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

 

研究分野 【 表示 / 非表示

  • 消化器内科学

 

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  • Horibe GI bleeding prediction score: a simple score for triage decision-making in patients with suspected upper GI bleeding

    Horibe M., Iwasaki E., Bazerbachi F., Kaneko T., Matsuzaki J., Minami K., Masaoka T., Hosoe N., Ogura Y., Namiki S., Hosoda Y., Ogata H., Chan A.T., Kanai T.

    Gastrointestinal Endoscopy (Gastrointestinal Endoscopy)  92 ( 3 ) 578 - 588.e4 2020年09月

    ISSN  00165107

     概要を見る

    © 2020 American Society for Gastrointestinal Endoscopy Background and Aims: Although upper GI bleeding (UGIB) is a significant cause of inpatient admissions, no scoring method has proven to be accurate and simple as a standard for triage purposes. Therefore, we compared a previously described 3-variable score (1 point each for absence of daily proton pump inhibitor use in the week before the index presentation, shock index [heart rate/systolic blood pressure] ≥1, and blood urea nitrogen/creatinine ≥30 [urea/creatinine≥140]), the Horibe gAstRointestinal BleedING scoRe (HARBINGER), with the 8-variable Glasgow-Blatchford Score (GBS) and 5-variable AIMS65 to evaluate and validate the accuracy in predicting high-risk features that warrant admission and urgent endoscopy. Methods: Consecutive patients presenting with suspected UGIB between 2012 and 2015 were prospectively enrolled in 3 acute care Japanese hospitals. On presentation to the emergency setting, an endoscopy was performed in a timely fashion. The primary outcome was the prediction of high-risk endoscopic stigmata. Results: Of 1486 enrolled patients, 637 (43%) harbored high-risk endoscopic stigmata according to international consensus statements. The area under the receiver operating characteristic curve (AUC) for the HARBINGER was.76 (95% confidence interval [CI],.72-.79), which was significantly superior to both the GBS (AUC,.68; 95% CI,.64-.71; P <.001) and the AIMS65 (AUC,.54; 95% CI,.50-.58; P <.001). When the HARBINGER cutoff value was set at 1 to rule out patients who needed admission and urgent endoscopy, its sensitivity and specificity was 98.8% (95% CI, 97.9-99.6) and 15.5% (95% CI, 13.1-18.0), respectively. Conclusions: The HARBINGER, a simple 3-variable score, provides a more accurate method for triage of patients with suspected UGIB than both the GBS and AIMS65.

  • Efficacy and safety of once-weekly exenatide after switching from twice-daily exenatide in patients with type 2 diabetes

    Watanabe Y., Saisho Y., Inaishi J., Kou K., Yamauchi A., Kanazawa Y., Okubo Y., Tokui M., Imai T., Murakami R., Tsuchiya T., Sasaki H., Masaoka T., Irie J., Meguro S., Itoh H.

    Journal of Diabetes Investigation (Journal of Diabetes Investigation)  11 ( 2 ) 382 - 388 2020年03月

    ISSN  20401116

     概要を見る

    © 2019 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd Aims/Introduction: To evaluate the efficacy and safety of once-weekly (q.w.) extended-release exenatide after switching from twice-daily (b.i.d.) exenatide in patients with type 2 diabetes. Materials and Methods: This was an investigator-initiated, prospective, single-arm, multicenter study. Individuals with type 2 diabetes who had been treated with exenatide b.i.d. for at least 3 months were enrolled and switched to exenatide q.w. for 24 weeks. The primary end-point was change in HbA1c at week 24 to test the glucose-lowering effect of exenatide q.w. versus exenatide b.i.d. Results: A total of 58 Japanese individuals with type 2 diabetes completed the study. Glycated hemoglobin was reduced by 0.2% at week 24 (7.2 ± 1.2% vs 7.0 ± 1.2% [56 ± 13 vs 53 ± 13 mmol/mol], 95% confidence interval −0.4 to −0.03%, P < 0.005 for non-inferiority, P = 0.01 for superiority). Fasting plasma glucose was reduced by 12 mg/dL at week 24 (154 ± 46 vs 142 ± 46 mg/dL, P = 0.02). β-Cell function assessed by homeostasis model assessment of β-cell function and C-peptide index was significantly improved at week 24. The incidence of self-reported hypoglycemia was reduced, and treatment satisfaction assessed by the Diabetes Treatment Satisfaction Questionnaire and Diabetes Medication Satisfaction Questionnaire was improved at week 24, with no change in body weight. There was no serious adverse event related to the study drug. Conclusions: Switching from exenatide b.i.d. to exenatide q.w. resulted in a reduction in glycated hemoglobin, fasting plasma glucose and the incidence of hypoglycemia, and improvement in β-cell function and treatment satisfaction in patients with type 2 diabetes. These findings will be useful for selecting optimal treatment in individuals with type 2 diabetes.

