今日は、先日インスタでお出ししました症例の読影例です。

完全に管理人独断の読影ですので何かご意見等ありましたらコメントくださいね❗️

Today, I would like to show you an example of a reading of a case that I recently presented in an installment.

The reading is completely at the discretion of the manager, so if you have any comments or suggestions, please feel free to comment.

症例は10年以上前にピロリ除菌成功が確認された胃角部大彎後壁寄りに認める7mm程度の発赤調陥凹性病変です。

The case is a 7mm erythematous depressed lesion located near the posterior wall of the greater fold of the gastric horn, which was confirmed to have been successfully sterilized of H. pylori more than 10 years ago.

まず、白色光にて発赤・陥凹が視認できますが何より少し出血していることに目を引きます。

こちらは内視鏡の接触はない状態ですので自然出血を認めていることになり、陥凹部の輪郭に一致して血液が付着している様に見えます。そのためなんとなく陥凹がある様に思われますが境界としては不明瞭と考えます。

First of all, the redness and depression are visible in white light, but what is most striking is that there is a little bleeding.

Since there is no endoscopic contact here, spontaneous bleeding is observed, and the blood appears to be adherent to the contour of the depression. Therefore, it seems that there is a depression, but the boundary of the depression is unclear.

続いてインジゴカルミン散布による色素内視鏡像です。色素を散布すると先程の陥凹と思われていた箇所がより際立って明らかな陥凹所見として確認できます。陥凹部は不整形かつ境界が明瞭となり、その一周外側には隆起が見られます。

Next is a dye endoscopic image with indigocarmine sprayed. The area that was thought to be a depression is more prominent and clearly visible when the dye is sprayed. The depression is irregularly shaped with a well-defined border and an elevation can be seen on its outer circumference.

NBI観察では陥凹部に一致してdemarcation line(;DL)を認め、一部白色不透明物質(white opaque substance;WOS)の沈着を認めます。腺管構造はabsent、血管構造はirregularであり癌と診断します。分化型腺癌を疑い、また粘膜下腫瘍(SMT)様の隆起や台状挙上などの粘膜下層(SM)浸潤を示唆する所見はもちろんありませんのでESDを施行しております。

結果は同様にぶ分化型腺癌(tub1>2)で進達度はMでした。

NBI observation reveals a demarcation line (;DL) in line with the depressed area and some deposition of white opaque substance (WOS). The glandular duct structure is absent and the vascular structure is irregular. Since there is no submucosal tumor (SMT)-like elevation or elevation of the peduncle that would suggest submucosal (SM) invasion, ESD is performed.

The result was a similarly poorly differentiated adenocarcinoma (tub1>2) with an M degree of progression.

この様に内視鏡挿入時の自然出血が早期癌発見の一助になることがあります。

腫瘍性病変を疑う所見の1つとして是非注意してみてください👀

Spontaneous bleeding during endoscopic insertion may help in the early detection of cancer.

Please pay attention to it as one of the findings to suspect neoplastic lesions!

 投稿がかなり遅くなってしましましたが、本日は5G遠隔診療の続報です✨

Sorry it's taken me so long to post this, but today I have a follow-up report on 5G telemedicine.

3月21日に神戸大学医学部附属病院を拠点としてLiveUのStep3実証が行われました🎉

On March 21, the LiveU Step 3 demonstration was held at Kobe University Hospital .

LiveUはアノテーションソフト改良や高画質映像伝送・音声双方向コミュニケーション等を実現を経ての実証でした❗️

LiveU was demonstrated through the improvement of annotation software and the realization of high quality video transmission and voice interactive communication, etc. 

また、突然ですが Zao Cloud Viewをご存知でしょうか？

Also, have you heard of Zao Cloud View?

日本のSoliton社で既に発売されている小型のモバイルソリューションで4K品質での映像伝送が最大12端末から可能となります

It is a compact mobile solution already available from Soliton in Japan that enables 4K quality video transmission from up to 12 devices!

