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Featured researches published by Takahiro Amano.
Endoscopy International Open | 2016
Hirotsugu Saiki; Tsutomu Nishida; Masashi Yamamoto; Shiro Hayashi; Hiromi Shimakoshi; Akiyoshi Shimoda; Takahiro Amano; Aisa Sakamoto; Yuriko Otake; Aya Sugimoto; Kei Takahashi; Kaori Mukai; Tokuhiro Matsubara; Sachiko Nakajima; Koji Fukui; Masami Inada; Katsumi Yamamoto; Ryozo Tokuda; Shiro Adachi
Background and study aims: Sessile serrated adenoma/polyps (SSA/Ps) have a different potential than traditional adenomatous polyps for developing into malignant colorectal cancer. However, little is known about the coexistent cancer rate. Here, we evaluate the frequency of carcinoma in serrated polyps removed by endoscopic resection (ER). Patients and methods: This was a retrospective single-center cohort study of consecutive patients with colorectal polyps who underwent ER from March 2003 to October 2014. We determined the frequency of serrated polyps among all resected colorectal polyps and analyzed the clinicopathological findings as well as the frequency and characteristics of coexistent carcinoma in the serrated polyps resected by ER based on pathology reports. Results: A total of 21,048 polyps from 15,326 patients were identified, including 15,984 traditional adenomatous polyps (75.9 %), 621 SSA/Ps (3.0 %), 136 traditional serrated adenomas (TSAs) (0.6 %), 1,121 hyperplastic polyps (5.3 %), and 3,186 polyps of other types (15.1 %). The clinical and endoscopic findings of SSA/Ps revealed a male predominance (68.6 %), with 61.7 % of the polyps located in the proximal colon. Males accounted for 77.2 % of all patients with TSAs, and 77.2 % of these polyps were located in the distal colon. The mean sizes of the SSA/Ps and TSAs were 8.8 and 10.7 mm, respectively. Among the SSA/Ps, 8 (1.3 %) cases had coexistent carcinoma, and 1 (0.7 %) patient with TSA showed coexistent carcinoma. In the patients with SSA/Ps, female sex and a tumor size ≥ 10 mm were predictive factors for coexistent carcinoma. Conclusions: The frequency of SSA/Ps with carcinoma was lower than that for traditional adenoma. Female sex and tumor size ≥ 10 mm were significant predictive factors for coexistent carcinoma.
Oncology Letters | 2017
Tokuhiro Matsubara; Tsutomu Nishida; Akiyoshi Shimoda; Hiromi Shimakoshi; Takahiro Amano; Aya Sugimoto; Kei Takahashi; Kaori Mukai; Masashi Yamamoto; Shiro Hayashi; Sachiko Nakajima; Koji Fukui; Masami Inada
Fatal chemotherapy-induced hepatitis B virus reactivation (HBV-R) is a well-described serious complication observed in patients with lymphoma and resolved HBV infection. The aim of the present study was to determine the predictive factors of the development of chemotherapy-induced HBV-R. A total of 77 consecutive newly diagnosed patients with lymphoma and resolved HBV infection, who received chemotherapy from 2007 through 2015 were analysed retrospectively. Significant predictive factors associated with HBV-R were identified based on the data from these patients. Ten patients developed HBV-R during and following chemotherapy, and two of these 10 patients developed HBV-associated hepatitis flares. There was a significant negative correlation between anti-hepatitis B core (HBc) titres prior to chemotherapy and time to HBV-R (P=0.016, R=−0.732). Univariate and multivariate logistic regression analyses demonstrated that anti-HBc and anti-hepatitis B surface (HBs) titres at baseline were significant predictive factors for HBV-R. In addition, patients with high anti-HBc titres at baseline (above 10 S/CO) were significantly more likely to experience HBV-R than patients with low anti-HBc and high anti-HBs titres (above 28 mIU/ml), who did not experience complete reactivation (P<0.0001). Furthermore, patients with low anti-HBs titres were significantly more likely to experience HBV-R than those with high anti-HBs titres (P=0.031). All HBV-R episodes among the patients with high anti-HBc titres occurred within 3 months following the initiation of chemotherapy. The combination of anti-HBc and anti-HBs titres, as opposed to either titre alone, at baseline in patients with lymphoma may serve as a surrogate marker for the occurrence of HBV-R under the influence of chemotherapy.
