Publications by authors named "Yoichiro Ono"

Background/aims: Helicobacter pylori infection-negative gastric cancer (HPNGC) has not been systematically investigated in consecutive patients. Hence, this study aimed to investigate the clinicopathological and endoscopic features of HPNGC.

Methods: This single-center retrospective study selected participants from patients with gastric cancer who were treated at the Fukuoka University Chikushi Hospital between January 2013 and December 2021.

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Background: Accurate evaluation of tumor invasion depth is essential to determine the appropriate treatment strategy for patients with superficial esophageal cancer. The pretreatment tumor depth diagnosis currently relies on the magnifying endoscopic classification established by the Japan Esophageal Society (JES). However, the diagnostic accuracy of tumors involving the muscularis mucosa (MM) or those invading the upper third of the submucosal layer (SM1), which correspond to Type B2 vessels in the JES classification, remains insufficient.

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Background: We previously developed a Japan Esophageal Society Barrett's Esophagus (JES-BE) magnifying endoscopic classification for superficial BE-related neoplasms (BERN) and validated it in a nationwide multicenter study that followed a diagnostic flow chart based on mucosal and vascular patterns (MP, VP) with nine diagnostic criteria. Our present post hoc analysis aims to further simplify the diagnostic criteria for superficial BERN.

Methods: We used data from our previous study, including 10 reviewers' assessments for 156 images of high-magnifying narrow-band imaging (HM-NBI) (67 dysplastic and 89 non-dysplastic histology).

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  • - This study investigates the link between multiple white and flat elevated lesions (MWFL) in the stomach and the use of oral proton pump inhibitors (PPIs), finding a significant association between the two.
  • - Out of 163 patients, those taking oral PPIs had a much higher occurrence of MWFL (49.3%) compared to those not on PPIs (10.9%), with results showing a strong statistical significance (p<0.001).
  • - The research suggests that oral PPI intake is a significant independent risk factor for the presence of MWFL, indicating a potential clinical concern for patients using these medications.
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  • * A questionnaire was sent to 16 high-volume Japanese centers to gather information on their initial treatment strategies for EC-ESCC and their approaches to preventing strictures after ESD.
  • * Results showed that ESD is being performed more widely than the current guidelines suggest, particularly for larger lesions, highlighting the need for further research into the effectiveness of these expanded treatment indications.
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  • Image-enhanced endoscopy is effective for detecting superficial oro-hypopharyngeal squamous cell carcinoma, but preoperative detection can miss lesions that are later found during surgery under general anesthesia.
  • A study of 63 patients revealed that endoscopy under general anesthesia detected a greater average number of lesions compared to preoperative endoscopy (1.47 vs. 1.17 lesions per patient).
  • The newly discovered lesions during general anesthesia were often small and less visually distinct, highlighting the method's potential for identifying multiple synchronous lesions.
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  • Patients with incomplete gastric intestinal metaplasia (GIM) have a higher risk of gastric cancer, and this study aims to investigate the effectiveness of micromucosal patterns observed during magnifying endoscopy with narrow-band imaging (M-NBI) in diagnosing incomplete GIM.
  • The research involved 98 patients, focusing on specific regions of the stomach and using endoscopic findings to classify GIM patterns, followed by targeted biopsies for histological analysis.
  • Results indicated that while micromucosal patterns weren't useful for diagnosing GIM subtype, the presence of white opaque substance (WOS) was a strong predictor for identifying incomplete GIM, showing high specificity and moderate sensitivity.
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  • - Gastric juvenile polyposis (GJP) is closely linked to the risk of developing gastric cancer, but this study reports a case where a patient with GJP diagnosed through magnifying endoscopy with narrow-band imaging (M-NBI) had non-cancerous polyps and early gastric cancer.
  • - A 50-year-old woman was referred after conventional endoscopy showed multiple polyps, and M-NBI revealed distinct patterns indicating non-cancerous areas and early gastric cancer, which was precisely mapped for treatment.
  • - The patient underwent endoscopic submucosal dissection (ESD) for the cancerous area, which was confirmed to be early-stage and successfully removed, showing no recurrence after 11 years
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Background And Study Aims: Gastric adenocarcinoma of fundic-gland type (GA-FG) was first proposed as a new entity of gastric adenocarcinoma in 2010. Subsequently, gastric adenocarcinoma of fundic-gland mucosa type (GA-FGM) was reported as a subtype of gastric adenocarcinoma. This study aimed to investigate the endoscopic findings of GA-FGM and to evaluate the differences between GA-FGM and GA-FG.

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  • A nationwide multicenter study evaluated the JES-BE classification system for diagnosing superficial Barrett's esophagus (BE)-related neoplasia using magnification endoscopy, aiming to establish its accuracy and reproducibility.
  • The study utilized high-definition magnification narrow-band imaging (HM-NBI), with a total of 186 images analyzed by both expert and non-expert reviewers during training and validation phases.
  • Results showed high sensitivity (87%) and specificity (97%) for diagnosing dysplastic BE, along with strong agreement between reviewers, indicating that the JES-BE system is reliable for clinicians regardless of experience level.
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Head and neck cancers, especially in hypopharynx and oropharynx, are often detected at advanced stage with poor prognosis. Narrow band imaging enables detection of superficial cancers and transoral surgery is performed with curative intent. However, pathological evaluation and real-world safety and clinical outcomes have not been clearly understood.

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Background: It has been reported that it is sometimes difficult to make a diagnosis of gastric cancer detected after ) eradication. Therefore, we conducted a study to determine the usefulness of magnifying endoscopy using vessel plus surface classification system for making a diagnosis of early gastric cancer after eradication.

