Publications by authors named "Tetsuya Tatsuta"
Background: The distribution of body weight in patients with achalasia and after peroral endoscopic myotomy (POEM) has not been investigated. The role of body weight assessment after treatment remains unclear.
Methods: Using the multicenter achalasia cohort, the frequency of underweight (body mass index [BMI] < 18.
Introduction: Esophageal achalasia is a typical esophageal motility disorder (EMD). Although viral infections have been hypothesized to play a role in the pathogenesis of esophageal achalasia, its etiology remains unclear. This study used esophageal muscle layer specimens collected during per-oral endoscopic myotomy (POEM) procedures to investigate the association between esophageal achalasia and esophagogastric junction outflow obstruction (EGJOO) and pattern recognition receptors.
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- Esophageal cancers that penetrate the muscularis mucosa or submucosa can have a risk of lymph node metastasis after endoscopic resection, but the patterns of metastatic recurrence post-treatment are not well-studied.
- Researchers analyzed data from 220 patients in Japan who received additional treatments (esophagectomy, chemoradiotherapy, or radiation) after endoscopic resection between 2006 and 2017 to identify risk factors for metastatic recurrence.
- They found that lymphatic invasion is a key risk factor for recurrence, and while both esophagectomy and chemoradiotherapy show similar risks for metastasis, esophagectomy tends to have higher locoregional recurrence but better survival rates for patients who do experience
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- * A modified scale (m-ES) was created to quantify symptoms like dysphagia, regurgitation, and chest pain, revealing that nearly 5% of patients still experience significant persistent symptoms affecting their QOL.
- * Results indicated that the m-ES correlates strongly with symptom severity and is more effective than the original Eckardt score in predicting persistent symptoms, with dysphagia and chest pain being the most common lingering issues.
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- TLR7 is crucial for the immune response to viral infections in cells like astrocytes and microglia, but its function in neurons is not fully understood yet.
- This research examined how resiquimod, a TLR7/8 activator, affects inflammatory chemokine production in SH-SY5Y human neuroblastoma cells, finding that TLR7 is always present in these cells.
- The study showed that resiquimod boosts CCL2 expression and activates NF-κB, suggesting it could have therapeutic potential for treating viral infections in the central nervous system by stimulating immune responses in neurons.
Surgery avoidance is an important goal in Crohn's disease (CD) treatment and predicting the risk of subsequent surgery is important to determine adequate therapeutic strength for patients with newly diagnosed CD. Herein, we aimed to construct a prediction model for the risk of subsequent surgery based on disease characteristics at the patients' initial visit. We retrospectively collected disease characteristic data from 93 patients with newly diagnosed CD.
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- High-resolution manometry (HRM) and esophagography are key diagnostic tools for achalasia, but the different phenotypes and treatment outcomes for patients have not been fully understood.
- A study involving 1824 treatment-naïve achalasia patients used machine learning to classify them into three distinct phenotypes based on various demographics and diagnostic findings.
- The findings revealed differing clinical characteristics across the phenotypes and developed predictive models indicating that specific factors, such as high pre-POEM Eckardt scores, could signal a greater risk for persistent symptoms post-treatment.
A novel treatment method for achalasia of the esophagus and related disorders is known as peroral endoscopic myotomy (POEM). This study aimed to calculate the resting energy expenditure (REE) and evaluated the degree of physical invasiveness based on metabolic changes during the perioperative period of POEM. Fifty-eight patients who underwent POEM were prospectively enrolled; REE, body weight (BW), and basal energy expenditure were measured on the day of POEM, postoperative day 1 (POD 1), and three days after POEM (POD 3).
View Article and Find Full Text PDFObjectives: This study aimed to clarify the disinfectant efficacy of the 222-nm far ultraviolet-C (UV-C) during esophagogastroduodenoscopy using bacterial cultures.
Methods: The endoscopists performed esophagogastroduodenoscopy wearing a gown with a tryptic soy agar medium plate on their epigastric region and were divided into two groups: 222-nm far UV-C irradiation (UV group) and non-UV irradiation (non-UV group). As a control group, tryptic soy agar medium plates were placed about 110 cm above the floor.
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- Absent contractility (AC) and ineffective esophageal motility (IEM) are esophageal disorders identified through high-resolution manometry (HRM), yet differences between AC and achalasia remain unclear.
- A multicenter study analyzed patient characteristics and HRM findings in 53 AC patients and 92 IEM patients, comparing them with 1,784 achalasia cases to refine diagnostic criteria, including a key IRP cutoff value.
- Findings indicate that AC often relates to systemic conditions, and symptom severity appears influenced more by underlying diseases than the level of hypomotility, with no noted transition from AC or IEM to achalasia.
Objectives: Clinical outcomes of endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinoma (ESCC) with esophageal varices (EVs) are obscure. We aimed to elucidate the clinical outcomes of ESD for ESCC with EVs in a multicenter, retrospective study.
Methods: We established a retrospective cohort of 30 patients with ESCC complicating EVs, who underwent ESD at 11 Japanese institutions.
Recently, the importance of achieving clinical and deep remissions with mucosal healing (MH) has been demonstrated as a therapeutic goal to avoid Crohn's disease (CD) surgical operations. Although ileocolonoscopy (CS) is considered the gold standard, there are increasing reports on the benefits of capsule endoscopy (CE) and serum leucine-rich α2-glycoprotein (LRG) for evaluating small-bowel lesions in CD. We evaluated the data of 20 patients with CD who underwent CE in our department between July 2020 and June 2021 and whose serum LRG level was measured within 2 months.
