研究者詳細 - 中村　正直

論文 - 中村　正直

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Comparison of the diagnostic ability of blue laser imaging magnification versus pit pattern analysis for colorectal polyps.

Nakano A, Hirooka Y, Yamamura T, Watanabe O, Nakamura M, Funasaka K, Ohno E, Kawashima H, Miyahara R, Goto H

Endoscopy international open 5 巻 ( 4 ) 頁： E224 - E231 2017年4月

当院におけるInsideStentの現状

田中浩敬, 廣岡芳樹, 川嶋啓揮, 大野栄三郎, 石川卓哉, 河合学, 須原寛樹, 竹山友章, 橋詰清孝, 小屋敏也, 酒井大輔, 松下正伸, 山村健史, 古川和宏, 舩坂好平, 中村正直, 宮原良二, 渡辺修, 後藤秀実

Gastroenterological Endoscopy 59 巻 ( Suppl.1 ) 頁： 926 - 926 2017年4月

【消化管結核の診断と治療-最近の進歩】抗結核薬による診断的治療が奏効した小腸多発潰瘍の1例

齋藤雅之, 中村正直, 渡辺修, 山村健史, 松下正伸, 中野有泰, 大島啓嗣, 佐藤淳一, 松浦倫三郎, 舩坂好平, 大野栄三郎, 川嶋啓揮, 宮原良二, 廣岡芳樹, 後藤秀実

胃と腸 52 巻 ( 2 ) 頁： 233 - 238 2017年2月

記述言語：日本語出版者・発行元：(株)医学書院

患者は60歳代,女性.下痢,食欲不振にて受診.腹部CT検査で腸間膜リンパ節腫大,腸管壁肥厚を認め,大腸内視鏡検査で回腸末端のびらんを認めた.小腸カプセル内視鏡検査およびバルーン内視鏡検査で中部空腸〜回腸末端までほぼ全域で多発する網目状潰瘍を認めた.生検では陰窩膿瘍を認めていた.Crohn病としてステロイド薬が投与されたが,病状悪化,血中サイトメガロウイルス(CMV)アンチゲネミアが陽転化し,CMV腸炎の診断で,ガンシクロビルが投与されたが,潰瘍治癒は得られなかった.結核菌,乾酪性肉芽腫は未検出,抗結核特異INF-γ陰性であったが,腸結核の可能性を考慮し,抗結核薬による診断的治療を行った.4ヵ月後に行った小腸内視鏡にて小腸潰瘍の消失を確認した.(著者抄録)

自己免疫性膵炎における造影超音波内視鏡(CE-EUS)を用いた血行動態の検討

橋詰清孝, 廣岡芳樹, 川嶋啓揮, 大野栄三郎, 石川卓哉, 河合学, 本多隆, 中村正直, 山本健太, 後藤秀実

超音波医学 44 巻 ( 1 ) 頁： 64 - 64 2017年1月

Specific characteristics of hemorrhagic Meckel's diverticulum at double-balloon endoscopy.

Mizutani Y, Nakamura M, Watanabe O, Yamamura T, Funasaka K, Ohno E, Kawashima H, Miyahara R, Murino A, Goto H Professor, Hirooka Y

Endoscopy international open 5 巻 ( 1 ) 頁： E35 - E40 2017年1月

Prospective study of factors important to achieve observation of the entire colon on colon capsule endoscopy 査読有り

Sato Junichi, Nakamura Masanao, Watanabe Osamu, Yamamura Takeshi, Funasaka Kohei, Ohno Eizaburo, Miyahara Ryoji, Kawashima Hiroki, Goto Hidemi, Hirooka Yoshiki

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY 10 巻 ( 1 ) 頁： 20 - 31 2017年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Therapeutic Advances in Gastroenterology

Background: Colon capsule endoscopy (CCE) is a procedure in which capsule swallowing facilitates observation of the lumen of the entire digestive tract. It does not require an air supply, and is a noninvasive procedure with a markedly low risk of adverse events in comparison with conventional colonoscopy (CS). It reduces patient stress, and may be acceptable to patients. A limitation of this procedure is that the entire colon observation rate (CCE excretion rate, completed CCE rate) is not 100%. In this study, we prospectively investigated clinical factors important to achieve observation of the entire colon on CCE. Methods: The participants were 70 patients for whom CCE was scheduled, and from whom written informed consent regarding participation in this study was obtained. We selected patient background/examination factors, and analyzed all factors involved in observation of the entire colon and factors for completion of the CCE within 4 h after the start of examination using multivariate analysis. Results: Of the 70 enrolled patients, 64 were analyzed, excluding 6. On multiple logistic analysis, only a water intake of ≥12.0 ml/min during examination [p = 0.025, odds ratio (OR): 46.753, 95% confidence interval (CI): 1.630-1341.248] was identified as an independent predictive factor involved in observation of the entire colon. With respect to factors involved in the completion of CCE within 4 h, multiple logistic analysis showed that a body mass index (BMI) of ≥25 (p = 0.039, OR: 13.723, 95% CI: 1.135-165.913), the absence of constipation (p = 0.030, OR: 13.988, 95% CI: 1.287-152.047), and a water intake of ≥12.0 ml/min during examination (p = 0.004, OR: 12.028, 95% CI: 2.225-65.029) were independent predictive factors. Conclusions: Completion of a CCE was most closely related to water intake per hour. In addition to water intake, CCE-promoting factors included a high BMI and the absence of constipation.

