Publications by authors named "Yasuhiro Fujiwara"
Background: The Esophageal Hypervigilance and Anxiety Scale (EHAS) is an English questionnaire created in the USA to assess these factors in all patients with esophageal diseases. The aim of this study was to develop and validate the Japanese version of EHAS and investigate the relationship between EHAS scores and symptoms in untreated disorders of esophagogastric junction (EGJ) outflow.
Methods: This prospective study recruited patients who underwent high-resolution manometry (HRM) at six tertiary centers in Japan.
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- * Key factors linked to bleeding included the use of antithrombotic agents, the size of the resection wound, and specimen size.
- * Direct oral anticoagulants (DOACs) were significantly associated with higher bleeding rates, indicating a need for caution in patients on these medications during postoperative recovery.
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- - Non-esophageal eosinophilic gastrointestinal diseases (non-EoE EGIDs) are allergic conditions linked to gastrointestinal dysfunction, but their incidence and how lifestyle factors affect them were previously unknown.
- - A study analyzing a large health database identified 1,368 cases of non-EoE EGIDs from over 15 million individuals, revealing a significant rise in incidence and prevalence since 2010.
- - Factors like allergic rhinitis and chronic sinusitis are associated with a higher risk for adults, while atopic dermatitis and certain perinatal conditions increase risk for children, with no significant links found to lifestyle choices like obesity or smoking.
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- Fecal incontinence (FI) affects a significant number of individuals in Japan, with a study revealing that 1.2% of participants met the criteria for FI, and 9.5% reported at least one episode in the past three months.
- Those with FI experienced a notable decline in health-related quality of life (HRQOL), exacerbated by the presence of other functional bowel disorders, especially functional diarrhea.
- The study identified alcohol consumption as a notable risk factor for developing FI, suggesting that lifestyle changes may be beneficial in managing this condition.
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- The study investigates whether the presence of pollen-specific immunoglobulin E (IgE) can predict seasonal eosinophilic esophagitis, a condition characterized by inflammation of the esophagus.
- Researchers included 122 patients with eosinophilic esophagitis across different seasons and examined their clinical and endoscopic findings while looking for trends in IgE positivity related to various pollen types.
- Results showed a significant correlation between alder-specific IgE positivity and seasonal onset of the condition, but no significant associations were found for other pollen types.
The management of eosinophilic esophagitis (EoE) has not been completely established yet. There is a controversy over the universal maintenance therapy for EoE to prevent esophageal fibrostenotic complications. Using an employer-based insurance claim database from January 2005 to September 2022, we investigated the treatment patterns of EoE and the occurrence of esophageal complications.
View Article and Find Full Text PDFBackground And Aim: Tofacitinib and aminosalicylic acid (5-ASA) are commonly used to treat ulcerative colitis (UC). However, evidence on the effect of concomitant 5-ASA use in patients receiving tofacitinib is limited. This study investigated the effects of 5-ASA combined with tofacitinib in UC patients.
View Article and Find Full Text PDFIntroduction: Excessive bothersome belching is clinically problematic and the Rome IV classification categorizes belching disorders as gastroduodenal disorders.
Methods: A total of 10,000 Japanese adults participated in this web-based survey. We aimed to examine the prevalence of belching disorders and their characteristics.
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- A study was conducted to evaluate the feasibility of using a 0.3 T MRI system for mapping macromolecular proton fraction (MPF) to quantify myelin content in brain tissue, traditionally challenging due to long imaging times and low signal quality.
- Researchers compared MPF measurements obtained from both 0.3 T and 3.0 T MRI systems, using a specific imaging protocol to calculate MPF maps from protein phantoms and healthy individuals.
- The results indicated a strong correlation between MPF values across different magnetic strengths, with only minor differences, demonstrating that 0.3 T MRI can effectively assess myelin levels in neural tissue.
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- A study was conducted to evaluate better bowel preparation methods for patients with constipation, focusing on the effectiveness of 1 L polyethylene glycol plus ascorbic acid combined with either senna or linaclotide before colonoscopy.
- The findings showed that patients who received linaclotide had a significantly lower rate of inadequate bowel preparation (11% vs 20%) and a higher adenoma detection rate (54% vs 45%) compared to those who received senna.
- The results suggest that linaclotide enhances bowel preparation effectiveness without compromising tolerability, making it a promising alternative for constipation patients.
