Toshikazu Sekiguchi

Gunma University, Maebashi-shi, Gunma-ken, Japan

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Publications (93)105.62 Total impact

  • Toshikazu SEKIGUCHI · Tsutomu HORIKOSHI · Motoyasu KUSANO · Youichi KON

    No preview · Article · Dec 2007 · Digestive Endoscopy
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    ABSTRACT: Gastrointestinal motility may be impaired after endoscopic mucosal resection of gastric lesions. We investigated whether oral erythromycin could improve motility. Twenty patients were divided randomly into groups that received oral omeprazole with or without erythromycin. Motility was recorded overnight at 3 days before and 4 days after endoscopic resection using a microtransducer probe. In the group without erythromycin, gastric phase III activity decreased significantly after endoscopic resection, while it was increased significantly by erythromycin (P < 0.01). After resection, there were significantly more gastric phase III events in the erythromycin group (P < 0.05). The interval between the start of the evening meal and the initial gastric phase III activity was significantly prolonged after resection, while this interval was significantly shortened by erythromycin (P < 0.05). The gastric phase III cycle length was also significantly shortened by erythromycin (P < 0.05). Postprandial and fasting gastrointestinal motility were impaired after endoscopic resection, and postprandial as well as fasting motility were improved by oral erythromycin.
    No preview · Article · Sep 2007 · Digestive Diseases and Sciences
  • Munetoshi TOKI · Tsuneo OHWADA · Toshikazu SEKIGUCHI
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    ABSTRACT: We observed the esophageal mucosa in 90 patients with reflux, esophagitis using a zoom-type electronic endoscope and clarified the endoscopic characteristics of each stage of the disease as well as the response to treatment. It was possible to differentiate between white slough, erosions and regenerating epithelium from observations of the magnified mucosa. The white slough appeared uniform and featureless, the erosions appeared irregular and had featureless reddish areas, and regenerating epithelium were noted in the reddish areas in addition to various types of mucosal surface structure. Biopsies obtained after the disappearance of the white sloughs of reflux esophagitis from the mucosal membrane of the discolored esophagitis generally showed the “accessory findings” of the diagnostic criteria of the Japanese Society of Esophageal Diseases. Even in the early scarring stage (S1), the inflammation persisted under the regenerating mucosa, and it was necessary to continue treatment until the late scarring stage (S2) to prevent recurrence. Regarding treatment, H2 receptor antagonists were effective, but 19.4% of the patients showed resistance to them. Intractable esophagitis was often seen in stage III and IV of the Savary & Miller classification and in the elderly patients. Intractable esophagitis was associated with a high incidence of hiatus hernia, a reduced lower esophageal sphincter pressure, and a reduction in primary peristalsis in the lower esophagus.
    No preview · Article · Aug 2007 · Digestive Endoscopy
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    ABSTRACT: The aim of this study was to determine whether the gastric longitudinal shortening occurs during the gastric phase III in man. Intragastric pH and gastroduodenal motility were simultaneously measured by means of a 24-h ambulatory recording system in 14 healthy volunteers. In nine subjects (group A), the catheter assembly was endoscopically clipped to the gastric mucosa with the middle transducer and the distal pH sensor in the antrum. In the remaining five subjects (group B), measurements were performed without securing the assembly. In 23 of the 25 gastrointestinal interdigestive migrating complexes in group A, the distal and middle transducers showed characteristic duodenal contractions (11-12 c.p.m.). Neutralization was noted at the distal pH sensor. Similar phenomena were observed during all 15 gastrointestinal interdigestive migrating complexes in group B. The catheter assemblies escaped into the duodenum despite the fact that they were secured to the stomach. This may be explained by gastric longitudinal shortening during gastric phase III activities. Studies of intragastric physiology with test catheters must take the effect of gastric longitudinal shortening during phase III into consideration.
    No preview · Article · Jan 2007 · Journal of Gastroenterology and Hepatology