今回はこのZaoという秘密兵器も導入しての実施となりました。

This time, we also introduced this secret weapon called Zao.

さまざまな新たな課題が見られました。

Various new challenges were encountered.

特に電波状況の確保。

One in particular was to secure the signal.

当日はWBCの準決勝戦と時間帯が被っていたことからAmazonのクラウドであるAWSは少し電波状況の不安定さがあった模様ですが、それだけみなさんが注目されているということで👀

The time of the day coincided with the semi-finals of the WBC, so AWS, Amazon's cloud, had a bit of unstable reception, but that's how much attention everyone was paying to the event .

社会実装に向けて"チームLiveU"一同、頑張っていきます✊

Team LiveU" will continue to work hard toward social implementation!

5G遠隔診療の取り組み📲 5G Remote Medical Treatment Initiatives

当院は、神戸大学国際がん医療センター（ICCRC）の森田先生にお誘い頂き、香川大学さんと3拠点4院でNTT docomoの5G回線と映像伝送ソリューション『LiveU』を用いた遠隔診療のプロジェクトに取り組んでいます。

背景として現在我が国はSociety 5.0時代を迎えており、IoT(Internet of Things)により人とモノが繋がり、人工知能(AI)により少子高齢化や地方過疎化等の課題克服を目指した社会の実現が待たれます。

消化器内視鏡分野も発展が著しく、様々な診断・治療技術やそのデバイスが開発される一方で、医師の地域偏在等の理由で受けられる医療や医師教育の質に差が生じているのも事実です。

私たちは前述の取り組みにより、現状打開の一歩にならないかと考えています。

Our hospital, invited by Dr. Morita of Kobe University International Cancer Center (ICCRC), is working with Kagawa University on a project for remote medical care using NTT docomo's 5G line and "LiveU," a video transmission solution, at four hospitals in three locations.

As a background, Japan is currently entering the Society 5.0 era, where people and things are connected through the Internet of Things (IoT), and artificial intelligence (AI) is expected to help overcome issues such as the declining birthrate, aging population, and depopulation in rural areas.

The field of gastrointestinal endoscopy is also making remarkable progress, with the development of various diagnostic and therapeutic technologies and devices, but it is also true that there is a gap in the quality of medical care and physician education available due to the uneven distribution of physicians in different regions.

We hope that the aforementioned efforts will be a step toward overcoming the current situation.

＜LiveU送信機＞

LiveU Transmitter

バックパックに入るほどのサイズで4K品質の動画伝送が可能です

Small enough to fit in a backpack and capable of 4K quality video transmission

＜映像伝送のイメージ＞

Image of image transmission

内視鏡術者の内視鏡画面は5G回線を経由してLiveU送信機にてdocomoのクラウドへと伝送されます。それをほぼリアルタイムに各拠点のダブレット端末（iPadなど）やPCなどで受信できます。アノテーション（キャプチャー画像に書き込みなどを行います）を適宜加え、それが発信元も含めた各施設にリアルタイムに共有されるため指導や情報共有が可能となります。

The endoscopist's endoscope screen is transmitted to the docomo cloud via a LiveU transmitter via a 5G line. It can be received almost in real time by a doublet terminal (e.g., iPad) or PC at each site. Annotation (writing on captured images) can be added as needed, and this information is shared in real time with each facility, including the sender, allowing for guidance and information sharing.

↓↓docomoさんが作成して下さった動画です↓↓

Here is a video created by DOCOMO

＜内視鏡4K映像伝送実証 1分ver.＞

Demonstration of endoscope 4K video transmission 1min. ver.

＜内視鏡4K映像伝送実証 3分ver.＞

Endoscope 4K image transmission demonstration 3min. ver.

BOSSのインタビューもあります❗️

There is also an interview with BOSS: ❗️

今後も随時Instagram等で進捗状況を発信📲していきます。

We will continue to post progress updates on Instagram and other social media.

