Kyushu University Academic Staff Educational and Research Activities Database
List of Papers
Moriyama Tomohiko Last modified date:2021.10.07

Associate Professor / Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University / International Medical Department / Kyushu University Hospital


Papers
1. Toshihiro Kita, Sinya Ashizuka, Naoki Ohmiya, Takayuki Yamamoto, Takanori Kanai, Satoshi Motoya, Fumihito Hirai, Hiroshi Nakase, Tomohiko Moriyama, Masanao Nakamura, Yasuo Suzuki, Shuji Kanmura, Taku Kobayashi, Hidehisa Ohi, Ryoichi Nozaki, Keiichi Mitsuyama, Shojiro Yamamoto, Haruhiko Inatsu, Koji Watanabe, Toshifumi Hibi, Kazuo Kitamura, Adrenomedullin for steroid-resistant ulcerative colitis: a randomized, double-blind, placebo-controlled phase-2a clinical trial., Journal of gastroenterology, 10.1007/s00535-020-01741-4, 56, 2, 147-157, 2021.02, BACKGROUND: Adrenomedullin (AM) is a bioactive peptide having many pleiotropic effects, including mucosal healing and immunomodulation. AM has shown beneficial effects in rodent models and in preliminary study for patients with ulcerative colitis (UC). We performed a clinical trial to investigate the efficacy and safety of AM in patients with UC. METHODS: This was a multi-center, double-blind, placebo-controlled phase-2a trial evaluating 28 patients in Japan with steroid-resistant UC. Patients were randomly assigned to four groups and given an infusion of 5, 10, 15 ng/kg/min of AM or placebo for 8 h per day for 14 days. The primary endpoint was the change in Mayo scores at 2 weeks. Main secondary endpoints included the change in Mayo scores and the rate of clinical remission at 8 weeks, defined as a Mayo score 0. RESULTS: No differences in the primary or secondary endpoints were observed among the four groups at 2 weeks. Despite the insufficient tracking rate, the Mayo score at 8 weeks was only significantly decreased in the high-dose AM group (15 ng/kg/min) compared with the placebo group (- 9.3 ± 1.2 vs. - 3.0 ± 2.8, P = 0.035), with its rate of clinical remission at 8 weeks being significantly higher (3/3, 100% vs. 0/2, 0%, P = 0.025). We noted mild but no serious adverse events caused by the vasodilatory effect of AM. CONCLUSIONS: In this double-blind randomized trial, we observed the complete remission at 8 weeks in patients with steroid-resistant UC receiving a high dose of AM. CLINICAL TRIAL REGISTRY: JAPIC clinical trials information; Japic CTI-205255 (200410115290). https://www.clinicaltrials.jp/cti-user/trial/Search.jsp ..
2. Shuji Shimizu, Shunta Tomimatsu, Kuriko Kudo, Shintaro Ueda, Aria Kekalih, Dadang Makmun, Riwanti Estiasari, Aqsa Sjunhada Oki, Tomohiko Moriyama, Remote Medical Education in Indonesia: Analysis of 10 Years of Activities, Journal of the International Society for Telemedicine and eHealth, e6, 1-6, 2020.12.
3. Shintaro Ueda, Kuriko Kudo, Tomohiko Moriyama, Shunta Tomimatsu, Shuji Shimizu, Barriers against and Improvement Measures of Discussion during Bilateral Video-conferencing in an Early Gastric Cancer Case Stud, Asia-Pacific Association for Medical Informatics (APAMI2020), 71-76, 2020.11.
4. Kuriko Kudo, Shintaro Ueda, Hidefumi Shitoh, Tetsuya Narikiyo, Shunta Tomimatsu, Sunao Watanabe, Takahiro Nakahara, Naoki Nakashima, Tomohiko Moriyama, Toshiaki Nakano, Shuji Shimizu, Participants’ Evaluation of a Virtual Academic Conference: Report from the 24th Japan Association of Medical Informatics Spring Symposium, Asia-Pacific Association for Medical Informatics (APAMI2020), 71-76, 2020.11.
5. Shunta Tomimatsu, Kuriko Kudo, Tomohiko Moriyama, Shintaro Ueda, Yasuyuki Hirai, Shuji Shimizu, Technical Support for Rapid Replacement of Face to face Events with Online Events due to the COVID 19 Pandemic: a Case Study from Kyushu University Hospital, Asia-Pacific Association for Medical Informatics (APAMI2020), 66-70, 2020.11.
