Publications by authors named "Mishiro T"

Chronic Helicobacter pylori (Hp) infection is the largest etiological factor for gastric cancer, but in recent years the reports of Hp-naïve gastric neoplasms (HpNGNs) have increased as the Hp-infected population in Japan has been declining. The histopathologic spectrum of HpNGNs differs significantly from that of conventional Hp-infected gastric neoplasms. Molecularly, the former harbor considerably fewer genetic and epigenetic abnormalities, reflecting the absence of chronic inflammatory conditions in the gastric mucosa.

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Reports of Helicobacter pylori (Hp)-naïve gastric neoplasm (HpNGN) cases have been rapidly increasing due to the recent increase in the Hp-naïve population in Japan. Most HpNGNs exhibit the gastric immunophenotype and a low malignant potential regardless of histological type. Especially, foveolar-type gastric adenoma (FGA) and intestinal-type gastric dysplasia (IGD) rarely progress to invasive carcinoma.

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This case report aims to highlight a rare occurrence of severe anemia and lymphadenopathy secondary to methotrexate (MTX)-induced ileal mucosa damage in a patient with elderly onset rheumatoid arthritis (EORA). We present the case of a 72-year-old female with a history of EORA, treated with MTX, who exhibited hematochezia without accompanying pain, diarrhea, or known infectious contacts. Diagnostic investigations included imaging and endoscopic procedures.

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Article Synopsis
  • Foveolar-type gastric adenoma (FGA) resembles Helicobacter pylori-naïve gastric hyperplastic polyp (HpN-GHP) but can be challenging to differentiate due to minimal histological differences; a study aimed to develop a diagnostic index to help distinguish between the two lesions.* -
  • The study analyzed 51 FGAs and 36 HpN-GHPs using white-light and narrow-band imaging endoscopy, with experts assessing specific visual features; FGAs exhibited unique characteristics such as bright-red color, peripheral hyperplasia, and a demarcation line more frequently than HpN-GHPs.* -
  • Results indicated high diagnostic accuracy for both endoscopic methods, achieving sensitivity of 90.2% and
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  • Viral infections like cytomegalovirus (CMV) can worsen ulcerative colitis (UC) by causing chronic intestinal inflammation, complicating treatment and recovery.
  • The relationship between CMV and UC, particularly in younger, immunocompetent patients, remains under-researched, highlighting the need for further studies.
  • A case study of a middle-aged immunocompetent woman with severe UC showed that she initially responded to high-dose prednisolone but eventually required additional treatments including anti-CMV medication to effectively manage her condition.
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Among the most severe complications of hepatic cystic diseases is infectious hepatic cysts (IHCs). IHCs may appear mainly among immunocompromised hosts. However, older patients have a variety of immunological conditions.

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Heyde syndrome is a multisystem disorder characterized by the triad of aortic stenosis (AS), gastrointestinal bleeding, and acquired von Willebrand syndrome. Age-related degeneration is the most common cause of aortic stenosis and is frequently encountered in today's aging society. Approximately 20% of patients with severe aortic stenosis have Heyde syndrome.

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The diagnosis of rheumatological diseases is challenging among older patients with multimorbidity. Rheumatological diseases in older patients show varied symptoms, such as fatigue, fever, and appetite loss. We encountered an older woman with anti-neutrophil cytoplasmic antibody (ANCA)-related vasculitis complicated by cytomegalovirus (CMV) infection.

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Hypoglycemia is caused by various clinical diseases. Among older patients, occult bacteremia may cause critical illness-related corticosteroid insufficiency (CIRCI), triggering hypoglycemia. Additionally, older patients have various chronic medical and homeostatic conditions.

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The interpretation of hepatocholangial laboratory test results is challenging. Possible liver biochemical tests include the evaluation of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, 5'-nucleotidase, lactate dehydrogenase, bilirubin, and albumin levels, as well as prothrombin time and international normalized ratio. When liver enzyme levels are elevated, R-values are generally used for diagnosis.

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Eosinophilic gastroenteritis (EGE) is a disease involving the gastrointestinal tract that involves the invasion of eosinophils into the lumen of the tract. Invasion of eosinophils in the tract causes edema and inflammation of the wall, resulting in acute or chronic diarrhea and abdominal pain. EGE can cause chronic inflammation in the small intestine, thereby mimicking chronic vasculitis.

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Article Synopsis
  • The recent decline in Helicobacter pylori infections has coincided with an increase in foveolar-type gastric adenoma (FGA) cases in H. pylori-naive individuals, indicating a shift in the characteristics of gastric tumors.
  • The study analyzed genomic features of sporadic FGA by performing whole genome sequencing on fresh-frozen tissue samples and examining cell proliferation and apoptosis profiles.
  • Notably, researchers identified a common single-nucleotide variation (SNV) in the tumor suppressor gene KLF4, which seems to impede cell growth, suggesting that this genetic change may contribute to the slow-growing nature of sporadic FGA.
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Objective: Lymphoid hyperplasia is endoscopically observed as multiple small whitish round nodules or spots. This retrospective study was performed to examine the prevalence of that finding in patients with Barrett's epithelium and its relationship with the status of infection.

