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1.
Endosc Int Open ; 6(5): E594-E601, 2018 May.
Article in English | MEDLINE | ID: mdl-29744378

ABSTRACT

BACKGROUND AND STUDY AIMS: Although endoscopic transpapillary gallbladder drainage (ETGBD) is reportedly useful in patients who have acute cholecystitis, its efficacy has not been compared to that of percutaneous transhepatic gallbladder drainage (PTGBD). We retrospectively compared the efficacy and safety of ETGBD and PTGBD in patients with acute cholecystitis. PATIENTS AND METHODS: We studied 75 patients who required gallbladder drainage for acute cholecystitis between January 2014 and December 2016. Using propensity score matching analysis, we compared the clinical efficacy and length of hospitalization in patients successfully treated with ETGBD and PTGBD. Moreover, we assessed the predictive factors for hospitalization period < 30 days using multivariate analysis. RESULTS: ETGBD and PTGBD were successfully performed in 33 patients (77 %) and 42 patients (100 %) ( P  < 0.001). Twenty-seven matched pairs were obtained after propensity score matching analysis. No significant differences were observed between patients treated with ETGBD and those treated with PTGBD with respect to improvement in white blood cell count and serum C-reactive protein level. The length of hospitalization in patients treated with ETGBD was significantly shorter than in those treated with PTGBD regardless of the need for surgery. Multivariate logistic regression analysis revealed ETGBD (odds ratio, 7.07; 95 % confidence interval 2.22 - 22.46) and surgery (odds ratio 0.26; 95 % confidence interval 0.09 - 0.79) as independent factors associated with hospitalization period. There were no significant differences in occurrence of complications in ETGBD and PTGBD procedure. CONCLUSIONS: ETGBD was shown to be as useful as PTGBD for treatment of acute cholecystitis and was associated with shorter hospitalization period. ETGBD can be an alternative treatment option for acute cholecystitis at times when PTGBD is not possible.

2.
Case Rep Gastroenterol ; 11(2): 312-319, 2017.
Article in English | MEDLINE | ID: mdl-28626377

ABSTRACT

Simple hepatic cysts are common and most often asymptomatic. In symptomatic cases, hemorrhage, rupture, and infection are major complications. However, urinary tract obstruction caused by a simple hepatic cyst is rare. We treated an 82-year-old Japanese man with an infected giant hepatic cyst causing right hydronephrosis who had a past history of left nephrectomy for renal cell carcinoma. The patient underwent ultrasound-guided percutaneous drainage and sclerotherapy with minocycline hydrochloride for the infected hepatic cyst. Right hydronephrosis was relieved, and renal dysfunction improved with regression of the hepatic cyst after treatment. This is the first report of hydronephrosis due to ureteral obstruction caused by compression from a hepatic cyst.

3.
PLoS One ; 12(6): e0178777, 2017.
Article in English | MEDLINE | ID: mdl-28644836

ABSTRACT

OBJECTIVE: To assess the influence of biliary drainage to cholangitis on modified Glasgow Prognostic Score (mGPS) in patients with pancreatic cancer. METHODS: mGPS was calculated before and after biliary drainage in 47 consecutive patients with inoperable pancreatic cancer who were receiving chemotherapy. Biliary drainage was indicated for malignant obstructive jaundice that prevented the administration of chemotherapy. To elucidate mGPS values, serum levels of CRP and albumin were measured at the time of diagnosis (before biliary drainage). Overall survival was evaluated and risk factors, which contribute to overall survival, were examined. RESULTS: Biliary drainage was performed in 15 patients. Using values obtained before biliary drainage, there were no significant differences in median survival time between patients with a mGPS of 0 and those with a mGPS of 1 or 2 (10.7 vs. 9.4 months; p = 0.757). However, using values obtained after biliary drainage, median survival time was significantly higher in patients with a mGPS of 0 than in those with a mGPS of 1 or 2 (11.4 vs. 4.7 months; p = 0.002). Multivariate analysis revealed that a mGPS of 1 or 2 (HR: 3.38; 95% CI: 1.35-8.46, p = 0.009), a carbohydrate antigen 19-9 >1000 U/mL (2.52; 1.22-5.23, p = 0.013), a performance status of 2 (7.68; 2.72-21.28, p = 0.001), carcinoembryonic antigen level >10 ng/mL (2.29; 1.13-4.61, p = 0.021) were independently associated with overall survival. CONCLUSION: mGPS values obtained after biliary drainage appear to be a more reliable indicator of overall survival in patients with inoperable pancreatic cancer.


