Reo Kobayashi

Kyoto Prefectural University of Medicine

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Ken Inoue

Kyoto Prefectural University of Medicine

Naohisa Yoshida

Kyoto Prefectural University of Medicine

Yoshito Itoh

Kyoto Prefectural University of Medicine

Osamu Dohi

Kyoto Prefectural University of Medicine

Ryohei Hirose

Kyoto Prefectural University of Medicine

Hikaru Hashimoto

Kyoto Prefectural University of Medicine

Yuri Tomita

Kyoto Prefectural University of Medicine

Satoshi Sugino

Kyoto Prefectural University of Medicine

Takaaki Murakami

Kyoto Prefectural University of Medicine

Yutaka Inada

Kyoto Prefectural University of Medicine

Cooperative Institutions

Kyoto Prefectural University of Medicine

Kyoto first Red Cross hospital

University Hospital Kyoto Prefectural University of Medicine

The University of Tokyo

National Institute of Diabetes and Digestive and Kidney Diseases

Kyoto City Hospital

Japanese Red Cross Society Kyoto Daini Hospital

Kyoto University

ProQuest (United States)

The Institute of Medical Science, Asahi Life Foundation

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A Case of Fifteen Simultaneous Rectal Neuroendocrine Tumors and Endocrine Cell Micronests Resected by Both Endoscopic Treatments and Surgery

Case Reports in Gastroenterology (2022)

Hikaru Hashimoto Naohisa Yoshida Ken Inoue Reo Kobayashi Yuri Tomita

A 65-year-old man without any symptoms received colonoscopy for cancer screening and underwent cold snare polypectomy (CSP) for a 3-mm rectal lesion at a local clinic. A histopathological examination revealed neuroendocrine tumor (NET) G1 with a positive margin. The patient was referred to our hospital for further treatment. Then, the post-CSP scar was removed by endoscopic submucosal dissection (ESD), with a sufficient endoscopically normal margin. Histopathology showed 4 NETs and endocrine cell micronests (ECMs) distant from the post-CSP scar, with a positive lateral margin. We considered that the possibility of other NETs was high. Additional surgery was performed. After a histopathological examination, 11 NETs and ECMs were found in the whole rectum, without lymph node metastasis. The patient had no recurrence at 24 months after surgery. In the past 10 years, we have experienced 4 cases (including the present case) of multiple rectal NETs among 56 cases of rectal NETs of ≤10 mm (7.1%). None of our 4 cases showed any recurrence (follow-up period: 12-32 months).We herein report a case involving a patient with 15 rectal NETs and ECMs. We reviewed our experience with multiple rectal NETs, and the rate of multiple rectal NETs was 7.1%. Endoscopists should consider that multiple lesions may be present in cases of rectal NET and be aware that some cannot be detected endoscopically.

Histopathology

Rectal examination

Histopathological examination

Rectal Polyp

Polypectomy

10.1159/000521522

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Analysis of Texture and Color Enhancement Imaging for Improving the Visibility of Non-polypoid Colorectal Lesions

Digestive Diseases and Sciences (2022)

Naohisa Yoshida Ken Inoue Osamu Dohi Reo Kobayashi Yuri Tomita

Visibility

Narrow-band imaging

Colorectal Polyp

10.1007/s10620-022-07460-5

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Su1742 MUCOSAL ADDRESSIN CELL ADHESION MOLECULE 1 EXPRESSION PREDICTS SUBSEQUENT RELAPSE IN PATIENTS WITH QUIESCENT ULCERATIVE COLITIS.

Gastroenterology (2023)

Kazuhiko Uchiyama Tomohisa Takagi Katsura Mizushima Kohei Asaeda Hikaru Hashimoto

Addressin

10.1016/s0016-5085(23)02540-4

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Prevalence of gastric cancer following colorectal endoscopic submucosal dissection for lesions more than 20 mm: A retrospective analysis

DEN Open (2024)

