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      • KCI등재

        Randomized, crossover questionnaire survey of acceptabilities of controlled-release mesalazine tablets and granules in ulcerative colitis patients

        Keiji Yagisawa,Taku Kobayashi,Ryo Ozaki,Shinji Okabayashi,Takahiko Toyonaga,Miki Miura,Mari Hayashida,Eiko Saito,Masaru Nakano,Hajime Matsubara,Tadakazu Hisamatsu,Toshifumi Hibi 대한장연구학회 2019 Intestinal Research Vol.17 No.1

        Background/Aims: Oral mesalazine is an important treatment for ulcerative colitis (UC), and non-adherence to mesalazineincreases the risk of relapse. Controlled-release (CR) mesalazine has 2 formulations: tablets and granules. The relative acceptabilitiesof these formulations may influence patient adherence; however, they have not been compared to date. This studyaimed to evaluate the acceptabilities of the 2 formulations of CR mesalazine in relation to patient adherence using a crossoverquestionnaire survey. Methods: UC patients were randomly assigned to 2 groups in a 1:1 ratio. Patients in each group tookeither 4 g of CR mesalazine tablets or granules for 6 to 9 weeks, and then switched to 4 g of the other formulation for a further 6to 9 weeks. The acceptability and efficacy were evaluated by questionnaires, and adherence was assessed using a visual analogscale. The difference in acceptabilities between the 2 formulations and its impact on adherence were assessed. Results: A totalof 49 patients were prospectively enrolled and 33 patients were included in the analysis. Significantly more patients found thetablets to be less acceptable than the granules (76% vs. 33%, P=0.0005). The granules were preferable to the tablets when the 2formulations were compared directly (73% vs. 21%, P=0.004), for their portability, size, and numbers of pills. The adherence ratewas slightly better among patients taking the granules (94% vs. 91%) during the observation period, but the difference was notsignificant (P=0.139). Conclusion: CR mesalazine granules are more acceptable than tablets, and may therefore be a better optionfor long-term medication. (Intest Res 2019;17:87-93)

      • KCI등재

        Relationship between Displacement of the Psoas Major Muscle and Spinal Alignment in Patients with Adult Spinal Deformity

        Yoshiaki Oda,Tomoyuki Takigawa,Ryo Ugawa,Yasuyuki Shiozaki,Haruo Misawa,Yoshihisa Sugimoto,Masato Tanaka,Toshifumi Ozaki 대한척추외과학회 2018 Asian Spine Journal Vol.12 No.2

        Study Design: Cross sectional study. Purpose: To clarify the difference in position of the psoas muscle between adult spinal deformity (ASD) and lumbar spinal stenosis (LSS). Overview of Literature: Although it is known that the psoas major muscle deviates in ASD patients, no report is available regarding the difference in comparison with LSS patients. Methods: This study investigates 39 patients. For evaluating spinal alignment, pelvic tilt (PT), pelvic incidence (PI), sacral slope, lumbar lordosis (LL), PI–LL, Cobb angle, and the convex side, the lumbar curves were measured. For measuring the position of the psoas major at the L4/5 disk level, magnetic resonance imaging was used. The displacements of psoas major muscle were measured separately in the anterior–posterior and lateral directions. We examined the relationship between the radiographic parameters and anterior displacement (AD) and lateral displacement (LD) of the psoas major muscle. Results: AD was demonstrated in 15 cases with ASD and nine cases with LSS (p >0.05). LD was observed in 13 cases with ASD and no cases with LSS (p <0.01). The Cobb angle was significantly greater in cases with AD than in those without AD (p =0.04). PT, LL, PI– LL, and Cobb angle were significantly greater in cases with LD (p <0.05). All cases with LD had AD, but no case without AD had LD (p <0.001). The side of greater displacement at L4/5 and the convex side of the lumbar curve were consistent in all cases. Conclusions: Despite AD being observed in LSS as well, LD was observed only in the ASD group. Radiographic parameters were worse when LD was seen, rather than AD.

      • KCI등재

        Steroid-refractory extensive enteritis complicated by ulcerative colitis successfully treated with adalimumab

        ( Shinji Okabayashi ),( Taku Kobayashi ),( Tomohisa Sujino ),( Ryo Ozaki ),( Satoko Umeda ),( Takahiko Toyonaga ),( Eiko Saito ),( Masaru Nakano ),( Maria Carla Tablante ),( Shojiroh Morinaga ),( Tosh 대한장연구학회 2017 Intestinal Research Vol.15 No.4

        Extracolonic involvement of the gastrointestinal tract is extremely uncommon in ulcerative colitis (UC) and rarely found in the upper gastrointestinal tract or in postoperative cases since it typically responds to steroids. Here we report a case of UC complicated by extensive ileal inflammation that was refractory to steroids. A 20-year-old man was diagnosed with UC of typical pancolitis without ileal involvement and started treatment with pH-dependent mesalazine and oral prednisolone. Although his symptoms transiently resolved, the condition flared when the steroid dose was tapered down. Computed tomography revealed marked thickening of the ileal wall, and capsule endoscopy and balloon-assisted enteroscopy found diffuse mucosal inflammation with ulcers in the ileum. On the contrary, the inflammation in the colon and rectum was improving. Since the response to the second steroid course was inadequate, treatment with adalimumab and 6-mercaptopurine was initiated and finally achieved clinical and endoscopic remission. The investigation of small intestinal lesions is necessary in patients with UC whose clinical deterioration cannot be explained by colonic lesions. (Intest Res 2017;15:535-539)

      • KCI등재

        Individualized treatment based on CYP3A5 single-nucleotide polymorphisms with tacrolimus in ulcerative colitis

        Shinji Okabayashi,Taku Kobayashi,Eiko Saito,Takahiko Toyonaga,Ryo Ozaki,Shintaro Sagami,Masaru Nakano,Junichi Tanaka,Keiji Yagisawa,Satoshi Kuronuma,Osamu Takeuchi,Toshifumi Hibi 대한장연구학회 2019 Intestinal Research Vol.17 No.2

        Background/Aims: The pharmacokinetics of tacrolimus (TAC) is known to be largely influenced by single-nucleotide polymorphisms (SNPs) in CYP3A5. Patients starting TAC require careful dose adjustment, owing to the wide range of optimal dosages, depending on their CYP3A5 expression status. Here, we evaluated whether individualization of TAC dosages based on CYP3A5 SNPs would improve its therapeutic efficacy in ulcerative colitis. Methods: Twenty-one patients were prospectively treated, with their initial dosage adjusted according to their CYP3A5 status (0.1, 0.15, and 0.2 mg/kg/day for CYP3A5*3/*3, CYP3A5*1/*3, and CYP3A5*1/*1, respectively). Their clinical outcomes were compared with those of patients treated with a fixed dose (0.1 mg/kg/day). Results: The first blood trough level of CYP3A5 expressors, CYP3A5*1/*3 or CYP3A5*1/*1, and the overall rate in achieving the target blood trough level within a week in the individualized-dose group were significantly higher than those in the fixed-dose group (5.15±2.33 ng/mL vs. 9.63±0.79 ng/mL, P=0.035 and 12.5% vs. 66.7%, P=0.01). The remission rate at 2 weeks in the expressors was as high as that in the nonexpressors, CYP3A5*3/*3, in the individualized-dose group. Conclusions: Individualized TAC treatment is effective against ulcerative colitis regardless of the CYP3A5 genotype. (Intest Res 2019;17:218-226)

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