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Endoscopic Diagnosis of Superficial Gastrointestinal Cancer.
Nakayama, A, Kato, M, Matsuura, N, Yahagi, N
Gastrointestinal endoscopy clinics of North America. 2024;(1):1-17
Abstract
White light image (WLI) findings are important for detection and characterization in the GI tract. However, magnified endoscopic examination with image enhanced endoscopy (IEE-NE) is becoming increasingly important for qualitative diagnosis of GI neoplastic lesions. IEE-ME is extremely useful for diagnosis of invasion depth in esophageal squamous cell cancer (ESCC) and colorectal cancer, whereas macroscopic findings of WLI are still useful in Barrett's adenocarcinoma (BAC) and gastric cancer. IEE-ME is also useful for diagnosis of tumor extent in BAC and gastric cancer, whereas chromoendoscopy with indigo carmine is useful in colorectal cancer and iodine staining is indispensable in ESCC.
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2.
Ammonia tolerance and microbial community in thermophilic co-digestion of sewage sludge initiated with lignocellulosic biomass.
Yamamoto-Ikemoto, R, Matsuura, N, Honda, R, Hara-Yamamura, H, Some, K, Prak, S, Koike, K, Togari, T
Bioresource technology. 2023;:128834
Abstract
Rice straw is a useful lignocellulosic biomass for controlling ammonia inhibition in the thermophilic anaerobic digestion of sewage sludge. However, it is challenging to procure rice straw throughout the year because of its seasonal production. This study investigated methane production in a laboratory-scale digester by gradually decreasing rice straw addition to solid thermophilic sewage sludge digestion. The decrease in rice straw did not accumulate volatile fatty acids and stabilized methane production. Even with increased sludge concentration without rice straw, methane production continued under high ammonia conditions. Ammonia tolerance of the digested sludge of the experimental digester was higher than that of conventionally digested sludge. The cellulose-degrading bacteria Clostridia and high ammonia-resistant archaea Methanosarcina were dominant in the experimentally digested sludge. The community was maintained for over 200 days after discontinuing the rice straw supply. These findings suggest that anaerobic digestion initiation with rice straw is appropriate to facilitate ammonia-tolerant communities.
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3.
Efficacy of polyglycolic acid sheeting with fibrin glue for perforations related to gastrointestinal endoscopic procedures: a multicenter retrospective cohort study.
Takimoto, K, Matsuura, N, Nakano, Y, Tsuji, Y, Takizawa, K, Morita, Y, Nagami, Y, Hirasawa, K, Araki, H, Yamaguchi, N, et al
Surgical endoscopy. 2022;(7):5084-5093
Abstract
OBJECTIVES Gastrointestinal (GI) perforations are one of the major adverse events of endoscopic procedures. Polyglycolic acid (PGA) sheets with fibrin glue have been reported to close GI perforations. However, its clinical outcome has not yet been fully investigated; thus, we conducted a multicenter retrospective observational study to assess the efficacy of PGA sheeting for GI perforation. METHODS The medical records of patients who underwent PGA sheeting for endoscopic GI perforations between April 2013 and March 2018 in 18 Japanese institutions were retrospectively analyzed. PGA sheeting was applied when the clip closure was challenging or failed to use. Perforations were filled with one or several pieces of PGA sheets followed by fibrin glue application through an endoscopic catheter. Nasal or percutaneous drainage and endoscopic clipping were applied as appropriate. Clinical outcomes after PGA sheeting for intraoperative or delayed perforations were separately evaluated. RESULTS There were 66 intraoperative and 24 delayed perforation cases. In intraoperative cases, successful closure was attained in 60 cases (91%). The median period from the first sheeting to diet resumption was 6 days (interquartile range [IQR], 4-8.8 days). Large perforation size (≥ 10 mm) and duodenal location showed marginal significant relationship to higher closure failure of intraoperative perforations. In delayed perforation cases, all cases had successful closure. The median period from the first sheeting to diet resumption was 10 days (IQR, 6-37.8 days). No adverse events related to PGA sheeting occurred. CONCLUSION Endoscopic PGA sheeting could be a therapeutic option for GI perforations related to GI endoscopic procedures.
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4.
Protein-enhanced feeds after esophagectomy for esophageal cancer attenuate postoperative catabolism: a prospective observational study.