症例２📗 Case 2

昨日Instagramに投稿しました、症例２の解説例（黒字：前田　赤字：内多先生）です。

インスタでの回答結果は

癌：71%、炎症：29%でリンパ腫と回答された方はいませんでした。

Here is an example of the explanation of Case 2 (black letters: Maeda, red letters: Dr. Uchita), which I posted on Instagram yesterday.

The results of the responses on Instagram were.

Cancer: 71%, Inflammation: 29%, no one answered lymphoma.

病変部位をこの写真では言及するのは困難ですが、胃体下部大弯に存在するピロリ除菌後の萎縮粘膜を背景とした7mm程度の領域です。周囲がやや発赤していることで褪色調に見えており、境界は明瞭で形状は不整形です。

It is difficult to mention the site of the lesion in this photograph, but it is an area of about 7 mm with a background of atrophic mucosa after Pylori eradication in the greater curvature of the lower gastric body. The lesion appears faded due to the slightly erythematous surrounding area, and has a clear border and irregular shape.

インジゴカルミン撒布像では白色光観察で視認できた境界と一致してインジゴの溜まりを認めます。しかし、一層外側の少し発赤している領域の外側には境界となる様なインジゴの溜まりを認めません。

The indigocarmine scatter image shows a pool of indigos consistent with the boundary visible in the white light observation. However, outside of the slightly erythematous region on the outer layer, there is no indigo accumulation that would serve as a boundary.

NBI観察でも同様にBrownishな領域として境界が視認できます。

The boundary is also visible as a brownish area in NBI observation.

NBI併用拡大観察では背景粘膜にLight Blue Crestを認め腸上皮化生粘膜であることが分かります。また、今までに境界として視認できていた軽度陥凹した箇所に一致してDemarcation Lineを認めます。微小血管構築像は不整でありMV：irregular、表面微細構造は視認できずMS：absentと判断しました。癌と診断しますが未分化型癌を示唆する様な無構造領域も認めず分化型腺癌と考えました。

また、白色光観察にて台状挙上などの所見は認めず深達度Mと診断してESDを行いました。

病理結果は早期胃癌（高分化腺癌：tub1）で深達度はMでした。

The magnified view with NBI shows a Light Blue Crest on the background mucosa, indicating the presence of intestinal epithelialized mucosa. A demarcation line is also observed in line with a slightly depressed area that was previously visible as a border. The microvascular architecture is irregular and is classified as MV: irregular, while the surface microstructure is not visible and is classified as MS: absent. The diagnosis of carcinoma was considered to be differentiated adenocarcinoma, as there were no unstructured areas suggestive of undifferentiated carcinoma.

In addition, no elevation of the pedicle was observed by white-light observation, and ESD was performed with a diagnosis of M depth.

The pathological result was early gastric cancer (highly differentiated adenocarcinoma: tub1) with a depth of M.

毛細血管網を見ていくと軽度の不整形はあるものの、networkを密に形成しており、分化のよい小型の腺管からなる高分化腺癌を考えます。辺縁にはWGAと思われる白色を呈する所見も認めます。NBIではしっかりと境界も認め、腫瘍の診断として難易度は低めです

The capillary network is mildly irregular, but the network is densely formed, suggesting a well-differentiated adenocarcinoma composed of small well-differentiated ducts. NBI shows a well-defined border, making the diagnosis of tumor less difficult.

 

中国への招聘🇨🇳

 現在の予定では、政府が新型コロナウイルス感染症（COVID-19）を2023年5月8日に感染症法「第5類」に引き下げられる予定です。これにより季節性インフルエンザと同等の扱いとなることになります。

According to current plans, the government is scheduled to lower new coronavirus infection (COVID-19) to "category 5" under the Infectious Disease Law on May 8, 2023. This will put it on the same level of treatment as seasonal influenza.

また、それに先駆けて3月13日よりマスク着用に対しての考え方が少し緩和される予定となっています。

In addition, prior to that, a slight relaxation of the concept of wearing masks is scheduled to take effect on March 13.

