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Yoshihide Kanno,Tetsuya Ohira,Yoshihiro Harada,Shinsuke Koshita,Takahisa Ogawa,Hiroaki Kusunose,Yoshiki Koike,Taku Yamagata,Toshitaka Sakai,Kaori Masu,Keisuke Yonamine,Kazuaki Miyamoto,Megumi Tanaka,T 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.3
Background/Aims: The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepinedrugs in outpatient endoscopy. Methods: In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextdayquestionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24hours, and examinee satisfaction were evaluated. Results: Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performedbetween November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopicultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. Themean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination withpropofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia,in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of thepatients desired propofol sedation in future examinations. Conclusions: Propofol sedation was found to be safe-without severe adverse events or accidents-for outpatient endoscopy on thebasis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painlessendoscopic screening.
Yoshihide Kanno,Tetsuya Ohira,Yoshihiro Harada,Yoshiki Koike,Taku Yamagata,Megumi Tanaka,Tomohiro Shimada,Kei Ito 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.3
Afferent loop syndrome is often difficult to resolve. Among patients with afferent loop syndrome whose data were extracted fromdatabases, 5 patients in whom metal stent placement was attempted were included and evaluated in this study. The procedure wastechnically successful without any adverse events in all patients. Metal stent(s) was placed with an endoscope in the through-the-scopemanner in 4 patients and via a percutaneous route in 1 patient. Obvious clinical efficacy was observed in all patients. Adverse eventsrelated to the procedure and stent occlusion during the follow-up period were not observed. Metal stent placement for malignantobstruction of the afferent loop was found to be safe and feasible.
Distribution of cytomegalovirus genotypes among ulcerative colitis patients in Okinawa, Japan
Saifun Nahar,Akira Hokama,Atsushi Iraha,Tetsuya Ohira,Tetsu Kinjo,Tetsuo Hirata,Takeshi Kinjo,Gretchen L. Parrott,Jiro Fujita 대한장연구학회 2018 Intestinal Research Vol.16 No.1
Background/Aims: To determine the prevalence of glycoprotein B (gB), glycoprotein N (gN), and glycoprotein H (gH) genotypes of human cytomegalovirus (HCMV) superimposed on ulcerative colitis (UC) patients in Japan. Methods: Four archivedstool samples and 7-archived extracted DNA from stool samples of 11 UC patients with positive multiplex polymerase chainreaction (PCR) results for HCMV were used UL55 gene encoding gB, UL73 gene encoding gN, and UL75 gene encoding gH were identified by PCR. Genotypes of gB and glycoprotein N were determined by sequencing. Results: Among 11 samples, 8samples were amplified through PCR. gB, gN, and gH genotypes were successfully detected in 3 of 8 (37.5%), 4 of 8 (50%), and8 of 8 (100%), respectively. The distribution of gB and gN genotypes analyzed through phylogenetic analysis were as follows:gB1 (2/3, 66.7%), gB3 (1/3, 33.3%), gN3a (2/4, 50%), and gN3b (2/4, 50%). Other gB genotypes (gB2 and gB4) and gN genotypes(gN1, gN2, and gN4) were not detected in this study. Out of successfully amplified 8 samples of gH genotype, gH1 and gH2 weredistributed in 12.5% and 75% samples, respectively. Only 1 sample revealed mixed infection of gH genotype. The distribution ofgH1 and gH2 differed significantly (1:6, P <0.05) in UC patients. The distribution of single gH genotype also revealed significantdifference in UC patients who were treated with immunosuppressive drug (P <0.05). Conclusions: In this study, gB1, gN3, andgH2 gene were determined as the most frequently observed genotypes in UC patients, which suggest that there might be an association between these genotypes of HCMV and UC.