  • 5-Aminosalicylic acid intolerance is associated with a risk of adverse clinical outcomes and dysbiosis in patients with ulcerative colitis

    Mizuno S., Ono K., Mikami Y., Naganuma M., Fukuda T., Minami K., Masaoka T., Terada S., Yoshida T., Saigusa K., Hirahara N., Miyata H., Suda W., Hattori M., Kanai T.

    Intestinal Research (Intestinal Research)  18 ( 1 ) 69 - 78 2020年01月

    ISSN  15989100

     概要を見る

    © 2020. Korean Association for the Study of Intestinal Diseases. Background/Aims: 5-Aminosalicylic acid (ASA) causes intolerance reactions in some patients. This study was performed to examine the prognosis of patients with ulcerative colitis (UC) and 5-ASA intolerance, and to evaluate the potential interaction between 5-ASA intolerance and the intestinal microbiota. Methods: We performed a retrospective cohort study of patients with UC who visited participating hospitals. The primary endpoint was to compare the incidence of hospitalization within 12 months between the 5-ASA intolerance group and the 5-ASA tolerance group. The secondary endpoint was to compare the risk of adverse clinical outcomes after the start of biologics between the 2 groups. We also assessed the correlation between 5-ASA intolerance and microbial change in an independently recruited cohort of patients with UC. Results: Of 793 patients, 59 (7.4%) were assigned to the 5-ASA intolerance group and 734 (92.5%) were assigned to the 5-ASA tolerance group. The admission rate and incidence of corticosteroid use were significantly higher in the intolerance than tolerance group (P<0.001). In 108 patients undergoing treatment with anti-tumor necrosis factor biologics, 5-ASA intolerance increased the incidence of additional induction therapy after starting biologics (P<0.001). The 5-ASA intolerance group had a greater abundance of bacteria in the genera Faecalibacterium, Streptococcus, and Clostridium than the 5-ASA tolerance group (P<0.05). Conclusions: In patients with UC, 5-ASA intolerance is associated with a risk of adverse clinical outcomes and dysbiosis. Bacterial therapeutic optimization of 5-ASA administration may be important for improving the prognosis of patients with UC.

  • 広範な潰瘍性病変を呈したアメーバ性大腸炎の一例

    津軽, 開, 高林, 馨, 南木, 康作, 野田, まりん, 林, 由紀恵, 下嵜, 啓太郎, 平田, 賢郎, 福原, 佳代子, 三上, 洋平, 水野, 慎大, 加藤, 元彦, 正岡, 建洋, 細江, 直樹, 長沼, 誠, 緒方, 晴彦 and 金井, 隆典

    Progress of Digestive Endoscopy 95 ( 1 ) 126 - 128 2019年12月

    ISSN  1348-9844

     概要を見る

    症例は63歳男性で、2年前より自然軽快する水様性下痢を繰り返していたが、2週間前からの血性下痢が軽快せず発熱や食事摂取困難を伴ったため入院した。血液検査では炎症反応上昇、低栄養、低Ig血症を認め、下部消化管内視鏡(CS)では全大腸に渡り粘稠度の高い白苔が付着した不整形潰瘍を全周性に認め、遠位結腸は一部正常粘膜が介在し回腸末端は異常を認めなかった。入院第5病日に生検検体および便塗抹検査にてアメーバ原虫を検出し、アメーバ性大腸炎と診断した。メトロニダゾールを10日間、その後パロモマイシンを7日間投与し、入院第17病日に退院した。退院3ヵ月後のCSで潰瘍は消失したが脾彎曲に小潰瘍を伴った浮腫性狭窄が残存し、退院9ヵ月後のCSでは狭窄部以外の全大腸の治癒を確認した。狭窄箇所の生検からはアメーバ原虫は検出されなかった。