Method: Usefulness of the markers of the vessel plus surface classification system for diagnosing gastric cancer using magnifying endoscopy with narrow-band imaging was investigated for gastric cancer detected after eradication (-eradicated group) vs.

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  • - This study assessed an AI system's ability to detect esophageal squamous cell carcinoma (ESCC) by using videos that simulate missed detection scenarios, addressing limitations of previous research on validation methods.
  • - The AI was developed with a large dataset, including images from both cancerous and noncancerous esophageal conditions, and was evaluated against the performance of endoscopists using both regular and AI-assisted video.
  • - Results showed that the AI had an 85.7% sensitivity in detecting ESCC but a lower specificity of 40%. Endoscopists improved their detection sensitivity from 75% to 77.7% with AI assistance, maintaining high specificity levels.
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This paper provides an overview of the principles of a vessel plus surface (VS) classification system to explain the diagnostic system of early gastric cancer using image-enhanced magnifying endoscopy. Furthermore, this paper introduces the magnifying endoscopy simple diagnostic algorithm for gastric cancer (MEADA-G) developed according to the VS classification system, with a description of the procedures performed for diagnosis. In addition to the diagnostic system, white opaque substance (WOS), light blue crest (LBC), white globe appearance (WGA), and vessels within epithelial circle (VEC) patterns, which are representative findings that can be observed in the gastric mucosa by image-enhanced magnifying endoscopy, are also described.

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 Magnifying endoscopy with narrow-band imaging (M-NBI) is reported to be useful in diagnosing invasion depth of superficial esophageal squamous cell carcinoma (SCC), but accurate diagnosis of deep submucosal invasion (SM2) has remained difficult. However, we discovered that irregularly branched microvessels observed with M-NBI are detected in SM2 cancers with high prevalence. Thus, this retrospective study aimed to investigate the diagnostic performance of irregularly branched microvessels as visualized by M-NBI for predicting SM2 cancers.

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  • - The study analyzed survival rates and causes of death among 1108 patients with Crohn's disease (CD) at a tertiary referral center, revealing important characteristics and outcomes related to their condition.
  • - It found that the cumulative survival rate 25 years post-diagnosis was significantly lower (91.7%) compared to a matched population (95.7%), indicating a poorer survival outlook for CD patients.
  • - The standardized mortality ratios (SMRs) for all causes and CD-specific causes were markedly high, particularly for cancers of the small intestine and colon, gastrointestinal diseases, complications from surgery, and amyloidosis.
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  • The Japan Esophageal Society formed a committee of experts to create a new classification system for diagnosing Barrett's esophagus-related neoplasms using magnifying endoscopy.
  • The classification is user-friendly, incorporating criteria from early gastric cancer and introducing new diagnostic features to improve accuracy in identifying mucosal patterns.
  • The process and structure of this new magnifying endoscopic classification aim to enhance the understanding and diagnosis of superficial esophageal conditions.
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Background/aims: Decreased trough levels of infliximab (TLI) and antibodies to infliximab (ATI) are associated with loss of response (LOR) in Crohn's disease. Two prospective studies were conducted to determine whether TLI or ATI better correlates with LOR (Study 1), and whether TLI could become a predictor of mucosal healing (MH) (Study 2).

Methods: Study 1 was conducted in 108 patients, including those with LOR and remission to compare ATI and TLI in discriminating the 2 conditions based on receiver operating characteristic (ROC) curve analyses.

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Background And Study Aims: The authors have successfully demonstrated that the white opaque substance (WOS) identified in gastric epithelial neoplasms is an accumulation of minute lipid droplets on the epithelial neoplasm. It is not known whether the lipid droplets originate from externally ingested lipids (typically foods). The purpose of this study was to investigate whether the oral ingestion of foods containing emulsified fats increases the density of the WOS in epithelial neoplasms.

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  • This study analyzed the incidence of intestinal complications like stenosis and fistulas in patients with Crohn's disease (CD) at a Japanese hospital, finding that about 50% develop these issues within 5 years.
  • The research involved 520 patients and looked at the cumulative rates of initial surgeries, revealing that about 50% of patients required surgery after 10 years.
  • Identified risk factors for undergoing initial surgery included being a current smoker and having moderate to severe stenosis in various parts of the intestines, particularly in those with upper gastrointestinal disease at diagnosis.
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Background And Aim: The aim of the present study was to endoscopically evaluate ileal mucosal healing during maintenance therapy with infliximab in order to investigate the clinical significance of endoscopic examination of ileal lesions in Crohn's disease patients.

Methods: This study retrospectively analyzed 54 patients who mainly had active ulcers of the ileum on endoscopy at baseline who were responsive to infliximab induction and who received infliximab maintenance therapy. Mucosal healing was defined as no ulcer or only ulcer scar.

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Background And Aim: Endoscopic balloon dilation (EBD) is an alternative to surgery for small bowel strictures of patients with Crohn's disease (CD). However, little is known about the long-term efficacy of EBD. The aim of the present study was to clarify the long-term outcome of EBD for small bowel strictures in patients with CD.

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Background And Aims: Pathological studies indicate papillary adenocarcinomas are more aggressive than tubular adenocarcinomas, but a definitive diagnosis is difficult using conventional endoscopy alone. The vessels within an epithelial circle (VEC) pattern, visualized using magnifying endoscopy with narrow-band imaging (ME-NBI), may be a feature of papillary adenocarcinoma. The aims of our study were to investigate whether the VEC pattern is useful in the preoperative diagnosis of papillary adenocarcinoma and to determine whether VEC-positive adenocarcinomas are more malignant than VEC-negative lesions.

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