6. Keizo Zeze, Atsushi Hirano, Takehiro Torisu, Motohiro Esaki, Tomohiko Moriyama, Junji Umeno, Keisuke Kawasaki, Shin Fujioka, Yuta Fuyuno, Yuichi Matsuno, Takanari Kitazono, Adding Thiopurine After Loss of Response to Infliximab Versus Early Combination in Treating Crohn's Disease: A Retrospective Study., Digestive diseases and sciences, 10.1007/s10620-020-06600-z, 2020.09, BACKGROUND: Although combining thiopurine with infliximab (IFX) is considered to improve the clinical efficacy of IFX when treating Crohn's disease (CD), it also increases the risk of adverse events (AEs). We compared the efficacy and safety of delayed thiopurine addition after loss of response (LOR) to IFX with the efficacy and safety of an earlier combination of thiopurine and IFX. METHODS: This retrospective study analyzed patients with CD who started IFX as a first-line biologic at Kyushu University Hospital between June 2002 and July 2018. Patients were assigned to either the early-combination (EC) group, who started IFX and thiopurine simultaneously, or the late-combination (LC) group, who were treated with IFX alone until they developed LOR. We compared the cumulative IFX continuation rates and AE incidence between the two groups. RESULTS: One hundred seventy-six patients were enrolled in this study; 49 were enrolled in the EC group, and 127 were enrolled in the LC group. Disease activity at baseline did not significantly differ between the groups, nor did the cumulative IFX continuation rates differ between the groups (P = 0.30); however, the AE rate was significantly higher in the EC group than in the LC group (38.7% vs. 21.2%; P = 0.02). The severe AE rate was also higher in the EC group than in the LC group (18.3% vs 3.1%; P = 0.001). CONCLUSION: Considering the risk-benefit balance, delayed addition of thiopurine after LOR to IFX might be an alternative strategy when using IFX to treat CD..
7. Tomimatsu S, Kudo K, Shimizu S, Moriyama T, Ueda S, Hirai Y, An Exploratory Analysis of Technical Issues in Remote Education Between International Medical Institutions, Advances in Usability, User Experience, Wearable and Assistive Technology, 181-188, 2020.07.
8. Zeze K, Hirano A, Torisu T, Esaki M, Shibata H, Moriyama T, Umeno J, Fujioka S, Okamoto Y, Fuyuno Y, Matsuno Y, Kitazono T, Mucosal dysbiosis in patients with gastrointestinal follicular lymphoma, Hematol Oncol, 38, 181-188, 2020.04.
9. Koji Shindo, Jaymel Castillo, Kenoki Ohuchida, Taiki Moriyama, Shuntaro Nagai, Tomohiko Moriyama, Takao Ohtsuka, Eishi Nagai, Shuji Shimizu, Masufumi Nakamura, Influence of endoscopic resection on additional laparoscopic distal gastrectomy: a propensity score-matching analysis, Surgery Today, 10.1007/s00595-020-02012-8, 2020.04.
10. Matsuno Y, Hirano A, Torisu T, Okamoto Y, Fuyuno Y, Fujioka S, Umeno J, Moriyama T, Nagai S, Hori Y, Fujiwara M, Kitazono T, Esaki M, Short-term and long-term outcome of indigo naturalis treatment for inflammatory bowel disease, J Gastroenterol Hepatol, 315, 412-417, 2020.03.
11. Harada A, Kurahara K, Moriyama T, Tanaka T, Nagata Y, Kawasaki K, Yaita K, Maehata Y, Umeno J, Oshiro Y, Fuchigami T, Kitazono T, Esaki M, Matsumoto T, Risk factors for reflux esophagitis after eradication of Helicobacter pylori, Scand J Gastroenterol, 54, 1183-1188, 2019.10.
12. Moriyama T, Kudo K, Ueda S, Tomimatsu S, Shimizu S, Remote education of early gastric cancer in Central Asia and Russia, News of the Academy of Sciences of the Republic of Tajikistan, 257, 105-111, 2019.10.
13. Maehata Y, Nagata Y, Moriyama T, Matsuno Y, Hirano A, Umeno J, Torisu T, Manabe T, Kitazono T, Esaki M, Risk of surgery in patients with structuring type of Crohn’s disease at the initial diagnosis: a single center experience, Intest Res, 17, 357-364, 2019.07.
14. Ihara Y, Torisu T, Moriyama T, Umeno J, Hirano A, Okamoto Y, Hori Y, Yamamoto H, Kitazono T, Esaki M, Endoscopic features of gastrointestinal stromal tumor in the small intestine, Intest Res, 17, 398-403, 2019.07.
