Papers - NAKAMURA, Masanao

腸リンパ管拡張症の診断と治療

中村 正直, 山村 健史, 前田 啓子, 澤田 つな騎, 水谷 泰之, 藤城 光弘

日本小腸学会学術集会プログラム・抄録集   Vol. 3 ( 0 ) page： 34_2 - 34_2   2019

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Language：Japanese   Publisher：日本小腸学会  

<p>【背景・目的】　小腸内視鏡診断の進歩により腸リンパ管拡張症（Intestinal lymphangiectasia：IL）を含む蛋白漏出性腸症の小腸精査が可能になった。本研究の目的はILの臨床経過を後ろ向きに評価し、その特徴を明らかにしたうえでより良い治療法を模索することであった。</p><p>【対象と方法】　対象は2003年6月から2019年6月までにILと診断された17例（男性9例、女性8例、発症年齢は中央値37歳、0-75歳）であった。ILの診断は蛋白漏出性腸症と診断され且つ内視鏡下生検もしくは剖検にて病理学的に腸リンパ管拡張を認めたもので、他疾患が否定的であったものとした。白色絨毛、散布性白点を有する白色絨毛群（WV）と、異常なしもしくは軽度絨毛腫大、ケルクリング襞腫大を認める非白色絨毛群（NWV）に分けて臨床成績を比較検討した。</p><p>【結果】　WV、NWVは10例、7例であった。平均血清アルブミン値（g/dl）はWV：NWV = 2.0：1.2でNWVにおいて有意に低かった（P = 0.0061）。平均<i>α</i>1アンチトリプシンクリアランスはWV：NWV = 132：284（P = 0.0509）であった。ステロイド治療への反応はWV：NWV = 2/7：6/6 例でみられた。平均観察期間48箇月において1例のILが影響した死亡例を経験したが、重篤な真菌感染症によるものであった。</p><p>【結論】　NWV群は蛋白漏出は多いがステロイドへの反応がWV群よりも良好であった。治療のゴールドスタンダードは存在せず可能な可能で効果があるものを続けることが現状であった。</p>

DOI： 10.32264/shocho.3.0_34_2

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MULTICENTER FEASIBILITY STUDY OF BOWEL PREPARATION WITH CASTOR OIL FOR COLON CAPSULE ENDOSCOPY

OHMIYA Naoki, HOTTA Naoki, MITSUFUJI Shoji, NAKAMURA Masanao, OMORI Takafumi, MAEDA Kohei, OKUDA Kotaro, YATSUYA Hiroshi, TAJIRI Hisao

GASTROENTEROLOGICAL ENDOSCOPY   Vol. 61 ( 12 ) page： 2646 - 2655   2019

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Language：Japanese   Publisher：Japan Gastroenterological Endoscopy Society  

<p>Background and Aim: Extensive use of laxatives and incomplete excretion rates are problematic for colon capsule endoscopy (CCE). The aim of the present study was to determine the effectiveness of castor oil as a booster.</p><p>Methods: At four Japanese hospitals, 319 examinees undergoing CCE were enrolled retrospectively. Before and after the introduction of castor oil, other preparation reagents were unchanged.</p><p>Results: Of 319 examinees who underwent CCE, 152 and 167 examinees took regimens with castor oil (between November 2013 and June 2016) and without castor oil (between October 2015 and September 2017), respectively. Capsule excretion rates within its battery life in the groups with and without castor oil were 97% and 81%, respectively (<i>P</i>＜0.0001). Multivariate analysis showed that ages younger than 65 years (adjusted odds ratio [OR], 3.00; <i>P</i>=0.0048), male gender (adjusted OR, 3.20; <i>P</i>=0.0051), and use of castor oil (adjusted OR, 6.29; <i>P</i>=0.0003) were predictors of capsule excretion within its battery life. Small bowel transit time was shorter and total volume of lavage and fluid intake was lower with castor oil than without (<i>P</i> = 0.0154 and 0.0013, respectively). Overall adequate cleansing level ratios with and without castor oil were 74% and 83%, respectively (<i>P</i> = 0.0713). Per-examinee sensitivity for polyps ≥6 mm with and without castor oil was 83% and 85%, respectively, with specificities of 80% and 78%, respectively.</p><p>Conclusion: Bowel preparation with castor oil was effective for improving capsule excretion rate and reducing liquid loading.</p>

