Publications by authors named "Hayato Yamaguchi"

22 Publications

  • Page 1 of 1

[Intra-abdominal bleeding caused after esophagogastroduodenoscopy: a case report].

Nihon Shokakibyo Gakkai Zasshi 2020 ;117(11):985-991

Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital.

An 86-year-old man was transferred to the Tokyo Medical University Hospital because of a temporary loss of consciousness and melena. We performed upper gastrointestinal endoscopy, which revealed Mallory-Weiss syndrome caused by a strong vomiting reflex. After an examination, he complained of abdominal pain, and his blood pressure decreased. Abdominal contrast-enhanced computed tomography showed fresh intra-abdominal hemorrhage. We performed transcatheter arterial embolization by using N-butyl-2-cyanoacrylate to control the bleeding from the right gastroepiploic artery. Intra-abdominal hemorrhage after upper gastrointestinal endoscopy is rare, and we report this case with the literature review.
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http://dx.doi.org/10.11405/nisshoshi.117.985DOI Listing
November 2020

Co-treatment with endoscopic laryngopharyngeal surgery and endoscopic submucosal dissection.

Auris Nasus Larynx 2021 Jun 14;48(3):457-463. Epub 2020 Oct 14.

Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

Objective: Endoscopic laryngopharyngeal surgery (ELPS) is an effective and minimally invasive treatment for pharyngeal cancers. However, the disadvantages of ELPS are the interference of instruments in the operative field and the difficulty in approaching certain areas. To overcome these drawbacks, we began to perform combination treatment of ELPS and endoscopic submucosal dissection (ESD). The aim of the present study was to compare the efficacies of treatment with ELPS alone and ELPS combined with ESD.

Methods: A total of 103 lesions in 73 patients who underwent pharyngeal ELPS for superficial pharyngeal cancer between August 2014 and January 2020 at our hospital were analyzed. Lesions were divided into the ELPS alone group and ELPS combined with ESD group. Lesion characteristics, technical results, adverse events, and long-term outcomes were analyzed.

Results: In the ELPS combined with ESD group, procedure speed was shorter than the ELPS alone group (20.2 ± 10.0 mm/min vs 13.0 ± 6.6 mm/min, p < 0.001), and R0 resection rate was higher (67.4% vs 45.6%, p = 0.027). There were no significant differences in tumor size, depth of tumor invasion, and adverse events among the 2 groups. These results remained unchanged after propensity score matching. The overall and cause-specific survival rates at 3 years were 96.7% and 100% for the ELPS combined with ESD group and ELPS alone group, respectively.

Conclusions: Combination treatment of ESD and ELPS enabled more efficient resection than ELPS alone. Cooperative treatment of pharyngeal cancer patients involving gastroenterologists and head and neck surgeons is effective and beneficial, and results in favorable long-term outcomes.
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http://dx.doi.org/10.1016/j.anl.2020.10.003DOI Listing
June 2021

"Pulley type" countertraction for colonic endoscopic submucosal dissection of laterally spreading tumors involving a diverticulum.

Endosc Int Open 2020 Sep 31;8(9):E1183-E1184. Epub 2020 Aug 31.

Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

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http://dx.doi.org/10.1055/a-1216-1740DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458728PMC
September 2020

The Relationship between Post-colonoscopy Colorectal Cancer and Quality Indicators of Colonoscopy: The Latest Single-center Cohort Study with a Review of the Literature.

Intern Med 2020 15;59(12):1481-1488. Epub 2020 Jun 15.

Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan.