COVID-19以前は当院も積極的に国際学会での発表や（また随時Instagramでも振り返り発信します）、近年内視鏡技術の発展が著しい中国に内多先生が6回程招聘され拡大内視鏡検査の教育のために訪問していました。

Prior to COVID-19, our hospital was actively involved in presentations at international conferences (and we will post our reflections on them on Instagram as needed), and Dr. Uchida was invited to China, where endoscopic technology has developed remarkably in recent years, about six times to provide education on magnified endoscopy.

📌中国浙江省金華市に指導に行きました（2019年）

Went to Jinhua, Zhejiang Province, China for guidance (2019)

📌拡大内視鏡を現地の先生方に直接指導

Direct teaching of magnifying endoscopy to local doctors

📌内視鏡先端フードの付け方ひとつにも

こだわって日々診療しています

We are particular about even the way 

the endoscope tip hood is attached.

📌内視鏡検査後、現地の先生方の多数の質問に

内多先生が答えています

After the endoscopy, numerous questions from local doctors Dr. Uchita 

answers many questions from local doctors after the endoscopy.

📌現地の先生方と内多先生

Dr. Uchida with local doctors

📌現地のガイドさん方と当院スタッフ

（左から、重久先生、内多先生、前田）

Local guides and our staff

(From left, Dr. Shigehisa, Dr. Uchida, and Dr. Maeda)

中国を始めとした海外諸国の内視鏡技術は着実に進歩しています。

その為、私たちもより一層世界最高峰と言われる内視鏡技術を世界に発信していく

必要があると感じることのできた機会でした。

Endoscopic technology in China and other overseas countries is steadily advancing.

Therefore, it was an opportunity for us to feel the need to further disseminate the world's best endoscopic technology to the rest of the world. 

We are now in a position to provide the world with the world's best endoscopic technology.

また、近い未来に海外との交流が再開することを祈っています。

We also hope that international exchanges will resume in the near future.

スタッフ業績✨ 〜Staff Performance〜

 ↓↓スタッフ業績 〜Staff Performance〜 ↓↓

📌Dr. Uchita

※英文

●First author 

Kunihisa Uchita, Hideki Kobara, Kenji Yorita, Yuriko Shigehisa, Chihiro Kuroiwa, Noriko Nishiyama, Yohei Takahashi, Yuka Kai, Jun Kunikata, Toshio Shimokawa, Uiko Hanaoka, Kenji Kanenishi, Tsutomu Masaki, Koki Hirano, Noriya Uedo. Quality Assessment of Endoscopic Forceps Biopsy Samples under Magnifying Narrow Band Imaging for Histological Diagnosis of Cervical Intraepithelial Neoplasia: A Feasibility Study. Diagnostics (Basel)

. 2021 Feb 20;11(2):360.

 

Kunihisa Uchita, Kenji Kanenishi, Koki Hirano, Hideki Kobara, Noriko Nishiyama, Ai Kawada, Shintaro Fujihara, Emi Ibuki, Reiji Haba, Yohei Takahashi, Yuka Kai, Kenji Yorita, Hirohito Mori, Jun Kunikata, Naoki Nishimoto, Toshiyuki Hata, Tsutomu Masaki. Characteristic findings of high-grade cervical intraepithelial neoplasia or more on magnifying endoscopy with narrow band imaging. Int J Clin Oncol. 2018 Aug;23(4):707-714.

 

Kunihisa Uchita , Takehiro Iwasaki, Koji Kojima. Finding we must pick up during endoscopy that may be signs of early gastric cancers. Dig Endosc. 2016 Apr;28 Suppl 1:34.

 

Kunihisa Uchita, Kenshi Yao, Noriya Uedo, Toshio Shimokawa, Takehiro Iwasaki, Koji Kojima, Ai Kawada, Mizu Nakayama, Michiyo Okazaki, Shinichi Iwamura. Highest power magnification with narrow-band imaging is useful for improving diagnostic performance for endoscopic delineation of early gastric cancers. BMC Gastroenterol. 2015 Nov 2;15:155.