15. Yutaka Nagata, Motohiro Esaki, Moriyama Tomohiko, Atsushi Hirano, Junji Umeno, Yuji Maehata, takehiro torisu, Takayuki Matsumoto, Takanari Kitazono, Anti-tumor necrosis factor therapy decreases the risk of initial intestinal surgery after diagnosis of Crohn’s disease of inflammatory type, Journal of gastroenterology, 10.1007/s00535-018-1511-x, 54, 4, 330-338, 2019.04, Background: Anti-tumor necrosis factor (TNF) therapy induces and maintains clinical remission in patients with Crohn’s disease (CD). However, the effect of anti-TNF therapy on the natural course of CD remains controversial. We aimed to investigate the effect of anti-TNF therapy on the initial intestinal surgery for CD. Methods: In this single-center retrospective cohort study, clinical course of 199 CD patients of inflammatory type at the initial diagnosis (the period between 1973 and 2014) was precisely reviewed until the end of 2016. Patients were divided into TNF and non-TNF groups based on anti-TNF agent use. After comparisons of clinical characteristics and medical treatments, propensity scores were calculated for covariates. Risk of intestinal surgery was compared by a Cox proportional hazards model using the propensity scores. The effect of immunomodulators on initial intestinal surgery was assessed in the TNF group. Results: During the study period, 108 patients received anti-TNF therapy. The patients in the TNF group were diagnosed more recently, and more frequently had isolated colonic involvement, and perianal disease. Immunomodulators were more frequently used in the TNF group. Cumulative probability of initial intestinal surgery was significantly lower in the TNF group (P < 0.0001). The hazard ratio in the TNF group was 0.32 (95% CI 0.13–0.74). Immunomodulators did not decrease the risk of initial intestinal surgery. Conclusions: Anti-TNF therapy can decrease the risk of intestinal surgery among patients with inflammatory-type CD at the initial diagnosis. Further studies should be necessary to determine the additive effect of immunomodulators on the risk of intestinal surgery..
16. Nagata Y, Esaki M, Moriyama T, Hirano A, Umeno J, Maehata Y, Torisu T, Matsumoto T, Kitazono T, Anti-tumor necrosis factor therapy decreases the risk of initial intestinal surgery after diagnosis of Crohn’s disease of inflammatory type, J Gastroenterol, 54, 330-338, 2019.04.
17. Kudo K, Moriyama T, Tomimatsu S, Ueda S, Shimizu S, A train-the trainer program for engineers for hosting multiparty international clinical teleconferences, J Int Soc Telemed eHealth, 7, e16, 1-8, 2019.03.
18. Yasuharu Okamoto, Ryu Nakadate, Shotaro Nakamura, Jumpei Arata, Susumu Oguri, Moriyama Tomohiko, Motohiro Esaki, tsutomu iwasa, Kenoki Ouchida, Tomohiko Akahoshi, Tetsuo Ikeda, Takanari Kitazono, Makoto Hashizume, Colorectal endoscopic submucosal dissection using novel articulating devices a comparative study in a live porcine model, Surgical endoscopy, 10.1007/s00464-018-6408-5, 33, 2, 651-657, 2019.02, Background and aims: Colonic endoscopic submucosal dissection (ESD) is time-consuming and bears a high risk of perforation. The aim of the present study was to compare the safety and efficacy between novel articulating devices and conventional ESD in live porcine colon models. Methods: Thirty ESDs in ten pigs were carried out at three different locations (15, 25, and 35 cm from the anus) by the conventional method (n = 15) and by the new method (n = 15). Procedure times, adverse events (perforation, bleeding), and damage to the muscular layer were recorded, and the ESD time per unit area of the specimens was calculated. Results: The perforation rate using the conventional method was 6.7% (1/15), whereas that using the new method was 0.0%. The number of sites of muscular damage was significantly lower in the new than conventional method (6 vs. 37, respectively; P = 0.024). The mean procedure time was significantly shorter in the new than conventional method (4.6 ± 2.0 vs. 7.0 ± 4.1 min/cm
2
, respectively; P = 0.042). Conclusions: Use of the new ESD method allows for reduced adverse events and a shortened resection time..
