conducted a systematic review and meta‐an...
INTRODUCTION
There have been several studies suggesting the association between Helicobacter pylori . ( H. pylori ) infection and colorectal adenoma or cancer. However, this causal relationship is still controversial. Most atrophic gastritis (AG) is caused by H. pylori infection and can be used as surrogate marker of H. pylori infection history. On...
Background
The environment surrounding Helicobacter pylori eradication treatment is dramatically changing. Recently, vonoprazan, a first-in-class potassium-competitive acid blocker (P-CAB), was introduced onto the market in 2015. The aging of Japan’s demographic structure is becoming pronounced. In this study, we examined the trend of the eradicati...
Background and Aim
The risk factors for early rebleeding following the management of colonic diverticular bleeding (CDB) are unclear. This study aimed to determine the risk factors for early rebleeding following initial colonoscopy.
Methods
Overall, 370 patients with CDB were divided as having presumptive (229) or definite CDB with stigmata of rec...
Acute hemorrhagic rectal ulcer syndrome (AHRUS) can cause fatal gastrointestinal bleeding. However, there have been few epidemiological studies investigating risk factors of AHRUS. To determine the risk factors and predict one-year survival after onset of AHRUS, we conducted a retrospective density case-control study in a tertiary referral hospital...
Inflammatory bowel disease (IBD) is a chronic disorder involving mainly the intestinal tract, but possibly other gastrointestinal and extraintestinal organs. Although etiology is still uncertain, recent knowledge in pathogenesis has accumulated, and novel diagnostic and therapeutic modalities have become available for clinical use. Therefore, the p...
Studies on ecology of medical care can provide valuable information on how people seek healthcare in a specific geographic area. The objective of this study was to update a 2003 report on the ecology of medical care in Japan, identifying relevant changes in healthcare patterns. We collected information based on a prospective health diary recorded f...
Background and aims:
Several endoscopic modalities have been used for the treatment of colonic diverticular bleeding (CDB). The aim of this study was to evaluate the effectiveness of endoscopic treatment for CDB.
Methods:
We performed a systematic review and meta-analysis of English literature. Main outcomes were initial hemostasis, early recurr...
Background and study aims Positive horizontal margins in resected specimens are sometimes encountered after endoscopic submucosal dissection (ESD) for early gastric cancers, and appropriate treatment strategies for these cases are not established. The aim of this study was to evaluate current empirical treatments for patients with positive horizont...
Background . There are several diagnostic methods for Helicobacter pylori (H. pylori) infection. A cost-effective analysis is needed to decide on the optimal diagnostic method. The aim of this study was to determine a cost-effective diagnostic method in patients with atrophic gastritis (AG). Methods . A decision-analysis model including seven diagn...
Background: The 21-gene Recurrence Score (RS) (Oncotype DX®; Genomic Health, Redwood City, CA) is the most valid and reliable multigene assay to predict prognosis or response to treatment in hormone receptor-positive invasive breast cancer patients. However, in Japan, the test is expensive (about 4,000 US dollars) and one of the problems is that ab...
131
Background: Additional early palliative care consultation (EPCC) on standard oncology care (SOC) was reported to prolong survival of patients with metastatic non–small cell lung cancer by one randomized controlled trial. However, its survival benefits for the patients with other advanced cancer have not fully been investigated yet. Pancreatic c...
Transparency document.
While cigarette smoking is a well-recognized cause of elevated white blood cell (WBC) count, studies on longitudinal effect of smoking cessation on WBC count are limited. We attempted to determine causal relationships between smoking and elevated WBC count by retrospective cross-sectional study consisting of 37,972 healthy Japanese adults who had a...
Background and aims:
Endoscopic band ligation (EBL) has been used to achieve hemostasis in patients with colonic diverticular bleeding. The safety and effectiveness of EBL when performed by non-expert endoscopists have not been sufficiently verified. This study aimed to elucidate the feasibility of the EBL technique when performed by non-expert en...
Introduction: Gallstone-associated cholecystitis and acute pancreatitis were reported to develop more
frequently in summer and spring, respectively. However, there have been no reports confi rming the association between meteorological factors and stone-associated pancreatohepatobiliary disease (SAPHBD), which includes acute cholelithiasis, acute c...
Background and study aims:
Endoscopic band ligation (EBL) has been used for hemostasis of colonic diverticular hemorrhage. However, early rebleeding (< 30 days after EBL) has been reported in some cases. The aim of this study was to elucidate risk factors for early rebleeding after EBL in treatment of colonic diverticular hemorrhage.
Patients and...
A retrospective cohort study was conducted in 55 symptomatic patients with amebic colitis that visited at St. Luke's International Hospital and Mie University Hospital from 1994 through 2013. To diagnose amebic colitis, 40 patients underwent total colonoscopy within 1 week after hospital visiting and before receiving any treatment. The percentage o...
The efficacy of 2nd-look esophagogastroduodenoscopy (EGD) with endoscopic hemostatic therapy (EHT) for the prevention of postendoscopic submucosal dissection (ESD) clinical bleeding remains controversial. The aim of this study was to estimate post-ESD bleeding rate using 2nd and 3rd-look strategy, and to determine risk factors for clinical bleeding...
Helicobacter pylori (H. pylori) infection is a strong risk factor for the development of gastric cancer. In 2013, the Japanese government approved H. pylori eradication therapy in patients with chronic gastritis as well as peptic ulcer. However, the continuing decline in eradication rates for first-line H. pylori eradication therapies is an urgent...
