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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.
Riadh Drira,Taku Matsumoto,Masashi Agawa,Kazuichi Sakamoto 한국식품영양과학회 2016 Journal of medicinal food Vol.19 No.3
The antiobesity effect of ice plant (IP) (Mesembryanthemum crystallinum), a salt-resistant African plant, has recently attracted increased attention. IP is rich in pinitol, which lowers blood sugar, and myo-inositol, which prevents fatty liver disease. Furthermore, IP can potentially prevent or reduce the symptoms of metabolic syndrome. However, the details of the physiological mechanisms and mechanisms of action of IP are unclear. A previous study by our group demonstrated the capability of IP extract to prevent adipogenesis in 3T3-L1 preadipocytes. In this study, we analyzed the physiological function of IP extract on lipolysis in 3T3-L1 cells and the underlying mechanisms of this process. We found that the release of glycerol from cells treated with IP extract increased in an IP dose-dependent manner. IP extract exhibited cytotoxic activity at concentrations above 4 mg/mL. Real-time polymerase chain reaction and western blotting showed that IP extract downregulated peroxisome proliferator-activated receptor (PPAR-)γ, hormone-sensitive lipase (HSL), and adipose triglyceride lipase (ATGL) in a concentration-dependent manner, but did not affect HSL-Ser563, HSL-Ser660, or perilipin phosphorylation. Although the cAMP-dependent protein kinase A (PKA)-specific inhibitor H89 did not affect IP extract-induced lipolysis, the extracellular signal-regulated kinase (ERK1/2) inhibitor U0126 significantly abrogated IP extract-activated glycerol release. Furthermore, IP extract strongly enhanced ERK1/2 phosphorylation at the concentrations used in the study. These results suggest that IP extract augments lipolysis by enhancing ERK phosphorylation.
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)
Shintaro Akiyama,Tsubasa Onoda,Moue Shoko,Noriaki Sakamoto,Taku Sakamoto,Hideo Suzuki,Enomoto Tsuyoshi,Daisuke Matsubara,Oda Tatsuya,Kiichiro Tsuchiya 대한장연구학회 2024 Intestinal Research Vol.22 No.1
Background/Aims: Mucosal adaptation of the ileum toward colonic epithelium has been reported in pouchitis in ulcerative colitis (UC); however, the clinical characteristics, endoscopic findings, and outcomes in patients with pouchitis with ileal mucosal adaptation are poorly understood.Methods: This was a single-center retrospective study comprising UC patients treated by proctocolectomy with ileal pouch-anal anastomosis who had undergone pouchoscopy at the University of Tsukuba Hospital between 2005 and 2022. Endoscopic phenotypes were evaluated according to the Chicago classification. High-iron diamine staining (HID) was performed to identify sulfomucin (colon-type mucin)-producing goblet cells (GCs) in pouch biopsies. We compared clinical data between patients with (high HID group) and without > 10% sulfomucin-producing GCs in at least one biopsy (low HID group).Results: We reviewed 390 endoscopic examination reports from 50 patients. Focal inflammation was the most common phenotype (78%). Five patients (10%) required diverting ileostomy. Diffuse inflammation and fistula were significant risk factors for diverting ileostomy. The median proportion of sulfomucin-producing GCs on histological analysis of 82 pouch biopsies from 23 patients was 9.9% (range, 0%–93%). The duration of disease was significantly greater in the high HID group compared to the low HID group. The median percentage of sulfomucin-producing GCs was significantly higher in patients with diffuse inflammation or fistula compared to other endoscopic phenotypes (14% vs. 6.0%, <i>P</i>= 0.011).Conclusions: Greater proportions of sulfomucin-producing GCs were observed in endoscopic phenotypes associated with poor outcomes in UC, indicating patients with pouchitis showing colonic metaplasia of GCs may benefit from early interventions.
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.
Dehydroabietic acid, a diterpene, improves diabetes and hyperlipidemia in obese diabetic KK-Ay mice.
Kang, Min-Sook,Hirai, Shizuka,Goto, Tsuyoshi,Kuroyanagi, Kayo,Kim, Young-Il,Ohyama, Kana,Uemura, Taku,Lee, Joo-Young,Sakamoto, Tomoya,Ezaki, Yoichiro,Yu, Rina,Takahashi, Nobuyuki,Kawada, Teruo Published for International Union of Biochemistry 2009 Biofactors Vol.35 No.5
<P>Terpenoids, which are contained in a large number of dietary and herbal plants, have many biological effects. In this study, the effects of dehydroabietic acid (DAA), a diterpene, on glucose and lipid metabolism were examined using obese diabetic KK-Ay mice. We showed here that DAA treatment decreased not only plasma glucose and insulin levels but also plasma triglyceride (TG) and hepatic TG levels. To examine the mechanism underlying the effects of DAA, the production of inflammatory cytokines was measured. It was shown that the DAA treatment suppressed the production of monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-alpha (TNFalpha) (proinflammatory cytokines) and increased that of adiponectin (an anti-inflammatory cytokine). As a result of the changes in the production of inflammatory cytokines caused by the DAA treatment, the accumulation of macrophages in adipose tissues was reduced. These results indicate that treatment with DAA improves the levels of plasma glucose, plasma insulin, plasma TG, and hepatic TG through the decrease in the macrophage infiltration into adipose tissues, suggesting that DAA is a useful food-derived compound for treating obesity-related diseases.</P>
Kazuya Inoki,Seiichiro Abe,Yusaku Tanaka,Koji Yamamoto,Daisuke Hihara,Ryoji Ichijima,Yukihiro Nakatani,Hsin- Yu Chen,Hiroyuki Takamaru,Masau Sekiguchi,Masayoshi Yamada,Taku Sakamoto,Satoru Nonaka,Haru 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.3
Background/Aims: Probe-based confocal laser endomicroscopy (pCLE) requires the administration of intravenous (IV) fluorescein. This study aimed to determine the optimal dose of IV fluorescein for both upper and lower gastrointestinal (GI) tract pCLE. Methods: Patients 20 to 79 years old with gastric high-grade dysplasia (HGD) or colorectal neoplasms (CRNs) were enrolled in thestudy. The dose de-escalation method was employed with five levels. The primary endpoint of the study was the determination ofthe optimal dose of IV fluorescein for pCLE of the GI tract. The reduced dose was determined based on off-line reviews by threeendoscopists. An insufficient dose of fluorescein was defined as the dose of fluorescein with which the pCLE images were notdeemed to be visible. If all three endoscopists determined that the tissue structure was visible, the doses were de-escalated. Results: A total of 12 patients with gastric HGD and 12 patients with CRNs were enrolled in the study. Doses were de-escalated to0.5 mg/kg of fluorescein for both non-neoplastic duodenal and colorectal mucosa. All gastric HGD or CRNs were visible with pCLEwith IV fluorescein at 0.5 mg/kg. Conclusions: In the present study, pCLE with IV fluorescein 0.5 mg/kg was adequate to visualize the magnified structure of both theupper and lower GI tract.