Subject(s)
Drainage , Pancreatic Neoplasms/mortality , Pancreatic Neoplasms/therapy , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Biomarkers, Tumor/blood , Carcinoembryonic Antigen/blood , Cholangitis/etiology , Cholangitis/therapy , Combined Modality Therapy , Female , Humans , Kaplan-Meier Estimate , Male , Multivariate Analysis , Pancreatic Neoplasms/blood , Prognosis , Proportional Hazards Models , Retrospective Studies , Risk Factors , Survival Rate , Treatment Outcome
4.
Clin J Gastroenterol ; 10(4): 388-391, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28516371

ABSTRACT

An 88-year-old woman with dementia was diagnosed as having perforated emphysematous cholecystitis with localized peritonitis. Because she was at high risk for surgery, gallbladder drainage was required before surgery. Endoscopic transpapillary gallbladder drainage instead of percutaneous transhepatic biliary drainage was performed because bile could leak from the puncture site to free space around the perforated gallbladder. After the insertion of a nasobiliary drainage tube, the gallbladder was drained and cleaned with saline solution. Subsequently, a nasobiliary drainage tube was replaced with a double-pigtail stent because she was at high risk of dislodging the nasobiliary drainage tube. Although clinical improvement was observed, she was treated conservatively without surgery. She was followed up for 6 months without developing cholecystitis. For perforated cholecystitis without developing panperitonitis, endoscopic transpapillary gallbladder drainage would be an effective option as a bridge to surgery for the initial treatment and as an alternative to surgery for long-term management for a later treatment. This is the first reported case of perforated emphysematous cholecystitis with localized peritonitis treated with endoscopic transpapillary gallbladder drainage.


Subject(s)
Emphysematous Cholecystitis/surgery , Endoscopy, Digestive System/methods , Aged, 80 and over , Drainage/methods , Emphysematous Cholecystitis/diagnostic imaging , Female , Gallbladder/surgery , Humans , Rupture, Spontaneous/diagnostic imaging , Rupture, Spontaneous/surgery , Stents , Tomography, X-Ray Computed
5.
Intern Med ; 56(5): 509-515, 2017.
Article in English | MEDLINE | ID: mdl-28250296

ABSTRACT

Overlap syndrome between primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) is extremely rare in Japan. We herein report two adult patients with PSC-AIH overlap syndrome. They were diagnosed with PSC-AIH overlap syndrome based on the findings of endoscopic retrograde cholangiography and liver biopsy, and using the International Autoimmune Hepatitis Group scoring system. In both cases, PSC preceded AIH, and combination therapy with steroid and ursodeoxycholic acid was effective. Because there are few reported cases in Japan, it is important to study more cases to shed light on the clinical and pathological features of PSC-AIH overlap syndrome.