DOI： 10.11280/gee.61.2646

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A CASE OF MULTIPLE HEMANGIOMAS OF THE SMALL INTESTINE TREATED BY SCLEROTHERAPY USING DOUBLE-BALLOON ENTEROSCOPY

YAMADA Keisaku, YAMAMURA Takeshi, NAKAMURA Masanao, SAWADA Tsunaki, MIZUTANI Yasuyuki, MAEDA Keiko, FURUKAWA Kazuhiro, MIYAHARA Ryoji, YOKOI Takio, HIROOKA Yoshiki

GASTROENTEROLOGICAL ENDOSCOPY   Vol. 61 ( 6 ) page： 1231 - 1236   2019

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Language：Japanese   Publisher：Japan Gastroenterological Endoscopy Society  

<p>A 70-year-old male was referred to our department due to melena which began one month previously. Esophagogastroduodenoscopy and colonoscopy were performed, but no signs of active bleeding were found. Therefore, capsule endoscopy was performed to check for small intestinal lesions. Capsule endoscopy revealed multiple protruded lesions and bloody intestinal fluid in a lesion in the upper ileum. Double-balloon enteroscopy revealed multiple protruded lesions suspicious of being hemangioma. Endoscopic mucosal resection of a lesion was performed, and it was finally diagnosed as capillary hemangioma. Sclerotherapy was performed by injecting polidocanol in the multiple hemangiomas. After this treatment, there was no melena and the follow-up endoscopy showed decreased size of the lesions. Thus, sclerotherapy was found to be useful in the treatment of multiple hemangiomas in the small intestine.</p>

DOI： 10.11280/gee.61.1231

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Vascular responses to abrupt blood flow change after bypass surgery for complex intracranial aneurysms

Hiroharu Kataoka, Yasuhide Makino, Kiyofumi Takanishi, Yohei Kimura, Kenji Takamura, Takanobu Yagi, Satoshi Iguchi, Akihide Yamamoto, Hidehiro Iida, Soshiro Ogata, Kunihiro Nishimura, Masanori Nakamura, Mitsuo Umezu, Koji Iihara, Jun C Takahashi

Acta Neurochirurgica   Vol. 160 ( 10 ) page： 1945 - 1953   2018.10

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer-Verlag Wien  

Background: Bypass surgery for complex intracranial aneurysms (IAs) results in drastic blood flow changes in intracranial arteries. The aim of the study was to elucidate how vessels adapt to blood flow changes after bypass surgery with phase-contrast magnetic resonance imaging (PC-MRI). Methods: This is a prospective observational study to assess changes of the blood flow in intracranial arteries after bypass surgery for IAs. Flow rates and vessel diameters were measured with PC-MRI in 52 intracranial arteries of 7 healthy volunteers and 31 arteries of 8 IA patients who underwent bypass surgery. Wall shear stress (WSS) was calculated with the Hagen-Poiseuille formula. In 18 arteries of 5 patients, the same measurement was performed 1, 3, and 12 months after surgery. Results: PC-MRI showed a strong positive correlation between the flow rate and the third power of vessel diameter in both healthy volunteers (r = 0.82, P < 0.0001) and IA patients (r = 0.90, P < 0.0001), indicating the constant WSS. Of the 18 arteries in 5 patients, WSS increased in 7 arteries and decreased in 11 arteries immediately after surgery. In the WSS-increased group, WSS returned to the preoperative value in the third postoperative month. In the WSS-decreased group, WSS increased in the 12th month, but did not return to the preoperative level. Conclusions: In a physiological state, WSS was constant in intracranial arteries. Changed WSS after bypass surgery tended to return to the preoperative value, suggesting that vessel diameter and flow rate might be controlled so that WSS remains constant.

