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Taku Sakamoto,Hourin Cho,Yutaka Saito 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4
Considering its contribution to reducing colorectal cancer morbidity and mortality, the most important task of colonoscopy is tofind all existing polyps. Moreover, the accurate detection of existing polyps determines the risk of colorectal cancer morbidity andis an important factor in deciding the appropriate surveillance program for patients. Image-enhanced endoscopy is an easy-tousemodality with improved lesion detection. Linked color imaging (LCI) and blue laser/light imaging (BLI) are useful modalitiesfor improving colonoscopy quality. Each mode has unique optical features; therefore, their intended use differs. LCI contributes toimproved polyp detection due to its brightness and high color contrast between the lesion and normal mucosa, while BLI contributesto the characterization of detected polyps by evaluating the vessel and surface patterns of detected lesions. The proper use of theseobservation modes allows for more efficient endoscopic diagnosis. Moreover, recent developments in artificial intelligence will soonchange the clinical practice of colonoscopy and this system will provide an efficient education modality for novice endoscopists.
Hasobe, Taku,Saito, Kenji,Kamat, Prashant V.,Troiani, Vincent,Qiu, Hongjin,Solladié,, Nathalie,Kim, Kil Suk,Park, Jong Kang,Kim, Dongho,D'Souza, Francis,Fukuzumi, Shunichi Royal Society of Chemistry 2007 Journal of materials chemistry Vol.17 No.39
<P>We have constructed supramolecular solar cells composed of a series of porphyrin–peptide oligomers [porphyrin functionalized α-polypeptides, P(H<SUB>2</SUB>P)<SUB><I>n</I></SUB> or P(ZnP)<SUB><I>n</I></SUB> (<I>n</I> = 1, 2, 4, 8, 16)], and fullerenes assembled on a nanostructured SnO<SUB>2</SUB> electrode using an electrophoretic deposition method. Remarkable enhancement in the photoelectrochemical performance as well as the broader photoresponse in the visible and near-infrared regions is seen with increasing the number of porphyrin units in α-polypeptide structures. Formation of supramolecular clusters of porphyrins and fullerenes prepared in acetonitrile–toluene = 3 : 1 has been confirmed by transmission electron micrographs (TEM) and the absorption spectra. The highly colored composite clusters of porphyrin–peptide oligomers and fullerenes have been assembled as three-dimensional arrays onto nanostructured SnO<SUB>2</SUB> films using an electrophoretic deposition method. A high power conversion efficiency (<I>η</I>) of ∼1.6% and the maximum incident photon-to-photocurrent efficiency (IPCE = 56%) were attained using composite clusters of free base and zinc porphyrin–peptide hexadecamers [P(H<SUB>2</SUB>P)<SUB>16</SUB> and P(ZnP)<SUB>16</SUB>] with fullerenes, respectively. Femtosecond transient absorption and fluorescence measurements of porphyrin–fullerene composite films confirm improved electron-transfer properties with increasing number of porphyrins in a polypeptide unit. The formation of molecular assemblies between porphyrins and fullerenes with a polypeptide structure controls the electron-transfer efficiency in the supramolecular complexes, meeting the criteria required for efficient light energy conversion.</P> <P>Graphic Abstract</P><P>Solar cells capable of incident photon-to-current conversion efficiency of up to 56% were constructed using a series of porphyrin–peptide oligomers and fullerene assemblies. <IMG SRC='http://pubs.rsc.org/services/images/RSCpubs.ePlatform.Service.FreeContent.ImageService.svc/ImageService/image/GA?id=b706678c'> </P>
Review : Indications for and Technical Aspects of Colorectal Endoscopic Submucosal Dissection
( Yutaka Saito ),( Yosuke Otake ),( Taku Sakamoto ),( Takeshi Nakajima ),( Masayoshi Yamada ),( Shin Haruyama ),( Eriko So ),( Seiichiro Abe ),( Takahisa Matsuda ) The Editorial Office of Gut and Liver 2013 Gut and Liver Vol.7 No.3