Subject(s)
Cholangitis, Sclerosing/diagnosis , Hepatitis, Autoimmune/diagnosis , Biopsy , Cholangiography , Cholangitis, Sclerosing/drug therapy , Cholangitis, Sclerosing/pathology , Drug Therapy, Combination , Glucocorticoids/therapeutic use , Hepatitis, Autoimmune/drug therapy , Hepatitis, Autoimmune/pathology , Humans , Liver/pathology , Male , Middle Aged , Syndrome , Tomography, X-Ray Computed , Ursodeoxycholic Acid/therapeutic use , Young Adult
6.
Clin J Gastroenterol ; 9(2): 68-72, 2016 Apr.
Article in English | MEDLINE | ID: mdl-26972102

ABSTRACT

Humoral hypercalcemia due to a gastric carcinoma-secreting parathyroid hormone-related protein (PTHrP) is a rare disease associated with poor prognosis. A 61-year-old male with gastric cancer who had been receiving chemotherapy showed serum hypercalcemia and an elevated level of serum PTHrP with a suppressed intact parathyroid hormone level. Computed tomography revealed stable disease 4 weeks prior, and the laboratory examination revealed no adverse effects 2 weeks prior. The biopsy at the time of diagnosis was immunohistochemically positive for PTHrP later. Despite intensive care, the patient died of multiorgan failure on the 14th day after admission. In case of undifferentiated gastric cancer, the possibility of humoral hypercalcemia of malignancy caused by gastric cancer should be considered even when the patient is receiving chemotherapy.


Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/metabolism , Carcinoma, Signet Ring Cell/drug therapy , Carcinoma, Signet Ring Cell/metabolism , Hypercalcemia/etiology , Parathyroid Hormone-Related Protein/metabolism , Stomach Neoplasms/drug therapy , Stomach Neoplasms/metabolism , Fatal Outcome , Humans , Male , Middle Aged
7.
Nihon Shokakibyo Gakkai Zasshi ; 111(10): 1983-9, 2014 Oct.
Article in Japanese | MEDLINE | ID: mdl-25283227

ABSTRACT

A 48-year-old man with colorectal cancer and right inguinal lymph node metastasis had previously undergone radiotherapy and chemotherapy (uracil/tegafur/leucovorin) after a colostomy in another hospital before being referred to us. Esophagogastroduodenoscopy (EGD) revealed the presence of a gastric metastatic lesion. After three courses of treatment with a modified regimen of leucovorin plus 5-fluorouracil plus oxaliplatin-6 (mFOLFOX6), EGD revealed that the gastric lesion had disappeared; computed tomography revealed that the size of the primary tumor and inguinal lymph node metastasis were markedly reduced. Subsequently, he underwent rectal resection of the primary tumor and continued treatment with mFOLFOX6 in combination with bevacizumab. We reviewed 29 similar cases from the literature, and determined that surgical resection of the tumor and appropriate chemotherapy can lead to long-term survival for patients with gastric metastases from colorectal cancer. Furthermore, positive CK20 and CDX2 expression and negative CK7 expression were useful adjuncts in the immunohistochemical diagnosis of gastric metastases from colorectal adenocarcinoma.


Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Rectal Neoplasms/drug therapy , Stomach Neoplasms/drug therapy , Adenocarcinoma/secondary , Adenocarcinoma/surgery , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Fluorouracil/administration & dosage , Humans , Leucovorin/administration & dosage , Male , Middle Aged , Neoplasm Staging , Organoplatinum Compounds/administration & dosage , Rectal Neoplasms/pathology , Rectal Neoplasms/surgery , Stomach Neoplasms/secondary , Tomography, X-Ray Computed
8.
Gan To Kagaku Ryoho ; 41(12): 2453-5, 2014 Nov.
Article in Japanese | MEDLINE | ID: mdl-25731555

