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| 1 | Fucoidan enhances intestinal barrier function by upregulating the expression of claudin-1显示文摘AIM:To evaluate the protective effects of fucoidan on oxidative stress-induced barrier disruption in human intestinal epithelial cells.METHODS:In Caco-2 cell monolayer models,the disruption of barrier function by oxidative stress is mediated by H2O2.The integrity of polarized Caco-2 cell monolayers was determined by measuring the transepithelial resistance(TER)and permeability was estimated by measuring the paracellular transport of FITC-labeled4-kDa dextran(FD4).The protective effects of fucoidan on epithelial barrier functions on polarized Caco-2 cell monolayers were evaluated by TER and FD4 flux.The expression of tight junction(TJ)proteins was assessed using reverse-transcription polymerase chain reaction(RT-PCR)and immunofluorescence staining.RESULTS:Without H2O2treatment,fucoidan significantly increased the TER compared to control(P<0.05),indicating a direct enhancement of intestinal epithelial barrier function.Next,H2O2disrupted the epithelial barrier function in a time-dependent manner.Fucoidan prevented the H2O2-induced destruction in a dosedependent manner.Fucoidan significantly decreased H2O2-induced FD4 flux(P<0.01),indicating the prevention of disruption in paracellular permeability.RTPCR showed that Caco-2 cells endogenously expressed claudin-1 and-2,and occludin and that H2O2reduced the mRNA expression of these TJ proteins.Treatment with fucoidan attenuated the reduction in the expressions of claudin-1 and claudin-2 but not occludin.Immunofluorescence staining revealed that the expression of claudin-1 was intact and high on the cell surface.H2O2disrupted the integrity of claudin-1.Treatment with fucoidan dramatically attenuated the expression of claudin-1.CONCLUSION:Fucoidan enhanced intestinal epithelial barrier function by upregulating the expression of claudin-1.Thus,fucoidan may be an appropriate therapy for the treatment of inflammatory bowel diseases. | Atsushi Iraha Hiroshi Chinen Akira Hokama Takumi Yonashiro Tetsu Kinjo Kazuto Kishimoto Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Futoshi Higa Masao Tateyama Fukunori Kinjo Jiro Fujita | 2013 | World Journal of Gastroenterology2013,19,33: | 15 |
| 2 | Diagnosis of intestinal tuberculosis using a monoclonal antibody to Mycobacterium tuberculosis显示文摘AIM:To investigate the utility of immunohistochemical(IHC) staining with an antibody to Mycobacterium tuberculosis(M.tuberculosis) for the diagnosis of intestinal tuberculosis(TB).METHODS:We retrospectively identified 10 patients(4 males and 6 females;mean age = 65.1 ± 13.6 years) with intestinal TB.Clinical characteristics,including age,gender,underlying disease,and symptoms were obtained.Chest radiograph and laboratory tests,including sputum Ziehl-Neelsen(ZN) staining,M.tuberculosis culture,and sputum polymerase chain reaction(PCR) for tubercle bacilli DNA,as well as Tuberculin skin test(TST) and QuantiFERON-TB gold test(QFT),were examined.Colonoscopic records recorded on the basis of Sato's classification were also reviewed,in addition to data from intestinal biopsies examined for histopathological findings,including hematoxylin and eosin staining,and ZN staining,as well as M.tuberculosis culture,and PCR for tubercle bacilli DNA.For the present study,archived formalin-fixed paraffin-embedded(FFPE) intestinal tissue samples were immunohistochemically stained using a commercially available species-specific monoclonal antibody to the 38-kDa antigen of the M.tuberculosis complex.These sections were also stained with the pan-macrophage marker CD68 antibody.RESULTS:From the clinical data,we found that no patients were immunocompromised,and that the main symptoms were diarrhea and weight loss.Three patients displayed active pulmonary TB,six patients(60%) had a positive TST,and 4 patients(40%) had a positive QFT.Colonoscopic findings revealed that all patients had type 1 findings(linear ulcers in a circumferential arrangement or linear ulcers arranged circumferentially with mucosa showing multiple nodules),all of which were located in the right hemicolon and/or terminal ileum.Seven patients(70%) had concomitant healed lesions in the ileocecal area.No