Objective This study aims to elucidate the association between the clinical characteristics of post-colonoscopy colorectal cancer (PCCRC) and quality indicators (QIs) of colonoscopy. Methods Patients with PCCRC who underwent total colonoscopy (TCS) and were histologically diagnosed with adenocarcinoma within six months to five years of the last examination were included in this study. PCCRC and normally detected cancer (NDC) identified within the same period were compared in terms of their clinicopathological characteristics. Furthermore, the QIs at PCCRC detection were compared to those at the last examination. Results Patients with PCCRC had a significantly higher rate of colon surgery history than those with NDC (PCCRC: 25/76, 32.9%; NDC: 31/1,437, 2.2%; p<0.001), but the invasion depth in these patients was significantly shallower (PCCRC: ≤Tis/≥T1, 37/39; NDC: ≤Tis/≥T1, 416/1,021; p<0.001). Among patients with PCCRC, the T1b group had significantly more non-polypoid growth (NPG)-type cases than PG-type CRC cases (p=0.018). The adenoma detection rate (ADR) of colonoscopists performing TCS was 30.2-52.8%. Furthermore, the ADR of colonoscopists at the time of PCCRC detection (36.7%±5.9%) was significantly higher than that of colonoscopists who performed the last examination (34.9%±4.4%; p=0.034). The withdrawal time for negative colonoscopy (WT-NC) at detection was significantly longer than that at the last examination (at detection: 494.3±253.8 s; at last examination: 579.5±243.6 s; p=0.010). Conclusion Given that these PCCRC cases were post-colon surgery cases, had a long WT-NC, and were detected by colonoscopists with a high ADR, most cases showed lesions that were missed during the previous colonoscopy. Caution should be practiced in order to avoid missing flat, NPG-type tumors.
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http://dx.doi.org/10.2169/internalmedicine.4212-19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7364247PMC
October 2020

Protective role of Galectin-7 for skin barrier impairment in atopic dermatitis.

Clin Exp Allergy 2020 08 14;50(8):922-931. Epub 2020 Jun 14.

Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Background: Atopic dermatitis (AD) patients have a barrier disorder in association with Th2 dominant skin inflammation. Galectin-7 (Gal-7), a soluble unglycosylated lectin, is highly expressed in the stratum corneum of AD patients. However, the biological significance of increased Gal-7 expression in AD skin lesions remains unclear.

Objective: We aimed to investigate the production mechanism and functional role of Gal-7 in AD patients and IL-4/IL-13-stimulated epidermal keratinocytes.

Methods: We assessed the Gal-7 expression levels in skin lesions and sera from AD patients. Gal-7 levels were also measured in monolayered normal human epidermal keratinocytes (NHEKs) and 3-dimensional (3D)-reconstructed epidermis in the presence or absence of IL-4/IL-13 with or without Stat3, Stat6 or Gal-7 gene silencing.

Results: Gal-7 was highly expressed in the stratum corneum or intercellular space of AD lesional epidermis as assessed by the stratum corneum proteome analysis and immunohistochemistry. A positive correlation was noted between serum Gal-7 level and transepidermal water loss in patients with AD. These clinical findings were corroborated by our in vitro data, which showed that IL-4/IL-13 facilitated the extracellular release of endogenous Gal-7 in both monolayered NHEKs and 3D-reconstructed epidermis. This machinery was caused by IL-4/IL-13-induced cell damage and inhibited by knockdown of Stat6 but not Stat3 in NHEKs. Moreover, we performed Gal-7 knockdown experiment on 3D-reconstructed epidermis and the result suggested that endogenous Gal-7 serves as a protector from IL-4/IL-13-induced disruption of cell-to-cell adhesion and/or cell-to-extracellular matrix adhesion.

Conclusion And Clinical Relevance: Our study unveils the characteristic of Gal-7 and its possible role as an alarmin that reflects the IL-4/IL-13-induced skin barrier impairment in AD.
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http://dx.doi.org/10.1111/cea.13672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496409PMC
August 2020

Type-I interferon regulates matrix metalloproteinases clearance of the bovine endometrial spheroid.

Anim Sci J 2020 Jan-Dec;91(1):e13350

Department of Animal and Marine Bioresource Sciences, Faculty of Agriculture, Kyushu University, Fukuoka, Japan.