Due to the widespread acceptance of gastric and esophageal endoscopic submucosal dissections (ESDs), the number of medical facilities that perform colorectal ESDs has grown and the effectiveness of colorectal ESD has been increasingly reported in recent years. The clinical indications for colorectal ESD at the National Cancer Center Hospital, Tokyo, Japan include laterally spreading tumor (LST) nongranular type lesions >20 mm and LST granular type lesions >30 mm. In addition, 0-IIc lesions >20 mm, intramucosal tumors with nonlifting signs and large sessile lesions, all of which are difficult to resect en bloc by conventional endoscopic mucosal resection (EMR), represent potential candidates for colorectal ESD. Rectal carcinoid tumors less than 1 cm in diameter can be treated simply, safely, and effectively by endoscopic submucosal resection using a ligation device and are therefore not indications for ESD. The en bloc resection rate was 90%, and the curative resection rate was 87% for 806 ESDs. The median procedure time was 60 minutes, and the mean size for resected specimens was 40 mm (range, 15 to 150 mm). Perforations occurred in 23 (2.8%) cases, and postoperative bleeding occurred in 15 (1.9%) cases, but only two perforation cases required emergency surgery (0.25%). ESD was an effective procedure for treating colorectal tumors that are difficult to resect en bloc by conventional EMR. ESD resulted in a higher en bloc resection rate as well as decreased invasiveness in comparison to surgery. Based on the excellent clinical results of colorectal ESDs in Japan, the Japanese healthcare insurance system has approved colorectal ESD for coverage. (Gut Liver 2013; 7:263-269)
Shinji Okabayashi,Taku Kobayashi,Eiko Saito,Takahiko Toyonaga,Ryo Ozaki,Shintaro Sagami,Masaru Nakano,Junichi Tanaka,Keiji Yagisawa,Satoshi Kuronuma,Osamu Takeuchi,Toshifumi Hibi 대한장연구학회 2019 Intestinal Research Vol.17 No.2
Background/Aims: The pharmacokinetics of tacrolimus (TAC) is known to be largely influenced by single-nucleotide polymorphisms (SNPs) in CYP3A5. Patients starting TAC require careful dose adjustment, owing to the wide range of optimal dosages, depending on their CYP3A5 expression status. Here, we evaluated whether individualization of TAC dosages based on CYP3A5 SNPs would improve its therapeutic efficacy in ulcerative colitis. Methods: Twenty-one patients were prospectively treated, with their initial dosage adjusted according to their CYP3A5 status (0.1, 0.15, and 0.2 mg/kg/day for CYP3A5*3/*3, CYP3A5*1/*3, and CYP3A5*1/*1, respectively). Their clinical outcomes were compared with those of patients treated with a fixed dose (0.1 mg/kg/day). Results: The first blood trough level of CYP3A5 expressors, CYP3A5*1/*3 or CYP3A5*1/*1, and the overall rate in achieving the target blood trough level within a week in the individualized-dose group were significantly higher than those in the fixed-dose group (5.15±2.33 ng/mL vs. 9.63±0.79 ng/mL, P=0.035 and 12.5% vs. 66.7%, P=0.01). The remission rate at 2 weeks in the expressors was as high as that in the nonexpressors, CYP3A5*3/*3, in the individualized-dose group. Conclusions: Individualized TAC treatment is effective against ulcerative colitis regardless of the CYP3A5 genotype. (Intest Res 2019;17:218-226)
( Shinji Okabayashi ),( Taku Kobayashi ),( Tomohisa Sujino ),( Ryo Ozaki ),( Satoko Umeda ),( Takahiko Toyonaga ),( Eiko Saito ),( Masaru Nakano ),( Maria Carla Tablante ),( Shojiroh Morinaga ),( Tosh 대한장연구학회 2017 Intestinal Research Vol.15 No.4
Extracolonic involvement of the gastrointestinal tract is extremely uncommon in ulcerative colitis (UC) and rarely found in the upper gastrointestinal tract or in postoperative cases since it typically responds to steroids. Here we report a case of UC complicated by extensive ileal inflammation that was refractory to steroids. A 20-year-old man was diagnosed with UC of typical pancolitis without ileal involvement and started treatment with pH-dependent mesalazine and oral prednisolone. Although his symptoms transiently resolved, the condition flared when the steroid dose was tapered down. Computed tomography revealed marked thickening of the ileal wall, and capsule endoscopy and balloon-assisted enteroscopy found diffuse mucosal inflammation with ulcers in the ileum. On the contrary, the inflammation in the colon and rectum was improving. Since the response to the second steroid course was inadequate, treatment with adalimumab and 6-mercaptopurine was initiated and finally achieved clinical and endoscopic remission. The investigation of small intestinal lesions is necessary in patients with UC whose clinical deterioration cannot be explained by colonic lesions. (Intest Res 2017;15:535-539)