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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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- - Anastomotic leakage (AL) after low anterior resection (LAR) for rectal cancer is a significant complication, often treated with over-the-scope clips (OTSC), but less is known about through-the-scope clips (TTSC).
- - The MANTIS clip, a type of TTSC designed for full-thickness closure, was used successfully in a 73-year-old man who experienced AL after surgery.
- - After laparoscopic drainage and ileostomy, the patient’s fistula showed improvement but remained persistent; it was ultimately resolved with the MANTIS clip, allowing for discharge just two days later.
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- Palbociclib combined with tamoxifen was tested in a phase 3 study involving 184 women with HR+/HER2- advanced breast cancer to evaluate its efficacy and safety compared to tamoxifen alone.
- The results showed a significant improvement in progression-free survival (PFS), with a median of 24.4 months for the palbociclib-tamoxifen group versus 11.1 months for the placebo-tamoxifen group.
- While overall survival (OS) data is still being gathered, there is a trend suggesting palbociclib-tamoxifen may also reduce mortality risk, though neutropenia was a common severe side effect.
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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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- The study investigates the risk of developing active tuberculosis (TB) in patients with Crohn's disease (CD) who are treated with various biologic therapies, focusing on TNF-α inhibitors compared to other biologics like ustekinumab (UST) and vedolizumab (VDZ).
- Researchers analyzed data from a large Japanese medical claims database, studying the association between biologic treatments and active TB occurrence across 28,811 patients, with a detailed assessment of treatment types and durations.
- The results indicated that TNF-α inhibitors significantly increase the risk of active TB, with none of the patients treated with UST or VDZ developing the infection, highlighting the safety of these alternatives for CD patients.
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- This study examines the impact of endoscopic submucosal dissection (ESD) on defecation in patients with rectal tumors, focusing on changes in the anorectum before and after the procedure.
- Conducted on 11 patients, the research found that ESD could reduce the length of the anal canal, particularly when the resection involved the dentate line, but most patients did not experience significant issues with constipation or incontinence.
- The findings suggest that while ESD may alter the structure and function of the rectum and anal canal, it does not typically lead to major defecation problems, especially in patients without pre-existing complications.
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- This study focused on the effectiveness of eribulin and capecitabine in treating advanced breast cancer patients with HER2-low expression after prior treatments with anthracyclines and taxanes.
- No significant differences were found in overall survival or progression-free survival rates between patients receiving eribulin and those receiving capecitabine, regardless of their HER2 status.
- The response rates varied, with eribulin showing slightly better effectiveness in hormone-positive patients compared to capecitabine, but no responses were observed in hormone-negative patients for either treatment.
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- Repro57 mice with a mutation in the Rnf212 gene are infertile, showing issues with sperm development in males and unclear infertility causes in females.
- In male mice, spermatogenesis is arrested, leading to the absence of mature sperm, while female mice show aneuploidy and altered chromosomal patterns in their oocytes.
- Although fertilization rates don’t significantly differ between wild-type and mutant mice, the mutant embryos struggle with later developmental stages, leading to lower success rates in forming morulae and blastocysts.
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- Folate receptor α (FRα) is a promising target for treating cervical cancer, with high FRα expression found in 72.4% of studied patients, particularly in non-squamous cell carcinomas (non-SCC).
- The study analyzed samples from 123 cervical cancer patients, assessing FRα and PD-L1 expression, finding a weak correlation between FRα and PD-L1 levels along with CD8-positive cell counts.
- High FRα expression was linked to worse patient outcomes, especially in those with low PD-L1 expression (CPS <10), suggesting that targeting FRα could be an effective treatment strategy for patients with cervical cancer who exhibit low PD-L1 levels.
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- - The study evaluates the effectiveness of deep neural networks (DNNs) in improving the quantification of cerebral blood flow (CBF) and cerebral blood volume (CBV) using multiparametric arterial spin labeling (MP-ASL), which is limited by low signal-to-noise ratio (SNR).
- - Results showed that DNNs provided higher accuracy and noise immunity and were six times faster in computation compared to conventional lookup table (LUT) methods, especially during tasks that induced changes in CBF and CBV.
- - The research concluded that DNN methods outperform both conventional DNN and LUT in estimating CBF and CBV, while all methods tested maintained good reproducibility.