19. Yoji Takeuchi, Manabu Sawaya, Shiro Oka, Naoto Tamai, Takuji Kawamura, Toshio Uraoka, Hiroaki Ikematsu, Moriyama Tomohiko, Masamichi Arao, Hideki Ishikawa, Yuri Ito, Takahisa Matsuda, Efficacy of autofluorescence imaging for flat neoplasm detection a multicenter randomized controlled trial (A-FLAT trial), Gastrointestinal Endoscopy, 10.1016/j.gie.2018.11.012, 2019.01, Background and Aims: Colorectal flat (nonpolypoid) lesions can be overlooked during colonoscopy. This study evaluated the efficacy of updated autofluorescence imaging (AFI) for detecting colorectal flat neoplasms. Methods: This was a prospective, multicenter, randomized controlled trial in 9 Japanese tertiary institutions. Patients undergoing colonoscopy because of positive fecal immunochemical tests, surveillance after polypectomy, or investigation of minor symptoms were enrolled and randomly assigned to either the white-light imaging (WLI) or the AFI group. Primary outcome measurement was number of flat neoplasms per patient. Results: From November 2015 to June 2017, 817 patients were enrolled. After excluding 15 patients, 802 were finally analyzed (404, WLI; 398, AFI). Patients’ backgrounds (sex, age, indication of colonoscopy, experience of endoscopists) and quality of colonoscopy (bowel preparation, sedative use, cecal insertion rate, insertion and withdrawal time) were not different between groups. Number of flat neoplasms in each patient was significantly higher in the AFI than in the WLI group (.87 [95% confidence interval [CI],.78-.97] vs.53 [95% CI,.46-.61]), whereas overall and polypoid neoplasm detection was not significantly different between the groups (1.33 [95% CI, 1.22-1.45] vs 1.14 [95% CI, 1.03-1.24],.46 [95% CI,.40-.53] vs.60 [95% CI,.53-.68]). Flat neoplasms were more frequently detected in the right-sided colon with AFI (.61 [95% CI,.54-.70] vs.30 [95% CI,.25-.36]) but not in the left-sided colon and rectum (.26 [95% CI,.21-.32] vs.23 [95% CI,.19-.28]). Conclusions: Updated AFI improves the detection of flat colorectal neoplasms in the right-sided colon compared with WLI. (Clinical trial registration number: UMIN000019355.).
20. Akira Harada, Takehiro Torisu, Yasuharu Okamoto, Atsushi Hirano, Junji Umeno, Moriyama Tomohiko, Ema Washio, Yuta Fuyuno, Shin Fujioka, Takanari Kitazono, Motohiro Esaki, Predictive Factors for Rebleeding after Negative Capsule Endoscopy among Patients with Overt Obscure Gastrointestinal Bleeding, Digestion, 10.1159/000496826, 2019.01, Background: Although capsule endoscopy (CE) is useful to evaluate obscure gastrointestinal bleeding (OGIB), CE does not always identify the responsible lesions in patients with overt OGIB. Objectives: To identify factors predictive of rebleeding after negative CE in patients with overt OGIB. Methods: We retrospectively analyzed the clinical data of 221 patients who underwent CE for overt OGIB. Among 120 patients with negative CE findings, clinical course of 112 patients after CE was followed-up. Clinical factors associated with rebleeding after negative CE and lesions responsible for rebleeding were investigated. Results: Rebleeding was identified in 37 patients (33.0%) during follow-up after negative CE, and 36 patients (32.1%) developed rebleeding within 24 months after negative CE. Multivariate analyses showed that ongoing overt OGIB (OR 2.67; 95% CI 1.07-5.80; p = 0.036) and severe anemia at the initial CE examination (OR 2.54; 95% CI 1.33-4.96; p = 0.005) were independent factors -associated with rebleeding. Rebleeding source was detected in 13 patients. Conclusions: Rebleeding is not a rare condition among patients with overt OGIB after negative CE. Patients with ongoing overt OGIB or severe anemia at the initial CE examination seem to have a higher risk of rebleeding..
21. Tomimatsu S, Kudo K, Moriyama T, Moriyama T, Taguchi T, Shimizu S, How to prevent technical issues in large multiparty medical videoconferencing., J Int Soc Telemed eHealth, 2018.11.
22. Ueda S, Kudo K, Moriyama T, Suyama Y, Shimizu S, A step forward in sharing images during telemedicine conference (JTTA 2018 FUKUOKA 第22回日本遠隔医療学会学術大会), 日本遠隔医療学会雑誌 = Japanese journal of telemedicine and telecare, 14, 2, 151-154, 2018.10.
23. Atsushi Hirano, Junji Umeno, Yasuharu Okamoto, Hiroki Shibata, Yoshitoshi Ogura, Moriyama Tomohiko, takehiro torisu, Shin Fujioka, Yuta Fuyuno, Yutaka Kawarabayasi, Takayuki Matsumoto, Takanari Kitazono, Motohiro Esaki, Comparison of the microbial community structure between inflamed and non-inflamed sites in patients with ulcerative colitis, Journal of Gastroenterology and Hepatology (Australia), 10.1111/jgh.14129, 33, 9, 1590-1597, 2018.09, Background and Aim: The gut microbiota is suggested to play an important role in the pathogenesis of ulcerative colitis (UC). However, interindividual and spatial variations hamper the identification of UC-related changes. We thus investigated paired mucosa-associated microbiota obtained from both inflamed and non-inflamed sites of UC patients and corresponding sites of non-inflammatory bowel disease (IBD) controls. Methods: Mucosal biopsies of both inflamed and non-inflamed sites were obtained from 14 patients with active UC of the left-sided or proctitis type. Paired mucosal biopsies of the corresponding sites were obtained from 14 non-IBD controls. The microbial community structure was investigated using 16S ribosomal RNA gene sequences, followed by data analysis using qiime and LEfSe softwares. Results: Microbial alpha diversity in both inflamed and non-inflamed sites was significantly lower in UC patients compared with non-IBD controls. There were more microbes of the genus Cloacibacterium and the Tissierellaceae family, and there were less microbes of the genus Neisseria at the inflamed site when compared with the non-inflamed site in UC patients. Decreased abundance of the genera Prevotella, Eubacterium, Neisseria, Leptotrichia, Bilophila, Desulfovibrio, and Butyricimonas was evident at the inflamed site of UC patients compared with the corresponding site of non-IBD controls. Among these taxa, the genera Prevotella and Butyricimonas were also less abundant at the non-inflamed site of UC patients compared with the corresponding site in non-IBD controls. Conclusions: Mucosal microbial dysbiosis occurs at both inflamed and non-inflamed sites in UC patients. The taxa showing altered abundance in UC patients might mediate colonic inflammation..