acid-fast bacilli were detected with ZN staining of the intestinal tissue samples,and both M.tuberculosis culture and PCR for tubercle bacilli DNA were negative in all samples.The histopathological data revealed that tuberculous granulomas were present in 4 cases(40%).IHC staining in archived FFPE samples with anti-M.tuberculosis monoclonal antibody revealed positive findings in 4 patients(40%);the same patients in which granulomas were detected by hematoxylin and eosin staining.M.tuberculosis antigens were found to be mostly intracellular,granular in pattern,and primarily located in the CD68 + macrophages of the granulomas.CONCLUSION:IHC staining with a monoclonal antibody to M.tuberculosis may be an efficient and simple diagnostic tool in addition to classic examination methods for the diagnosis of intestinal TB. | Yasushi Ihama Akira Hokama Kenji Hibiya Kazuto Kishimoto Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Haley L Cash Futoshi Higa Masao Tateyama Fukunori Kinjo Jiro Fujita | 2012 | World Journal of Gastroenterology2012,18,47: | 12 |
| 3 | Endoscopic and radiographic features of gastrointestinal involvement in vasculitis显示文摘Vasculitis is an inflammation of vessel walls,followed by alteration of the blood flow and damage to the dependent organ.Vasculitis can cause local or diffuse pathologic changes in the gastrointestinal (GI) tract.The variety of GI lesions includes ulcer,submucosal edema,hemorrhage,paralytic ileus,mesenteric ischemia,bowel obstruction,and life-threatening perforation.The endoscopic and radiographic features of GI involvement in vasculitisare reviewed with the emphasis on small-vessel vasculitis by presenting our typicalcases,including Churg-Strauss syndrome,HenochSch nlein purpura,systemic lupus erythematosus,and Beh et's disease.Important endoscopic features are ischemic enterocolitis and ulcer.Characteristic computed tomographic findings include bowel wall thickening with the target sign and engorgement of mesenteric vessels with comb sign.Knowledge of endoscopic and radiographic GI manifestations can help make an early diagnosis and establish treatment strategy. | Akira Hokama Kazuto Kishimoto Yasushi Ihama Chiharu Kobashigawa Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Futoshi Higa Masao Tateyama Fukunori Kinjo Kunitoshi Iseki Seiya Kato Jiro Fujita | 2012 | World Journal of Gastrointestinal Endoscopy2012,4,3: | 9 |
| 4 | 胃肠的淀粉样变性病的内视镜、组织病理学说的特征显示文摘 Amyloidosis is a rare disorder, characterized by the extracellular deposition of an abnormal fibrillar protein, which disrupts tissue structure and function. Amyloidosis can be acquired or hereditary, and systemic or localized to a single organ, such as the gastrointestinal (GI) tract. Clinical manifestations may vary from asymptomatic to fatal forms. Primary amyloidosis (monoclonal immunoglobulin light chains, AL) is the most common form of amyloidosis. AL amyloidosis has been associated with plasma cell dyscrasias, such as, mul- tiple myeloma. Secondary amyloidosis is caused by the deposition of fragments of the circulating acute-phase reactant, serum amyloid A protein (SAA). Common causes of AA amyloidosis are chronic inflammatory dis-orders. Although GI symptoms are usually nonspecific, histopathological patterns of amyloid deposition are associated with clinical and endoscopic features. Amyloid deposition in the muscularis mucosae, submucosa, and muscularis propria has been dominant in AL amyloidosis, leading to polypoid protrusions and thickening of the valvulae conniventes, whereas granular amyloid deposition mainly in the propria mucosae has been related to AA amyloidosis, resulting in the fine granular appearance, mucosal friability, and erosions. As a result, AL amyloidosis usually presents with constipation, mechanical obstruction, or chronic intestinal pseudoobstruction while AA amyloidosis presents with diarrhea and malabsorption Amyloidotic GI symptoms are mostly refractory and have a negative impact on quality of life and survival. Diagnosing GI amyloidosis requires high suspicion of evaluating endoscopists. Because of the absence of specific treatments for reducing the abundance of the amyloidogenic precursor protein, we should be aware of certain associations between patterns of amyloid deposition and clinical and endoscopic features. | Akira Hokama Kazuto Kishimoto Manabu Nakamoto Chiharu Kobashigawa Tetsuo Hirata Nagisa Kinjo Fukunori Kinjo Seiya Kato Jiro Fujita | 2011 | World Journal of Gastrointestinal Endoscopy2011,3,8: | 6 |
