正岡 建洋 (マサオカ タツヒロ)

Masaoka, Tatsuhiro

写真a

所属(所属キャンパス)

医学部 内科学教室(消化器) (信濃町)

職名

専任講師

 

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  • Colonic dysmotility and morphological abnormality frequently detected in Japanese patients with irritable bowel syndrome

    Mizukami, T., Sugimoto, S., Masaoka, T., Suzuki, H. and Kanai, T.

    Intest Res 15 ( 2 ) 236 - 243 2017年04月

    ISSN  1598-9100

     概要を見る

    BACKGROUND/AIMS: Colonoscopy and computed tomography (CT) are used primarily to exclude organic diseases in patients with irritable bowel syndrome (IBS), rather than to assess the pathophysiology of IBS. We aimed to evaluate colonic dysmotility and morphology in Japanese patients with IBS. METHODS: One hundred eighty-four patients with IBS and 49 asymptomatic controls who underwent colonoscopy in combination with CT colonography or barium enema were retrospectively reviewed between 2008 and 2012. Water-aided colonoscopy was performed without sedation by a single endoscopist. The duration and pattern of colonic movement and cecal intubation time were recorded. To assess colonic morphology, barium enema or CT colonography were performed immediately after colonoscopy. RESULTS: Colonic dysmotility was more frequent in the IBS group (28.8% vs. 2.0% in controls, P<0.001), especially in cases of IBS with diarrhea (IBS-D) (IBS with constipation [IBS-C] 28.8% vs. IBS-D 60.0% vs. mixed IBS [IBS-M] 5.1%, P<0.001). Colonic morphological abnormality was more frequent in the IBS group than in the control group (77.7% vs. 24.5%, P<0.001), especially in IBS-M and IBS-C groups (IBS-C 77.5% vs. IBS-D 48.9% vs. IBS-M 100%, P<0.001). Most patients with IBS with colonic dysmotility had experienced stress related to their symptoms. Cecal intubation time was significantly longer in the IBS group than in the control group (12.1+/-6.9 minutes vs. 4.6+/-1.9 minutes, P<0.001). CONCLUSIONS: Unsedated colonoscopy, combined with radiographic findings, can detect colonic dysmotility and morphological abnormality. Technical difficulties observed during cecal intubation may partially explain the pathophysiology of IBS.

  • Gender Difference of Gastric Emptying in Healthy Volunteers and Patients with Functional Dyspepsia

    Mori, H., Suzuki, H., Matsuzaki, J., Taniguchi, K., Shimizu, T., Yamane, T., Masaoka, T. and Kanai, T.

    Digestion 95 ( 1 ) 72 - 78 2017年

    ISSN  1421-9867

     概要を見る

    BACKGROUND AND AIM: Delayed gastric emptying is one of the reasons why functional dyspepsia (FD) occurs. The 13C-acetate breath test is widely used to evaluate gastric emptying. Nevertheless, the standard value of 13C-acetate breath test has not taken into account the gender difference of gastric emptying among healthy individuals. The main aim of this study was to readjust the standard value of 13C-acetate breath test in the light of gender differences. In addition, we clarified the prevalence and clinical characteristics of delayed gastric emptying in patients with FD using the modified standard values of 13C-acetate breath test. METHODS: Fifty-two healthy individuals and 126 patients with patients with FD were enrolled. Gastric emptying was evaluated by the 13C-acetate breath test. The cut-off points of Tmax for the diagnosis of delayed gastric emptying were determined on the basis of results from healthy individuals making a distinction of genders. Gastroesophageal reflux symptoms, dyspeptic symptoms, scores of anxiety and depression, age, body mass index (BMI), smoking and alcohol consumption were compared between the delayed gastric emptying group and the non-delayed gastric emptying group. RESULTS: Since gastric emptying was delayed in healthy women compared with that in healthy men (Tmax, 53.6 +/- 19.3 vs. 42.7 +/- 16.9 min, p = 0.04), we set the cut-off points of Tmax at 60 min in men and at 75 min in women. In patients with FD, the prevalence of delayed gastric emptying was not different between men and women with the modified standard values of 13C-acetate breath test. (31.0 vs. 27.4%, p = 0.68). BMI was lower in the delayed gastric emptying group than in the non-delayed group among the male patients. Reflux symptoms were more severe in delayed gastric emptying group than in the non-delayed group among the female patients. CONCLUSION: The standard values of 13C-acetate breath test should be modified bearing the gender difference in mind. It provides us more appropriate information to understand the mechanisms of FD.