24. Maehata Y, Nakamura S, Esaki M, Ikeda F, Moriyama T, Hida R, Washio E, Umeno J, Hirahashi M, Kitazono T, Matsumoto T, Characteristics of primary and metachronous gastric cancers discovered after Helicobacter pylori eradication: A multicenter propensity score-matched study., Gut Liver, 2017.11.
25. Kudo K, Tomimatsu S, Moriyama T, Tanimoto MA, Jalife SLV, Shimizu S, Remote Medical Education in Latin America, 267-276, 2017.07.
26. Youichiro Nuki, Moriyama Tomohiko, Comparison of the therapeutic efficacy and safety between tacrolimus and infliximab for moderate-to-severe ulcerative colitis: a single center experience., 2016.06.
27. Asano Kouichi, Moriyama Tomohiko, Contribution of susceptibility variants at FCGR2A and 13q12 to the risk of relapse among Japanese patients with ulcerative colitis., Journal of Gastroenterology, 2015.11.
28. Nagata Y, Esaki M, Umeno J, Fuyuno Y, Ikegami K, Maehata Y, Asano K, Moriyama T, Nakamura S, Kitazono T, Matsumoto T, Therapeutic strategy for Crohn's disease with a loss of response to infliximab: a single-center retrospective study, Digestion, 2015.11.
29. Shiro Oka, Moriyama Tomohiko, Improved visibility of colorectal flat tumors using image-enhanced endoscopy, Digestive Endoscopy, 2015.04.
30. Toshio Uraoka, Moriyama Tomohiko, Feasibility of a novel colonoscope with extra-wide angle of view: a clinical study, Endoscopy, 2015.03.
31. Ryu Nakadate, Moriyama Tomohiko, Gastric endoscopic submucosal dissection using novel 2.6-mm articulating devices: an ex vivo comparative and in vivo feasibility study, Endoscopy, 2015.02.
32. Yutaka Nagata, motohiro esaki, Moriyama Tomohiko, Therapeutic strategy for Crohn’s disease with a loss of response to infliximab: a single-center retrospective study, Digestion, 2015.01.
33. Moriyama Tomohiko, Takayuki Matsumoto, motohiro esaki, Shotaro Nakamura, Hiroshi Kimura, Topical anesthesia for transnasal esophagogastroduodenoscopy: spray, applicator, or both?, Digestive Endoscopy, 25, 20-24, 2013.03, 経鼻内視鏡検査の前処置方法について、スプレー法、スティック法、併用法で比較検討を行った。.
34. Maehata Y, Nakamura S, Fujisawa K, Esaki M, Moriyama T, Asano K, Fuyuno Y, Yamaguchi K, Egashira I, Kim H, Kanda M, Hirahashi M, Matsumoto T., Long-term effect of Helicobacter pylori eradication on the development of metachronous gastric cancer after endoscopic resection of early gastric cancer., Gastrointestinal endoscopy, 75, 39-46, 2012.01.
35. Moriyama T, Matsumoto T, Hirakawa K, Ikeda H, Tsuruya K, Hirakata H, Iida M, Helicobacter pylori status and esophagogastroduodenal mucosal lesions in patients with end-stage renal failure on maintenance hemodialysis., Journal of gastroenterology, 2010.03.
36. Matsumoto T, Nakamura S, Esaki M, Yada S, Moriyama T, Yanai S, Hirahashi M, Yao T, Iida M, Double-balloon endoscopy depicts diminutive small bowel lesions in gastrointestinal lymphoma, Digestive Disease and Science, 55, 158-165, 2010.01.