 

●co-author

Takanori Matsui, Hideki Kobara, Noriko Nishiyama, Kaho Nakatani, Tingting Shi, Naoya Tada, Kazuhiro Kozuka, Nobuya Kobayashi, Taiga Chiyo, Tatsuo Yachida, Akihiro Kondo, Takayoshi Kishino, Keiichi Okano, Shintaro Fujihara, Kunihisa Uchita, Kingo Hirasawa, Tsutomu Masaki. Comparison of purse-string suture versus over-the-scope clip for gastric endoscopic full-thickness closure: traction and leak pressure testing in ex vivo porcine model.  BMC Surg. 2023 Jan 26;23(1):20.

 

Azusa Kawasaki, Kunihiro Tsuji, Noriya Uedo, Takashi Kanesaka, Hideaki Miyamoto, Ryosuke Gushima, Yosuke Minoda, Eikichi Ihara, Ryosuke Amano, Kenshi Yao, Yoshihide Naito, Hiroyuki Aoyagi, Takehiro Iwasaki 8, Kunihisa Uchita, Hisatomi Arima, Hisashi Doyama. Non-atrophic gastric mucosa is an independently associated factor for superficial non-ampullary duodenal epithelial tumors: a multicenter, matched, case-control study. Clin Endosc. 2023 Jan;56(1):75-82.

 

Takehiro Iwasaki, Kunihisa Uchita, Nobuya Kobayashi, Koji Kojima, Noriko Nishiyama, Hiromichi Yamai, Hideki Kobara. Clinical feasibility of endoscopic full-thickness resection and closure using O-ring and over-the-scope clip system. Endoscopy. 2022 Dec;55(S 01): E205-E206.

 

Hideki Kobara, Kunihisa Uchita, Noriya Uedo, Jun Kunikata, Kenji Yorita, Naoya Tada, Noriko Nishiyama, Yuriko Shigehisa, Chihiro Kuroiwa, Noriko Matsuura, Yohei Takahashi, Yuka Kai, Uiko Hanaoka, Yumiko Kiyohara, Shoji Kamiura, Kenji Kanenishi, Tsutomu Masaki, Koki Hirano. Flexible Magnifying Endoscopy with Narrow Band Imaging for Diagnosing Uterine Cervical Neoplasms: A Multicenter Prospective Study. J Clin Med. 2021 Oct 16;10(20):4753.

 

Ai Kawada, Shinichi Iwamura, Kenji Yorita, Rikiya Daike, Yu Tanaka, Naoto Kuroda, Yoh Zen, Michiyo Okazaki, Kunihisa Uchita. The Acute Onset of Autoimmune Hepatitis During Pregnancy in the Absence of Hypergammaglobulinemia and Autoantibodies. Intern Med

. 2021 Oct 15;60(20):3231-3237.

 

Hiroya Ueyama, Takashi Yao, Yoichi Akazawa, Takuo Hayashi, Koichi Kurahara, Yumi Oshiro, Masayoshi Yamada, Ichiro Oda, Shin Fujioka, Chiaki Kusumoto, Masayoshi Fukuda, Kunihisa Uchita, Tomohiro Kadota, Yasuhiro Oono, Kazuhisa Okamoto, Kazunari Murakami, Yasumasa Matsuo, Motohiko Kato, Tadateru Maehata, Naohisa Yahagi, Yumiko Yasuhara, Tomoyuki Yada, Koji Uraushihara, Tetsumi Yamane, Taiji Matsuo, Masanori Ito, Yasuhiko Maruyama, Ayumi Osako, Shoko Ono, Mototsugu Kato, Kazuyoshi Yagi , Takashi Hashimoto, Natsumi Tomita, Sho Tsuyama, Tsuyoshi Saito, Kohei Matsumoto, Kenshi Matsumoto, Sumio Watanabe, Naomi Uemura, Tsutomu Chiba, Akihito Nagahara. Gastric epithelial neoplasm of fundic-gland mucosa lineage: proposal for a new classification in association with gastric adenocarcinoma of fundic-gland type. J Gastroenterol 2021 Sep;56(9):814-828.