  • Bifidobacterium-Rich Fecal Donor May Be a Positive Predictor for Successful Fecal Microbiota Transplantation in Patients with Irritable Bowel Syndrome

    Mizuno, S., Masaoka, T., Naganuma, M., Kishimoto, T., Kitazawa, M., Kurokawa, S., Nakashima, M., Takeshita, K., Suda, W., Mimura, M., Hattori, M. and Kanai, T.

    Digestion 96 ( 1 ) 29 - 38 2017年

    ISSN  1421-9867

     概要を見る

    BACKGROUND/AIMS: Dysbiosis is associated with various systemic disorders including irritable bowel syndrome (IBS). Fecal microbiota transplantation (FMT) might restore intestinal microbial balance. The study aimed to determine the safety and efficacy of FMT in IBS patients, as well as also positive predictors for FMT. METHODS: This was a single-arm, open-label study. Eligible patients were diagnosed based on Rome III Diagnostic Criteria. Fecal materials were administered to the patient via colonoscopy. The primary end point was a change in the Bristol stool form scale at 4 weeks after FMT. Recovery to types 3-4 was considered a clinical response. The secondary end point was a change in intestinal microbiota and psychological status using the Hamilton Rating Scale. RESULTS: Ten patients were enrolled. Six patients achieved a clinical response. The diversity of patients 4 weeks after FMT increased significantly compared with patients before FMT, and that of responding patients was significantly higher than non-responder patients. The abundance of Bifidobacterium in effective donors was significantly higher than in ineffective donors and patients. Psychological status of all patients was significantly improved after FMT. CONCLUSIONS: FMT for patients with IBS is safe, and relatively effective. Bifidobacterium-rich fecal donor may be a positive predictor for successful FMT. Key Summary: (1) Dysbiosis is associated with various gastrointestinal disorders including IBS. (2) FMT has potential to restore intestinal microbial balance. (3) We showed that FMT improved stool form and psychological status of IBS patients. (4) Bifidobacterium-rich donor efficiently induced symbiosis in IBS patients.

  • A simple scoring system to assess the need for an endoscopic intervention in suspected upper gastrointestinal bleeding: A prospective cohort study

    Horibe, M., Kaneko, T., Yokogawa, N., Yokota, T., Okawa, O., Nakatani, Y., Ogura, Y., Matsuzaki, J., Iwasaki, E., Hosoe, N., Masaoka, T., Inadomi, J. M., Suzuki, H., Kanai, T. and Namiki, S.

    Dig Liver Dis 48 ( 10 ) 1180 - 6 2016年10月

    ISSN  1878-3562

     概要を見る

    BACKGROUND: Assessment of the emergent endoscopy for upper gastrointestinal bleeding (UGIB) patients has important clinical implications. There is no validated criterion to triage. AIMS: To develop a simple score predicting an endoscopic intervention. METHODS: A prospective cohort study was conducted at a tertiary care centre. Primary outcome was the high-risk stigmata which were well-established endoscopic findings to determine the need for an endoscopic intervention. We created a simple score by multivariable logistic regression and compared with the Glasgow Blatchford Score (GBS). External validation was performed in a second cohort. RESULTS: 284 of consecutive 568 patients with suspected UGIB had the high-risk stigmata. Three variables were selected: "no daily use of proton pump inhibitors during one week before examination (+1 point)", "shock index (heart rate/systolic blood pressure)>/=1 (+1 point)" and "urea/creatinine>/=140 (blood urea nitrogen/creatinine>/=30) (+1 point)". The accumulating score (range 0-3) achieved an area under the receiver-operating characteristic curve (AUC) of 0.74 (95% confidence interval [CI], 0.70-0.78), which was superior to the GBS (AUC, 0.63; 95% CI, 0.59-0.68; p<0.001). Validation in an external cohort demonstrated superiority to the GBS (AUC, 0.78 vs. 0.59; p<0.001). CONCLUSIONS: The simple score has greater accuracy than the GBS for assessing the need for an endoscopic intervention in cases of suspected UGIB. Further external validation should be performed to verify generalizability.