37. Takayuki Matsumoto, Shotaro Nakamura, Motohiro Esaki, Shinichiro Yada, Tomohiko Moriyama, Shunichi Yanai, Minako Hirahashi, Takashi Yao, Mitsuo Iida, Double-balloon endoscopy depicts diminutive small bowel lesions in gastrointestinal lymphoma., Digestive diseases and sciences, 10.1007/s10620-009-0713-8, 55, 1, 158-65, 2010.01, The aim was to determine the prevalence of small bowel involvement in patients with gastrointestinal (GI) lymphoma by double-balloon endoscopy (DBE). We examined 29 patients with primary GI lymphoma by oral and anal DBEs. Clinicopathologic features related to the prevalence of diminutive small bowel involvement and the clinical outcome were retrospectively investigated. Diminutive small bowel lesions were found in 14 patients. The prevalence of the lesions was not different between patients with primary small bowel lymphoma and those with primary extra-small bowel lymphoma (50% versus 47%, P = 0.6). However, clinical stage was more advanced in patients with the lesions than in those without (P < 0.05). The lesions were more frequently found in T-cell lymphoma (100%) and follicular lymphoma (77%) than in the other types of lymphoma (15%) (P < 0.05). Diminutive small intestinal lesions occur in patients with GI lymphoma, especially in those with follicular lymphoma and T-cell lymphoma. GI lymphomas of these histologic types are candidates for scrutiny by DBE..
38. Takayuki Matsumoto, Motohiro Esaki, Ritsuko Yanaru-Fujisawa, Tomohiko Moriyama, Shinichiro Yada, Shotaro Nakamura, Takashi Yao, Mitsuo Iida, Small-intestinal involvement in familial adenomatous polyposis: evaluation by double-balloon endoscopy and intraoperative enteroscopy., Gastrointestinal endoscopy, 10.1016/j.gie.2008.02.067, 68, 5, 911-9, 2008.11, BACKGROUND: Small-intestinal adenoma occurs in patients with familial adenomatous polyposis (FAP). OBJECTIVES: The aim was to analyze the diagnostic yield of a double-balloon endoscopy (DBE) and an intraoperative enteroscopy (IOE) for small-intestinal involvement in FAP. PATIENTS: Forty-one patients with FAP. INTERVENTIONS: We examined 12 patients with FAP by using oral DBE before a colectomy and 29 patients with FAP by using IOE. The incidence and the endoscopic findings of adenoma were compared between the 2 procedures. Phenotypes of FAP and genotypes of adenomatous polyposis coli (APC) were then compared between patients with small-intestinal adenomas and those without. The genotype was classified into a 5' mutation (exons 1-14), a 3' mutation (exon 15), and a negative mutation of APC. MAIN OUTCOME MEASUREMENT: The prevalence of adenoma. RESULTS: A DBE detected small-intestinal adenomas in 9 of 12 patients (75%), as did an IOE in 15 of 29 patients (52%, P > .05). The adenomas occurred predominantly in the jejunum, with a configuration of diminutive polyps in 22 patients. In addition, a DBE detected nonpolypoid adenoma in a patient, and nodular, broad-based protrusion (advanced lesions) in 3 patients, whereas an IOE detected advanced lesions in a patient. Patients with small-intestinal adenoma had more severe duodenal adenomatosis than those patients without small-intestinal adenoma (P < .001). In cases in which APC was analyzed, the prevalence of small-intestinal adenoma was higher in patients with a 3' mutation (100%) than in those with a 5' mutation (44%) and with a negative mutation (42%, P < .02). LIMITATION: Not a prospective randomized study. CONCLUSIONS: A DBE is equal to an IOE for scrutiny of small-intestinal adenomas in FAP. There seems to be a genotype-jejunal phenotype correlation in FAP..
39. Takayuki Matsumoto, Motohiro Esaki, Shinichiro Yada, Yukihiko Jo, Tomohiko Moriyama, Mitsuo Iida, Is small-bowel radiography necessary before double-balloon endoscopy?, AJR. American journal of roentgenology, 10.2214/AJR.07.3155, 191, 1, 175-81, 2008.07, OBJECTIVE: Small-bowel radiography may be replaced by enteroscopy in the diagnosis of small-intestine lesions. We retrospectively elucidated the diagnostic yield of small-bowel radiography performed before double-balloon endoscopy. MATERIALS AND METHODS: One hundred twenty-four patients who underwent double-balloon endoscopy during the period 2004-2006 were classified into those with abnormal radiographic findings (n = 45), normal radiographic findings (n = 31), and no small-bowl radiographs (n = 48). The classification was based on the use of small-bowel radiography and the diagnosis before double-balloon endoscopy. The indications for, approaches to, and diagnostic yields of double-balloon endoscopy were compared for the three groups. The diagnostic yield of small-bowel radiography was considered positive when any sign of pathologic change in the small bowel was identified. The diagnostic yield of double-balloon endoscopy was considered positive when endoscopic or biopsy findings explained the clinical manifestations. RESULTS: The group with abnormal findings on small-bowel radiography was younger (15-86 years) and less frequently had obscure bleeding (8.9%) than the group with normal findings on small-bowel radiography (age, 17-84 years; frequency of obscure bleeding, 45.2%) (p = 0.01) or the group without small-bowel radiographs (age, 15-91 years; frequency of obscure bleeding, 64.6%) (p < 0.0001). The positive diagnostic yield of double-balloon endoscopy was highest in the group with abnormal findings on small-bowel radiography (71.1%), followed by the group with no small-bowel radiographs (45.8%) and the group with normal findings on small-bowel radiography (35.5%) (p = 0.0002). Among patients who did undergo small-bowl radiography, the accuracy of the technique was 68.4%, the positive predictive value was 71.1%, and the negative predictive value was 64.5%. The positive diagnostic yields of small-bowel radiography and double-balloon endoscopy were not statistically different (59.2% for small-bowel radiography, 56.6% for double-balloon endoscopy; p > 0.1). CONCLUSION: The diagnostic accuracy of double-balloon endoscopy seems to improve if the procedure is preceded by small-bowel radiography..