This study investigated the effect of type-I interferon (IFN) on the expression of matrix metalloproteinases (MMPs) of the bovine endometrial stromal cells (BES) and epithelial cells (BEE). The cells were separated and purified from the caruncles and cultured in DMEM/F-12 containing 10% fetal bovine serum. Spheroids were generated by using ascorbate. Zymograms of the supernatant showed that BEE predominantly expressed MMP-9, whereas MMP-2 was expressed in BES and homo-spheroids. While MMPs expression was not detected in hetero-spheroids. Real-time quantitative PCR revealed that type-I IFN and P4 suppressed the gene expression of MMP-2 and MMP-9 in hetero-spheroids, respectively. On the other hand, gelatin zymography analysis of the supernatant showed that type-I IFN strongly promote the clearance of MMPs. While zymograms of the MMPs stocked in the hetero-spheroids were significantly reduced by type-I IFN. Phenylmethanesulfonyl fluoride and leupeptin (both are serine proteinase inhibitors) significantly repressed the clearance of MMP-2 and MMP-9 induced by type-I IFN. Moreover, collagen fibers in hetero-spheroids significantly decreased after the treatment with type-I IFN. In conclusion, it was suggested that type-I IFN participate in the tissue remodeling by regulation the clearance of MMPs.
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http://dx.doi.org/10.1111/asj.13350DOI Listing
August 2020

Predictive Factors of Postendoscopic Submucosal Dissection Electrocoagulation Syndrome and the Utility of Computed Tomography Scan after Esophageal Endoscopic Submucosal Dissection.

Digestion 2020 14;101(5):579-589. Epub 2019 Aug 14.

Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.

Background/aims: Recently, postendoscopic submucosal dissection electrocoagulation syndrome (PEECS) has attracted attention. However, the criteria for computed tomography (CT) scanning following esophageal endoscopic submucosal dissection (ESD) are unclear. In this study, we aimed to identify the predictive factors of PEECS and the usefulness of CT scanning after esophageal ESD.

Methods: A total of 245 lesions in 223 patients who underwent esophageal ESD between February 2008 and October 2018 were retrospectively analyzed. Patients with double cancers, those who experienced procedural accidents, such as aspiration pneumonitis or perforation, and those who were unable to undergo CT were excluded from the study. PEECS evaluation items included body temperature (≤37.7°C = 1 point, ≥37.8°C = 2 points), white blood cell count (<10,800/μL = 1 point, ≥10,800/μL = 2 points), and chest pain (numerical rating scale [NRS] ≤4 = 1 point, NRS ≥5 = 2 points). Scores of ≥5 points were categorized as the PEECS-positive group, and scores of ≤4 points were categorized as the PEECS-negative group. The degree of mediastinal emphysema on CT was stratified into 5 grades, in which grades 0 and 1 were considered as the "low-grade" group, and grades 2, 3, and 4 were considered as the "high-grade" group. We analyzed the prognostic factors of high-grade mediastinal emphysema, including the presence or absence of PEECS.

Results: The PEECS-positive group comprised 18 out of the 163 patients (11.0%), and mediastinal emphysema was stratified into grades 0 (94), 1 (51), 2 (12), 3 (5), and 4 (1 patient). Three independent risk factors for the onset of PEECS were identified, as follows: resected area ≥750 mm2 (OR 7.28, 95% CI 1.42-37.33, p = 0.017), treatment duration ≥75 min (OR 10.26, 95% CI 1.20-87.77, p = 0.034), and muscle layer exposure (OR 10.92, 95% CI 2.22-53.74, p = 0.003). Two independent predictive factors of high-grade mediastinal emphysema were identified, which were PEECS positivity (OR 4.31, 95% CI 1.29-14.41, p = 0.018), and muscle layer exposure (OR 4.08, 95% CI 1.18-14.06, p = 0.026).