View Article and Find Full Text PDFObjectives: Gastrointestinal endoscopy increases the risk of bacterial exposure to endoscopists. However, before 2019, most endoscopists did not pay attention to microorganism transmission from patients. This study aimed to investigate the incidence of bacterial exposure to endoscopists' faces during gastrointestinal endoscopic procedures using the bacterial culture method.
View Article and Find Full Text PDFBackground: The guidelines recommend additional gastrectomy after noncurative endoscopic resection for early gastric cancers (EGCs). However, no additional treatment might be acceptable in some patients aged ≥ 85 years. We aimed to identify this patient group using the data in a highly aged area.
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- Peroral endoscopic myotomy (POEM) is a procedure for treating esophageal motility disorders, but its effects on high-resolution manometry (HRM) findings and post-POEM outcomes are not fully understood.
- In a study of 2,171 patients with achalasia, 7% had significant residual high integrated relaxation pressure (IRP) after POEM, with high pre-procedure IRP being a strong predictor of this outcome.
- Findings suggest that while extended gastric myotomy can reduce IRP values, the recovery of peristalsis is more related to the type of achalasia rather than the length of the myotomy, indicating that high post-POEM IRP does not equ
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- The study examines the characteristics and diagnosis of achalasia using the Starlet high-resolution manometry (HRM) system compared to ManoScan and Sandhill systems, noting a higher frequency of type I achalasia in Starlet.
- It analyzes various factors such as age, sex, Obesity, and disease duration that may affect integrated relaxation pressure (IRP) values, finding no significant impact from calcium channel blockers and nitrites on IRP despite symptom relief.
- The research highlights that in recurrent achalasia cases, lower IRP values correlate with advanced disease progression, emphasizing the need for careful interpretation when making treatment decisions based on these measurements.
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- Peroral endoscopic myotomy (POEM) is a treatment for achalasia that may not work for some patients, leading researchers to create a risk scoring system to predict its effectiveness before surgery.
- The study included 2,740 patients who underwent POEM, identifying clinical failure based on a specific scoring system, resulting in a 4.1% failure rate after 6 months.
- The scoring system assigns points based on preoperative factors, categorizing patients into low and high-risk groups, which helps guide treatment decisions by estimating the likelihood of clinical failure.
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- Capsule endoscopy is a non-invasive method for diagnosing intestinal issues, and the study focuses on creating an automated system to assess the severity of ulcerative colitis using machine learning (ResNet50).
- Researchers collected videos from patients, divided them into segments, and extracted images for further analysis, resulting in a large dataset that was carefully classified into six categories.
- The automated system achieved high accuracy rates (99.2% training and 97.3% validation), which could help streamline evaluations and reduce the workload on medical professionals interpreting these images.
Objectives: Patients with esophageal motility disorders (EMDs) including achalasia after gastric surgery have not been thoroughly characterized. Furthermore, the efficacy of peroral endoscopic myotomy (POEM) in this population should be clarified.
Methods: In this retrospective multicenter study of 3707 patients with EMDs, 31 patients (0.
Background: The risk of bleeding after gastric endoscopic submucosal dissection (ESD) in antithrombotic agent users has increased, and its management remains a problem. Second-look endoscopy (SLE) following gastric ESD in antithrombotic agent users may be effective in preventing delayed bleeding, but this requires elucidation. Therefore, this study aimed to investigate the efficacy of SLE in reducing bleeding after gastric ESD in patients receiving antithrombotic agents.
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- The study aimed to analyze the causes and persistence of chest pain in patients with achalasia-related esophageal motility disorders after undergoing peroral endoscopic myotomy (POEM).
- It included 2,294 patients with chest pain and 1,280 without, finding that about 69.5% experienced complete relief from chest pain post-POEM, while 30.5% did not, with various factors influencing outcomes.
- Key factors affecting chest pain prevalence and severity included age, sex, disease duration, and previous treatment, while the type of myotomy (anterior vs. posterior) could impact pain persistence, suggesting tailored approaches could enhance treatment efficacy.
Purpose: Little is known about the prognostic factors for survival after endoscopic submucosal dissection (ESD) in elderly patients with early gastric cancer (EGC). The aim of this study is to determine prognostic factors and a prediction model of 3-year survival after ESD for EGC in patients aged ≥ 85 years.
Methods: We retrospectively evaluated the clinical outcomes of 740 patients with EGC aged ≥ 85 years, who were treated by ESD at 30 institutions in Japan.
Esophageal endoscopic submucosal dissection (ESD) is considered to be more complex than gastric ESD. This study aimed to assess the physical invasiveness of esophageal ESD during perioperative periods by measuring resting energy expenditure (REE). The factors affecting REE that could be used to identify patients requiring perioperative management were also investigated.
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- The study analyzed a cohort of 3707 patients with achalasia-related esophageal motility disorders (AEMDs) to understand the prevalence and characteristics of dilated and sigmoid esophagus, and esophageal diverticulum (ED).
- Key findings include that longer disease duration, advanced age, obesity, and type I achalasia are linked to the development of sigmoid esophagus, while severe symptoms and integrated relaxation pressure are negatively correlated.
- The prevalence of ED was low, with correlations indicating that advanced age and non-dilated esophagus were factors in its development, highlighting the need for early diagnosis and treatment of AEMDs to prevent complications.