ABSTRACT

Perforation, bleeding, and ileus are known complications of small intestinal lymphoma and can occur either at diagnosis or during the course of treatment. Surgery is an important component in the management of these gastrointestinal complications. However, there is no consensus regarding the indications for and timing of surgery in small intestinal lymphoma. We herein present our experience with a case of small intestinal lymphoma with ileus that required surgery during chemotherapy. A 69-year-old man developed abdominal pain. Computed tomography revealed lower right jaw lymphadenopathy, small intestinal wall thickening, and mesenteric lymphadenopathy. Malignant lymphoma (diffuse large B-cell type) was diagnosed on the basis of a lower jaw lymph node biopsy. The patient was initially administered chemotherapy. After the third cycle of chemotherapy, the patient developed small intestinal obstruction detected upon abdominal computed tomography. Because a stricture persisted despite medical treatment, we performed partial resection of the small intestine. The postoperative course was good, and the patient rapidly resumed chemotherapy. Currently, 6 months after the surgery, the patient is alive without any progression of the lymphoma. A multidisciplinary treatment strategy, including surgery, is desirable to achieve a safe but radical cure for small intestinal lymphoma.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Ileus/surgery , Intestinal Neoplasms/drug therapy , Intestine, Small/pathology , Lymphoma, Large B-Cell, Diffuse/drug therapy , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Humans , Ileus/chemically induced , Intestinal Neoplasms/pathology , Male
9.
Nihon Shokakibyo Gakkai Zasshi ; 107(8): 1312-8, 2010 Aug.
Article in Japanese | MEDLINE | ID: mdl-20693756

ABSTRACT

A 30-year-old woman with hepatitis for 5 months was admitted to our hospital. She had been given a diagnosis of liver dysfunction 2 years previously, and the hepatitis in this case was believed to be drug-induced. On admission, the patient was asymptomatic. Serologic tests for hepatitis A, B, and C were negative, and the laboratory results showed a WBC count of 7600/mm3 (lymphocytes, 85%), an AST level of 559 U/L, ALT level of 427 U/L, and EBV-DNA of 2.9x10(6) copies/microg DNA. Histopathological examination of the liver biopsy specimens revealed moderate lymphocyte infiltration in the sinusoids and positive Epstein-Barr-encoded RNA (EBER) -lymphocytes. Therefore, chronic active Epstein-Barr virus infection (CAEBV) was diagnosed. However, 9 months after the diagnosis she died of mycotic sepsis. We presume that the patient may have developed CAEBV at the prior diagnosis of liver dysfunction 2 years previously. Therefore, CAEBV associated with liver dysfunction should be considered during the differential diagnosis of patients showing persistent liver dysfunction.


Subject(s)
Epstein-Barr Virus Infections/complications , Liver Diseases/etiology , Adult , Chronic Disease , Female , Humans , Recurrence
10.
Int J Food Sci Nutr ; 60(4): 344-51, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19115124

ABSTRACT

We clarified how raffinose, one of the non-digestive oligosaccharides, reaches the large intestine. Seven healthy male volunteers were given a test meal containing 10.0 g raffinose. A double-lumen tube was placed in the terminal ileum, and the ileal contents were aspirated through the tube. The amounts of raffinose were orally administered and collected from the terminal ileum and were compared with each other. The result was that the mean+/-standard error percentage of the amount of ingested raffinose collected in the terminal ileum was 97.1+/-2.4%. Furthermore, the average times taken for 20%, 40%, 60% and 80% of raffinose to reach the terminal ileum were 2.0+/-0.6 h, 2.6+/-0.7 h, 3.6+/-0.7 h and 4.9+/-0.7 h, respectively. In conclusion, approximately 100% of ingested raffinose was recovered in the terminal ileum in the present study. This corresponds with the present generally accepted definition of a dietary fibre.


Subject(s)
Dietary Fiber , Gastrointestinal Transit/physiology , Ileum/metabolism , Intestinal Absorption/physiology , Raffinose/pharmacokinetics , Administration, Oral , Adolescent , Humans , Male , Time Factors , Young Adult
11.
Luminescence ; 23(3): 132-8, 2008.
Article in English | MEDLINE | ID: mdl-18452131