Conclusions: A large resected area, prolonged treatment duration, and muscle layer exposure are risk factors for the onset of PEECS. Mediastinal emphysema was observed in 43% of patients following ESD. When marked clinical symptoms of PEECS appear, high-grade mediastinal emphysema may be observed, and therefore CT should be performed in these cases.
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http://dx.doi.org/10.1159/000501478DOI Listing
June 2021

Impact of gastric endoscopic submucosal dissection in elderly patients: The latest single center large cohort study with a review of the literature.

Medicine (Baltimore) 2019 Mar;98(11):e14842

Department of Gastroenterology and Hepatology.

With the increase in the elderly population, we are witnessing an increase in the rate of patients with underlying diseases and those under treatment with antithrombotic drugs.In this study, we compared the treatment outcomes of endoscopic submucosal dissection (ESD) and other parameters in the following 3 groups: super-elderly, elderly, and nonelderly.Compared with the other groups, the super-elderly group showed a significantly higher incidence of underlying diseases and the rate of antithrombotic treatment (P < .05). However, we observed no significant difference in the rate of curative resection or incidence of complications among the 3 groups. ESD is a relatively safe technique when performed on super-elderly patients. However, we have identified some cases in the super-elderly group, for which ESD was selected as a minimally invasive treatment for lesions that did not meet the inclusion criteria for open surgery as well as for which follow-up observations were selected rather than additional surgery for noncurative resections.Further investigations concerning ESD are required, focusing on aspects such as indications, additional surgery, and informed consent of the patient or family, particularly when ESD is performed for super-elderly patients.
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http://dx.doi.org/10.1097/MD.0000000000014842DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426470PMC
March 2019

A case of severe stenosis of hepatic veins and inferior vena cava with stomal variceal bleeding induced by oxaliplatin-based chemotherapy.

Clin J Gastroenterol 2018 Apr 9;11(2):150-155. Epub 2018 Jan 9.

Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.

A 27-year-old woman with colon cancer and liver metastasis was referred to our hospital. Colectomy and colostomy were performed to improve her ileus. Following 13 sessions of oxaliplatin-based chemotherapy (OC) with mFOLFOX6 + bevacizumab, thrombocytopenia and frequent peristomal bleeding occurred. Computed tomography showed severe ascites, splenomegaly, significant collateral veins around the stoma, and severe stenosis of the hepatic veins (HV) and inferior vena cava (IVC). Ultrasound elastography showed high liver (and spleen) stiffness values. Repeated OC appeared to cause IVC stenosis as a result of worsening sinusoidal obstruction syndrome (SOS), and peristomal variceal bleeding. After ultrasound-guided percutaneous embolization, bleeding did not recur. Unfortunately, the patient died of liver dysfunction caused by severe SOS. The incidence of OC-induced SOS is reported to be about 50%; however, there is apparently no report of OC-induced HV and IVC stenosis, and in most cases, portal hypertension is improved after OC cessation. This is the first report of OC-induced severe HV and IVC stenosis resulting in refractory peristomal variceal bleeding and eventual death.
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http://dx.doi.org/10.1007/s12328-017-0814-4DOI Listing
April 2018

Sensitive skin is highly frequent in extrinsic atopic dermatitis and correlates with disease severity markers but not necessarily with skin barrier impairment.

J Dermatol Sci 2018 Jan 2;89(1):33-39. Epub 2017 Nov 2.

Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan. Electronic address:

Background: Sensitive skin is a condition of cutaneous hypersensitivity to environmental factors. Lactic acid stinging test (LAST) is commonly used to assess sensitive skin and composed of four distinct sensations (pain, burning sensation, itch, and crawly feeling). A link between sensitive skin and barrier dysfunction has been proposed in atopic dermatitis (AD) patients. However, clinical and laboratory factors that are associated with sensitive skin remain unelucidated.

Objective: To investigate relationship between sensitive skin and AD-associated markers.