Yuri Tomita Naohisa Yoshida Hideki Ishikawa Takahiro Otani Reo Kobayashi

Abstract Objectives Colorectal endoscopic submucosal dissection (ESD) for large tumors is spreading worldwide. Gastric cancer (GC) sometimes occurs after colorectal ESD. However, its status including frequency and risk factors have not been examined well. In this study, we analyzed the detailed status of GC after colorectal ESD. Methods This was a single‐center retrospective study. Patients receiving colorectal ESD between 2010 and 2018 were reviewed. All patients were recommended to receive esophagogastroduodenoscopy (EGD) for screening. Finally, 436 patients receiving EGD, who underwent colorectal ESD for lesions of ≥20 mm were analyzed. The primary outcome was the GC rate after colorectal ESD, including intramucosal cancer. As a control, we compared it to the GC rate in matched Japanese national cancer registry data. The secondary outcome was risk factors for developing GC. Results The mean age was 66.9 ± 10.6 and 55.3% were males. The GC rate was 5.96% (26/436) with a median observation period of 27 months. It was significantly higher than the mean GC rate in the diagnosed age calculated with the cancer registry (0.26%, observed value/expected value ratio [95% confidence interval]: 22.20 [14.50–32.53], p < 0.01). The comparison between cases with and without GC showed that significant risk factors were male ( p = 0.02) and smokers ( p < 0.01) and their GC rates were 8.3% and 10.9%. Also, in the limited cases, Helicobacter pylori infection (past and present) and atrophic gastritis were significant and their GC rates were 11.1% and 11.6%. Conclusion The GC rate was high after resecting colorectal tumors of ≥20 mm, suggesting the necessity of EGD.

Esophagogastroduodenoscopy

Endoscopic submucosal dissection

10.1002/deo2.70042

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Association Between the Cool Temperature-dependent Suppression of Colonic Peristalsis and Transient Receptor Potential Melastatin 8 Activation in Both a Randomized Clinical Trial and an Animal Model

Journal of Neurogastroenterology and Motility (2022)

Satoshi Sugino Ken Inoue Reo Kobayashi Ryohei Hirose Toshifumi Doi

Several studies have assessed the effect of cool temperature on colonic peristalsis. Transient receptor potential melastatin 8 (TRPM8) is a temperature-sensitive ion channel activated by mild cooling expressed in the colon. We examined the antispasmodic effect of cool temperature on colonic peristalsis in a prospective, randomized, single-blind trial and based on the video imaging and intraluminal pressure of the proximal colon in rats and TRPM8-deficient mice.In the clinical trial, we randomly assigned a total of 94 patients scheduled to undergo colonoscopy to 2 groups: the mildly cool water (n = 47) and control (n = 47) groups. We used 20 mL of 15°C water for the mildly cool water. The primary outcome was the proportion of subjects with improved peristalsis after treatment. In the rodent proximal colon, we evaluated the intraluminal pressure and performed video imaging of the rodent proximal colon with cool water administration into the colonic lumen. Clinical trial registry website (Trial No. UMIN-CTR; UMIN000030725).In the randomized controlled trial, after treatment, the proportion of subjects with no peristalsis with cool water was significantly higher than that in the placebo group (44.7% vs 23.4%; P < 0.05). In the rodent colon model, cool temperature water was associated with a significant decrease in colonic peristalsis through its suppression of the ratio of peak frequency (P < 0.05). Cool temperature-treated TRPM8-deficient mice did not show a reduction in colonic peristalsis compared with wild-type mice.For the first time, this study demonstrates that cool temperature-dependent suppression of colonic peristalsis may be associated with TRPM8 activation.

Peristalsis

10.5056/jnm21198

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Gastrointestinal Angiodysplasia before and after Treatment of Severe Aortic Stenosis

New England Journal of Medicine (2023)

Masaki Yashige Ken Inoue Kan Zen Reo Kobayashi Shunsuke Nakamura

Angiodysplasia

Gastrointestinal bleeding

10.1056/nejmc2306027

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[A Long‒Term Survival Case of Gastric Cancer with Disseminated Intravascular Coagulation due to Myelocarcinomatosis Treated with S‒1 plus Oxaliplatin Therapy].

PubMed (2021)

Ryuichi Morita Takeshi Ishikawa Yuki Sawai Mariko Kajiwara Kohei Asaeda

We report the case of a 36‒year‒old man who was treated with S‒1 plus oxaliplatin(SOX)therapy for gastric cancer with disseminated intravascular coagulation(DIC). The patient visited our hospital for the treatment of an unresectable type 4 advanced gastric cancer. He had respiratory distress at the first visit. A chest CT scan revealed ground‒glass shadows as well as interstitial and septal thickening diffusely located in both the lungs, which suggested cancerous lymphangiopathy. Moreover, based on blood test results, DIC was diagnosed. After the administration of SOX in combination with recombinant human soluble thrombomodulin, the patient recovered from DIC, and the values of the tumor markers(CEA and CA19‒9) were normalized. After more than 14 months post treatment, the patient has survived without relapse. There are several reports that chemotherapy for gastric cancer is effective for DIC; however, there are no reports on regimens using oxaliplatin. Regimens using this drug may improve the prognosis of gastric cancer complicated by disseminated myelocarcinomatosis and DIC.