40. Matsumoto T, Esaki M, Yada S, Jo Y, Moriyama T, Iida M, Is small-bowel radiography necessary before double-balloon endoscopy?, America Journal of Roentgenology, 191: 175-181, 2008, 2008.06.
41. Matsumoto T, Esaki M, Yanaru-Fujisawa R, Moriyama T, Yada S, Nakamura S, Yao T, Iida M, Small-intestinal involvement in familial adenomatous polyposis: evaluation by double-balloon endoscopy and intraoperative enteroscopy, Gastrointestinal Endoscopy, 68: 911-919, 2008, 2008.06.
42. Tomohiko Moriyama, Takayuki Matsumoto, Shotaro Nakamura, Yukihiko Jo, Ryuichi Mibu, Takashi Yao, Mitsuo Iida, Hypermethylation of p14 (ARF) may be predictive of colitic cancer in patients with ulcerative colitis., Diseases of the colon and rectum, 50, 9, 1384-92, 2007.09, PURPOSE: The microsatellite instability and CpG island hypermethylation of p14 ( ARF ) and p16 ( INK4a ) are related to the pathogenesis of neoplasia in ulcerative colitis. This study was designed to assess the significance of those genetic or epigenetic alterations for cancer surveillance in ulcerative colitis. METHODS: During surveillance colonoscopy in 39 patients with ulcerative colitis, biopsy specimens were obtained from the cecum and the rectum as well as from any other areas suspected of being neoplasia by chromoscopy. Using DNA extracts, the methylation status of p14 ( ARF ) and p16 ( INK4a ) and the microsatellite status were determined. RESULTS: Microsatellite instability was positive in one of five dysplasias, but it was negative in the cecum and the rectum. The incidence of hypermethylation of p14 ( ARF ) was 0 percent in the cecum, 26 percent in the rectum, and 100 percent in dysplasia, whereas that of p16 ( INK4a ) was 10, 10, and 0 percent, respectively. Patients who were positive for the hypermethylation of p14 ( ARF )in the rectum had a longer duration of ulcerative colitis than those who were negative for such hypermethylation. Two of 10 patients who were positive for p14 ( ARF ) hypermethylation in the rectum and 1 of 29 patients who were negative for the hypermethylation had dysplasia. During the subsequent surveillance of 36 patients, dysplasia was detected in 2 of 8 patients with p14 ( ARF ) hypermethylation and in none of 28 patients without hypermethylation (P = 0.044). CONCLUSIONS: In patients with ulcerative colitis, hypermethylation of p14 ( ARF ) seems to be associated with an early stage of dysplasia. The hypermethylation may be one of candidates for potential biomarker to identify patients at a high risk of dysplasia..
43. Takayuki Matsumoto, Tomohiko Moriyama, Takashi Yao, Ryuichi Mibu, Mitsuo Iida, Autofluorescence imaging colonoscopy for the diagnosis of dysplasia in ulcerative colitis., Inflammatory bowel diseases, 13, 5, 640-1, 2007.05.
44. Moriyama T, Matsumoto T, Nakamura S, Jo Y, Mibu R, Yao T, Iida M, Hypermethylation of p14(ARF) may be predictive of colitic cancer in patients with ulcerative colitis., Dis Colon Rectum, 50: 1384-1392, 2007.01.