 

Takashi Kanesaka, Noriya Uedo, Hisashi Doyama, Naohiro Yoshida, Takashi Nagahama, Kensei Ohtsu, Kunihisa Uchita, Koji Kojima, Tetsuya Ueo, Haruhiko Takahashi, Hiroya Ueyama, Yoichi Akazawa, Toshio Shimokawa, Kenshi Yao. Diagnosis of histological type of early gastric cancer by magnifying narrow-band imaging: A multicenter prospective study. DEN Open. 2021 Sep 28;2(1): e61.

 

Naoya Tada, Hideki Kobara, Noriko Nishiyama, Ken Ishimura, Kunihisa Uchita, Akira Nishiyama, Tsutomu Masaki. Combination sandwich therapy using cyanoacrylate and polyglycolic acid sheets for refractory enterocutaneous fistula closure. Endoscopy. 2021 Mar;53(3): E114-E115.

 

Hideki Kobara, Kunihisa Uchita, Noriya Uedo, Noriko Matsuura, Noriko Nishiyama, Kenji Kanenishi, Tsutomu Masaki. Uterine Cervical Neoplasm Diagnosed by Flexible Magnifying Endoscopy with Narrow Band Imaging. Diagnostics (Basel). 2020 Nov 4;10(11):903.

 

Ai Kawada, Michiyo Okazaki, Taku Takahashi, Rikiya Daike, Takehiro Iwasaki, Koji Kojima, Kunihisa Uchita, Shinichi Iwamura, Hiromichi Yamai, Kenji Yorita. A case of pancreatic cancer with clusters of invasive micropapillary carcinoma markedly reduced by chemotherapy. Gastroenterol Endosc. 2019;116(5):419-427. 

 

Takashi Kanesaka, Takashi Nagahama, Noriya Uedo, Hisashi Doyama, Tetsuya Ueo, Kunihisa Uchita, Naohiro Yoshida, Yasuhito Takeda, Kentaro Imamura, Kurato Wada, Hideki Ishikawa, Kenshi Yao. Clinical predictors of histologic type of gastric cancer. Gastrointest Endosc. 2018 Apr;87(4):1014-1022.

 

Takashi Nagahama, Kenshi Yao, Noriya Uedo, Hisashi Doyama, Tetsuya Ueo, Kunihisa Uchita, Hideki Ishikawa, Takashi Kanesaka, Yasuhito Takeda, Kurato Wada, Kentaro Imamura, Hisatomi Arima, Toshio Shimokawa. Delineation of the extent of early gastric cancer by magnifying narrow-band imaging and chromoendoscopy: a multicenter randomized controlled trial. Endoscopy. 2018 Jun;50(6):566-576.

 