DOI： 10.1007/s00701-018-3653-2

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MULTICENTER RETROSPECTIVE ANALYSIS OF BOWEL PREPARATION INCLUDING CASTOR-OIL FOR COLON CAPSULE ENDOSCOPY

Nakamura Masanao, Ohmiya Naoki, Hotta Naoki, Mitsufuji Shoji, Omori Takafumi, Okuda Kotaro, Goto Hidemi, Tajiri Hisao

GASTROINTESTINAL ENDOSCOPY   Vol. 87 ( 6 ) page： AB527 - AB527   2018.6

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MULTICENTER PROSPECTIVE CASE-CROSSOVER STUDY ON THE ASSOCIATION BETWEEN OVERT SMALL-BOWEL BLEEDING AND DRUGS USING CAPSULE ENDOSCOPY DATABASE IN JAPAN

Ohmiya Naoki, Fujimori Shunji, Nakamura Masanao, Yamada Atsuo, Oka Shiro, Esaki Motohiro, Nakajima Atsushi, Matsumoto Takayuki, Tanaka Shinji, Kubota Kiyoshi, Sakamoto Choitsu

GASTROINTESTINAL ENDOSCOPY   Vol. 87 ( 6 ) page： AB64 - AB65   2018.6

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MULTICENTER RETROSPECTIVE ANALYSIS OF BOWEL PREPARATION INCLUDING CASTOR-OIL FOR COLON CAPSULE ENDOSCOPY

Nakamura Masanao, Ohmiya Naoki, Hotta Naoki, Mitsufuji Shoji, Omori Takafumi, Okuda Kotaro, Goto Hidemi, Tajiri Hisao

GASTROINTESTINAL ENDOSCOPY   Vol. 87 ( 6 ) page： AB527 - AB527   2018.6

MULTICENTER PROSPECTIVE CASE-CROSSOVER STUDY ON THE ASSOCIATION BETWEEN OVERT SMALL-BOWEL BLEEDING AND DRUGS USING CAPSULE ENDOSCOPY DATABASE IN JAPAN

Ohmiya Naoki, Fujimori Shunji, Nakamura Masanao, Yamada Atsuo, Oka Shiro, Esaki Motohiro, Nakajima Atsushi, Matsumoto Takayuki, Tanaka Shinji, Kubota Kiyoshi, Sakamoto Choitsu

GASTROINTESTINAL ENDOSCOPY   Vol. 87 ( 6 ) page： AB64 - AB65   2018.6

MULTICENTER PROSPECTIVE CASE-CROSSOVER STUDY ON THE ASSOCIATION BETWEEN OVERT SMALL-BOWEL BLEEDING AND DRUGS USING CAPSULE ENDOSCOPY DATABASE IN JAPAN

Ohmiya Naoki, Fujimori Shunji, Nakamura Masanao, Yamada Atsuo, Oka Shiro, Esaki Motohiro, Nakajima Atsushi, Matsumoto Takayuki, Tanaka Shinji, Kubota Kiyoshi, Sakamoto Choitsu

GASTROINTESTINAL ENDOSCOPY   Vol. 87 ( 6 ) page： AB64 - AB65   2018.6

MULTICENTER RETROSPECTIVE ANALYSIS OF BOWEL PREPARATION INCLUDING CASTOR-OIL FOR COLON CAPSULE ENDOSCOPY

Nakamura Masanao, Ohmiya Naoki, Hotta Naoki, Mitsufuji Shoji, Omori Takafumi, Okuda Kotaro, Goto Hidemi, Tajiri Hisao

GASTROINTESTINAL ENDOSCOPY   Vol. 87 ( 6 ) page： AB527 - AB527   2018.6

特集 緊急内視鏡の適応と実際 5 .小腸出血

中村 正直, 大宮 直木, 廣岡 芳樹, 後藤 秀実

臨床消化器内科   Vol. 33 ( 5 ) page： 505 - 511   2018.4

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Language：Japanese   Publisher：日本メディカルセンター  

＜文献概要＞小腸出血の診断はカプセル内視鏡(capsuleendoscopy;CE)とバルーン内視鏡(balloon-assisted endoscopy;BAE)を中心に行う.2015年12月に小腸内視鏡診療ガイドラインが提唱された.小腸出血が疑われた場合,まず問診により,年齢,基礎疾患,薬剤内服歴,既往歴などをチェックする.上下腹部造影CT検査を施行し,腸管内への造影剤の漏出がないか,出血源となる炎症疾患,腫瘍や憩室がないか,またCE滞留の原因になるような閉塞機転がないかを確認する.CTで異常があればダイレクトでBAEを,CTで異常がなければ小病変を考慮しCEを行う.小腸出血における緊急内視鏡では,持続出血と画像による出血の所見がその適応となる.持続出血は今もまさに出血中,もしくは最後の出血から48時間以内の場合である.緊急内視鏡によって診断される出血源は血管性病変が半数以上であり,緊急内視鏡時には血管性病変を念頭に検査に臨む.

