Publications by authors named "Naohisa Yahagi"
Introduction: Eosinophilic gastrointestinal disease (EGID) is divided into eosinophilic esophagitis (EoE) and non-eosinophilic esophagitis eosinophilic gastrointestinal disease (non-EoE-EGID), based on the involved gastrointestinal organs. The present survey was performed to provide an overview of the current status of the epidemiology, diagnosis, and treatment of EGID in Asia.
Methods: Responses to the questionnaire were obtained from 228 doctors at various institutions in eight Asian countries.
Background And Aim: It is important for endoscopist to diagnose the lesion redness. In this study, we focused on the redness of duodenal bulb. We objectively analyzed the changes in redness of the duodenal bulb using linked color imaging (LCI) with chromatic indicators.
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- Live swine are not ideal for training to manage intraoperative bleeding during endoscopic submucosal dissection (ESD) due to their coagulation issues.
- The study aimed to determine an effective heparin dosage for a bleeding model and to see how it affects bleeding during ESD procedures.
- Results showed that high doses of heparin led to significantly more intraoperative bleeding and hematomas in the heparinized model compared to a control group.
Background And Aim: Optical diagnosis of superficial nonampullary duodenal epithelial tumors using white-light imaging (WLI) and/or narrow-band imaging with magnifying endoscopy (NBI-ME) is used to guide the treatment strategy and avoid biopsy-induced fibrosis. However, the effectiveness of this approach has not been elucidated. We conducted a systematic review and meta-analysis aiming to investigate the diagnostic yield between Vienna classification category 3 (VCL C3) and categories 4 or 5 (VCL C4/C5) using biopsy, WLI, NBI-ME, and WLI + NBI-ME.
View Article and Find Full Text PDFA modified double-layered suturing procedure (origami method; OGM) can achieve robust closure, even for large mucosal defects, by folding the muscle layer using through-the-scope clips. This study aimed to evaluate the feasibility of OGM in duodenal endoscopic submucosal dissection (ESD).This retrospective, observational study was conducted at a tertiary care hospital.
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- Endoscopic submucosal dissection including papilla (ESDIP) was developed to improve outcomes for patients with duodenal tumors, addressing issues like lesion size and local recurrence that are common with endoscopic papillectomy (EP).
- A study of 54 patients from 2010 to 2024 showed that ESDIP had a high success rate, with 96% of resections completed and a low overall recurrence rate of 15% after one year.
- While some complications occurred, such as intraprocedural perforation and delayed bleeding, the approach remains a promising low-invasive alternative to more extensive surgeries like pancreaticoduodenectomy.
Article Synopsis
- The study investigates the link between duodenal epithelial tumors (DETs) and colorectal tumors, addressing a controversial topic in familial colorectal adenomatous polyposis.
- Conducted over four years, the research compared 163 patients with DETs to 177 individuals undergoing routine colonoscopy, finding a significantly higher adenoma detection rate (ADR) in the DET group (63.2% vs 23.6%).
- The results indicated that DETs are associated with a five-fold increase in adenoma detection and a six-fold increase in advanced neoplasia detection, suggesting the need for screening colonoscopy in DET patients.
Article Synopsis
- The study investigates the safety and effectiveness of endoscopic submucosal dissection (ESD) for colorectal and gastric cancers, focusing on predicting resectability using endoscopic ultrasound (EUS).
- EUS classifications for tumors were established, determining how visible the submucosal layer was, and the findings showed a significant correlation with the pathological results following ESD.
- The results indicated that EUS could be crucial in predicting which tumors are likely to be successfully resected, with higher success rates observed in Type I tumors compared to Type II and III.
The incidence of duodenal tumors (DTs) is increasing. However, the mechanisms underlying its development remain unclear. Environmental factors, including the microbiome and bile acids (BAs), are believed to influence tumor development.
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- The Water Pressure Method (WPM) in colorectal endoscopic submucosal dissection (ESD) has advantages but faces challenges like excess water injection and field contamination.
- A study evaluated a new continuous liquid-suction catheter attachment (CLCA) to improve ESD outcomes using WPM, analyzing 31 cases from August 2022 to September 2023.
- Results showed all lesions were successfully removed without perforation, with effective volume measurements for injection and suction, indicating that the novel system helps maintain a clear operative field during the procedure.
The dense stroma is one cause of poor efficacy of T cell-mediated immunotherapy in pancreatic ductal adenocarcinoma (PDAC). Carbohydrate sulfotransferase 15 (CHST15) is a proteoglycan-synthetic enzyme responsible for remodeling tumor stroma. Intra-tumoral injection of CHST15 small interfering RNA (siRNA) has been shown to increase the tumor-infiltrating T cells (TILs) in patients with unresectable PDAC.
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- Superficial pharyngeal cancers can be effectively treated with transoral surgery (TOS), which helps maintain organ function and quality of life.
- This study evaluated the outcomes of a specific technique called water pressure method-endoscopic submucosal dissection (WPM-ESD) for treating pharyngeal lesions at Keio University.
- Results showed that WPM-ESD had a 100% en bloc resection rate, short procedure time, no serious complications, and a median hospital stay of 6 days, indicating its potential as a viable treatment option for these types of cancers.
Background: Respiratory syncytial virus (RSV) affects children, causing serious infections, particularly in high-risk groups. Given the seasonality of RSV and the importance of rapid isolation of infected individuals, there is an urgent need for more efficient diagnostic methods to expedite this process.
Objective: This study aimed to investigate the performance of a machine learning model that leverages the temporal diversity of symptom onset for detecting RSV infections and elucidate its discriminatory ability.
Video 1A case of bile and pancreatic duct injury with duodenal perforation during endoscopic submucosal dissection for superficial duodenal epithelial neoplasia.
View Article and Find Full Text PDFUnlabelled: This study examined the effectiveness of a systematic approach to the clinical management of COVID-19, focusing on nursing turnover.
Methods: Between 2017 and 2019, a clinical process support system based on structured clinical knowledge (Team Compass with the Patient Condition Adaptive Path System; TC-PCAPS) was developed, and implemented in hospitals. In 2020, the COVID-19 clinical management system (COVID-19-CMS) was developed.
Article Synopsis
- The study focuses on developing an AI-based automated phase-recognition system to improve the efficiency of endoscopic submucosal dissection (ESD) for treating superficial esophageal cancer, considering the complexities and labor needs of current processes.
- Utilizing 94 videos from ESD procedures, the researchers trained a deep neural network that achieved an impressive 90% accuracy in automatically recognizing different stages of the procedure, verified by experienced gastroenterologists.
- This pioneering AI system shows potential for clinical application, offering insights into treatment phases that may help enhance future techniques and address unmet medical needs in esophageal cancer care.
Article Synopsis
- Underwater endoscopic mucosal resection (UEMR) and cold snare polypectomy (CSP) are two new techniques being evaluated for treating superficial duodenal tumors, with no clear consensus on their best use.
- A study conducted from January 2020 to June 2022 found that UEMR had a significantly higher rate of sufficient vertical resection compared to CSP (65.6% vs 41.5%), although the overall R0 resection rates were similar between the two.
- While UEMR is more effective for certain lesions, CSP is quicker and has fewer bleeding complications, making it preferable for most small tumors that are easier to manage.