World Journal of Gastrointestinal Endoscopy | 2016
Shiro Hayashi; Tsutomu Nishida; Hiromi Shimakoshi; Akiyoshi Shimoda; Takahiro Amano; Aya Sugimoto; Kei Takahashi; Kaori Mukai; Tokuhiro Matsubara; Masashi Yamamoto; Sachiko Nakajima; Koji Fukui; Masami Inada
AIM To estimate the efficacy of 2 h post-endoscopic retrograde cholangiopancreatography (ERCP) serum amylase levels and other factors for predicting post-ERCP pancreatitis. METHODS This was a retrospective, single-center cohort study of consecutive patients who underwent ERCP from January 2010 to December 2013. Serum amylase levels were measured 2 h post-procedure, and patient- and procedure-related pancreatitis (PEP) risk factors were analyzed using a logistic model. RESULTS A total of 1520 cases (average age 72 ± 12 years, 60% male) were initially enrolled in this study, and 1403 cases (725 patients) were ultimately analyzed after the exclusion of 117 cases. Fifty-five of these cases developed PEP. We established a 2 h serum amylase cutoff level of two times the upper limit of normal for predicting PEP. Multivariate analysis revealed that a cannulation time of more than 13 min [odds ratio (OR) 2.28, 95%CI: 1.132-4.651, P = 0.0210] and 2 h amylase levels greater than the cutoff level (OR = 24.1, 95%CI: 11.56-57.13, P < 0.0001) were significant predictive factors for PEP. Forty-seven of the 55 patients who developed PEP exhibited 2 h amylase levels greater than the cutoff level (85%), and six of the remaining eight patients who developed PEP (75%) required longer cannulation times. Only 2 of the 1403 patients (0.14%) who developed PEP did not exhibit concerning 2 h amylase levels or require longer cannulation times. CONCLUSION These findings indicate that the combination of 2 h post-ERCP serum amylase levels and cannulation times represents a valuable marker for identifying patients at high risk for PEP.
World Journal of Gastroenterology | 2018
Takahiro Amano; Tokuhiro Matsubara; Tsutomu Nishida; Hiromi Shimakoshi; Akiyoshi Shimoda; Aya Sugimoto; Kei Takahashi; Kaori Mukai; Masashi Yamamoto; Shiro Hayashi; Sachiko Nakajima; Koji Fukui; Masami Inada
A 64-year-old woman was referred to our hospital with jaundice of the bulbar conjunctiva and general fatigue. After admission, she developed hepatic encephalopathy and was diagnosed with fulminant hepatitis based on the American Association for the Study of Liver Disease (AASLD) position paper. Afterwards, additional laboratory findings revealed that serum ceruloplasmin levels were reduced, urinary copper levels were greatly elevated and Wilson’s disease (WD)-specific routine tests were positive, but the Kayser-Fleischer ring was not clear. Based on the AASLD practice guidelines for the diagnosis and treatment of WD, the patient was ultimately diagnosed with fulminant WD. Then, administration of penicillamine and zinc acetate was initiated; however, the patient unfortunately died from acute pneumonia on the 28th day of hospitalization. At autopsy, the liver did not show a bridging pattern of fibrosis suggestive of chronic liver injury. Here, we present the case of a patient with clinically diagnosed late-onset fulminant WD without cirrhosis, who had positive disease-specific routine tests.