Methods: The study subjects were 3353 patients (males 2186, females 1167; mean age 55.

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Gastric dysplasia and gastric cancer in Helicobacter pylori (Hp)-naïve patients usually exhibit a gastric phenotype, reflecting gastric mucosa without intestinal metaplasia (IM). We showed that intestinal-type gastric dysplasia (IGD) rarely occurs in the Hp-naïve stomach. In the last 10 years, we treated 1760 gastric dysplasia and gastric cancer patients, with 3.

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Aim: Nodular gastritis has been demonstrated to be strongly associated with infection. The present retrospective study was performed to elucidate factors related to a negative serum antibody test result in adults with nodular gastritis.

Materials And Methods: We investigated 116 -positive subjects endoscopically diagnosed with nodular gastritis and subjected to a serum anti- immunoglobulin G (IgG) antibody test.

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Background/aims: The gastric acid pocket has an important role in gastroesophageal reflux disease development. In this study, we utilized a novel 8-channel pH monitoring system with sensor intervals of 1 cm on the vertical axis for evaluation of postprandial gastric acid pocket in healthy Japanese adults, as well as the effects of vonoprazan and rabeprazole.

Methods: Twelve healthy volunteers without infection were enrolled.

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Article Synopsis
  • Foveolar-type gastric adenoma (FGA) has been known as a rare, flat polyp, but a new variant, FGA with a raspberry-like appearance (FGA-RA), is frequently found in patients without Helicobacter pylori infection.
  • A study of 647 patients revealed that 7.7% were H. pylori-naïve, and among them, 43 were diagnosed with FGA-RA, characterized by distinct endoscopic and histological features.
  • The lesions were mostly low-grade intraepithelial neoplasms, with significant differences noted in patients with multiple FGA-RAs compared to solitary cases, particularly in the presence of fundic gland polyps.
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Gastrointestinal stromal tumors (GISTs) develop in the digestive tract, mainly in the stomach, small intestine, colon, or esophagus. However, primary tumors with the same pathologic features as GISTs have been reported to occur outside of the digestive tract and are called extragastrointestinal stromal tumor (EGIST). We herein report a rare case of EGIST arising from the greater omentum in a patient with abdominal pain caused by intraperitoneal bleeding from the tumor.

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Background This study was performed to examine the prevalence of asymptomatic angiodysplasia detected in upper gastrointestinal endoscopic examinations and of hereditary hemorrhagic telangiectasia (HHT) suspected cases. Methodology The study participants were 5,034 individuals (3,206 males, 1,828 females; mean age 53.5 ± 9.

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There are no reports regarding the efficacy of sodium-glucose cotransporter 2 inhibitor (SGLT2i) and dipeptidyl peptidase 4 inhibitor (DPP4i) administrations in nonalcoholic fatty liver disease (NAFLD) patients without type 2 diabetes mellitus. The purpose of this study was to evaluate the efficacy of those drugs in such patients. NAFLD patients without type 2 diabetes mellitus were enrolled in this single center double-blind randomized prospective study, and allocated to receive either dapagliflozin (SGLT2i) or teneligliptin (DPP4i) for 12 weeks.

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Eosinophilic gastroenteritis (EGE) is characterized by dense infiltration of eosinophils in gastrointestinal tissues, resulting in morphological and functional abnormalities of the gastrointestinal tract. EGE susceptibility is most common among individuals aged 40-50 years old, and hence it is likely that affected patients will be encountered at the time of a medical checkup. In this report, we present two rare cases of EGE that presented interesting manifestations in findings obtained in a fluoroscopic examination performed at an annual medical checkup.

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Objective This study was conducted to clarify the prevalence of short segment Barrett's esophagus (SSBE) using endoscopic observations with linked color imaging (LCI). In addition, the relationship between the presence of Barrett's epithelium (BE) and the status of H. pylori infection was investigated.

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Objective This retrospective study was performed to investigate the anti-Helicobacter pylori IgG antibody serum titers in H. pylori-negative subjects with different degrees of gastric mucosal atrophy including C0 grade atrophy. Methods The absence of H.

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Quiescent ulcerative colitis (UC) patients often have irritable bowel syndrome (IBS)-like symptoms and we recently showed that the prevalence of IBS-like symptoms in UC patients in clinical remission was significantly higher as compared to healthy control subjects. However, the prevalence of functional dyspepsia (FD)-like symptoms in quiescent UC patients remains unknown. The purpose of this study was to evaluate the prevalence of FD-like symptoms and the overlap with IBS-like symptoms in such patients.

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  • Magnification endoscopy with narrow-band imaging (NBIME) and acetic acid enhancement (A-NBIME) helps visualize colorectal polyp structures and vascular patterns, and the study compares their diagnostic accuracy against traditional white light endoscopy (WLE).
  • In a sample of 628 colorectal polyps, A-NBIME had the highest diagnostic accuracy at 86.1%, while WLE and NBIME were at 80.8% and 79.3%, respectively.
  • A-NBIME also showed better reproducibility in diagnoses, with higher interobserver agreement (Fleiss's kappa value of 0.65) compared to WLE (0.43) and NBIME (0.52),
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