  • Current status of first- and second-line Helicobacter pylori eradication therapy in the metropolitan area: a multicenter study with a large number of patients

    Mori H., Suzuki H., Omata F., Masaoka T., Asaoka D., Kawakami K., Mizuno S., Kurihara N., Nagahara A., Sakaki N., Ito M., Kawamura Y., Suzuki M., Shimada Y., Sasaki H., Matsuhisa T., Torii A., Nishizawa T., Mine T., Ohkusa T., Kawai T., Tokunaga K., Takahashi S.

    Therapeutic Advances in Gastroenterology (Therapeutic Advances in Gastroenterology)  12 2019年07月

    ISSN  1756283X

     概要を見る

    © The Author(s), 2019. Background: The environment surrounding Helicobacter pylori eradication treatment is dramatically changing. Recently, vonoprazan, a first-in-class potassium-competitive acid blocker (P-CAB), was introduced onto the market in 2015. The aging of Japan’s demographic structure is becoming pronounced. In this study, we examined the trend of the eradication rate of H. pylori in the metropolitan area and examined factors concerning successful eradication. Methods: We collected data from 20 hospitals in the Tokyo metropolitan area on patients who received first-line eradication therapy with a proton-pump inhibitor (PPI)/P-CAB, amoxicillin, and clarithromycin for 1 week and second-line eradication therapy with a PPI/P-CAB, amoxicillin, and metronidazole for 1 week from 2013 to 2018. The annual eradication rate and associated factors for successful eradication were analyzed. Results: We collected data of 4097 and 3572 patients in the first- and second-line eradication therapies, respectively. The eradication rate decreased from 2013 to 2014 and increased again from 2015 to 2018 with the first-line therapy [the eradication rates in 2013, 2014, 2015, 2016, 2017 and 2018 were 71.8%, 63.7%, 78.5%, 84.6%, 89.7 and 90.1%, respectively, in the per protocol (PP)]. The second-line eradication rates were 90.0%, 82.6%, 88.8%, 87.5%, 91.8% and 90.1% in 2013, 2014, 2015, 2016, 2017 and 2018, respectively, in PP. Vonoprazan was an independent factor for successful eradication in not only first-line, but also second-line eradication. Age over 75 years was an independent factor for eradication failure in both first- and second-line eradication therapies. Conclusion: The eradication rate improved from 2015 to 2018 with the first-line therapy because of the introduction of vonoprazan in the market. The eradication rates with first- and second-line regimens in elderly patients were lower than those in younger patients.

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  • 【いま知っておきたい! 内科最新トピックス】巻頭トピックス 新規便秘治療薬の特徴

    猪口 和美, 正岡 建洋

    内科 ((株)南江堂)  126 ( 3 ) 353 - 356 2020年09月

    ISSN  0022-1961

     概要を見る

    <文献概要>・2012年にlubiprostoneが保険適用になって以降,linaclotide,elobixibatなどの新規便秘治療薬が次々と利用可能になり,以前より許可されていたものの便秘に対する適用を有さなかったラクツロース製剤やすでに海外では広く使用されてきたポリエチレングリコールも慢性便秘に対して使用できるようになった.・オピオイド誘発性便秘に対してオピオイド受容体拮抗薬であるnaldemedine(スインプロイク)が発売された.・従来の便秘薬では高マグネシウム血症や刺激性下剤への依存,メラノーシスが問題となることがあったが,使用できる薬剤の選択肢が増え,従来のものと組み合わせることでより安全に便秘治療が行えるようになった.・今後は,長期的な安全性の評価や多様化した便秘治療薬の使い分け方法を確立することが期待される.

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

  • 内科学(消化器)講義

    2020年度

  • 内科ケーススタディー

    2020年度

  • 内科ケーススタディー

    2019年度

  • 内科学(消化器)講義

    2019年度