Yamashita, K, Yamasaki, M, Miyazaki, Y, Matsuura, N, Tanaka, K, Makino, T, Saito, T, Yamamoto, K, Takahashi, T, Motoori, M, et al
Surgery today. 2022;(4):624-632
Abstract
PURPOSE To evaluate if nutritional supplements can attenuate postoperative catabolism in esophageal cancer patients after radical esophagectomy. METHODS We analyzed data prospectively from 30 patients who underwent curative esophagectomy for esophageal cancer between August and December, 2019. We compared postoperative nitrogen balance and changes in body composition between patients who received protein-enhanced enteral feeds (PEF) or other enteral feeds (OF). RESULTS Postoperative enteral feeding was administered safely to all patients. The average nitrogen balance was significantly higher in the PEF group than in the OF group on postoperative days (PODs) 3 (2.41 vs. - 1.50 g, P = 0.002), 4 (3.74 vs. - 0.08 g, P = 0.006), and 5 (3.27 vs. 0.11 g, P = 0.031). The cumulative nitrogen balance in the 7 days after surgery was significantly higher in the PEF group than in the OF group (6.12 vs. - 8.40 g, P = 0.025). The bodyweight loss and lean body mass loss on POD 14 were equivalent in the two groups (bodyweight loss 3.70 vs. 2.87%, P = 0.25; lean body mass loss, 4.34 vs. 1.91%, P = 0.33). CONCLUSIONS PEF improved the postoperative nitrogen balance significantly in patients who underwent esophagectomy.
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Efficacy of vonoprazan in prevention of bleeding from endoscopic submucosal dissection-induced gastric ulcers: a prospective randomized phase II study.
Hamada, K, Uedo, N, Tonai, Y, Arao, M, Suzuki, S, Iwatsubo, T, Kato, M, Shichijo, S, Yamasaki, Y, Matsuura, N, et al
Journal of gastroenterology. 2019;(2):122-130
Abstract
BACKGROUND Vonoprazan, potassium-competitive acid blocker, is expected to reduce incidence of delayed bleeding after gastric endoscopic submucosal dissection (ESD); however, preliminary data to design a large-scale comparative study are lacking. This study aimed to assess the efficacy of vonoprazan in preventing delayed bleeding after gastric ESD. METHODS In this single-center randomized phase II trial, a modified screened selection design was used with a threshold non-bleeding rate of 89% and an expected rate of 97%. In this design, Simon's optimal two-stage design was first applied for each parallel group, and efficacy was evaluated in comparison with the threshold rate using binomial testing. Patients were randomly assigned in a 1:1 ratio to receive either vonoprazan 20 mg (VPZ group) or lansoprazole 30 mg (PPI group) for 8 weeks from the day before gastric ESD. The primary endpoint was the incidence of delayed bleeding, defined as endoscopically confirmed bleeding accompanied by hematemesis, melena, or a decrease in hemoglobin of ≥ 2 g/dl. RESULTS Delayed bleeding occurred in three of 69 patients (4.3%, 95% CI 0.9-12.2%, p = 0.047) in the VPZ group, and four of 70 (5.7%, 95% CI 1.6-14.0%, p = 0.104) in the PPI group. As only vonoprazan showed significant reduction in delayed bleeding compared with the threshold rate, it was determined to be efficacious treatment. CONCLUSIONS Vonoprazan efficaciously reduced the delayed bleeding rate in patients with an ESD-induced gastric ulcer. A large-scale, randomized, phase III study is warranted to definitively test the effectiveness of vonoprazan compared with proton pump inhibitors.
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6.
Impact of Diarrhea after Drinking on Colorectal Tumor Risk: A Case Control Study.
Shiotani, A, Ishikawa, H, Mutoh, M, Takeshita, T, Nakamura, T, Morimoto, K, Sakai, T, Wakabayashi, K, Matsuura, N
Asian Pacific journal of cancer prevention : APJCP. 2019;(3):795-799
Abstract
Background: Recently, the number of colorectal cancer (CRC) cases in Japan has been increasing, and is strongly influenced by alcohol consumption. On the other hand, there are several reports suggesting a relationship between bowel movement (constipation and diarrhea) and CRC development. Moreover, it is generally known that diarrhea may occur after drinking. However, the mechanism by which drinking alcohol increases CRC is not fully clarified yet. We hypothesized that diarrhea after drinking may play an important role in colorectal carcinogenesis. Methods: We examined the presence of diarrhea after drinking and further evaluated the correlation of diarrhea after drinking with the incidence of colorectal tumors. To obtain the status of the feces, a self-recorded questionnaire survey was administered using the dietary-recording method. Blood samples were obtained to analyze the ALDH2 Glu504Lys and ADH1B His48Arg polymorphisms. Results: The participants were 417 patients who had undergone a total colonoscopy. The control was selected from 186 patients who underwent a medical checkup at the same hospital during the same time period. The odds ratio for all subjects was 2.1 (95% CI: 1.18 - 3.80), and that for heavy drinkers was 4.2 (1.48 - 11. 90). Conclusions: The results demonstrated that those who have diarrhea after drinking possess a high risk of developing colon tumors.