DOI： 10.19020/cg.0000000317

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ASSOCIATIONS BETWEEN DRUGS AND SMALL-BOWEL MUCOSAL BLEEDING: MULTICENTER CAPSULE-ENDOSCOPY STUDY

NIIKURA Ryota, YAMADA Atsuo, MAKI Koutarou, NAKAMURA Masanao, WATABE Hirotsugu, FUJISHIRO Mitsuhiro, OKA Shiro, ESAKI Motohiro, FUJIMORI Shunji, NAKAJIMA Atsushi, OHMIYA Naoki, MATSUMOTO Takayuki, TANAKA Shinji, KOIKE Kazuhiko, SAKAMOTO Choitsu

GASTROENTEROLOGICAL ENDOSCOPY   Vol. 60 ( 11 ) page： 2428 - 2439   2018

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Language：Japanese   Publisher：Japan Gastroenterological Endoscopy Society  

<p>Background and Aim: Although several drugs may induce small-bowel mucosal injuries, it is unclear whether these injuries contribute to overt small-bowel bleeding. This study was designed to evaluate the associations between drug use and small-bowel mucosal injury and between these mucosal injuries and overt bleeding in a disease-relevant population.</p><p>Methods: We retrospectively studied patients with suspected small-bowel diseases who underwent capsule endoscopy between 2010 and 2013. Drug exposure, Charlson Comorbidity Index, smoking, and alcohol consumption were assessed before capsule endoscopy. Adjusted odds ratios (AOR) and confidence intervals (CI) were estimated for small-bowel mucosal injury and small-bowel overt bleeding. </p><p>Results: In total, 850 patients were analyzed during the study period. Median age was 64 years, and 544 patients (64.0%) were men. Among the patients with small-bowel mucosal injury (<i>n</i> = 60) and without mucosal injury (<i>n</i> = 705), use of nonsteroidal anti-inflammatory drugs (NSAIDs) (AOR 1.8, 95% CI 1.01-3.31) was significantly associated with an increased risk of small-bowel mucosal injury compared with non-use. Patients with small-bowel mucosal injury with overt bleeding (<i>n</i> = 85) and without overt bleeding (<i>n</i> = 60) were compared, and no significant difference between the groups in the usage rates for NSAIDs, thienopyridine, other antiplatelets, anticoagulants, acetaminophen, tramadol hydrochloride, or steroids was revealed, even after adjusting for confounders.</p><p>Conclusion: Although the use of NSAIDs was significantly associated with an increased risk of small-bowel mucosal injury, no significant associations were observed between the use of such drugs and small-bowel overt bleeding.</p>

DOI： 10.11280/gee.60.2428

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特集 小腸の炎症性病変を見直す Ⅱ.各論　　( 6 )小腸リンパ管拡張症の臨床像と治療

中村 正直, 大宮 直木, 廣岡 芳樹, 後藤 秀実

INTESTINE   Vol. 21 ( 6 ) page： 531 - 535   2017.11

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Publisher：日本メディカルセンター  

DOI： 10.19020/int.0000000117

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Multicenter retrospective analysis of bowel preparation including castor oil for colon capsule endoscopy

Ohmiya Naoki, Hotta Naoki, Mitsufuji Shoji, Nakamura Masanao, Ohmori Takafumi, Okuda Kotaro, Goto Hidemi, Tajiri Hisao

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   Vol. 32   page： 222 - 222   2017.9

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Multicenter retrospective analysis of bowel preparation including castor oil for colon capsule endoscopy

Ohmiya Naoki, Hotta Naoki, Mitsufuji Shoji, Nakamura Masanao, Ohmori Takafumi, Okuda Kotaro, Goto Hidemi, Tajiri Hisao