Endoscopy International Open | 2018
Takahiro Amano; Tsutomu Nishida; Hiromi Shimakoshi; Akiyoshi Shimoda; Naoto Osugi; Aya Sugimoto; Kei Takahashi; Kaori Mukai; Dai Nakamatsu; Tokuhiro Matsubara; Masashi Yamamoto; Shiro Hayashi; Sachiko Nakajima; Koji Fukui; Masami Inada
Background and study aims Adenoma detection rate (ADR) is a well-known quality indicator (QI) for colonoscopy. It is, however, difficult to evaluate ADR during practice. The aim of this study was to investigate the number of endoscopically detected polyps as a QI for colonoscopy. Patients and methods This was a retrospective single-center cohort study of 5,190 consecutive patients who underwent colonoscopy from January 2015 to May 2016. Among these patients, we ultimately enrolled 1,937 patients for initial colonoscopy. We evaluated QIs including bowel preparation, cecum intubation time, withdrawal time, number of endoscopically detected polyps, ADR and advanced neoplasia detection rate (ANDR) Results The mean number of endoscopically detected polyps, ADR and ANDR were 1.5 ± 2.3 (95 % confidence interval (CI)1.4 – 1.6), 38.6 % (95 % CI 36.5-40.8), and 18.3 % (95 % CI 16.6 – 20.1), respectively. ADR and ANDR increased with the number of endoscopically detected polyps, but the correlation reached a plateau at five or more polyps. We divided the patients into three groups based on the number of polyps (1 to 2, 3 to 4, and 5 or more). Logistic regression analysis adjusted by age and sex revealed that presence of a large number of polyps was a strong predictor of advanced neoplasia (odds ratio: 3.1 [95 % CI 2.2 – 4.3] for 3 to 4 polyps and 7.9 [95 % CI 5.4 – 11.8] for 5 or more polyps when using the presence of 1 or 2 polyps as a reference). Conclusion The number of endoscopically detected polyps can predict risk of advanced neoplasia and may thus be a new QI for colonoscopy.
Digestion | 2018
Makiko Urabe; Tsutomu Nishida; Hiromi Shimakoshi; Akiyoshi Shimoda; Takahiro Amano; Aya Sugimoto; Kei Takahashi; Kaori Mukai; Tokuhiro Matsubara; Masashi Yamamoto; Shiro Hayashi; Sachiko Nakajima; Koji Fukui; Tsukasa Tanida; Takamichi Komori; Shunji Morita; Masami Inada
Background/Aims: It is unclear why colonic diverticular bleeding and diverticulitis rarely coexist. This study compared the characteristics of these conditions. Methods: This single-center retrospective study examined 310 consecutive patients hospitalized with an episode of diverticular disease (cases) and outpatients without a diverticular episode (controls) from January 2012 to December 2015. We investigated distinct clinical factors in hospitalized patients with diverticular bleeding and diverticulitis. Results: We identified 183 patients with 263 episodes of diverticular bleeding and 127 patients with 135 episodes of diverticulitis during the study period. Patients with diverticular bleeding were significantly older than those with diverticulitis (median age 76 vs. 56 years) and had more cardiovascular disease, hypertension, diabetes, cerebrovascular disease, chronic kidney disease, lipid disorder, or a poorer performance status. Significantly more diverticular bleeding patients were taking antiplatelet drugs, anticoagulant drugs, proton pump inhibitors, or laxative agents. Multivariate analysis revealed that an age > 65 years (OR 5.42), and antiplatelet agent use (OR 7.29) were more significant risk factors for diverticular bleeding than for diverticulitis. Conclusions: Elderly people using antiplatelet drugs may be more susceptible to diverticular bleeding than diverticulitis.