Objectives
Thrombocytopenia (TP) is a common adverse effect of linezolid (LZD). However, risk factors for LZD-associated TP have been reported in Western patients with relatively heavy body weight. The aim of this study was to determine the risk factors for LZD-associated TP in Asian population.
Materials and methods
A retrospective cohort study w...
Objective:
The effectiveness of narrow band imaging (NBI), chromoendoscopy (CE), and cap-assisted colonoscopy (CAC) on adenoma detection rate (ADR) has been investigated in previous meta-analyses; however, there have been no meta-analyses of autofluorescence imaging (AFI) or flexible spectral imaging color enhancement (FICE) or i-scan. The aim of...
Background: Thrombocytopenia (TP) is one of the adverse effects associated with linezolid (LZD). The association between body mass index (BMI) and LZD induced TP has not been reported. The aim of this study was to identify the independent risk factors for LZD induced TP and particularly to evaluate whether low BMI is a risk factor.
Methods: A ret...
In Japan, the eradication rate of first-line therapy for Helicobacter pylori (H. pylori) with a proton pump inhibitor (PPI), amoxicillin (AMPC) and clarithromycin (CAM) has been decreasing because of a high prevalence of CAM resistance. A possible decrease of the eradication rate for second-line therapy with a PPI, AMPC and metronidazole (MNZ) is o...
Objective:
Transcatheter arterial chemoembolization (TACE) is an essential therapy for patients with hepatocellular carcinoma (HCC) in whom administering other treatments such as liver transplantation, resection or local therapy is not feasible. The purpose of our study was to determine the independent risk factors for one-year recurrence and two-...
The aim of the present study was to investigate the significance of appendicoliths as an exacerbating factor of acute appendicitis using multivariate analysis. A total of 254 patients with pathologically proved acute appendicitis were enrolled in this retrospective study (male, 51 %; mean age, 40.1 years; range, 15-91 years). Two radiologists perfo...
Aims: The aim of this study was to evaluate very long-term clinical outcomes and potential predictors after percutaneous coronary intervention (PCI) with bare metal stents (BMS) for unprotected left main coronary artery disease (ULMCAD). Methods and results: From March 1991 to August 2001, 151 patients who underwent PCI with BMS for ULMCAD were inv...
Background:
Predictors of refractory colonic diverticular hemorrhage after endoscopic clipping (EC) remain unclear.
Objective:
To elucidate the predictors of uncontrolled bleeding after EC.
Design:
Retrospective study.
Setting:
Two tertiary referral centers.
Patients:
Eighty-nine patients with colonic diverticular hemorrhage who underwent...
Background and aims
In the Western world, 10–20 % of patients with GERD complain of at least weekly episodes of heartburn and/or acid regurgitation, while the corresponding value for GERD patients in Asia is <5 %. Reports of the risk factors for mucosal damage in patients with GERD are scarce. The aim of this study was to compare the severity of mu...
To determine the effectiveness of pancreatic duct (PD) stent placement for the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in high risk patients.
Authors conducted a single-blind, randomized controlled trial to evaluate the effectiveness of a pancreatic spontaneous dislodgement stent against post-ERCP panc...
Plasma ammonia has been used in emergency departments to assess whether or not generalized convulsion attacks exist in patients who are suspected of having convulsions. However, there are few reports that have assessed the relationship between generalized convulsions and hyperammonemia. The clinical significance of plasma ammonia measurements in th...
The number of sample cases of colonic diverticular hemorrhage treated with endoscopic band ligation (EBL) has been small to date.
To elucidate the safety and efficacy of EBL for colonic diverticular hemorrhage.
Retrospective study.
General hospital.
A total of 29 patients with 31 colonic diverticula with stigmata of recent hemorrhage (SRH).
Urgent...
Quantitative fecal immunochemical test (QTFIT) has the advantage of being able to describe test characteristics on a scaled rather than binary system. The aims of this study were to decide the optimal cut-off points of QTFIT and to make a multivariate prediction model for colorectal neoplasms in asymptomatic adults.
We retrospectively analyzed 1085...
Endoscopic mucosal resection (EMR) is a therapy for early gastric cancer (EGC) that can be provided relatively easily and safely in any institution. Identification of the resection margin is a problem in EMR, especially in cases of piecemeal EMR. Despite the long-standing widespread use of piecemeal EMR for EGC, its limitation and long-term outcome...
Some reports have suggested that the location of primary intracerebral hemorrhage (ICH) is affected by oral antithrombotic agents (ATs). This is important, given the increasing use of ATs to treat arteriosclerotic disease. The aim of this study was to explore whether oral AT therapy increase the incidence of any specific location of primary ICH. A...
The new postgraduate medical education (PGME) was recently introduced to improve quality of emergency care in Japan.
To compare the quality of care and confidence in provision of emergency medicine between physicians who completed the old and new PGME programs.
A cross-sectional survey was sent to 279 physicians of postgraduate years 4-9, and 208 r...
In-hospital and long-term mortality of infective endocarditis (IE) are well noted, but the studies for mid-term (90-day) mortality of IE is still limited. We determine the mid-term mortality rate of IE and its significant predictors. Seventy patients with IE were hospitalised at St. Luke's International Hospital between January 1996 and March 2009,...