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( Takeshi Suzuki ),( Yosuke Seki ),( Tomoaki Matsumura ),( Makoto Arai ),( Toyoyuki Hanazawa ),( Yoshitaka Okamoto ),( Haruhiko Suzuki ),( Kazunori Kasama ),( Akiko Umezawa ),( Yoshimoti Kurokawa ),( 대한소화기기능성질환·운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.1
Background/Aims The Lyon Consensus defined parameters based on upper endoscopy and 24-hour combined multichannel intraluminal impedancepH (MII-pH), that conclusively establish the presence of gastroesophageal reflux disease (GERD). However, the true role of upper endoscopy and MII-pH to evaluate patients with extraesophageal symptoms (EES) has not been well established. Hypopharyngeal MII (HMII), which directly measures laryngopharyngeal reflux (LPR) events, has been utilized to evaluate patients with EES suggestive of LPR. Methods This was a retrospective study involving patients with EES for > 12 weeks despite proton pump inhibitor therapy, and had no endoscopic confirmatory evidence for GERD and negative MII-pH. All patients were subsequently referred for further evaluation of EES with “unknown” etiology and underwent laryngoscopy and HMII. Based on HMII, abnormal proximal exposure (APE) was defined as LPR ≥ 1/day and/or full column reflux (reflux 2 cm distal to the upper esophageal sphincter) > 4/day. Patients with APE were offered antireflux surgery (ARS) and the outcome of ARS was objectively assessed using Reflux Symptom Index. Results Of 21 patients with EES which was thought to be GERD-unrelated based on endoscopy and MII-pH, 17 patients (81%) had APE. Eight patients with APE who had undergone ARS had significant symptomatic improvement in the Reflux Symptom Index score (19.6 ± 4.9 pre-ARS to 5.8 ± 1.4 post-ARS, P = 0.008). Conclusions A conventional diagnostic approach using endoscopy and MII-pH may not be sufficient to evaluate patients with EES suggestive of LPR. HMII is essential to evaluate patients with EES, and APE could be a reliable indicator for successful treatment outcomes. (J Neurogastroenterol Motil 2022;28:69-77)
Tomoaki Higuchi,Takashi Nakanishi,Kunio Takada,Mitsuyo Matsumoto,Makoto Okada,Hideyuki Horikoshi,Kimihiro Suzuki 대한의학회 2010 Journal of Korean medical science Vol.25 No.9
This report presents the case of a patient demonstrating multicentric Castleman’s disease (MCD) with a lung lesion that was successfully treated with an anti-interleukin-6 receptor antibody, tocilizumab in combination with corticosteroid and tacrolimus. A 43-yr-old female with abnormal shadows on a chest X-ray was referred to the hospital for further examination. She was diagnosed as having MCD based on the characteristic pathology of inguinal lymph node, lung lesions, laboratory data, and undifferentiated arthritis. Corticosteroid and rituximab therapy did not fully ameliorate the symptoms; thus, the therapeutic regimen was changed to include tocilizumab, oral corticosteroid and tacrolimus. This regimen resulted in clinical remission and the dose of tocilizumab and corticosteroid could be tapered. Tocilizumab in combination with corticosteroid and tacrolimus may therefore be a beneficial treatment regimen for lung lesions associated with MCD.
