Publications by authors named "Tomohisa Takagi"

Objectives: A novel self-assembling peptide gel (SAPG) was recently developed for hemostasis during endoscopic resection (ER) as an alternative for electrocoagulation and clip placement. Therefore, this exploratory study aimed to evaluate the hemostatic effect of SAPG on bleeding during ER of the duodenum.

Methods: Patients with superficial duodenal epithelial tumors who underwent endoscopic submucosal dissection (ESD) or cold-snare polypectomy (CSP) between June 2022 and October 2023 were enrolled in the study.

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Background: This study aimed to explore the relationship between ultra-processed foods (UPFs) consumption and gut microbiota in patients with type 2 diabetes (T2D).

Methods: This cross-sectional study included 362 participants with T2D. UPFs consumption was assessed using a brief-type self-administered diet history questionnaire, quantified as the density of UPFs intake (g/1000 kcal).

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Background And Aim: We conducted a retrospective study to identify incidence rates and potential risk factors of major adverse cardiac events (MACE) in Japanese patients with ulcerative colitis (UC), as existing data are scarce, inconsistent, and provide limited representation of the real-world situation of MACE in Japan.

Methods: We utilized administrative claims data, collected between January 2013 and December 2022, from Medical Data Vision, Japan. Patients (aged ≥ 20 years) diagnosed with UC within ± 1 month of the prescription date during the study period were included in the incident cohort.

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Background: A serum biomarker for diagnosing ulcerative colitis (UC) remains to be established. Although we recently reported an anti-integrin αvβ6 antibody (V6 Ab) for diagnosing UC with high sensitivity and specificity, no large-scale validation study exists. This study aimed to validate the diagnostic value of V6 Ab for UC using a nationwide multicenter cohort study.

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The role of the gut microbiota, especially bacterial flora, in the pathogenesis of inflammatory bowel disease (IBD) is becoming clearer. Advances in gut microbiota analysis and the use of gnotobiotics models have underscored the importance of gut bacteria and their metabolites in the progression of IBD. Fecal microbiota transplantation has shown promise in clinical trials for ulcerative colitis started as Advanced Medical Care B in Japan, raising expectations for its outcomes.

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With the emergence of immune checkpoint inhibitors(ICIs)in recent years, the treatment outcomes for unresectable recurrent esophageal cancer have improved markedly. In 5-FU+cisplatin(FP)first-line therapy, 5-FU administration takes 5 days and generally requires hospitalization. However, frequent hospitalization for treatment is a crucial issue that must be resolved in terms of time investment and optimal use of hospital resources.

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Background: Ulcerative colitis (UC) is a chronic inflammatory disease of unknown cause for which no curative treatments have been developed. Cytokines play an important role in the pathogenesis of UC, and therapies targeting specific cytokines have been successful in treating refractory UC. The purpose of this study was to measure mucosal cytokines in UC and identify those that contribute to non-relapsing mucosal healing diagnosed by endoscopy.

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Background/objectives: Circulating bile acid (BA) profiles change with lifestyle and are closely related to intestinal BA metabolisms such as deconjugation and conversion to secondary BAs. The composition of BA in the blood is involved in systemic nutrient metabolism and intestinal health. Herein, we explored the associations of lifestyle and physical fitness with the circulating BA profile of middle-aged men.

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In strategies to extend a healthy lifespan, early detection and prevention of frailty are critical. The purpose of this study was to analyze the current state and clinical risk factors of frailty among community-dwelling older to conduct a cross-sectional analysis of the individuals, correlation between frailty and nutrient intake, dietary diversity, and dietary patterns, and to elucidate the correlation between frailty-related dietary factors and the gut microbiota. The study included 786 participants aged ≥65 years from the Kyotango Multipurpose Cohort Study who had available data on their gut microbiota.

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Article Synopsis
  • * The study involved 2,962 patients in Japan, using upper gastrointestinal endoscopy to assess various conditions related to GERD and to analyze the correlation of symptoms using the FSSG and GSRS scoring systems.
  • * Results indicate that FSSG and GSRS scores are effective in diagnosing the severity of reflux esophagitis, with FSSG scores linked to mucosal atrophy and GSRS scores relating to the functionality of the gastroesophageal flap.
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  • The Japan Gastroenterological Association released clinical guidelines for chronic diarrhea in 2023, detailing its definition, classification, and diagnostic methods.
  • The guidelines emphasize distinguishing between types of chronic diarrhea and recommend lifestyle and dietary changes as the first line of treatment, followed by probiotics and anti-diarrheals.
  • They also note that many other treatments lack sufficient evidence, indicating a need for future research to improve chronic diarrhea management globally.
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  • - The Japan Gastroenterological Association released the first version of clinical guidelines for chronic constipation in 2023, detailing its definition, classification, diagnostic criteria, and treatment options based on the latest evidence.
  • - Treatment begins by identifying whether constipation is secondary due to other diseases or medications, then assessing for motility disorders; initial management includes lifestyle changes and osmotic laxatives.
  • - The guidelines emphasize a structured approach to diagnosis and treatment, including flowcharts, and suggest that stimulant laxatives should be used sparingly while alternative therapies have less evidence.
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Texture and color enhancement imaging (TXI) may improve the visibility of gastric tumors and allow their early detection. However, few reports have examined the utility of TXI. Between June 2021 and October 2022, 56 gastric tumors in 51 patients undergoing endoscopic submucosal dissection at Fukuchiyama City Hospital were evaluated preoperatively using conventional white light imaging (WLI), narrow-band imaging (NBI), and TXI modes 1 and 2.