  • Influence of regular exercise on gastric emptying in healthy men: a pilot study

    Matsuzaki, J., Suzuki, H., Masaoka, T., Tanaka, K., Mori, H. and Kanai, T.

    J Clin Biochem Nutr 59 ( 2 ) 130 - 133 2016年09月

    ISSN  0912-0009

     概要を見る

    Functional gastrointestinal disorders (FGIDs), including functional dyspepsia (FD), are common chronic disorders even in the younger population. Physical activity is advocated for patients with FGIDs, although the evidence is insufficient. We investigated the association between the intensity of regular exercise and gastric emptying to determine the effect of physical activity on dyspeptic symptoms. Thirty healthy individuals were selected and divided into three groups (low, moderate, and high) using the index of total exercise intensity in a week. Gastric emptying was evaluated by the 13C-acetate breath test. Gastroesophageal reflux symptoms, dyspeptic symptoms, stool forms, scores of anxiety and depression, and scores of sleep quality were also compared. Baseline scores of gastroesophageal reflux symptoms, anxiety, depression, and sleep quality were not different among the three groups. Gastric emptying was significantly faster in low-intensity exercise group than the moderate-intensity exercise group. Although the presence of loose stool and alcohol consumption were also associated with the intensity of regular exercise, these variables were not confounders. In conclusion, the intensity of regular exercise was independently associated with gastric emptying in healthy individuals. These baseline data would be useful for consideration of an optimal exercise intervention for the treatment of FD.

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KOARA(リポジトリ)収録論文等 【 表示 / 非表示

研究発表 【 表示 / 非表示

  • PPIのbeyond acid suppression-H.pylori 除菌後陰性易再発性潰瘍に対するPPIの効果

    岩崎栄典, 森下鉄夫, 大原正志, 鈴木秀和, 正岡 建洋, 長田高志, 石井裕正

    第22回Cytoprotection研究会 (京都) , 2004年02月, 口頭(一般)

  • Helicobacter pylori 感染スナネズミ胃炎の進展とSonic Hedgehog 発現の関連 -胃粘膜再生への新規マーカーの模索- 「消化器領域の再生医療 Part Ⅱ」

    鈴木秀和, 峯岸ゆり子, 大田孝幸, 正岡 建洋, Gijs R. van den Brink, 石井裕正

    第22回Cytoprotection研究会 (京都) , 2004年02月, 口頭(一般)

  • Passive transfer of Anti-urease immunoglobulin Y can confer protection against Helicobacter pylori infection

    'Nomura Sachiko, Suzuki Hidekazu, MASAOKA TATSUHIRO, Kurabayashi Kumiko, Minegishi Yuriko, Nomoto Kikuo, Kitajima Masaki, Ishii Hiromasa'

    Annual Conference of Japan-Korea Joint Meeting on Helicobacter Infection ('Seoul, Korea') , 2004年02月, 口頭(一般)

  • Human β defensinの胃粘膜炎症・免疫反応及び微小循環系への影響能の検討

    大原正志, 森下鉄夫, 岩崎栄典, 長田高志, 鈴木秀和, 正岡 建洋, 石井裕正

    第29回日本微小循環学会総会 (熊本) , 2004年02月, 口頭(一般)

  • Helicobacter pylori感染スナネズミ胃炎におけるSonic Hedgehog (Shh)の検討

    '鈴木秀和, 峯岸ゆり子, 大田孝幸, 正岡 建洋, 高嶋恵美, Gijs R. van den Brink, 石井裕正'

    第15回消化管細胞機能研究会 (掛川) , 2004年02月, 口頭(一般)

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担当授業科目 【 表示 / 非表示

  • 内科ケーススタディー

    2019年度

  • 内科学(消化器)講義

    2019年度