  • No preview · Article · Feb 2002 · Journal of Gastroenterology
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    ABSTRACT: A 22-year-old man was unable to belch. He could sense intraesophageal gas, but had no chest pain. An upper gastrointestinal X-ray series and endoscopic examination showed no abnormalities. Esophageal manometry showed normal relaxation of both the upper and lower esophageal sphincters with primary peristalsis during deglutition. However, bolus injection of air into the middle esophagus failed to initiate the belch reflex.
    No preview · Article · Apr 2001 · Journal of Gastroenterology and Hepatology
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    ABSTRACT: To simplify assessment of gastric emptying, we have developed a radiopaque barium marker method. The subjects were 11 healthy volunteers, 30 patients with progressive systemic sclerosis, 16 patients with dysmotility-like dyspepsia, 7 patients with irritable bowel syndrome, and 6 patients with diabetes mellitus. We tested three types of radiopaque markers with manometry by a three-channel strain gauge transducer. The 4.5-mm ring-shaped markers with a specific gravity of 1.2 were emptied from the stomach in correlation with the number of high-amplitude (>50 mm Hg) antral contractions. The percentage of residual markers at 2 hr was significantly (P < 0.05) lower in patients with irritable bowed syndrome than in normal controls, and at 5 hr it was significantly (P < 0.05) higher in patients with systemic sclerosis with esophageal dysmotility, dysmotility-like dyspepsia, or diabetes than in normal controls. This radiopaque barium marker method may be useful as a screening test for determining whether gastric emptying is rapid or delayed.
    No preview · Article · Feb 2000 · Digestive Diseases and Sciences
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    ABSTRACT: The role of Helicobacter pylori infection in the development and exacerbation of reflux esophagitis was investigated. The prevalence of Helicobacter pylori infection, the severity of atrophic gastritis, and esophageal motility (determined by esophageal manometry by an infusion catheter method) were assessed in patients with mild (n = 46) and severe (n = 27) reflux esophagitis and subjects without reflux (n = 28). Compared with the prevalence of Helicobacter pylori infection in the non-reflux group, the prevalence in the mild and severe reflux groups (60.7%, 47.8%, and 14.8%, respectively) was significantly (P < 0.05) lower. Atrophic gastritis was milder in both reflux groups than in the non-reflux group. The degree of gastritis was also milder in the severe reflux group than in the mild reflux group. The esophageal sphincter pressure was significantly (P < 0.05) lower in the reflux groups than in the non-reflux group, and the amplitude of primary peristalsis was significantly (P < 0.05) lower in the severe reflux group than in the non-reflux group. There were no significant differences between reflux patients with and without Helicobacter pylori infection in the parameters of esophageal manometry. These data imply that a low prevalence of Helicobacter pylori infection may result in a milder grade of atrophic gastritis, and consequently, exacerbate reflux esophagitis.
    No preview · Article · Nov 1999 · Journal of Gastroenterology
  • T. Yamada · M. Kusano · O. Kawamura · T. Sekiguchi
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    ABSTRACT: To detect the characteristic endoscopic features of intractable reflux esophagitis, we defined intractable reflux esophagitis as 1) failure to respond to treatment with a proton pump inhibitor (PPI) for eight weeks and 2) the need for PPI maintenance therapy. In patients with esophageal mucosal deformity of LA grade A-D, there was a significantly higher incidence of intractable reflux esophagitis than in patients without mucosal deformity. The lower esophageal sphincter pressure was also significantly lower in patients with esophageal mucosal deformity than in patients without deformity. We concluded that esophageal mucosal deformity along with esophageal manometry findings could be an indicator of whether the reflux esophagitis would be intractable or not.
    No preview · Article · Jul 1999 · Stomach and Intestine
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    ABSTRACT: A new endoscopic classification of gastroesophageal reflux disease (GERD) has been proposed, and the term mucosal break has been introduced to describe mucosal damage. This new classification was evaluated by endoscopists with different levels of experience. Fifty endoscopic photographs for each of 20 randomly selected patients with GERD were assessed retrospectively by three groups of seven endoscopists classified by experience: group 1 (100 to 500 procedures), group 2 (500 to 3000), and group 3 (more than 3000). The new classification was modified by adding grade 0 to describe healed mucosal breaks, so that there were five grades. All photographs were assessed twice at an interval of more than 1 week, and kappa statistics were used to determine observer variation. Interobserver variation within group 3 (kappa = 0.39, n = 21) and between groups 3 and 2 (kappa = 0.36, n = 49) was significantly different (p < 0.01) from that between groups 3 and 1 (kappa = 0.26, n = 49). Intraobserver variation in group 1 (kappa = 0.39, n = 7) was significantly different (p < 0.01) from that in group 2 (kappa = 0.51, n = 7) and group 3 (kappa = 0.54, n = 7). Observer variation depends on level of endoscopic experience. Only experienced endoscopists should use the new classification for grading of GERD.
    No preview · Article · Jun 1999 · Gastrointestinal Endoscopy
  • M Yanagisawa · M Kusano · I Doi · K Motegi · K Nakamura · O Kawamura · M Mori · T Sekiguchi