DOI： 10.1177/1756283X16673556

Web of Science

Scopus

PubMed

Endoscopic Characteristics, Risk Grade, and Prognostic Prediction in Gastrointestinal Stromal Tumors of the Small Bowel 査読有り

Nakano Arihiro, Nakamura Masanao, Watanabe Osamu, Yamamura Takeshi, Funasaka Kohei, Ohno Eizaburo, Kawashima Hiroki, Miyahara Ryoji, Goto Hidemi, Hirooka Yoshiki

DIGESTION 95 巻 ( 2 ) 頁： 122 - 131 2017年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Digestion

Background/Aims: Balloon-assisted endoscopy allows us to diagnose gastrointestinal (GI) stromal tumors (GISTs) in the small bowel including endoscopic ultrasonography and taking biopsy. The aim of this study was to retrospectively clarify clinical and endoscopic characteristics of small bowel GISTs using double-balloon endoscopy (DBE). Methods: We reviewed 25 patients who underwent DBE and were diagnosed with GISTs. The risk of GISTs was stratified using the National Institute of Health (NIH) consensus criteria. We evaluated the available DBE route, the diagnostic yield of biopsy examination, and the relationship between endoscopic characteristics and recurrence-free survival (RFS). Results: Of all 25 patients, 23 had any endoscopic findings related to GIST. They were detected using the antegrade approach in 91.3%. GISTs were classified into high risk (n = 7), intermediate risk (n = 4), low risk (n = 10), and very low risk (n = 4) based on surgical specimens. The diagnostic result of biopsy was 46.7% (7/15), but it was difficult to predict the NIH risk group. Endoscopic characteristics were not associated with RFS. The NIH risk group was significantly associated with RFS. Conclusions: Antegrade DBE was preferable for exploring small bowel GIST, but the diagnostic ability of biopsy examination was limited.

DOI： 10.1159/000454728

Web of Science

Scopus

PubMed

Dexmedetomidine provides less body motion and respiratory depression during sedation in double-balloon enteroscopy than midazolam.

Oshima H, Nakamura M, Watanabe O, Yamamura T, Funasaka K, Ohno E, Kawashima H, Miyahara R, Goto H, Hirooka Y

SAGE open medicine 5 巻頁： 2050312117729920 2017年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：SAGE Open Medicine

Objectives: Patients undergoing double-balloon enteroscopy require sedatives such as midazolam; however, patient’s body motion often hampers the outcome of double-balloon enteroscopy. Recently, dexmedetomidine has been used for endoscopic sedation and was reported to effectively reduce body motion. This study aimed to evaluate the efficacy and safety of sedation with dexmedetomidine in double-balloon enteroscopy (UMIN ID000015785). Methods: A prospective, observational study was conducted in 81 patients who underwent 111 double-balloon enteroscopy from July to December 2015 (dexmedetomidine group). The medical records of 112 patients who underwent 166 double-balloon enteroscopy with midazolam and pentazocine sedation from January 1 to October 31, 2014, were used for comparison (midazolam group). After propensity score matching, 182 double-balloon enteroscopy (91 double-balloon enteroscopy for each group) were analyzed. Results: There were 13 cases (11.7%) with body movements in the dexmedetomidine group. Comparison of the two groups matched by propensity score showed that the dexmedetomidine group had less body movement (12.1% vs 34.1%, p = 0.001) and less respiratory depression (50.5% vs 68.1%, p = 0.023). Hypotension (8.8% vs 4.4%, p = 0.232) and bradycardia (2.2% vs 0%, p = 0.497) were not significantly different in the two groups. Conclusion: Using dexmedetomidine for conscious sedation can reduce body motion and respiratory depression compared to our previous records.

DOI： 10.1177/2050312117729920

Web of Science

Scopus

PubMed

原因不明消化管出血精査後における再出血予測因子と適切な経過観察期間に関する検討

内田元太, 中村正直, 渡辺修, 山村健史, 松下正伸, 石川卓哉, 古川和宏, 舩坂好平, 大野栄三郎, 川嶋啓揮, 宮原良二, 後藤秀実, 廣岡芳樹

日本消化器病学会雑誌 114 巻 ( 10 ) 頁： 1819 - 1829 2017年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：一般財団法人日本消化器病学会

<p>原因不明消化管出血（OGIB）の長期予後に基づくマネジメント方法について検討した．対象は，2004年6月から2015年12月にOGIBに対して当院にて小腸カプセル内視鏡（CE）を施行した386例のうち，可視的出血をともなうovert OGIB症例318例で，その臨床的特徴と再出血予測因子について後方視的に検討し，再出血予測モデルを作成した．Overt OGIBの再出血予測因子は，CEにおける小腸血管性病変の存在，輸血歴，年齢60歳以上であり，それらの予測因子の保有数を参考にすることで，再出血率の推測が可能となり，個々の症例に対する適切なフォローアップ期間を提案できる可能性が示唆された．</p>

DOI： 10.11405/nisshoshi.114.1819

Scopus

PubMed

CiNii Research

Usefulness of flexible spectral imaging color enhancement (FICE) for the detection of angiodysplasia in the preview of capsule endoscopy. 査読有り

Nakamura M, Ohmiya N, Miyahara R, Ando T, Watanabe O, Kawashima H, Itoh A, Hirooka Y, Goto H.

Hepatogastroenterology 59 巻 ( 117 ) 頁： 1474-1477 2012年7月

Are symptomatic changes in irritable bowel syndrome correlated with the capsule endoscopy transit time? A pilot study using the 5-HT4 receptor agonist mosapride.

Nakamura M, Ohmiya N, Miyahara R, Ando T, Watanabe O, Kawashima H, Itoh A, Hirooka Y, Niwa Y, Goto H.

58 巻 ( 106 ) 頁： 453-458 2011年3月

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