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Shin, Sangah,Saito, Eiko,Sawada, Norie,Ishihara, Junko,Takachi, Ribeka,Nanri, Akiko,Shimazu, Taichi,Yamaji, Taiki,Iwasaki, Motoki,Sasazuki, Shizuka,Inoue, Manami,Tsugane, Shoichiro,Tsugane, S.,Sawada, Elsevier 2018 Clinical nutrition Vol.37 No.3
<P><B>Summary</B></P> <P><B>Background & aims</B></P> <P>A finding between dietary pattern and cancer may provide visions beyond the assessment of individual foods or nutrients. We examined the influence of dietary pattern with colorectal cancer (CRC) among a Japanese population.</P> <P><B>Methods</B></P> <P>A total of 93,062 subjects (43,591 men, 49,471 women) who participated in the Japan Public Health Center-based Prospective Study were followed from 1995–1998 to the end of 2012, during which 2482 cases of CRC (1514 men, 968 women) were newly identified. Dietary data was obtained from a validated food-frequency questionnaire between 1995 and 1998.</P> <P><B>Results</B></P> <P>Three dietary pattern was derived from principal components factor: prudent, westernized, and traditional pattern. After controlled for potential confounders, the prudent pattern showed a decreased association of CRC risk in men (HR for highest quintile vs lowest: 0.85; 95% CI: 0.72–1.00; <I>P</I> trend <0.05), slightly more strongly with distal colon cancer (<I>P</I> trend <0.05); but an increased risk of rectal cancer in women (<I>P</I> trend <0.05). The westernized pattern showed a significant positive linear trend for colon (<I>P</I> trend <0.05) and distal cancer (<I>P</I> trend <0.05) in women. There was no apparent association of traditional Japanese dietary pattern on the overall or any specific sites risk of CRC.</P> <P><B>Conclusions</B></P> <P>A prudent dietary pattern showed an inverse association with CRC risk in men, and a westernized pattern was related with a higher risk of colon and distal cancer in women.</P>
REVIEW : Tacrolimus for the Treatment of Ulcerative Colitis
( Katsuyoshi Matsuoka ),( Eiko Saito ),( Toshimitsu Fujii ),( Kento Takenaka ),( Maiko Kimura ),( Masakazu Nagahori ),( Kazuo Ohtsuka ),( Mamoru Watanabe ) 대한장연구학회 2015 Intestinal Research Vol.13 No.3
Tacrolimus is a calcineurin inhibitor used for the treatment of corticosteroid-refractory ulcerative colitis (UC). Two randomized controlled trials and a number of retrospective studies have assessed the therapeutic effect of tacrolimus in UC patients. These studies showed that tacrolimus has excellent short-term efficacy in corticosteroid-refractory patients, with the rates of clinical response ranging from 61% to 96%. However, the long-term prognosis of patients treated with tacrolimus is disappointing, and almost 50% of patients eventually underwent colectomy in long-term follow-up. Tacrolimus can achieve mucosal healing in40-50% of patients, and this is associated with a favorable long-term prognosis. Anti-tumor necrosis factor (TNF)-α antibodies are another therapeutic option in corticosteroid-refractory patients. A prospective head-to-head comparative study of tacrolimus and infliximab is currently being performed to determine which treatment is more effective in corticosteroid-refractory patients. Several retrospective studies have demonstrated that switching between tacrolimus and anti-TNF-α antibody therapy was effective in patients who were refractory to one of the treatments. Most adverse events of tacrolimus are mild; however,opportunistic infections, especially pneumocystis pneumonia, are the most important adverse events, and these should be carefully considered during treatment. Several issues on tacrolimus treatment in UC patients remain unsolved (e.g., use of tacrolimus as remission maintenance therapy). Further controlled studies are needed to optimize the use of tacrolimus for the treatment of UC. (Intest Res 2015;13:219-226)
Chen, Yu,Wu, Fen,Saito, Eiko,Lin, Yingsong,Song, Minkyo,Luu, Hung N.,Gupta, Prakash C.,Sawada, Norie,Tamakoshi, Akiko,Shu, Xiao-Ou,Koh, Woon-Puay,Xiang, Yong-Bing,Tomata, Yasutake,Sugiyama, Kemmyo,Par Springer-Verlag 2017 Diabetologia Vol.60 No.6
<P>Diabetes was associated with a 26% increased risk of death from any cancer in Asians. The pattern of associations with specific cancers suggests the need for better control (prevention, detection, management) of the growing epidemic of diabetes (as well as obesity), in order to reduce cancer mortality.</P>