Hiroyoshi Nakanishi, Hisashi Doyama, Hideki Ishikawa, Noriya Uedo, Takuji Gotoda, Mototsugu Kato, Shigeaki Nagao, Yasuaki Nagami, Hiroyuki Aoyagi, Atsushi Imagawa, Junichi Kodaira, Shinya Mitsui, Nozomu Kobayashi, Manabu Muto, Hajime Takatori, Takashi Abe, Masahiko Tsujii, Jiro Watari, Shuhei Ishiyama, Ichiro Oda, Hiroyuki Ono, Kazuhiro Kaneko, Chizu Yokoi, Tetsuya Ueo, Kunihisa Uchita, Kenshi Matsumoto, Takashi Kanesaka, Yoshinori Morita, Shinichi Katsuki, Jun Nishikawa, Katsuhisa Inamura, Tetsu Kinjo, Katsumi Yamamoto, Daisuke Yoshimura, Hiroshi Araki, Hiroshi Kashida, Ayumu Hosokawa, Hirohito Mori, Haruhiro Yamashita, Osamu Motohashi, Kazuhiko Kobayashi, Michiaki Hirayama, Hiroyuki Kobayashi, Masaki Endo, Hiroo Yamano, Kazunari Murakami, Tomoyuki Koike, Kingo Hirasawa, Youichi Miyaoka, Hidetaka Hamamoto, Takuto Hikichi, Norihiro Hanabata, Ryo Shimoda, Shinichiro Hori, Tadashi Sato, Shinya Kodashima, Hiroyuki Okada, Tomohiko Mannami, Shojiro Yamamoto, Yasumasa Niwa, Kazuo Yashima, Satoshi Tanabe, Hiro Satoh, Fumisato Sasaki, Tetsuro Yamazato, Yoshiou Ikeda, Hogara Nishisaki, Masahiro Nakagawa, Akio Matsuda, Fumio Tamura, Hitoshi Nishiyama, Keiko Arita, Keisuke Kawasaki, Kazushige Hoppo, Masashi Oka, Shinichi Ishihara, Michita Mukasa, Hiroaki Minamino, Kenshi Yao. Evaluation of an e-learning system for diagnosis of gastric lesions using magnifying narrow-band imaging: a multicenter randomized controlled study. Endoscopy. 2017 Oct;49(10):957-967.

Kenji Yorita, Takehiro Iwasaki, Kunihisa Uchita, Naoto Kuroda, Koji Kojima, Shinichi Iwamura, Yutaka Tsutsumi, Akinobu Ohno, and Hiroaki Kataoka: Russell body gastritis with Dutcher bodies evaluated using magnification endoscopy. World J Gastrointest Endosc. 2017 Aug 16; 9(8): 417–424.

 

Takao Kanemitsu, Kenshi Yao, Takashi Nagahama, Kentaro Imamura, Shoko Fujiwara, Toshiharu Ueki, Kenta Chuman, Hiroshi Tanabe, Ota Atsuko, Akinori Iwashita, Toshio Shimokawa, Kunihisa Uchita, Takashi Kanesaka. Extending magnifying NBI diagnosis of intestinal metaplasia in the stomach: the white opaque substance marker. Endoscopy. 2017 Jun;49(6):529-535.

 

Kenji Yorita, Shiori Sasaki, Ai Kawada, Michiyo Okazaki, Hiromichi Yamai, Kunihisa Uchita, Shinichi Iwamura, Kimiko Nakatani, Satoshi Ito, Naoto Kuroda. Hepatoid Adenocarcinoma of the Extrahepatic Bile Duct in a Patient with Polysplenia Syndrome. Intern Med. 2017;56(4):401-407.

 

Toshiaki Hirasawa, Kunihisa Uchita, Tomonori Yano. How many pictures are demanded for screening gastroscopy? Dig Endosc. 2016 Apr;28 Suppl 1:33-4.

 

Shoko Fujiwara, Kenshi Yao, Takashi Nagahama, K Uchita, Takao Kanemitsu, Kozue Tsurumi, Noritaka Takatsu, Takashi Hisabe, Hiroshi Tanabe, Akinori Iwashita, Toshiyuki Matsui. Can we accurately diagnose minute gastric cancers (≤5 mm)? Chromoendoscopy (CE) vs magnifying endoscopy with narrow band imaging (M-NBI). Gastric Cancer. 2015 Jul;18(3):590-6.

 

Kenshi Yao, Hisashi Doyama, Takuji Gotoda, Hideki Ishikawa, Takashi Nagahama, Chizu Yokoi, Ichiro Oda, Hirohisa Machida, Kunihisa Uchita, Masahiko Tabuchi. Diagnostic performance and limitations of magnifying narrow-band imaging in screening endoscopy of early gastric cancer: a prospective multicenter feasibility study. Gastric Cancer. 2014 Oct;17(4):669-79.