Masao Koda,Chikato Mannoji,Masazumi Murakami,Tomoaki Kinoshita,Jiro Hirayama,Tomohiro Miyashita,Yawara Eguchi,Masashi Yamazaki,Takane Suzuki,Masaaki Aramomi,Mitsutoshi Ota,Satoshi Maki,Kazuhisa Takaha 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.6
Study Design: Retrospective case-control study. Purpose: To determine whether kissing spine is a risk factor for recurrence of sciatica after lumbar posterior decompression using a spinous process floating approach. Overview of Literature: Kissing spine is defined by apposition and sclerotic change of the facing spinous processes as shown in X-ray images, and is often accompanied by marked disc degeneration and decrement of disc height. If kissing spine significantly contributes to weight bearing and the stability of the lumbar spine, trauma to the spinous process might induce a breakdown of lumbar spine stability after posterior decompression surgery in cases of kissing spine. Methods: The present study included 161 patients who had undergone posterior decompression surgery for lumbar canal stenosis using a spinous process floating approaches. We defined recurrence of sciatica as that resolved after initial surgery and then recurred. Kissing spine was defined as sclerotic change and the apposition of the spinous process in a plain radiogram. Preoperative foraminal stenosis was determined by the decrease of perineural fat intensity detected by parasagittal T1-weighted magnetic resonance imaging. Preoperative percentage slip, segmental range of motion, and segmental scoliosis were analyzed in preoperative radiographs. Univariate analysis followed by stepwise logistic regression analysis determined factors independently associated with recurrence of sciatica. Results: Stepwise logistic regression revealed kissing spine (p =0.024; odds ratio, 3.80) and foraminal stenosis (p <0.01; odds ratio, 17.89) as independent risk factors for the recurrence of sciatica after posterior lumbar spinal decompression with spinous process floating procedures for lumbar spinal canal stenosis. Conclusions: When a patient shows kissing spine and concomitant subclinical foraminal stenosis at the affected level, we should sufficiently discuss the selection of an appropriate surgical procedure.
( Kenichiro Okimoto ),( Makoto Arai ),( Hideaki Ishigami ),( Keiko Saito ),( Shoko Minemura ),( Daisuke Maruoka ),( Tomoaki Matsumura ),( Tomoo Nakagawa ),( Tatsuro Katsuno ),( Masaki Suzuki ),( Yukio 대한간학회 2018 Gut and Liver Vol.12 No.1
Background/Aims: Eosinophilic esophagitis (EoE) is often erroneously diagnosed as gastroesophageal reflux disease (GERD). The aim of this study is to investigate the prevalence of EoE and the expression of tight junction (TJ) proteins in patients with GERD symptoms. Methods: One hundred patients with GERD symptoms and 10 healthy controls were prospectively studied. Sixty-two patients had symptoms refractory to proton pump inhibitors (PPI). All patients underwent esophageal biopsy. Patients were diagnosed with EoE if the number of eosinophil granulocytes per high-power field was ≥15. Immunohistochemical analysis of TJ proteins (claudin-1, claudin-4, occludin, and zonula occludin-1 [ZO-1]) was performed. Results: EoE was diagnosed in six of 100 patients (6%) with GERD symptoms and in six patients (9.7%) of 62 patients with PPI-refractory GERD. Only one had typical EoE endoscopic findings. The proportion of ZO-1-positive cells was significantly lower in the lower than in the middle esophagus (56.0%±14.0% vs 66.0%±11.5%, p<0.05). There were no significant correlations between TJ protein expression and GERD symptoms. Conclusions: The prevalence of EoE among patients with PPI-refractory GERD is approximately 10%. Regardless of endoscopic findings, esophageal biopsy is crucial in diagnosing EoE. The disruption of ZO-1 expression in the lower esophagus is significantly associated with GERD symptoms. (Gut Liver 2018;12:30-37)
Biological Effects of Extract from the Mixed Tea (Komori Kan Gen Cha)
Takeo Hasegawa,Yeunhwa Gu,Katuyuki Miyata,Kayoko Maeda,Atsushi Fukuyama,Satoshi Ando,Morikazu Amano,Tomoaki Suzuki,Kousuke Murabayashi,Kazushi Ida,Ohno Yukiko,Hitomi Kitaoka,Michihiro Kureki,Toshifum 한국방사성폐기물학회 2004 한국방사성폐기물학회 학술논문요약집 Vol.2 No.2
The Enhancement of Immunological Activity by Mild Hypothermia
Takeo Hasegawa,Yeunhwa Gu,Katuyuki Miyata,Kayoko Maeda,Atsushi Fukuyama,Satoshi Ando,Morikazu Amano,Tomoaki Suzuki,Kousuke Murabayashi,Kazushi Ida,Ohno Yukiko,Hitomi Kitaoka,Michihiro Kureki,Toshifumi 한국방사성폐기물학회 2004 한국방사성폐기물학회 학술논문요약집 Vol.2 No.2