45. Motohiro Esaki, Takayuki Matsumoto, Tomohiko Moriyama, Kazuoki Hizawa, Yutaka Ohji, Shotaro Nakamura, Katsuya Hirakawa, Minako Hirahashi, Takashi Yao, Mitsuo Iida, Probe EUS for the diagnosis of invasion depth in superficial esophageal cancer: a comparison between a jelly-filled method and a water-filled balloon method., Gastrointestinal endoscopy, 63, 3, 389-95, 2006.03, BACKGROUND AND OBJECTIVE: Diagnostic accuracy of probe EUS depends on the constant maintenance of luminal medium for acoustic coupling. This study compared the accuracy of probe EUS by a jelly-filled method (EUS-J) and by a water-filled balloon method (EUS-W) for the assessment of invasion depth in superficial esophageal cancer. DESIGN AND SETTING: A prospective, single-center study. PATIENTS: Forty superficial esophageal cancers in 38 patients. INTERVENTIONS: Patients were alternately assigned to EUS-J or EUS-W. The depth of invasion was classified into epithelium or lamina propria mucosae (D1), muscularis mucosae or superficial layer of the submucosa (D2), and deep portion of the submucosa (D3). Depiction rate, interobserver variation between 2 observers, and accuracy for the determination of invasion depth were compared between EUS-J and EUS-W. MAIN OUTCOME MEASUREMENTS AND RESULTS: Eighteen cancers were examined by EUS-J, and 22 cancers were examined by EUS-W. The actual depth of invasion was D1 in 21 cancers, D2 in 9 cancers, and D3 in 10 cancers. Depiction rate (94.4% vs 77.2%, P = .14) and interobserver agreement of EUS determination (82.3% vs 58.8%, P = .13) was higher in EUS-J than in EUS-W. The overall accuracy for the diagnosis of invasion depth was 77.8% in EUS-J and 59.1% in EUS-W (P = .18). The sensitivity for the diagnosis of D1 cancer was significantly higher in EUS-J than in EUS-W (100% vs 50%, P = .03), while the specificity was not different between the 2 procedures (81.8% vs 87.5%). CONCLUSIONS: EUS-J is superior to EUS-W for the assessment of invasion depth in superficial esophageal cancer, especially for intramucosal cancer..
46. Takayuki Matsumoto, Tomohiko Moriyama, Motohiro Esaki, Shotaro Nakamura, Mitsuo Iida, Performance of antegrade double-balloon enteroscopy: comparison with push enteroscopy., Gastrointestinal endoscopy, 62, 3, 392-8, 2005.09, BACKGROUND: Double-balloon enteroscopy (DBE) is a novel procedure for the diagnosis of small-bowel pathology. The aim of this retrospective study was to compare the performance and the diagnostic value of antegrade DBE with those of push enteroscopy (PE). METHODS: We reviewed endoscopic and histologic findings in 118 patients examined by PE or antegrade DBE during a period 1980 to 2004. The maximal length of insertion under plain radiograph was compared between patients examined by PE and those examined by antegrade DBE. Diagnostic yield was compared among patients stratified by indication for enteroscopy and the duodenal pathology. RESULTS: Ninety-one patients were examined by PE and 27 patients by antegrade DBE. Length of insertion from the ligament of Treitz was significantly greater in antegrade DBE (median, 92 cm; range, 40-144 cm) than in PE (median, 22 cm; range, 0-98 cm; p < 0.0001). In 90 nonbleeding patients with inflammatory or miscellaneous diseases or polyposis, the diagnostic yield was not different between PE and antegrade DBE (64% vs. 82%, p = 0.13). However, it was higher in antegrade DBE (79%) than in PE (31%, p = 0.012) in nonbleeding patients without duodenal pathology. In bleeding patients, the diagnostic yield was 40% in antegrade DBE and 36% in PE (p = 0.61). CONCLUSIONS: Antegrade DBE is superior to PE in exploration of the small intestine and in diagnostic yield for small-intestinal pathology..
47. Moriyama T, Matsumoto T, Jo Y, Yada S, Hirahashi M, Yao T, Iida M, Mucosal proinflammatory cytokine and chemokine expression of gastroduodenal lesions in Crohn’s disease., Aliment Pharmacol Ther, 10.1111/j.1365-2036.2005.02480.x, 21, 85-91, 21 Suppl 2: 85-91, 2005.01.
48. Moriyama T, Matsumoto T, Fuchigami T, Nakamura S, Ishikawa N, Takubo N, Yamamoto S, Oshiro Y, Nakanishi M, Tomioka K, Iida M, Changes in Helicobacter pylori status in patients with rheumatoid arthritis under non-steroidal anti-inflammatory drugs., Scand J Gastroenterol, 10.1080/00365520310008089, 39, 2, 111-118, 39: 111-118, 2004.01.
49. Moriyama T, Matsumoto T, Hizawa K, Tada S, Fuchigami T, Iwai K, Yao T, Iida M, Inflammatory myoglandular polyps: a case series of nine patients., Endoscopy, 10.1055/s-2003-38138, 35, 4, 363-365, 35: 363-365, 2003.01.