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Marine Crevice Corrosion of Stainless Steel Alloys under Biofilmed and Sterile Conditions

Kenya Ohashi Reo Kobayashi J.F.D. Stott Michael Schofield

Crevice corrosion

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Additional 30-second observation of the right-sided colon for missed polyp detection with linked color imaging compared with narrow band imaging

Endoscopy International Open (2024)

Hikaru Hashimoto Naohisa Yoshida Yoshikazu Inagaki Kohei Fukumoto Daisuke Hasegawa

Abstract Background and study aims We previously demonstrated the efficacy of an additional-30-seconds (Add-30s) observation with linked color imaging (LCI) or narrow band imaging (NBI) of the cecum and ascending colon (right-sided colon) after white light imaging (WLI) observation for improving adenoma detection rate (ADR) by 3% to 10%. We herein compared Add-30s LCI with Add-30s NBI in a large number of cases. Patients and methods We retrospectively collected 1023 and 1011 cases with Add-30s LCI and NBI observation for right-sided colon in 11 affiliated institutions from 2018 to 2022 and propensity score matching was performed. Add-30s observation was as follows. First observation: WLI observation of the right-sided colon as first observation. Second observation: Reobservation of right-sided colon by Add-30s LCI or NBI. The comparison of the mean numbers of adenoma+sessile serrated lesions (SSLs) and adenomas per patient (MASP and MUTYH-associated polyposis) were analyzed in the Add-30s LCI/NBI groups. The increase in right-sided ADR was also analyzed in the groups. Results Among 748 matched cases in the Add-30s LCI/NBI groups, the MASP and MAP were 0.18/0.19 (P = 0.54) and 0.14/0.15 (P = 0.70). Among experts, they were 0.17/0.22 (P = 0.16) and 0.15/0.21 (P = 0.08). Among non-experts, they were 0.13/0.12 (P = 0.71) and 0.12/0.07 (P = 0.04). The right-sided ADRs of the first+second observations in the LCI and NBI groups were 32.2% and 28.9% (P = 0.16) and the increase of ADRs were 7.5% and 7.2% (P = 0.84). Conclusions In right-sided colon, the detection of adenoma/SSL did not differ between Add-30s LCI and NBI. Both of them significantly increased ADR.

Narrow-band imaging

10.1055/a-2399-7554

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A comparison of the diagnostic ability of magnified narrow band imaging and blue laser/light imaging for sessile serrated lesions

Research Square (Research Square) (2023)

Reo Kobayashi Naohisa Yoshida Yukiko Morinaga Hikaru Hashimoto Yuri Tomita

Abstract Purpose The diagnosis of sessile serrated lesions (SSL) and SSL with dysplasia (SSLD) using blue laser/light imaging (BLI) has not been well evaluated. We analyzed the diagnostic ability and specific endoscopic findings of BLI for SSL and SSLD compared to those of narrow band imaging (NBI). Methods We retrospectively reviewed 476 resected lesions from the cecum to the descending colon, which showing Type1 of the Japan NBI Expert Team (JNET) classification completely or partially with magnified NBI or BLI between 2014 and 2021 in our institution. The comparison of the NBI and BLI groups after matching was performed regarding the diagnostic ability of SSL and SSLD. The endoscopic findings of SSL on NBI and BLI were defined as expanded crypt opening (ECO) or thick and branched vessels (TBV) based on previous reports. Additionally, those of SSLD originally defined as network vessels (NV) and white dendritic change (WDC) were analyzed. Results After matching, the sensitivity of lesions with either ECO or TBV for diagnosing SSL and with those with either WDC or NV for diagnosing SSLD in the NBI/BLI were 97.5%/98.5% (p = 0.668) and 81.0%/88.9% (p = 0.667). Regarding the comparison of specific endoscopic findings between the SSLD and SSL, there were significant differences in WDC (66.4% vs. 8.6%, p < 0.001), NV (55.3% vs. 1.4%, p < 0.001), and either WDC or NV (86.8% vs. 9.0%, p < 0.001). Conclusions There was no difference in the diagnostic ability of NBI and BLI for SSL and SSLD. NV and WDC might be useful for diagnosing SSLD.

Narrow-band imaging

10.21203/rs.3.rs-2463554/v1

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