Keiji Yagisawa,Taku Kobayashi,Ryo Ozaki,Shinji Okabayashi,Takahiko Toyonaga,Miki Miura,Mari Hayashida,Eiko Saito,Masaru Nakano,Hajime Matsubara,Tadakazu Hisamatsu,Toshifumi Hibi 대한장연구학회 2019 Intestinal Research Vol.17 No.1
Background/Aims: Oral mesalazine is an important treatment for ulcerative colitis (UC), and non-adherence to mesalazineincreases the risk of relapse. Controlled-release (CR) mesalazine has 2 formulations: tablets and granules. The relative acceptabilitiesof these formulations may influence patient adherence; however, they have not been compared to date. This studyaimed to evaluate the acceptabilities of the 2 formulations of CR mesalazine in relation to patient adherence using a crossoverquestionnaire survey. Methods: UC patients were randomly assigned to 2 groups in a 1:1 ratio. Patients in each group tookeither 4 g of CR mesalazine tablets or granules for 6 to 9 weeks, and then switched to 4 g of the other formulation for a further 6to 9 weeks. The acceptability and efficacy were evaluated by questionnaires, and adherence was assessed using a visual analogscale. The difference in acceptabilities between the 2 formulations and its impact on adherence were assessed. Results: A totalof 49 patients were prospectively enrolled and 33 patients were included in the analysis. Significantly more patients found thetablets to be less acceptable than the granules (76% vs. 33%, P=0.0005). The granules were preferable to the tablets when the 2formulations were compared directly (73% vs. 21%, P=0.004), for their portability, size, and numbers of pills. The adherence ratewas slightly better among patients taking the granules (94% vs. 91%) during the observation period, but the difference was notsignificant (P=0.139). Conclusion: CR mesalazine granules are more acceptable than tablets, and may therefore be a better optionfor long-term medication. (Intest Res 2019;17:87-93)
Efficacy of Current Traction Techniques for Endoscopic Submucosal Dissection
Seiichiro Abe,Shih Yea Sylvia Wu,Mai Ego,Hiroyuki Takamaru,Masau Sekiguchi,Masayoshi Yamada,Satoru Nonaka,Taku Sakamoto,Haruhisa Suzuki,Shigetaka Yoshinaga,Takahisa Matsuda,Ichiro Oda,Yutaka Saito 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.6
This systematic review aimed to assess the efficacy of the current approach to tissue traction during the endoscopic submucosal dissection (ESD) of superficial esophageal cancer, early gastric cancer, and colorectal neoplasms. We performed a systematic electronic literature search of articles published in PubMed and selected comparative studies to investigate the treatment outcomes of tractionassisted versus conventional ESD. Using the keywords, we retrieved 381 articles, including five eligible articles on the esophagus, 13 on the stomach, and 12 on the colorectum. A total of seven randomized controlled trials and 23 retrospective studies were identified. Clip line traction and submucosal tunneling were effective in reducing the procedural time during esophageal ESD. The efficacy of traction methods in gastric ESD varied in terms of the devices and strategies used depending on the lesion location and degree of submucosal fibrosis. Several prospective and retrospective studies utilized traction devices without the need to reinsert the colonoscope. When pocket creation is included, the traction devices and methods effectively shorten the procedural time during colorectal ESD. Although the efficacy is dependent on the organ and tumor locations, several traction techniques have been demonstrated to be efficacious in facilitating ESD by maintaining satisfactory traction during dissection.