Methods: Forty-two Japanese AD patients and 10 healthy subjects (HS) were enrolled. AD patients were divided into extrinsic (EAD; high IgE levels) and intrinsic (IAD; normal IgE levels) types. We conducted 1% LAST by assessing the four distinct sensations and calculated the frequencies of sensitive skin in EAD, IAD, and HS. We also performed clinical AD-related tests, including transepidermal water loss (TEWL), visual analogue scale (VAS) of pruritus, and quality of life, and measured laboratory markers, including blood levels of IgE, CCL17/TARC, lactate dehydrogenase (LDH) and eosinophil counts, and concentration levels of serum Th1/Th2 cytokines. Filaggrin (FLG) mutations were examined in 21 patients. These values were subjected to correlation analyses with each of the four sensation elements.

Results: According to the standard criteria for LAST positivity, the frequencies of LAST-positive subjects were 54.8% and 10.0% in AD and HS, respectively (P=0.014). EAD patients showed a significantly (P=0.026) higher frequency of positive LAST (65.6%) than did IAD patients (20.0%). Among the four LAST sensation elements, the crawly feeling and pain scores positively correlated with VAS of pruritus, total serum IgE, mite-specific IgE, CCL17/TARC, and/or LDH. There was no association of the LAST scores with serum Th1/Th2 cytokine levels. Notably, neither TEWL nor FLG mutations correlated with LAST positivity or any sensation scores.

Conclusions: The frequency of sensitive skin is higher in EAD than in IAD. Sensitive skin is associated with AD severity, but not necessarily with barrier condition.
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http://dx.doi.org/10.1016/j.jdermsci.2017.10.011DOI Listing
January 2018

[Concentration of Soluble CD14-Subtype (Presepsin) in Plasma of Non-Inflammatory and Septic Febrile Children].

Rinsho Byori 2016 09;64(9):1001-1006

CD14 is present in macrophage, monocyte, and granulocyte cell membranes. Its soluble fraction (soluble CD14-subtype), named presepsin (P-SEP) is present in blood in association with infections, due to phagocy- tosis of microorganisms. Increased serum concentration of P-SEP was reported in adult patients with se- vere bacterial sepsis, however, reports on pediatric patients have been limited. In order to clarify if P-SEP increases in pediatric patients with bacterial sepsis, we conducted a study of plasma P-SEP concentration in children with various febrile diseases. Eighty-eight subjects (49 males, 39 females, 18 days to 168 months after birth, mean 3.2 years old) who admitted to our hospital were enrolled. Among them, blood culture was performed for 56 children. As control, twelve afebrile, non-septic children who admitted for routine cardiac catheter examinations for con- genital heart anomaly were enrolled. Blood was withdrawn on admission. Plasma was obtained within 24 hours after blood withdrawal, stored at 4 Celsius degree until assays. P-SEP was assayed using PATHFAST(TM) chemiluminescent enzyme immunoassay system (LSI Medience Inc, Tokyo, Japan). Together with P-SEP assays, blood culture, white blood cell count, serum C-reactive protein (CRP) and procalcitonin (PCT) were assayed. Local ethic committee approved this study. P-SEP concentration ranged 195 to 866 (median 445) pg/mL in patients whose blood culture was positive on admission (n=7). On the other hand, patients with blood culture negative (n=49) remained low level, 82.1 to 770 (median 242) pg/mL(p=0.046). Control subjects (n=12) showed significantly low concentration of P-SEP (mean 160, SD 189, ranged 79.4 to 411 pg/mL) compared to those from blood culture positive children (mean 487, SD 478 pg/mL, p=0.010). Though number of samples was limited, P-SEP may possibly act as a new mark- er of febrile bacteremia even in children. More study is needed for reference intervals for children. [Original].
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September 2016

TSLP Directly Interacts with Skin-Homing Th2 Cells Highly Expressing its Receptor to Enhance IL-4 Production in Atopic Dermatitis.

J Invest Dermatol 2015 Dec 19;135(12):3017-3024. Epub 2015 Aug 19.

Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Thymic stromal lymphopoietin (TSLP) is overtly expressed on skin lesions of atopic dermatitis (AD), and the initiative role of TSLP-activated DCs in AD has gained much attention in the past few years, while its actions on other immune cells such as T cells have been given less notice. We aimed to clarify whether TSLP receptor (TSLPR) is expressed on certain populations of T cells and whether TSLP possesses the capability to directly interact with T cells from AD patients. Peripheral lymphocytes from 51 AD patients are analyzed by flow cytometry, and ex vivo experiments using peripheral blood and lesional skin-derived T cells were conducted. TSLPR expression was defined to CD4+ T cells, and CD4+CCR4+CXCR3-CCR7-CCR10+CLA+ T cells in AD patients exhibited enhanced TSLPR expression. The frequency of TSLPR+CD4+ T cells correlated with disease activity. CD4+ T cells from AD patients directly interacted with TSLP to produce a higher amount of IL-4 than those from normal subjects, and this action was attenuated with anti-TSLPR antibody. The importance of IL-4 in the induction of TSLPR expression was found in AD T cells. Our findings indicate that T cells from AD patients possess strong potential to directly interact with TSLP to promote Th2 response.
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http://dx.doi.org/10.1038/jid.2015.318DOI Listing
December 2015

Intrinsic atopic dermatitis shows high serum nickel concentration.

Allergol Int 2015 Jul 12;64(3):282-4. Epub 2015 Feb 12.

Department of Dermatology, Hamamatsu University School of Medicine, Shizuoka, Japan.

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http://dx.doi.org/10.1016/j.alit.2015.01.003DOI Listing
July 2015

Gross cystic disease fluid protein 15 in stratum corneum is a potential marker of decreased eccrine sweating for atopic dermatitis.

PLoS One 2015 28;10(4):e0125082. Epub 2015 Apr 28.

Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

It is well known that eccrine sweating is attenuated in patients with atopic dermatitis (AD). We have reported by using proteome analysis that gross cystic disease fluid protein 15 (GCDFP15), a substance secreted from eccrine sweat glands, is decreased in tape-stripped stratum corneum (SC) samples from AD patients. The aim of this study was to evaluate GCDFP15 production by eccrine glands with SC samples and to assess sweating in AD. SC samples were obtained from 51 healthy control (HC) and 51 AD individuals. Sweat samples were from 18 HC and 12 AD subjects. GCDFP15 was quantified by ELISA. By immunohistochemistry, the expression of GCDFP15 in eccrine glands was examined in normal and AD skin specimens. To identify GCDFP15-producing cells, double immunofluorescence staining for GCDFP15 and S100 protein was performed in frozen sections. To address the mechanism underlying the decreased eccrine sweating in AD patients, we examined the expression of cholinergic receptor M3 (CHRM3), a receptor for acetylcholine-induced sweating, in eccrine sweat glands. The amounts of GCDFP15 in the SC extracts were significantly lower in AD than HC (P < 0.0001). The sweat samples from AD patients also had lower levels of GCDFP15 concentration (P < 0.05). Immunohistochemistry showed positive GCDFP15 staining in the eccrine gland secretory cells and the ductal and acrosyringial lumen in normal skin, but AD lacked clear staining. Immunofluorescence staining revealed that GCDFP15 was co-expressed with S100 protein, suggesting that the clear cell of eccrine glands produces GCDFP15. Finally, we found that the expression of CHRM3 was depressed in AD, suggesting contribution to the low sweating. The SC of AD patients contains a low amount of GCDFP15 due to both low sweating and low GCDFP15 concentration in the sweat. GCDFP15 in SC is a potential marker for dysregulated sweating in AD.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125082PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412570PMC
April 2016

Leukoderma in patients with atopic dermatitis.

J Dermatol 2015 Feb 27;42(2):215-8. Epub 2014 Dec 27.