ABSTRACT

Helicobacter pylori infection has been reported to cause enhanced reactive oxygen species in the gastric mucosa. We examined the relationship between H. pylori infection and neutrophil function of peripheral blood. The subjects were 904 volunteers who participated in the Iwaki Health Promotion Project in 2005. 158 subjects who were infected with H. pylori in 2005 also participated in this project in 2006 and were categorized into two groups: the eradication group, in which H. pylori was successfully eradicated during the 12 month period, and the non-eradication group, in which eradication was unsuccessful or the subjects did not receive eradication therapy. The laboratory assays performed were: a titre of H. pylori antibody; neutrophil counts; and oxidative burst activity (OBA) of neutrophils. Logistic regression analysis was executed, with H. pylori infection as the dependent variable and other items as the independent variables. OBA showed an inverse association with H. pylori infection in 2005. Additionally, when comparing the eradication and non-eradication groups, the change rates of OBA between 2005 and 2006 did not show any significant difference. It was concluded that H. pylori infection does not lower OBA, but those individuals in whom OBA was lower were more prone to H. pylori infection.


Subject(s)
Disease Susceptibility/etiology , Helicobacter Infections/etiology , Neutrophils/metabolism , Respiratory Burst/immunology , Antibodies, Bacterial/blood , Blood Cell Count , Helicobacter pylori , Humans , Neutrophils/cytology
12.
Dig Dis Sci ; 53(3): 712-8, 2008 Mar.
Article in English | MEDLINE | ID: mdl-17763952

ABSTRACT

We investigated the effects of cellulose supplementation on fecal consistency and fecal weight. About 26 women were classified into two groups-normal defecation and constipation groups. All subjects ate the following meals during the experiment: ordinary meals (first week), experimental meals (second week), and experimental meals mixed with 4 g (third week) and 8 g (fourth week) cellulose. The experimental meal contained 16.7 g fiber. Fecal weights, fecal water content, fecal consistency, and defecation frequency were measured during the experimental period. As a result, in the normal defecation group, the mean fecal weight was 222.9 g day(-1) in the first week, and thereafter decreased. Although 20/24 g of fiber intake in the third/fourth week increased the fecal weight to over 150 g, the fecal consistency was still lower than the optimal consistency of around 300 g cm(-2). However, these changes were not observed in the constipated group.


Subject(s)
Cellulose/pharmacology , Constipation/drug therapy , Defecation/drug effects , Dietary Fiber/pharmacology , Feces , Adult , Cellulose/therapeutic use , Dietary Fiber/statistics & numerical data , Dietary Fiber/therapeutic use , Eating , Feces/chemistry , Female , Humans , Middle Aged , Water/analysis
13.
Tohoku J Exp Med ; 212(3): 207-19, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17592208

ABSTRACT

Gastric cancer in Japan, previously the top killer cancer, has recently shown decreased incidence and mortality rates. Epidemiological studies have demonstrated that environmental factors are closely associated with stomach oncogenesis, as evident from the geographical differences seen throughout Japan in both incidence and mortality. Moreover, Japanese immigrant populations gradually exhibit the lower incidence and mortality rates of gastric cancer in their chosen country. Likewise, younger generations in Japan have lower mortality rates than older generations at the same age, which may be accounted by the dramatic lifestyle changes in Japan after World War II. In addition to exploring and learning from the impact of these environmental factors, deliberate strategies to further lower the incidence and mortality rates of gastric cancer must include aggressive eradication programs for Helicobacter pylori and dietary education in both school curricula and for the general adult population to lower the intake of causative agents such as salt and increase the intake of beneficial agents such as fruits, vegetables and seaweeds. The dietary education should be coupled with better motivation for the general population to undergo regular screening with improved techniques. In the future, changes in these environmental factors and progresses in the diagnosis of and therapeutic strategies for gastric cancer will lead to further decrease in the incidence and mortality rates of this disease in Japan.


