Protective Effect of Daikenchuto on Dextran Sulfate Sodium-Induced Colitis in Mice.

Aim. To investigate the effect of daikenchuto (TJ-100; DKT) for ulcerative colitis (UC) model mouse and assess its anti-inflammatory mechanisms. Methods. We evaluated the effects of DKT on dextran sulfate sodium- (DSS-) induced experimental colitis. First, we assessed the short-term effects of DKT using two groups: 5% DSS group and 5% DSS with DKT group. Colon length; histological scores; and interleukin- (IL-) 10, IL-1ß, and tumor necrosis factor-α mRNA expression profiles were analyzed using real-time PCR. Second, we assessed the long-term effects of DKT, by comparing survival time between 2% DSS and 2% DSS with DKT groups. Results. After 7 days, the colon lengths of DSS + DKT group were longer than those of the DSS group (mean values: 6.11 versus 5.69 cm, p < 0.05). Furthermore, compared to DSS group, the DSS + DKT group maintained significantly higher levels of serum hemoglobin (13.1 versus 10.7 g/dL, p < 0.05) and exhibited significantly higher expression levels of IL-10 (p < 0.05). The 2% DSS + DKT group exhibited significantly longer survival time than the 2% DSS group (70 versus 44 days, p < 0.01). Conclusion. Our results indicate that DKT prevented inflammation in the colon, indicating its potential as a new therapeutic agent for UC.

Effect of capsule placement with transnasal endoscopy.

AIM: One of the prohibiting factors in achieving complete small bowel capsule endoscopy is slow gastric transit of the capsule. The present study retrospectively investigated the success rate of, and the time required for, transnasal endoscope-assisted capsule placement to assess its clinical utility. METHODS: In 24 of 27 patients who underwent capsule placement assisted by a transnasal endoscope, the capsule was successfully transported to and released in the duodenum (capsule placement group). For each patient in the capsule placement group, three age- and sex-matched patients who underwent conventional capsule endoscopy were assigned as controls (n=72). Gastric transit time, small bowel transit time, and rate of capsule arrival at the cecum within 8h were compared between the two patient groups. RESULTS: Among the 27 patients in whom capsule placement was carried out, the capsule was successfully placed in the duodenum in 24 patients (88.9% success rate). In the capsule placement group, gastric transit time was significantly shorter (10.5 vs 46.2min, P=0.0021), small bowel transit time was significantly longer (354.7 vs 301.3min, P=0.0134), and completion rate (capsule arrival at the cecum within 8h) was significantly higher (83.3 vs 61.1%, P=0.0455) than in the control group. There were no procedural accidents associated with capsule placement. CONCLUSION: Transnasal endoscope-assisted capsule placement appears to be a safe and reliable procedure, achieving complete small bowel capsule endoscopy, and is considered clinically useful.

Correlations between obesity/metabolic syndrome-related factors and risk of developing colorectal tumors.

BACKGROUND/AIMS: Colorectal cancer/adenoma development may correlate with obesity/metabolic syndrome in the Japanese. We sought to clarify the relation between colorectal adenoma prevalence and various factors to develop a better colorectal tumor screening strategy. METHODOLOGY: Of 2668 patients who underwent colonoscopy, medical records of 837 patients (467 men, 370 women; age, 40-80 years) with available data on measured values of body mass index, waist circumference, body fat percentage, and prior history of hypertension, diabetes and hyperlipidemia were reviewed and analyzed. RESULTS: Of these patients, 460 (55.0%) had colorectal tumor or prior history thereof (lesions >=1mm). Multivariate analysis revealed significant differences in gender, age and waist circumference between patients with/without colorectal adenoma, with men at significantly higher risk than women of developing colorectal tumor (OR=2.57, 95% CI: 1.84-4.65; p<0.001). In patients with/without colorectal tumor, age, waist circumference and body fat percentage were significantly different among men, but only age was significantly different among women. CONCLUSIONS: Present findings that waist circumference and body fat percentage correlated with prevalence of colorectal tumor among men may contribute to more accurate prediction of colorectal tumor risk and an efficient colorectal cancer screening system.

[A case of enteric muco-submucosal elongated polyp].

A woman in her seventies was admitted because of black stool. Esophagogastroduodenoscopy and colonoscopy revealed no bleeding lesions. Balloon endoscopy showed a long and slender polyp. The polyp was covered with normal mucosa and accompanied with ulcerations. The long polypoid lesion was found to be located in the duodenojejunal flexure by a small bowel series. We performed endoscopic polypectomy. The polyp was composed of edematous mucosa and submucosa with dilated blood vessels and lymphangiectasia. The histologic findings of resected specimen were compatible with colonic muco-submucosal elongated polyp. The polyp was considered to be classified as enteric muco-submucosal elongated polyp.

Usefulness of computed tomography enteroclysis in the intestinal tract.

PURPOSE: The aim of this study was to evaluate computed tomography enteroclysis (CTE) of the small intestinal tract. MATERIALS AND METHODS: A total of 36 patients underwent CTE for further examination of small intestinal disease. RESULTS: The indications were obscure gastrointestinal bleeding (OGIB) (n = 16), suspected Crohn's disease (n = 7), suspected and diagnosed by exclusion a small intestinal tumor (n = 5), and others (n = 8). Regarding OGIB, positive findings were observed in nine patients: angiodysplasia (n = 2), suspected ileac tumor (n = 2), colon cancer (n = 1), colon diverticulosis and diverticulitis (n = 2), Crohn's disease (n = 1), and enteritis (n = 1). As for Crohn's disease, hyperplasia of the small intestinal wall was shown in six patents. Positive findings of a small intestinal tumor were observed in two patients. In the "others" category, colon diverticulitis was found in three patients and isolated dissection of the superior mesenteric artery in one of four patients with abdominal pain. Primary carcinoid was identified in the pancreas in one patient, with liver carcinoid metastasis in the remaining four patients. CONCLUSION: CT enteroclysis is a noninvasive method and useful approach in the diagnosis of small intestinal diseases.