Publications by authors named "Eikichi Ihara"
Background: Ulcerative colitis (UC) is a refractory inflammatory disease that affects the rectum and colon, with pivotal involvement of the rectal environment in relapse initiation. This study was conducted in two phases to examine the differences in gene expression between the rectum and colon and to identify relapse factors.
Methods: In ***Study 1, RNA sequencing was performed on biopsies from the colon and rectum of patients with active UC, those with remission UC, and controls.
Background: The Esophageal Hypervigilance and Anxiety Scale (EHAS) is an English questionnaire created in the USA to assess these factors in all patients with esophageal diseases. The aim of this study was to develop and validate the Japanese version of EHAS and investigate the relationship between EHAS scores and symptoms in untreated disorders of esophagogastric junction (EGJ) outflow.
Methods: This prospective study recruited patients who underwent high-resolution manometry (HRM) at six tertiary centers in Japan.
Article Synopsis
- The Japan Gastroenterological Association released clinical guidelines for chronic diarrhea in 2023, detailing its definition, classification, and diagnostic methods.
- The guidelines emphasize distinguishing between types of chronic diarrhea and recommend lifestyle and dietary changes as the first line of treatment, followed by probiotics and anti-diarrheals.
- They also note that many other treatments lack sufficient evidence, indicating a need for future research to improve chronic diarrhea management globally.
EP prostanoid receptor (EPR) contributes to the intestinal epithelial Cl secretion, and inhibition of prostaglandin E (PGE) production by non-steroidal anti-inflammatory drugs (NSAIDs) plays a central role in NSAID-induced enteropathy. Although M muscarinic acetylcholine receptor (MR) also contributes to the intestinal epithelial Cl secretion, it remains unclear whether MR is involved in NSAID-induced enteropathy due to a lack of selective agents. The present study explored how MR is involved in the regulation of the intestinal epithelial Cl secretion and its pathophysiological role in NSAID-induced enteropathy.
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- - The Japan Gastroenterological Association released the first version of clinical guidelines for chronic constipation in 2023, detailing its definition, classification, diagnostic criteria, and treatment options based on the latest evidence.
- - Treatment begins by identifying whether constipation is secondary due to other diseases or medications, then assessing for motility disorders; initial management includes lifestyle changes and osmotic laxatives.
- - The guidelines emphasize a structured approach to diagnosis and treatment, including flowcharts, and suggest that stimulant laxatives should be used sparingly while alternative therapies have less evidence.
Article Synopsis
- A nationwide study in Japan investigated the cancer risk associated with different lengths of Barrett's esophagus (BE) among 33,478 subjects who underwent endoscopy between 2013 and 2017, with follow-ups until 2022.
- The findings showed that the incidence of esophageal adenocarcinoma increased with the length of BE, with higher risks for those with BE lengths of 1-3 cm and ≥3 cm.
- The study highlights the importance of considering the length of BE in managing patients, as longer BE is correlated with a greater cancer risk.
Article Synopsis
- Achalasia is an esophageal disorder with unclear causes, and the study investigates how changes in smooth muscle contractions and inflammation contribute to its development, along with the role of esophageal microbiota.
- Analysis of esophageal samples from patients showed that those with achalasia had significantly lower levels of myosin light chain phosphorylation compared to healthy controls, along with increased levels of certain inflammatory cytokines.
- The findings suggest that both the hypophosphorylation of myosin light chains and changes in the esophageal microbiota may play a role in the impaired contractility and worsening of achalasia symptoms.
Background: In gastric solid-type poorly differentiated adenocarcinoma (PDA), the role of microsatellite instability and immune escape mechanism remains unclear. The current study aimed to elucidate the clinical significance of mismatch repair (MMR) status, genome profile, C-X-C motif chemokine receptor 2 (CXCR2) expression, and myeloid-derived suppressor cell (MDSC) infiltration in solid-type PDA.
Methods: In total, 102 primary solid-type PDA cases were retrieved, and classified into 46 deficient-MMR (dMMR) and 56 proficient-MMR (pMMR) cases based on immunohistochemistry (IHC) and polymerase chain reaction-based molecular testing results.
Background: Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric neoplasms (EGN). Controlling intraoperative bleeding is crucial for ensuring safe and reliable procedures. ESD using the spray coagulation mode (SCM-ESD) has been developed to control bleeding more effectively than ESD using the conventional forced coagulation mode (FCM-ESD).
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- This study focuses on reflux hypersensitivity (RH), a severe form of gastroesophageal reflux disease, specifically looking at how an advanced endoscopy system can help assess duodenogastroesophageal reflux (DGER).
- Researchers tested a special imaging mode (Bil mode) for visibility of bilirubin and compared its effectiveness against traditional imaging techniques, finding it significantly superior for certain concentrations.
- Results indicated that higher bilirubin levels in the esophagus correlate well with nonacid reflux events, suggesting that the Bil mode could be an effective tool for diagnosing RH in patients.
Background And Aim: Colonic self-expandable metallic stent (SEMS) placement enables preoperative total colonoscopy (TCS) in patients with obstructive colorectal cancer. Following SEMS placement, it is possible to assess the presence or absence of synchronous proximal colon cancers and perform preoperative endoscopic resection (ER) for neoplastic lesions proximal to the primary lesion. The objective of this study was to determine the usefulness and safety of preoperative TCS and ER after SEMS placement in patients with obstructive colorectal cancer.
View Article and Find Full Text PDFBackground: We have determined that the impaired accommodation of the lower esophageal sphincter (LES) underlies the pathogenesis of esophagogastric junction outflow obstruction (EGJOO). We have also found that acotiamide may treat EGJOO by improving impaired LES accommodation. The effects of acotiamide in patients with EGJOO need to be further confirmed in a prospective study.
View Article and Find Full Text PDFWe report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapy that was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of melena. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4bN1M0).
View Article and Find Full Text PDF[A stepwise treatment strategy based on the pathophysiology of irritable bowel syndrome].
Nihon Shokakibyo Gakkai Zasshi
March 2023
Article Synopsis
- This study investigates the unclear causes of superficial non-ampullary duodenal epithelial tumors (SNADETs) and their relationship with Helicobacter pylori infection and gastric mucosal atrophy.
- A total of 177 patients with SNADETs were compared to 531 matched controls to analyze the prevalence of H. pylori infection and endoscopic gastric mucosal atrophy.
- The findings revealed that non-atrophic gastric mucosa was a significant risk factor for SNADETs, indicating a strong association independent of H. pylori infection status.