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)
Kanako Kono,Tohru Morisada,Kumiko Saika,Eiko Saitoh Aoki,Etsuko Miyagi,Kiyoshi Ito,Hirokazu Takahashi,Tomio Nakayama,Hiroshi Saito,Daisuke Aoki 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.3
Objective: In 2013, a cohort study aimed to clarify the positive and negative effects ofintroducing the human papillomavirus (HPV) testing for population-based cervical cancerscreening has been launched in Japan. This study included four screenings during thesubsequent 7-year follow-up period. We aim to describe the results of the first round of thisstudy on cervical cancer screening here. Methods: This study began in September 2013 with recruitment completed in March 2016. Women aged 30–49 years were divided into 2 groups: those who received uterine cervicalcytology alone in the first year (control group), or those who received a combination ofcytology and HPV testing (intervention group), based on their age. After first screening,women with positive result of cytology or positive HPV test required referral. We summarizedthe results of the first round of cervical cancer screening. Results: Of the 25,074 women who were eligible for the study, 13,845 women (55.2%) werescreened with cytology alone; 11,229 women (44.8%) received a combination of cytologyand HPV testing. After screening, 407 women (2.9%) in the control group and 1,003 women(8.9%) in the intervention group required referral, respectively. Adding HPV testing increasedreferral rate significantly (p<0.001). Conclusion: After first screening, introduction of HPV testing appears to contribute tosignificantly higher referral rates, suggesting that the number of colposcopies as a detailedexamination may increase. These preliminary findings suggest that if HPV testing is introduced into screening, medical institutions need to be prepared for an increasing numberof follow-up examinations.
Rapid prediction of 1-year efficacy of tofacitinib for treating refractory ulcerative colitis
( Hiromichi Shimizu ),( Toshimitsu Fujii ),( Shuji Hibiya ),( Maiko Motobayashi ),( Kohei Suzuki ),( Kento Takenaka ),( Eiko Saito ),( Masakazu Nagahori ),( Kazuo Ohtsuka ),( Mamoru Watanabe ) 대한장연구학회 2021 Intestinal Research Vol.19 No.1
( 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)
Ami Kawamoto,Kento Takenaka,Shuji Hibiya,Yoshio Kitazume,Hiromichi Shimizu,Toshimitsu Fujii,Eiko Saito,Kazuo Ohtsuka,Ryuichi Okamoto 대한장연구학회 2024 Intestinal Research Vol.22 No.1
Background/Aims: Endoscopic activity confirmed by enteroscopy is associated with poor clinical outcome in Crohn’s disease (CD). We investigated which of the existing biomarkers best reflects endoscopic activity in CD patients including the small bowel, and whether their combined use can improve accuracy.Methods: One hundred and four consecutive patients with ileal and ileocolonic type CD who underwent balloon-assisted enteroscopy (BAE) from October 2021 to August 2022 were enrolled, with clinical and laboratory data prospectively collected and analyzed.Results: Hemoglobin, platelet count, C-reactive protein, leucine-rich alpha-2 glycoprotein (LRG), fecal calprotectin, and fecal hemoglobin all showed significant difference in those with ulcers found on BAE. LRG and fecal calprotectin showed the highest areas under the curve (0.841 and 0.853) for detecting ulcers. LRG showed a sensitivity of 78% and specificity of 80% at a cutoff value of 13 μg/mL, whereas fecal calprotectin showed a sensitivity of 91% and specificity of 67% at a cutoff value of 151 μg/g. Dual positivity for LRG and fecal calprotectin, as well as LRG and fecal hemoglobin, both predicted ulcers with an improved specificity of 92% and 100%. A positive LRG or fecal calprotectin/hemoglobin showed an improved sensitivity of 96% and 91%. Positivity for LRG and either of the fecal biomarkers was associated with increased risk of hospitalization, surgery, and relapse.Conclusions: The biomarkers LRG, fecal calprotectin, and fecal hemoglobin can serve as noninvasive and accurate tools for assessing activity in CD patients confirmed by BAE, especially when used in combination.
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)