Subject(s)
Stomach Neoplasms/epidemiology , Humans , Incidence , Japan/epidemiology
14.
Drugs R D ; 6(6): 385-94, 2005.
Article in English | MEDLINE | ID: mdl-16274261

ABSTRACT

OBJECTIVE: To investigate the effects of mild to moderate hepatic impairment on the pharmacokinetics and pharmacodynamics of landiolol hydrochloride, a new ultra-short-acting beta1-adrenergic antagonist. METHODS: Six patients with hepatic impairment and six healthy volunteers were enrolled in the open-label, parallel-group study. Landiolol hydrochloride was given intravenously with a 1-minute loading infusion of 0.06 mg/kg/min, followed by a 60-minute infusion of 0.02 mg/kg/min using an automated infusion pump. Venous blood was drawn just before (predose) and 1, 2, 5, 15, 30 and 61 minutes after beginning the continuous intravenous infusion (during infusion); 2, 5, 10 and 30 minutes and 1, 4 and 8 hours after the end of the infusion (after infusion); and 24 hours after beginning the infusion (next day). Urine samples were collected up to 24 hours after beginning the infusion. Before subjects were discharged, an indocyanine green elimination test, clinical laboratory testing, physical examination and recording of ECGs and vital signs were performed. RESULTS: The geometric mean maximum plasma concentration and area under the concentration-time curve values for the patients with hepatic impairment were 42% and 44% higher, respectively, than those observed for the healthy volunteers, indicating that hepatic impairment affected the disposition of landiolol hydrochloride. There were no significant changes in the elimination half-life of the drug. There were no clinically significant differences between the two groups in terms of reductions in heart rate or blood pressure. CONCLUSION: The pharmacokinetic and pharmacodynamic characteristics of this ultra-short-acting beta1-blocker were maintained even in the patients with hepatic impairment. Although we did not observe any drug-related adverse events in these patients, hypotension or bradycardia should be considered, necessitating continuous monitoring of both heart rate and BP in patients with hepatic impairment who receive landiolol hydrochloride.


Subject(s)
Adrenergic beta-Antagonists , Heart Rate/drug effects , Liver Diseases/metabolism , Morpholines , Receptors, Adrenergic, beta-1/metabolism , Urea/analogs & derivatives , Adrenergic beta-Antagonists/administration & dosage , Adrenergic beta-Antagonists/pharmacokinetics , Adrenergic beta-Antagonists/pharmacology , Aged , Female , Humans , Infusions, Intravenous , Liver Diseases/physiopathology , Male , Metabolic Clearance Rate , Middle Aged , Morpholines/administration & dosage , Morpholines/pharmacokinetics , Morpholines/pharmacology , Urea/administration & dosage , Urea/pharmacokinetics , Urea/pharmacology
15.
World J Gastroenterol ; 11(35): 5568-70, 2005 Sep 21.
Article in English | MEDLINE | ID: mdl-16222758

ABSTRACT

Acute esophageal necrosis (AEN) is extremely rare and the pathogenesis of this is still unknown. We report a case of AEN caused by alcohol abuse. In our case, the main pathogenesis could be accounted for low systemic perfusion caused by severe alcoholic lactic acidosis. After the healing of AEN, balloon dilatation was effective to manage the stricture.


Subject(s)
Alcoholism/pathology , Esophagus/pathology , Acidosis, Lactic/etiology , Acute Disease , Adult , Alcoholism/complications , Esophageal Stenosis/etiology , Esophageal Stenosis/pathology , Esophageal Stenosis/therapy , Humans , Male , Necrosis
16.
Nutrition ; 21(9): 914-9, 2005 Sep.
Article in English | MEDLINE | ID: mdl-16043326