| 5 | Endoscopic and histopathological study on the duodenum of Strongyloides stercoralis hyperinfection显示文摘AIM:To investigate endoscopic and histopathological findings in the duodenum of patients with Strongyloides stercoralis(S.stercoralis)hyperinfection. METHODS:Over a period of 23 years(1984-2006),we investigated 25 patients withS.stercoralis hyperinfection who had had an esophagogastroduodenoscopy before undergoing treatment for strongyloidiasis.The clinical and endoscopic findings were analyzed retrospectively. RESULTS:Twenty-four(96%)of the patients investigated were under immunocompromised condition which was mainly due to a human T lymphotropic virus type 1(HTLV-1)infection.The abnormal endoscopic findings,mainly edematous mucosa,white villi and erythematous mucosa,were observed in 23(92%) patients.The degree of duodenitis including villous atrophy/destruction and inflammatory cell infiltration corresponded to the severity of the endoscopic findings. The histopathologic yield for identifying larvae was 71.4% by duodenal biopsy.The endoscopic findings of duodenitis were more severe in patients whose biopsies were positive for larvae than those whose biopsies were negative(Endoscopic severity score:4.86±2.47vs 2.71 ±1.38,P<0.05). CONCLUSION:Our study clearly demonstrates that,in addition to stool analysis,endoscopic observation and biopsies are very important.We also emphasize that S.stercoralis and HTLV-1 infections should be ruled out before immunosuppressive therapy is administered in endemic regions. | Kazuto Kishimoto Akira Hokama Tetsuo Hirata Yasushi Ihama Manabu Nakamoto Nagisa Kinjo Fukunori Kinjo Jiro Fujita | 2008 | World Journal of Gastroenterology2008,14,11: | 4 |
| 6 | Detection of active bleeding from gastric antral vascular ectasia by capsule endoscopy显示文摘Gastric antral vascular ectasia(GAVE) has been recognized as one of the important causes of occult and obscure gastrointestinal bleeding.The diagnosis is typically made based on the characteristic endoscopic features,including longitudinal row of flat,reddish stripes radiating from the pylorus into the antrum that resemble the stripes on a watermelon.These appearances,however,can easily be misinterpreted as moderate to severe gastritis.Although it is believed that capsule endoscopy(CE) is not helpful for the study of the stomach with its large lumen,GAVE can be more likely to be detected at CE rather than conventional endoscopy.CE can be regarded as 'physiologic' endoscopy,without the need for gastric inflation and subsequent compression of the vasculature.The blood flow of the ecstatic vessels may be diminished in an inflated stomach.Therefore,GAVE may be prominent in CE.We herein describe a case of active bleeding from GAVE detected by CE and would like to emphasize a possibility that CE can improve diagnostic yields for GAVE. | Tetsuya Ohira Akira Hokama Nagisa Kinjo Manabu Nakamoto Chiharu Kobashigawa Yuya Kise Satoshi Yamashiro Fukunori Kinjo Yukio Kuniyoshi Jiro Fujita | 2013 | World Journal of Gastrointestinal Endoscopy2013,5,3: | 2 |
| 7 | Esophagitis dissecans superficialis and autoimmune bullous dermatoses: A review显示文摘Esophagitis dissecans superficialis(EDS)is a rare and severe endoscopic finding characterized by sloughing of large fragments of esophageal mucosal lining.Although EDS has been reported in association with serious illnesses and certain medications,the pathophysiological association of autoimmune bullous dermatoses with EDS has gained remarkable attention.Among these dermatoses,pemphigus vulgaris and pemphigoid frequently present with various types of esophageal involvement including EDS.We review the pathophysiology and clinical features of this involvement with the presentation of our experiences.The importance of endoscopic evaluation of this entity is discussed. | Akira Hokama Yu-ichi Yamamoto Kiyohito Taira Mitsuteru Nakamura Chiharu Kobashigawa Manabu Nakamoto Tetsuo Hirata Nagisa Kinjo Fukunori Kinjo Kenzo Takahashi Jiro Fujita | 2010 | World Journal of Gastrointestinal Endoscopy2010,2,7: | 1 |