    No preview · Article · Oct 1998 · Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology
  • M Kusano · T Sekiguchi · O Kawamura · K Kikuchi · K Nakamura · M Mori
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    ABSTRACT: It is known that there is a close relationship between serum motilin fluctuation and the initiation of gastric interdigestive migrating complexes (IMC) (1). The administration of synthetic motilin initiates IMC (2), and antimotilin serum blocks the initiation of IMC (3). Erythromycin has recently been shown to be a motilin-receptor agonist (4), and motilin receptors have been found in the human stomach (5). At present motilin is considered to initiate IMC through both the vagal cholinergic pathway and direct stimulation of smooth muscle. From the clinical point of view, Labo et al (6) and our group (7) recently reported on the relationship between a low motilin concentration and disturbance of IMC in patients with dyspepsia. On the other hand, little is known about the effect of an abnormally high motilin concentration on gastroduodenal motility. We have found three outpatients in our clinic at Gunma University Hospital with duodenal ulcer or duodenitis who had disturbed initiation of IMC despite an abnormally high plasma motilin concentration.
    No preview · Article · Sep 1998 · Digestive Diseases and Sciences
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    ABSTRACT: It is known that there is a close relationshipbetween serum motilin fluctuation and the initiation ofgastric interdigestive migrating complexes (IMC) (1).The administration of synthetic motilin initiates IMC (2), and antimotilin serum blocks theinitiation of IMC (3). Erythromycin has recently beenshown to be a motilin-receptor agonist (4), and motilinreceptors have been found in the human stomach (5). At present motilin is considered to initiateIMC through both the vagal cholinergic pathway anddirect stimulation of smooth muscle. From the clinicalpoint of view, Labo et al (6) and our group (7) recently reported on the relationship between a lowmotilin concentration and disturbance of IMC in patientswith dyspepsia. On the other hand, little is known aboutthe effect of an abnormally high motilin concentration on gastroduodenal motility. We have found threeoutpatients in our clinic at Gunma University Hospitalwith duodenal ulcer or duodenitis who had disturbedinitiation of IMC despite an abnormally high plasma motilin concentration.
    No preview · Article · Aug 1998 · Digestive Diseases and Sciences
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    ABSTRACT: Clinical, pathological, and virological analysis including hypervariable region-1 of hepatitis C virus (HCV) was performed to predict the effect of interferon (IFN) on 41 patients with chronic hepatitis type C. The low virus load, low frequency of the mutation in the hypervariable region-1 as the change of amino acid and high level of serum aminotransferase make one estimate the good effect of IFN on patients with HCV. Mutation in the hypervariable region-1 of HCV measured by fast assay fluorescence single-stranded conformational polymorphism was more frequent in nonresponders to IFN than responders. The most frequently mutated position was amino acid number 406. This indicates that the specific mutation site might affect the response of IFN.
    No preview · Article · Dec 1997 · Digestive Diseases and Sciences
  • K Kikuchi · T Sekiguchi · M Kusano · O Kawamura

    No preview · Article · May 1997 · Nippon rinsho. Japanese journal of clinical medicine
  • M Miyazaki · M Kusano · T Sekiguchi

    No preview · Article · May 1997 · Nippon rinsho. Japanese journal of clinical medicine
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    ABSTRACT: To investigate interdigestive gastroduodenal motility with an infused catheter and measure plasma motilin levels in eight normal individuals and 18 patients with dysmotility-like dyspepsia. All normal individuals had normal gastroduodenal interdigestive migrating complexes. Patients with dysmotility-like dyspepsia were classified into three subgroups on the basis of gastric antral motility: 1) seven patients with normal interdigestive migrating complexes, 2) five patients without interdigestive migrating complexes and with gastric phase II predominant over phase I, and 3) six patients without interdigestive migrating complexes and with phase I predominance. The maximum and mean plasma motilin levels were significantly different in normal individuals from those in subgroup 3 (Kruskal-Wallis test, p < 0.05). Dysmotility-like dyspepsia appears to be a heterogeneous condition. Abnormal motilin secretion may cause dysmotility in subgroup 3, but dyspepsia in subgroup 1 and the absence of interdigestive migrating complexes in subgroup 2 could not be explained only on this basis.
    No preview · Article · Apr 1997 · The American Journal of Gastroenterology
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    ABSTRACT: The patient was an 81-year-old woman. Colorectal endoscopy was performed due to lasting sense of abdominal fullness and, as a result well differentiated adenocarcinoma of approximately 40 mm in size was found in the ascending colon. She wished to avoid surgical resection due to her high age and so an endoscopic treatment was adopted. After local injection of physiological salt solution to prevent perforation, piecemeal endoscopic mucosal resection was performed followed by the endoscopic microwave coagulation therapy. The techniques were repeated 3 times in total. She has been observed for 30 months but neither residue nor recurrence has been found on endoscopy. Endoscopic microwave coaguration therapy is effective as an additional treatment after endoscopic mucousal resection of early colorectal cancer and local radical cure seems possible even when cancer has grown to a size unresectable as a lump.
    Preview · Article · Jan 1996
  • T Horikoshi · T Horie · T Sekiguchi · O Kawamura · M Kusano · M Mori · S Nakamura · S Ohwada
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    ABSTRACT: We report a rare case of benign esophagobronchial fistula associated with achalasia. The fistula healed spontaneously after esophagocardioplasty with a gastric patch, suggesting the utility of this procedure.
    No preview · Article · Sep 1995 · The American Journal of Gastroenterology
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    ABSTRACT: A 37-year-old Japanese man was admitted with delirium and hyperammonemia. He was diagnosed as having type II citrullinemia because of an elevated citrulline level on amino acid analysis and very low hepatic argininosuccinate synthetase activity. He also showed a low neutrophil count and a low serum level of granulocyte colony-stimulating factor. Reduced production of this cytokine and/or impairment of its feedback regulation by the neutrophil count may have played a role in the neutropenia of this patient.
    No preview · Article · Aug 1995 · Internal Medicine