ABSTRACT

OBJECTIVE: Dietary fiber by definition is resistant to digestion and absorption in the human small intestine, and it should naturally reach the large intestine. To date, there have been several reports that have examined in vivo how much dietary fiber actually reaches the terminal ileum in human subjects using glucose, with large differences in results. We compared the amount of pectin in the human terminal ileum with that of orally administered pectin. METHODS: Seven healthy male volunteers ages 20 to 27 y were given a test meal containing 4.05 g of pectin. A double-lumen tube was placed in the terminal ileum by using the endoscopic retrograde bowel insertion method, and the ileal contents were aspirated through the tube. Amounts of pectin orally administered and collected from the terminal ileum were estimated as galacturonic acid concentrations (Englyst's method) and were compared with each other. RESULTS: The mean +/- standard deviation amount of pectin collected in the terminal ileum was 3.58 +/- 0.43 g, or 88.4 +/- 10.5% of pectin administered. Further, there were large individual differences in recovery, ranging from 76.8% to 105.1%. CONCLUSIONS: Approximately 90% of ingested pectin was recovered in the terminal ileum in this study. Ten percent may have been degraded by bacteria within the digestive tract, especially the terminal ileum.


Subject(s)
Hexuronic Acids/analysis , Ileum/chemistry , Pectins/administration & dosage , Pectins/metabolism , Administration, Oral , Adult , Dietary Fiber/administration & dosage , Dietary Fiber/metabolism , Digestion , Endoscopy, Gastrointestinal , Fermentation , Humans , Intestinal Absorption , Male
17.
Nihon Rinsho ; 63(5): 744-9, 2005 May.
Article in Japanese | MEDLINE | ID: mdl-15881164

ABSTRACT

Ulcerative colitis (UC) is an idiopathic, non-specific inflammatory disorder involving primarily the mucosa and submucosa of the colon, especially the rectum. It usually produces a bloody diarrhea and various degrees of systemic involvement. These definitions of idiopathic proctocolitis were established by Council for International Organization of Medical Science (CIOMS) in 1973. In Japan, the first criteria for diagnosis of UC were established by the Research Committee of UC (the Japanese Ministry of Health and Welfare) in 1974, based on the definitions by CIOMS. Since then, some minor revisions have been made. The newest criteria for diagnosis of UC were published in 1998. The diagnosis of UC is made on the basis of a combination of clinical, endoscopic, radiologic, and histologic findings.


Subject(s)
Colitis, Ulcerative , Colitis, Ulcerative/classification , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/physiopathology , Colon/diagnostic imaging , Colonoscopy , Diagnosis, Differential , Humans , Radiography , Reference Standards , Severity of Illness Index
18.
Eur J Epidemiol ; 19(10): 905-13, 2004.
Article in English | MEDLINE | ID: mdl-15575348

ABSTRACT

BACKGROUND: It is well recognized that the season of the year exerts an influence on some diseases and causes of death such as coronary heart diseases, stroke, infectious diseases and so on. METHODS: We evaluated the influence of seasonal changes on diseases and causes of death in Japan using the Japan Vital Statistics from 1970 to 1999 and recorded weather data (mean temperature), by a Fourier decomposition in a log linear regression model. RESULTS: Major influences of seasonal change with the highest rates in winter were seen on the following: the overall causes of death; infectious and parasitic diseases including tuberculosis; respiratory disease, including pneumonia and influenza; heart and cerebrovascular diseases; diabetes; and digestive diseases and accidents. Two peaks were seen in suicides, a large peak in April and a small peak in autumn. Cancer and homicides were little or not at all influenced by seasonality. There was no major difference in changes between the years studied, except for respiratory disease and tuberculosis, which showed a clear reduction in the seasonality effect from 1970 to 1999. CONCLUSIONS: To reduce the overall mortality rate and to prolong life expectancy in Japan, measures must be taken to reduce those mortality rates associated with seasonal differences, especially those causes of death which show a strong correlation with seasonal change: respiratory, heart, cerebrovascular, diabetes and infectious diseases.


