Publications by authors named "Risaburo Akasaka"
Article Synopsis
- * The lesion was 10 mm with an observable rod-like object, and advanced imaging indicated it was likely granulation tissue due to the presence of foreign material.
- * Following a detailed medical history, it was determined that the woman had prior pelvic surgery involving mesh placement, raising concerns that the mesh might have perforated the rectum, necessitating surgery to remove it.
Background/aims: Although colonic diverticular bleeding (CDB) is common, few reports have described the effects of antithrombotic agents (ATs) on CDB. This study aimed to clarify the risk factors of re-bleeding within a year in CDB patients.
Methods: We retrospectively analyzed the risk of re-bleeding in CDB patients.
Some studies have reported an association between clinicopathological features and mucin phenotypes of non-ampullary duodenal epithelial tumors (NADETs). However, the association between clinical outcomes of endoscopic resection (ER) and mucin phenotypes has not been elucidated. The aim of this retrospective study was to analyze clinical outcomes of ER of NADETs with reference to mucin phenotypes.
View Article and Find Full Text PDFBackground: Clinical outcomes and prognostic factors for survival after endoscopic submucosal dissection (ESD) in older patients aged ≥ 85 years with early gastric cancer (EGC) are not well defined. The aim of this study was to investigate the clinical outcomes and prognostic factors for survival after ESD in older patients aged ≥ 85 years with EGC.
Methods: Clinical outcomes of 70 patients aged ≥ 85 years with EGC treated with ESD were evaluated retrospectively.
Background And Aim: Underwater endoscopic mucosal resection (U-EMR) has been attracting much attention as treatment for patients with nonampullary duodenal epithelial tumors (NADETs). We aim to compare treatment outcomes, including submucosal resectability, between patients undergoing U-EMR and conventional endoscopic mucosal resection (C-EMR) for NADET.
Methods: We conducted a retrospective review of 38 patients with NADET treated by U-EMR or C-EMR.
Purpose: The aim of this study was to examine the predictive scoring system of advanced liver fibrosis in severely obese Japanese patients.
Methods: Seventy-two patients underwent laparoscopic sleeve gastrectomy and intraoperative liver biopsies. We classified these patients into two groups: Brunt stage ≥ 2 (advanced fibrosis) and 0/1 (none/mild fibrosis).
Objectives: Both potassium-competitive acid blockers (P-CABs) and proton pump inhibitors (PPIs) are known to be protective against bleeding after gastric endoscopic dissection (ESD) for early gastric cancers. The aim was to compare the effect of PPI and P-CAB treatment against bleeding after gastric ESD.
Materials And Methods: This was a single-center, retrospective analysis.
Background: Intestinal metaplasias (IMs) are generally regarded as pre-neoplastic gastric lesions. However, molecular alterations including genetic and epigenetic changes occurring in individual IM glands are not well defined.
Aims: We sought to identify DNA methylation status, microsatellite instability (MSI) and allelic imbalance (AI) occurring in individual IM glands and non-IM glands within the same mucosa.
Background: Crawling-type adenocarcinoma (CRA) is an important gastric cancer (GC) subtype that exhibits a specific histological pattern and has characteristic clinicopathological findings. Despite its characteristic histology, little is known about the molecular characteristics of CRA.
Methods: We examined 177 GC cases, including 51 cases of CRA and 126 cases having conventional differentiated adenocarcinomas (CDAs).
Objectives: Epstein-Barr virus-associated gastric cancer (EBVGC) has been reported to be associated with a low risk for lymph node metastasis (LNM). However, the curative criteria for endoscopic submucosal dissection (ESD) for submucosal EBVGC (pT1b-EBVGC) remain unclear. Our study aimed to investigate the risk factors for LNM in pT1b-EBVGC.
View Article and Find Full Text PDFEosinophilic esophagitis with a severe stenosis: report of a Japanese case.
Clin J Gastroenterol
October 2020
A 49 years old male, who had had postprandial dysphagia during the preceding 10 years, was referred to our hospital. Esophagogastroduodenoscopy (EGD) revealed longitudinal furrows and concentric rings in the mid to lower esophagus and stenosis in the lower esophagus. Histologic findings from esophageal biopsies showed eosinophilic infiltration (> 15 per high-power field).
View Article and Find Full Text PDFObjectives: Little is known about the usefulness of magnifying endoscopy with crystal violet staining (ME-CV) for the diagnosis of duodenal tumors. We assessed the ability of ME-CV to distinguish Vienna classification (VCL) category 4/5 (C4/5) from category 3 (C3) non-ampullary duodenal epithelial tumors (NADETs).
Methods: A total of 76 NADETs were studied.
Article Synopsis
- Magnifying endoscopic classification systems, like the JNET, help predict the nature and depth of colorectal tumors, but differences in observer opinions can lead to subjective diagnoses.
- A study analyzed endoscopic images of 169 colorectal tumors to evaluate endoscopic microvascular density (eMVD) as a more objective diagnostic tool.