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   Vol. 32   page： 222 - 222   2017.9

Multicenter retrospective analysis of bowel preparation including castor oil for colon capsule endoscopy

Ohmiya Naoki, Hotta Naoki, Mitsufuji Shoji, Nakamura Masanao, Ohmori Takafumi, Okuda Kotaro, Goto Hidemi, Tajiri Hisao

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY   Vol. 32   page： 222 - 222   2017.9

The Study of Diagnostic Ability for the Colorectal Neoplasms by Imaged Enhanced Endoscopy Using by JNET (Japan NBI Expert Team) Classification

Yamamura Takeshi, Watanabe Osamu, Nakamura Masanao, Matsushita Masanobu, Oshima Hiroshi, Sato Junichi, Matsuura Rinzaburo, Saito Masashi, Mizutani Yasuyuki, Sawada Tsunaki, Niwa Yoshiki, Ishikawa Eri, Uchida Genta, Otsuka Hiroyuki, Suzuki Hiroto, Nishikawa Takahiro, Ishida Tetsuya, Ishikawa Takuya, Furukawa Kazuhiro, Funasaka Kohei, Ohno Eizaburo, Kawashima Hiroki, Miyahara Ryoji, Hirooka Yoshiki, Goto Hidemi

GASTROINTESTINAL ENDOSCOPY   Vol. 85 ( 5 ) page： AB402 - AB402   2017.5

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.gie.2017.03.932

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Establishment of a New Scoring System for Predicting the Necessity of Double-Balloon Endoscopy in Obscure Gastrointestinal Bleeding

Uchida Genta, Watanabe Osamu, Nakamura Masanao, Yamamura Takeshi, Matsushita Masanobu, Oshima Hiroshi, Sato Junichi, Saito Masashi, Matsuura Rinzaburo, Mizutani Yasuyuki, Sawada Tsunaki, Niwa Yoshiki, Ishikawa Eri, Otsuka Hiroyuki, Suzuki Hiroto, Nishikawa Takahiro, Ishida Tetsuya, Ishikawa Takuya, Furukawa Kazuhiro, Funasaka Kohei, Ohno Eizaburo, Kawashima Hiroki, Miyahara Ryoji, Goto Hidemi, Hirooka Yoshiki

GASTROINTESTINAL ENDOSCOPY   Vol. 85 ( 5 ) page： AB300 - AB300   2017.5

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.gie.2017.03.687

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The Outcome of Treatment in Hypopharyngeal and Cervical Esophageal Carcinoma

Fujiyoshi Toshihisa, Miyahara Ryoji, Funasaka Kohei, Furukawa Kazuhiro, Matsushita Masanobu, Yamamura Takeshi, Ishikawa Takuya, Ohno Eizaburo, Nakamura Masanao, Kawashima Hiroki, Watanabe Osamu, Hirooka Yoshiki, Goto Hidemi

GASTROINTESTINAL ENDOSCOPY   Vol. 85 ( 5 ) page： AB597 - AB598   2017.5

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DOI： 10.1016/j.gie.2017.03.1377

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One Year Follow-Up After Cold Polypectomy Compared With Hot Polypectomy for Small Colorectal Polyps - a Prospective Randomized Controlled Trial

Saito Masashi, Yamamura Takeshi, Watanabe Osamu, Nakamura Masanao, Matsushita Masanobu, Oshima Hiroshi, Sato Junichi, Matsuura Rinzaburo, Mizutani Yasuyuki, Sawada Tsunaki, Niwa Yoshiki, Ishikawa Eri, Uchida Genta, Otsuka Hiroyuki, Suzuki Hiroto, Nishikawa Takahiro, Ishida Tetsuya, Ishikawa Takuya, Furukawa Kazuhiro, Funasaka Kohei, Ohno Eizaburo, Kawashima Hiroki, Miyahara Ryoji, Goto Hidemi, Hirooka Yoshiki

GASTROINTESTINAL ENDOSCOPY   Vol. 85 ( 5 ) page： AB365 - AB366   2017.5

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DOI： 10.1016/j.gie.2017.03.845

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