Subject(s)
Cause of Death , Seasons , Accidents, Traffic/mortality , Brain Infarction/mortality , Cardiovascular Diseases/mortality , Cause of Death/trends , Diabetes Mellitus/mortality , Digestive System Diseases/mortality , Heart Diseases/mortality , Homicide/statistics & numerical data , Humans , Japan/epidemiology , Neoplasms/mortality , Respiratory Tract Diseases/mortality , Suicide/statistics & numerical data , Temperature
19.
J Nutr ; 134(8): 1881-6, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15284370

ABSTRACT

Only a few reports have compared the fermentation of pectin and cellulose using the hydrogen-breath test, and no studies have examined the relation between the hydrogen breathing pattern and colonic microflora. Using breath-hydrogen measurements, we investigated whether different dietary fibers (DFs) were fermented differently and whether there were individual differences after ingestion of the same DF; we also examined the relation between individual fecal microflora and the fermentation of DF. Results of hydrogen tests in 14 men were compared after they had ingested 20 g of pectin, 20 g of cellulose, or 6 g of lactulose (a DF-like substance). We examined the relation between the breath hydrogen results and the subjects' fecal microflora. We defined significant fermentation (i.e., positive cases) as a continuous rise in hydrogen in the expiratory air of >19 ppm. The subjects were divided into 3 groups according to their hydrogen breath test pattern, i.e., positive for lactulose and pectin (Group LP, n = 4); positive for lactulose alone (Group L, n = 7); and negative for pectin, cellulose, and lactulose (Group N, n = 3). Individual differences were noted in subjects from Group LP and Group L. The detection frequency of lecithinase-negative clostridia was higher in Group LP than in the other groups (P < 0.05), and the detection frequency and the number of lecithinase-positive clostridia were higher in Groups LP and L than in Group N (P < 0.05). These findings suggest that the Clostridium species are associated with hydrogen production. The hydrogen breath test results of DFs depend on both the type of DF and the individual colonic microflora. The amount and constitution of colonic microflora might be predicted by the hydrogen-breath test using different DFs.


Subject(s)
Cellulose/metabolism , Clostridium/isolation & purification , Dietary Fiber/metabolism , Feces/microbiology , Lactulose/metabolism , Pectins/metabolism , Adult , Breath Tests , Cellulose/blood , Fermentation , Humans , Hydrogen/chemistry , Lactulose/blood , Male , Pectins/blood
20.
Tohoku J Exp Med ; 203(1): 9-16, 2004 May.
Article in English | MEDLINE | ID: mdl-15185967

ABSTRACT

In the past few decades, the number of bed-ridden elderly patients has been increasing. This group of patients is frequently fed with a liquid formula diet. The aim of this study was to evaluate the usefulness of a liquid formula diet containing dietary fiber (DF) for elderly bed-ridden patients. Eighteen elderly, bed-ridden patients were given L-3 Fiber, a DF-containing liquid formula diet (DF-LFD), for 4 weeks, while a number of parameters were monitored, including serum levels of total cholesterol, triglyceride, total protein, creatinine, uric acid, glucose, sodium, potassium, and calcium, urine protein/sugar, and defecation frequency. Total protein, albumin and total cholesterol significantly increased following the administration of the DF-LFD, associated with an average increase in body weight of 1.94 kg (5.0%). Defecation frequency significantly increased one week after DF-LFD administration was started, but this effect was transient. Although a few patients complained of nausea, vomiting or abdominal pain, no severe side effects were seen. In conclusion, DF-LFD supplementation appears to be beneficial for elderly bed-ridden patients, and can increase nutritional-related parameters, such as body weight, total protein, albumin and total cholesterol, without severe side effects.


Subject(s)
Bed Rest , Dietary Fiber/administration & dosage , Dietary Fiber/pharmacology , Dietary Supplements , Food, Formulated , Nutritional Physiological Phenomena/physiology , Aged , Aged, 80 and over , Blood Glucose/analysis , Blood Proteins/analysis , Body Weight/drug effects , Cholesterol/blood , Defecation/drug effects , Dietary Fiber/adverse effects , Dietary Supplements/adverse effects , Female , Food Preferences , Food, Formulated/adverse effects , Humans , Immobilization , Male , Middle Aged , Urine/chemistry
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