- Results showed that eMVD is significantly higher in carcinomas compared to adenomas, with a cutoff value of 0.133 providing moderate sensitivity (56.9%) and specificity (67.0%) for distinguishing between the two.
Article Synopsis
- A review was conducted on 11 patients experiencing immune checkpoint inhibitor-induced diarrhea between 2015 and 2019, aged 46-81 years, with a median age of 63.
- Colonoscopy results showed that four patients had normal findings, while seven displayed signs resembling ulcerative colitis, including inflammation and erosions, indicating ICI-induced colitis.
- Treatment varied among patients, with five requiring prednisolone and two needing infliximab due to resistance, highlighting the complexity and need for thorough diagnosis through colonoscopy and biopsy for effective management.
Background: Little is known about the risk factors for post endoscopic submucosal dissection (post-ESD) bleeding with anticoagulant therapy.
Aims: We aimed to investigate the risk factors for post-ESD bleeding for early gastric cancer (EGC) with an emphasis on anticoagulant therapy.
Methods: We retrospectively analyzed 2355 EGCs, including 137 lesions in patients treated under anticoagulants.
Objective Indigo naturalis (IN) is a traditional Chinese medicine that has recently been reported to be effective for ulcerative colitis (UC). The aim of this study was to evaluate the efficacy and safety of IN. Methods We performed a retrospective observational study for 14 patients with UC treated with IN from October 2015 to December 2016.
View Article and Find Full Text PDFArticle Synopsis
- This study aimed to explore the differences between differentiated-type minute intramucosal neoplasia (MIMN), tumors smaller than 5 mm, and other types of intramucosal neoplasia (non-MIMN) in terms of their clinical and biological characteristics.
- Researchers analyzed various factors including tumor location, sex ratios, and specific biological markers like TP53 overexpression and DNA methylation patterns in both MIMNs and non-MIMNs.
- The results showed notable differences in the frequency of intranuclear β-catenin accumulation and DNA methylation types, suggesting that these factors may play a role in the progression from MIMN to more advanced neoplasia forms.
Background: Little is known about the long-term outcomes and prognostic factors with non-curative endoscopic submucosal dissection (ESD) in elderly patients with early gastric cancer.
Methods: Clinicopathological findings and long-term outcomes were evaluated in 87 patients with early gastric cancer (EGC) aged ≥ 75 years who were treated with non-curative ESD. Prognostic factors for overall survival (OS) were analyzed with the Kaplan-Meier method and a Cox proportional hazards model.
Aim: To determine appropriate fecal calprotectin cut-off values for the prediction of endoscopic and histologic remission in Japanese patients with ulcerative colitis (UC).
Methods: We performed a cross-sectional observational study of 131 Japanese patients with UC and measured fecal calprotectin levels by fluorescence enzyme immunoassay. The clinical activity of UC was assessed with the partial Mayo score (PMS).
In a 64-year-old woman, we identified a flat, elevated lesion that was located at the caecum and was composed of 3 different areas (areas A, B, and C). We diagnosed it as "carcinoma with sessile serrated adenoma/polyp (SSA/P)" histologically. Although area A was diagnosed as classical SSA/P, area B was regarded as a high-grade SSA/P.
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- - The study investigated the relationship between clinicopathological features, mucin phenotypes, and endoscopic findings in non-ampullary duodenal epithelial tumors (NADETs) using crystal violet staining (ME-CV).
- - Researchers categorized 55 NADET patients based on mucin phenotypes and identified four distinct ME-CV patterns, finding significant differences among these groups.
- - Results indicated that gastric-type tumors frequently exhibited a "pinecone" pattern, particularly those associated with pyloric gland adenomas, and had distinct endoscopic appearances compared to other mucin types.
Aim: To examine the association between white opaque substance (WOS) and histologically verified lipid droplets in colorectal epithelial neoplasms.
Methods: We reviewed colonoscopy records at our institution from 2014 to 2016 and identified cases of endoscopically or surgically resected colorectal epithelial neoplasms observed by magnifying narrow-band imaging (M-NBI) colonoscopy. Immunohistochemistry was used to stain tumors with a monoclonal antibody specific to adipophilin as a marker of lipids.
Tumor tissue consists of a heterogeneous cell population. The allelic imbalance (AI) ratio, determined in isolated tumor glands, is a good index of tumor heterogeneity. However, associations of the patterns of AI and microsatellite instability (MSI) development, observed in most cases of colorectal cancer (CRC), with tumor progression have not been reported previously.
View Article and Find Full Text PDFBackground And Aims: There has been little information about the long-term outcomes of patients with early gastric cancer (EGC) treated by non-curative endoscopic submucosal dissection (ESD) with negative resected margins (R0 resection). We aimed to compare the clinical outcomes of non-curative ESD with R0 resection between patients who underwent additional gastrectomy and those who did not.
Methods: Among EGC patients treated by ESD from 2002 to 2010, 66 patients were treated by non-curative ESD with R0 resection.