Department of Dermatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Atopic dermatitis (AD) is occasionally associated with vitiligo, however, the incidence and conditions of vitiligo or leukoderma, and the characteristics of concurrent AD, remain unclear. We conducted a prospective observational study to investigate the leukoderma-related clinical manifestations and bioparameters of AD. Because vitiligo in AD lesions is occasionally associated with inflammation, we used leukoderma in this study. Enrolled were all AD patients who had been followed up in our AD outpatient clinic and visited within the previous 4 months. During this period, we carefully inspected whether the patients had leukoderma. Eight of 52 patients had leukoderma (15.4%) and were designated as the leukoderma group, and the remaining 44 patients comprised the non-leukoderma group. While the ages were statistically not different between the two groups, female preponderance was significantly observed in the leukoderma group. The leukoderma patients tended to have higher values of SCORAD, CCL17/thymus and activation regulated chemokine and lactate dehydrogenase than the non-leukoderma patients. The leukoderma group was also characterized by a lower frequency of allergic rhinitis and a higher frequency of prurigo lesions. Thus, despite the possession of high AD severity, the leukoderma patients may possibly retain a relatively T-helper 1-skewing state in relation to the development of leukoderma and less association with rhinitis.
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http://dx.doi.org/10.1111/1346-8138.12746DOI Listing
February 2015

Psychological aspects of patients with intrinsic atopic dermatitis.

Eur J Dermatol 2014 Mar-Apr;24(2):253-4

Department of Dermatology, Hamamatsu University School of Medicine 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan.

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http://dx.doi.org/10.1684/ejd.2014.2273DOI Listing
July 2015

High frequencies of positive nickel/cobalt patch tests and high sweat nickel concentration in patients with intrinsic atopic dermatitis.

J Dermatol Sci 2013 Dec 12;72(3):240-5. Epub 2013 Aug 12.

Department of Dermatology, Hamamatsu University School of Medicine, Japan.

Background: Atopic dermatitis (AD) is classified into extrinsic AD with high serum IgE levels and impaired barrier, and intrinsic AD with low serum IgE levels and unimpaired barrier. Intrinsic AD has a lower frequency of FLG mutations and a higher frequency of circulating Th1 cells, implying that non-protein antigens, represented by metals, may be an exacerbation factor in intrinsic AD.

Objective: To investigate metal allergy in intrinsic AD.

Methods: Enrolled in this study were 86 Japanese AD patients seen in three university hospitals, consisting of 55 extrinsic and 31 intrinsic AD patients. Patch testing was performed, focusing on nickel, cobalt, and chrome, in parallel with other 14 metals. FLG mutations were analyzed in 49 patients (extrinsic, 29; intrinsic, 20). In 17 patients (extrinsic, 12; intrinsic, 5), sweat was collected from the forearms by exercise, and the concentration of nickel was fluorometrically measured.

Results: Nickel, cobalt, and chrome were the major positive metals. Intrinsic AD showed significantly higher percentages of positive reactions than extrinsic AD to nickel (intrinsic 41.9% vs extrinsic 16.4%, P=0.019) and cobalt (38.7% vs 10.9%, P=0.005). There was no significant difference between FLG mutation-bearing and non-bearing patients. The concentration of nickel was higher in the sweat of intrinsic AD than extrinsic AD patients (333.8 vs 89.4ng/g, P=0.0005) and inversely correlated with serum IgE levels.

Conclusions: Nickel and cobalt allergy may be involved in intrinsic AD. Given that the metals are excreted through sweat, intrinsic AD might be exaggerated by highly metal-containing sweat.
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http://dx.doi.org/10.1016/j.jdermsci.2013.07.009DOI Listing
December 2013

Cutaneous plasmacytosis as a skin manifestation of IgG4-related disease.

Eur J Dermatol 2013 Jul-Aug;23(4):560-2

Department of Dermatology, Hamamatsu School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Japan.

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http://dx.doi.org/10.1684/ejd.2013.2113DOI Listing
June 2014
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