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  • IgA is crucial for mucosal immunity as it helps reduce infections and supports a healthy relationship between the host and microbes.
  • The study explored the role of Bach1, a transcriptional repressor, in IgA-mediated mucosal immunity using mice lacking the Bach1 gene, revealing increased levels of IgA in the intestinal mucosa and plasma, but decreased levels in feces.
  • Findings suggest that the absence of Bach1 reduces the expression of the polymeric immunoglobulin receptor (pIgR), disrupting normal IgA secretion in the intestines, which points to a new understanding of Bach1's role in gut immunity.
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  • * Research with mice and cultured cells shows that Uro A increases mucin 2 expression and thickens colonic mucus without affecting tight junctions, which are crucial for maintaining barrier integrity.
  • * Uro A treatment also reduces gut permeability and inflammation, promotes beneficial bacteria, and works through specific signaling pathways (Nrf2 and AhR) to enhance mucus secretion and support intestinal health.
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  • This study assessed the effectiveness of NUDT15 codon 139 genotyping to improve thiopurine treatment for inflammatory bowel disease (IBD) among 4628 patients in Japan.
  • Retrospective analysis showed that while genotyping did not significantly change thiopurine induction rates, it led to customized dosing that reduced adverse events (AEs) and improved treatment retention.
  • Findings indicated that starting doses and genotype-based adjustments can minimize risks, with specific genotypes correlating to different reactions to thiopurine treatments—providing a basis for more tailored treatment strategies.
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Patients with diarrhea-predominant irritable bowel syndrome (IBS-D) show excessive peristalsis, and antispasmodic agents may be useful therapeutic agents. There are few reports on the use of Kampo medicines for the treatment of IBS-D. Shakuyakukanzoto (SKT) is a Kampo medicine that is effective against abdominal pain.

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  • Advanced gastric cancer is aggressive, and this study investigated the impact of ascites (fluid in the abdomen) on patient survival rates, using CT scans to classify ascites as none, small, moderate, or massive.
  • Patients without ascites had better overall survival (43.5% at 1 year) compared to those with ascites (29.1%), with moderate or massive ascites leading to even poorer outcomes (28.0% at 1 year).
  • Key factors influencing overall survival included cancer type (specifically diffuse-type gastric cancer), the degree of ascites, and the effectiveness of chemotherapy, with moderate or massive ascites significantly impacting survival.
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Introduction: Whether white blood cell (WBC) counts are predictors for the effectiveness of thiopurine treatment in ulcerative colitis (UC) has been inconclusive in previous studies with small sample sizes. We investigated the association between WBC counts and future relapses in UC patients in a large-scale multi-center study.

Methods: This retrospective cohort study enrolled a total of 723 UC patients in remission from 33 hospitals and followed up for 3 years.

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This study investigated the trends in idiopathic peptic ulcers, examined the characteristics of refractory idiopathic peptic ulcer, and identified the optimal treatment. The characteristics of 309 patients with idiopathic peptic ulcer were examined. We allocated idiopathic peptic ulcers that did not heal after 8 weeks' treatment (6 weeks for duodenal ulcers) to the refractory group and those that healed within this period to the healed group.

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Background And Aims: This retrospective study aimed to compare the short- and long-term outcomes of endoscopic submucosal dissection and laparoscopic and endoscopic cooperative surgery in patients with superficial non-ampullary duodenal epithelial tumors.

Patients And Methods: We investigated consecutive patients with SNADETs > 10 mm in size who underwent ESD (ESD group) or LECS (LECS group) between January 2015 and March 2021. The data was used to analyze the clinical course, management, survival status, and recurrence between the two groups.

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Background: Hospitalization for ulcerative colitis (UC) is potentially life-threatening. Severe disease in the Japanese criteria which modifies the Truelove-Witts' criteria might encompass more fulminant cases than the definition for acute severe UC. However, few studies have investigated the predictive factors for clinical remission (CR) after medical treatments for severe hospitalized patients by Japanese criteria.

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Background And Aims: Free D-amino acids, which have different functions from L-amino acids, have recently been discovered in various tissues. However, studies on the potential interactions between intestinal inflammation and D-amino acids are limited. We examined the inhibitory effects of D-alanine on the pathogenesis of intestinal inflammation.

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