Publications by authors named "Kunio Asonuma"

Background: Intestinal ultrasound (IUS) is a non-invasive tool for evaluating transmural inflammation in Crohn's disease (CD). However, its utility is constrained by operator dependency and limited accessibility.

Aims: To explore the feasibility of serum biomarkers-specifically leucine-rich alpha-2 glycoprotein (LRG)-as an alternative to IUS for assessing transmural inflammation.

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Background: Janus kinase (JAK) inhibitors, filgotinib (FIL) and upadacitinib (UPA) have emerged as promising treatments for ulcerative colitis (UC). However, a comparative analysis of these JAK inhibitors, particularly in patients previously treated with tofacitinib (TOF), has not been performed.

Aims: To compare the efficacy and safety of FIL and UPA in patients with UC, including those previously exposed to TOF.

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Article Synopsis
  • The study investigated the impact of immunomodulators (IMs) on relapse rates in ulcerative colitis (UC) patients who stopped anti-TNF-α antibody treatment.
  • 257 patients were followed over a median of 22 months, with 114 experiencing relapses, but IMs did not significantly affect relapse rates compared to those who did not take IMs.
  • Factors like discontinuations due to side effects and younger age were found to predict higher relapse risks, suggesting the need for careful monitoring in these cases.
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Introduction: A large proportion of small bowel lesions in Crohn's disease (CD) may exist beyond the reach of ileocolonoscopy and there is no gold standard imaging modality to screen them, suggesting the need for optimal biomarkers. We aimed to compare the usefulness of C-reactive protein (CRP), faecal calprotectin (FC), and leucine-rich alpha-2 glycoprotein (LRG) in determining small bowel lesions of CD.

Methods: This was a cross-sectional observational study.

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Objectives: Acute hemorrhagic rectal ulcer syndrome (AHRUS) causes massive bleeding and often recurrent rebleeding from rectal ulcers that form immediately above the dentate line. This study aimed to determine the clinical background and risk factors contributing to rebleeding in patients with AHRUS and the most appropriate method of hemostasis treatment.

Methods: This retrospective study included 93 patients diagnosed with AHRUS at Showa University Fujigaoka Hospital, Japan, between April 2009 and November 2018.

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Background And Aim: Crohn's disease (CD) often causes intractable diarrhea after intestinal resection. Anion exchange resins have been reported to be effective in patients with bile acid diarrhea after distal ileectomy; furthermore, bile acid metabolism has been implicated in the pathogenesis of CD. Therefore, we aimed to examine the effectiveness of colestimide in the management of postoperative CD, and to compare its impact between patients with and those without ileocecal resection.

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Article Synopsis
  • - This study examined the effectiveness of bowel ultrasonography as a non-invasive method to monitor ulcerative colitis (UC) activity and predict clinical response to treatment.
  • - Researchers analyzed data from 100 patients undergoing induction therapy, finding that changes in rectal bowel wall thickness within the first week were significant predictors of remission by week 8.
  • - The results suggest that early improvements in bowel wall thickness can help inform treatment decisions for patients with UC, potentially leading to better outcomes.
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Background: Mucosal healing is a treatment target for patients with ulcerative colitis. However, the relevance of proactive treatment for residual inflammation limited to the distal colon is unclear.

Materials And Methods: Patients with ulcerative colitis who had extensive colitis in clinical remission and underwent colonoscopy were retrospectively enrolled and followed up for 2 years.

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  • Sessile serrated lesions (SSL) are important precursors to colorectal cancers, and appropriate treatment, like endoscopic submucosal dissection (ESD), could help prevent these cancers.
  • In a study involving 370 ESD cases, characteristics of SSL were compared to non-SSL, revealing trends like younger women and proximal colon locations being more common in the SSL group.
  • The study found that ESD was safe and had better dissection speeds for SSL compared to non-SSL, suggesting ESD could be a viable treatment option for SSL.
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Background And Aim: The usefulness of second-generation colon capsule endoscopy (CCE2) in ulcerative colitis (UC), especially in clinically inactive patients, has been reported. Capsule Scoring of Ulcerative Colitis (CSUC) was developed as a severity index for UC. We aimed to determine whether CSUC is useful for predicting relapse during clinical remission.

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Background And Aim: Cases of colorectal endoscopic submucosal dissection (ESD) with poor maneuverability are often encountered. We aimed to evaluate the efficacy of balloon-assisted endoscopy (BAE) for such cases.

Methods: We confirmed maneuverability preoperatively in 400 consecutive cases of colorectal ESD performed at a single center from April 2011 to April 2018.

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The patient was a 54-year-old male who had been suffering from extensive ulcerative colitis (UC) for 17 years. Colonoscopy revealed an elevated lesion in the affected rectum, and its biopsy demonstrated neuroendocrine carcinoma (NEC). The surgical specimen obtained on laparoscopic high anterior resection showed extensive active inflammatory and dysplastic lesions and three grossly visible multifocal malignant lesions: a polypoid fungating tumor of NEC (type 1, 20 mm in diameter, pT3) that had been preoperatively noticed, a polypoid fungating tumor of adenocarcinoma (type 1, 22 mm, pT2) and a protruded sessile polypoid tumor (0-Is, 5 mm, pTis) of adenocarcinoma.

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Background: Emphysematous liver abscesses are defined as liver abscesses accompanied by gas formation. The fatality rate is extremely high at 27%, necessitating prompt intensive care.

Case Presentation: The patient was a 69-year-old Japanese man with type 2 diabetes.

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Article Synopsis
  • A 49-year-old woman with pseudomembranous enterocolitis was admitted for treatment after not responding well to standard antibiotics like vancomycin and metronidazole.
  • She underwent fecal microbiota transplantation, which showed positive results quickly, with diarrhea resolving within 3 days.
  • A follow-up colonoscopy showed no signs of pseudomembranes, and there were no reported recurrences of the condition in the year following her discharge.
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Background And Aim: Calprotectin is an abundant protein in neutrophils, which infiltrate the mucosa during inflammation. Fecal calprotectin (FC) level has shown correlation with disease activity in ulcerative colitis (UC) patients. Additionally, FC level is expected to indicate mucosal healing (MH).

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Emphysematous gastritis is an extremely rare disease with an unfavorable prognosis. To date, very few studies have been conducted regarding the intragastric recovery process based on endoscopic findings. We herein report a case of emphysematous gastritis that improved with long-term (five months) conservative treatment in which we were able to observe the intragastric recovery process endoscopically.

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Article Synopsis
  • Small intestinal anisakiasis is a rare and challenging disease to diagnose, often requiring surgical intervention initially, but usually resolves with conservative treatment.
  • A 63-year-old man with acute abdominal pain, following raw fish consumption, was diagnosed with small intestinal obstruction likely caused by anisakiasis through CT scans and antibody testing.
  • The patient was successfully treated with conservative methods (fasting, fluid replacement, and an ileus tube), leading to symptom resolution and discharge within a week, highlighting that unnecessary surgery can often be avoided.
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Background: Although invasive ductal adenocarcinoma of the pancreas (PDAC) manifests as a relatively uniform histomorphological feature of the pancreatobiliary type, it may be complicated by metaplastic changes and heterogeneous gastric and intestinal elements. This study aimed to investigate the complication rate and clinicopathological significance of such heterogeneous elements.

Methods: Fifty-nine patients who underwent resection of PDAC were examined in this study.

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