Publications by authors named "Norihisa Ishimura"

Amiodarone is an antiarrhythmic drug that is widely used for atrial fibrillation and other refractory arrhythmias. Although beneficial, its long-term administration is associated with adverse effects on various organs. One patient presented with amiodarone-induced liver injury, which led to liver failure.

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Background And Aims: Females with Barrett's esophagus (BE) have a lower risk of neoplastic progression than males, but sufficiently powered risk analyses are lacking. This systematic review and meta-analysis of individual patient data (IPD) aimed to provide more robust evidence on neoplastic progression risk in females.

Methods: We conducted a systematic literature search of 3 electronic databases (Medline, Embase, Google Scholar) from inception until August 2023.

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  • 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.
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  • - A man in his 30s was referred for evaluation of bile duct stricture and an intrahepatic bile duct stone, five years after having surgery for a massive liver tumor (hemangioma).
  • - Imaging tests showed multiple defects in his bile duct, and an endoscopic ultrasound revealed a raised lesion, leading to concerns about a potential tumor.
  • - A diagnosis of intraductal papillary neoplasm (low-grade dysplasia) was confirmed through oral cholangioscopy, which showed no progression of the lesion over 1.5 years.
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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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Objective The presence of a short white hair-like appearance in the lower esophagus has recently been noted during esophagogastroduodenoscopy (EGD) at our institution. Histological findings showed that this formation was a spiked protrusion of the esophageal papilla. The results regarding the prevalence of such lesions in individuals who underwent EGD examinations as part of medical checkup procedures are herein presented.

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Background: Superior mesenteric artery (SMA) syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta (SMA-Ao). Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome, individual variations in the optimal patient position have been noted. In this report, we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each patient.

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Fecal calprotectin (FC) is a promising biomarker for diagnosis and treatment of inflammatory bowel disease, ulcerative colitis (UC), and Crohn's disease. An enzyme immunoassay (EIA) is widely used for FC detection, though the considerable lag time, up to several days, causes clinical management delay. This study was performed to examine the new rapid kit fCAL-turbo, which is based on a particle-enhanced turbidimetric immunoassay (15 min), by comparing FC values with other EIAs (EliA, PhiCal, Bühlmann) and endoscopic scores.

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Objective This study investigated the prevalence of gastric epithelial tumor in Helicobacter pylori-uninfected subjects who underwent esophagogastroduodenoscopy (EGD) as part of an annual checkup. Methods A total of 20,540 EGD examinations of H. pylori-uninfected individuals (12,917 men, 7,623 women; mean age 51.

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Background: The incidence of gastric neoplasms in Helicobacter pylori (Hp)-naïve patients has recently increased due to a remarkable decrease in the Hp-infected population in Japan. We investigated the clinicopathologic differences between Hp-infected gastric neoplasms (HpIGNs) and Hp-naïve gastric neoplasms (HpNGNs) that have not been fully elucidated so far.

Methods: This retrospective multicenter study investigated 966 consecutive patients with 1131 gastric dysplasia or cancers who underwent endoscopic or surgical treatment for the recent decade.

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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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Superior mesenteric artery (SMA) syndrome (also known as Wilkie's syndrome, cast syndrome, or aorto-mesenteric compass syndrome) is an obstruction of the duodenum caused by extrinsic compression between the SMA and the aorta. The median age of patients is 23 years old (range 0-91 years old) and predominant in females over males with a ratio of 3:2. The symptoms are variable, consisting of postprandial abdominal pain, nausea and vomiting, early satiety, anorexia, and weight loss and can mimic anorexia nervosa or functional dyspepsia.

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A 59-year-old man underwent submandibular gland excision for salivary duct carcinoma (SDC). One year later, esophagogastroduodenoscopy indicated gastric diffuse mucosal thickening with luminal contraction, mimicking scirrhous gastric carcinoma. Biopsy specimens showed dense proliferation of neoplastic cells expressing androgen receptor and human epidermal growth factor 2, indicating SDC.

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Protruded signet-ring cell carcinoma (SRCC) is extremely rare. We herein report a rare case of flat elevated gastric SRCC in a patient without Helicobacter pylori infection. Esophagogastroduodenoscopy of a woman in her 50s revealed a flat, whitish lesion in the gastric body with elevation.

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Objective This study was performed to clarify the prevalence of raspberry-type gastric foveolar-type tumors, along with the time-course changes in the size and clinical course. Methods The subjects were 10,663 consecutive patients who underwent a medical checkup between April 2016 and March 2022, including an esophagogastroduodenoscopy (EGD) examination and determination of Helicobacter pylori infection status (uninfected, positive, post-eradication). The presence of characteristic reddish polypoid lesions in the stomach was investigated, and a diagnosis of raspberry-type gastric foveolar-type tumor was made based on histological findings.

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Objective This study was performed to clarify the association of the degree of gastric mucosal atrophy (GMA) with the occurrence of gastric cancer in patients with Helicobacter pylori-eradicated status. Methods The subjects were 3,058 patients (2,035 men, 1,023 women; mean age 57.9 ± 9.

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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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Although tacrolimus (TAC) has remarkable effects in ulcerative colitis (UC) patients when given as remission induction therapy, some can develop renal dysfunction during TAC administration, resulting in withdrawal, though related details remain poorly understood. This study was conducted to determine the impact of oral TAC on renal function for remission induction therapy in UC patients. Fifty-five patients (10 elderly, 45 non-elderly) with UC and treated with oral TAC at our hospital were retrospectively evaluated.

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  • Subjective symptoms of eosinophilic esophagitis (EoE) like dysphagia are non-specific, making it crucial to identify endoscopic features for accurate biopsy.
  • Poor agreement among endoscopists can complicate diagnosis, particularly with less experienced practitioners.
  • A computer-assisted diagnosis (CAD) system using a convolutional neural network (CNN) showed high diagnostic accuracy for EoE, correctly identifying 94.7% of cases, demonstrating its potential to assist inexperienced endoscopists.
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Oxaliplatin, widely used as a chemotherapy drug for colorectal cancer, is known to cause various adverse reactions. In particular, special attention for the development of portal hypertension associated with porto-sinusoidal vascular disease is necessary, as it is a serious adverse life-threating reaction, although rare. We herein report a case of oxaliplatin-related portal hypertension that developed several years after oxaliplatin administration and led to esophageal varices and refractory massive ascites.

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