Case Reports in Gastroenterology | 2018
Takahiro Amano; Shiro Hayashi; Tsutomu Nishida; Tokuhiro Matsubara; Kei Takahashi; Dai Nakamatsu; Yoshito Tomimaru; Masashi Yamamoto; Sachiko Nakajima; Koji Fukui; Hiromi Tamura; Shiro Adachi; Keizo Dono; Masami Inada
A 37-year-old man had an asymptomatic 17-mm mass in the liver by health check with ultrasonography. Five years later, he was referred to our hospital because the mass was slightly enlarged with a peripancreatic lymph node. We performed endoscopic ultrasonography fine-needle aspiration (EUS-FNA) to evaluate a lymph node, but it showed amorphous eosinophilic material and eosinophilic infiltrate in necrotic tissue of toothpaste-like white specimen. However, we diagnosed as potentially malignant liver mass with lymph node metastasis because of 2-deoxy-2-(fluorine-18) fluorodeoxyglucose uptake. We then performed hepatectomy and enucleation of the pancreas. DNA polymerase chain reaction analysis revealed Echinococcus multilocularis infection. Retrospectively, we could find a part of Echinococcus in the specimens of EUS-FNA.
World Journal of Gastroenterology | 2017
Hiromi Tamura; Hirotsugu Saiki; Takahiro Amano; Masashi Yamamoto; Shiro Hayashi; Hiroka Ando; Reiko Doi; Tsutomu Nishida; Katsumi Yamamoto; Shiro Adachi
A case of esophageal carcinoma exclusively composed of adenocarcinoma simulating an esophageal gland duct in a 61-year-old man is presented. The tumor arose as a slightly elevated lesion in the middle intrathoracic esophagus. It was almost completely overlaid with non-neoplastic stratified squamous epithelial cells. Beneath the overlying surface epithelium, an adenocarcinoma that was bilayered in structure diffusely invaded both the mucosal and submucosal layers. Although the tumor consisted exclusively of adenocarcinomatous cells, a keratinizing squamous cell carcinoma component was focally observed. The invasive carcinoma was focally continuous with the small area of the surface squamous epithelial layer, which was confirmed to be neoplastic by immunohistochemistry. Morphological and immunohistochemical examinations suggested that the adenocarcinomatous component arose from the esophageal surface epithelium and clearly differentiated into an esophageal gland duct. It is important to consider the possibility of this type of adenocarcinoma when diagnosing a ductal or glandular lesion of the esophagus in small biopsy specimens.
Digestive Endoscopy | 2016
Takahiro Amano; Tsutomu Nishida; Masami Inada
Acanthosis nigricans (AN) is a skin condition characterized by areas of dark, velvety discoloration. It is usually found in the axillary, inguinal and nuchal areas. The cause of AN is unclear, but it has been associated with various conditions, although most of these are benign. Papillomatosis is common on cutaneous and mucosal surfaces in a patients with AN, and it can involve the esophagus. In general, esophageal papilloma is a rare finding during endoscopy, and diffuse esophageal papillomatosis is quite rare.We have identified diffuse esophageal papillomatosis using endoscopy in a patient with AN. A 45-year-old man began displaying velvety discoloration. He was then diagnosed with AN and had been seeing a dermatologist for 15 years with no symptoms, including acid reflux, other than symptoms that involved the skin. He was referred to us because his dermatologist suspected a neoplastic disease when he was 60 years old as a result of a slight elevation in his tumor markers. Positron emission tomography with 2-deoxy2-[fluorine-18] fluoro-D-glucose integrated with computed tomography (CT) imaging showed diffuse uptake in the esophagus. Esophagogastroduodenoscopy (EGD) (Fig. 1A)
Gastrointestinal Endoscopy | 2015
Shiro Hayashi; Tsutomu Nishida; Takahiro Amano; Aisa Sakamoto; Yuriko Otake; Wataru Takagi; Hirotsugu Saiki; Hisashi Kondo; Makiko Urabe; Kei Takahashi; Tokuhiro Matsubara; Masashi Yamamoto; Sachiko Nakajima; Koji Fukui; Masami Inada
Frequency of post ERCP pancreatitis in both groups www.giejournal. Number of patient (%) org P-value Normal hydration Aggressive hydration No PEP* 28 (93.3%) 27 (90%) 0.081 Mild PEP* 2 (6.7%) 0 (0%) Moderate PEP* 0 (0%) 3 (10%) Severe PEP* 0 (0%) 0 (0%) All case PEP* 2 (6.7%) 3 (10%) 1.000 *PEP Post ERCP Pancreatitis