※和文 

内多 訓久, 内藤 祐士, 前田 充毅, 窪田 綾子, 矢山 貴之, 大家 力矢, 岩﨑 丈紘, 小島 康司, 岡﨑 三千代, 頼田 顕. 除菌後発見胃癌の内視鏡診断—狭帯域光拡大観察の見地から：微小血管構築像に焦点を当てて. 胃と腸 57：52-60, 2022

 

内多 訓久, 岩﨑 丈紘, 小島 康司, 岩村 伸一, 頼田 顕辞, 黒田 直人. NBI 併用拡大内視鏡の除菌後胃癌および未除菌胃癌に対する範囲診断能の検討. 臨牀消化器内科　Vol. 32 No. 12：1641-2646, 2017

 

内多 訓久, 八尾 建史, 岩﨑 丈紘, 小島 康司, 川田 愛, 中山 瑞, 岡崎三千代, 岩村 伸一,胃病変の鑑別診断および早期胃癌の境界診断に拡大内視鏡が有用であった 2 症例. 臨牀消化器内科 Vol. 29 No. 10：1398-1402, 2014

小島 康司, 内多 訓久. 白色調扁平隆起を呈した胃底腺粘膜型胃癌の1例. 臨牀消化器内科　Vol. 35 No. 11：1395-1399, 2020 

 

小島　康司, 内多　訓久. 発赤調陥凹型を呈した胃底腺粘膜型腺癌の 1 例. 臨牀消化器内科　Vol. 38 No. 3：347-351, 2023

 

小島　康司, 内多　訓久, 岩﨑　丈紘, 大家　力矢, 高橋　　拓, 岩村　伸一. 褪色調表面平坦型（0—Ⅱb）を呈した胃底腺型胃癌の 1 例. 臨牀消化器内科　Vol. 34 No. 2：221-226, 2019

 

内多 訓久, 八尾 建史, 岩﨑 丈紘, 小島 康司, 川田 愛, 中山 瑞, 岡﨑 三千代, 岩村 伸一. NBI併用拡大内視鏡の観察倍率による胃癌範囲診断能の違い. 胃と腸57：301-310, 2015

 

内多 訓久, 前田 充毅, 重久 友理子, 宮田 好裕, 大家 力矢, 佐々木 紫織, 岩﨑 丈紘 , 小島 康司, 岡﨑 三千代, 岩村 伸一. 早期胃癌の範囲診断. 胃と腸55：18-27, 2020 

 

内多 訓久, 佐々木 紫織, 岩﨑 丈紘, 小島 康司, 川田 愛, 中山 瑞, 岡﨑 三千代, 岩村 伸一. 除菌後に発見され診断に苦慮した胃癌の1例. 胃と腸　51：814-819, 2016

 

内多 訓久, 八尾 建史, 佐々木 紫織, 岩﨑 丈紘, 小島 康司, 川田 愛, 中山 瑞, 岡﨑 三千代, 岩村 伸一, 賴田 顕辞, 黒田 直人. 拡大内視鏡による胃癌の側方進展範囲診断. 胃と腸　51：604-613, 2016 

内多 訓久, 高橋 拓, 大家 力也, 岩﨑 丈紘, 小島 康司, 川田 愛, 岡﨑 三千代, 岩村 伸一. 拡大内視鏡が早期胃癌の診断をどう変えたか.  胃と腸53：1462-1470, 2018

 

内多 訓久, 八尾 建史, 前田 充毅, 重久 友理子, 宮田 好裕, 大家 力矢, 佐々木 詩織, 岩﨑 丈紘, 小島 康司, 岡﨑 三千代, 岩村 伸一. 胃の画像強調内視鏡診断法. 消化器内視鏡 32：536-544, 2020

 

内多 訓久, 八尾 建史. 拡大観察でdemarcation lineがわからない. 消化器内視鏡 34：372-373, 2022

 

著書

（共著）

内視鏡診断㊙ノート2

私の内視鏡Tips

百症例式胃の拡大内視鏡×病理対比アトラス

今年10月23日、スペインのバルセロナで開催された国際学会、「第27回欧州消化器病週間」（United European Gastroenterology Week ; UEGW 2019）にて演題発表した時の動画です。