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Shimizu, Hirotaka,Arai, Katsuhiro,Takeuchi, Ichiro,Minowa, Kei,Hosoi, Kenji,Sato, Masamichi,Oka, Itsuhiro,Kaburaki, Yoichiro,Shimizu, Toshiaki The Korean Society of Pediatric Gastroenterology 2021 Pediatric gastroenterology, hepatology & nutrition Vol.24 No.1
Purpose: The long-term efficacy and safety of infliximab (IFX) in children with ulcerative colitis (UC) have not been well-evaluated. Here, we reviewed the long-term durability and safety of IFX in our single center pediatric cohort with UC. Methods: This retrospective study included 20 children with UC who were administered IFX. Results: For induction, 5 mg/kg IFX was administered at weeks 0, 2, and 6, followed by every 8 weeks for maintenance. The dose and interval of IFX were adjusted depending on clinical decisions. Corticosteroid (CS)-free remission without dose escalation (DE) occurred in 30% and 25% of patients at weeks 30 and 54, respectively. Patients who achieved CS-free remission without DE at week 30 sustained long-term IFX treatment without colectomy. However, one-third of the patients discontinued IFX treatment because of a primary nonresponse, and one-third experienced secondary loss of response (sLOR). IFX durability was higher in patients administered IFX plus azathioprine for >6 months. Four of five patients with very early onset UC had a primary nonresponse. Infusion reactions (IRs) occurred in 10 patients, resulting in discontinuation of IFX in four of these patients. No severe opportunistic infections occurred, except in one patient who developed acute focal bacterial nephritis. Three patients developed psoriasis-like lesions. Conclusion: IFX is relatively safe and effective for children with UC. Clinical remission at week 30 was associated with long-term durability of colectomy-free IFX treatment. However, approximately two-thirds of the patients were unable to continue IFX therapy because of primary nonresponse, sLOR, IRs, and other side effects.
Fluorescence Behavior of Benzo[f]Quinoline Doped In Lpd Silica Thin Films
Mabuchi, Toshiaki,Suzuki, Satoshi,Nakajima, Tsuyoshi,Ino, Juichi,Takemura, Kazuo,Shimizu, Etsuro Korean Society of Photoscience 1998 Journal of Photosciences Vol.5 No.3
By using the liquid -phase-deposition (LPD) process, which has a potetnial of preparing organic inorganic composite materials, samples doped with benzo[f]quinoline (BfQ)into silica thia films wre prepared. We observed the fluorescene and fluorescene excitation spectra of the samples, as well as the fluorescence lifetimes and time-resoluved fluorescence spectra. The comparison of thefluorescence spectra in pH-controlled buffer solutions yields the results that the dominant species of BfQ in the LPD silica films is a protonated one. The fluorescence band assigned to a hydrogen-bonded species was observed on the samples prepared from the dipping solutions of 3 and 2 M hexafluorosilicic acid. The band assignment was confirmed by the fluorescence lifetime measurement. The FT-IR M hexaflurosilicic acid. The band assignment was confirmed by the flurescence lifetime meausurement. The FT-IR data proved the existence of included water in silica films prepared from the LPD process. The appearance of the band corresponding to the hydrogen-bonded species within LPD silica phases was explained by the proesence of included water. Depending on the preparation conditions of LPD silica films, the band assigned to protonated species shows bad shifts in a wavenumber region between the peak of hydrogen-bonded and typical protonated species. This implies that there is some distribution of steric conformation of protonated species of BfQ interacting with adsorbing sites of LPD silica. The time -resolved fluorescence spectra suggest that some relaxation process is involved in the conformation of BfQ doped into the solid phase of LPD silica.
Kazuhide Tokita,Hirotaka Shimizu,Ichiro Takeuchi,Toshiaki Shimizu,Katsuhiro Arai 대한소아소화기영양학회 2022 Pediatric gastroenterology, hepatology & nutrition Vol.25 No.6
Purpose: Golimumab (GLM) is an anti-tumor necrosis factor (TNF)-α antibody preparation known to be less immunogenic than infliximab (IFX) or adalimumab. Few reports on GLM in pediatric patients with ulcerative colitis (UC) are available. This study aimed to review the long-term durability and safety of GLM in a pediatric center. Methods: The medical records of 17 pediatric patients (eight boys and nine girls) who received GLM at the National Center for Child Health and Development were retrospectively reviewed. Results: The median age at GLM initiation was 13.9 (interquartile range 12.0–16.3) years. Fourteen patients had pancolitis, and 11 had severe disease (pediatric ulcerative colitis activity index ≥65). Ten patients were biologic-naïve, and 50% achieved corticosteroid-free remission at week 54. Two patients discontinued prior anti-TNF-α agents because of adverse events during remission. Both showed responses to GLM without unfavorable events through week 54. However, the efficacy of GLM in patients who showed primary nonresponse or loss of response to IFX was limited. Four of the five patients showed non-response at week 54. Patients with severe disease had significantly lower corticosteroid-free remission rate at week 54 than those without severe disease. No severe adverse events were observed during the study period. Conclusion: GLM appears to be safe and useful for pediatric patients with UC. Patients with mild to moderate disease who responded to but had some adverse events with prior biologics may be good candidates for GLM. Its safety and low immunogenicity profile serve as favorable options for selected children with UC.
Itsuhiro Oka,Rie Funayama,Hirotaka Shimizu,Ichiro Takeuchi,Shuko Nojiri,Toshiaki Shimizu,Katsuhiro Arai 대한소아소화기영양학회 2023 Pediatric gastroenterology, hepatology & nutrition Vol.26 No.4
Purpose: The development of assistive devices has allowed for the performance of capsule endoscopy in children. Anticipating the capsule’s transit time could affect the efficacy of the investigation and potentially minimize the fasting period. This study determined the predictors of small bowel transit time for small-bowel capsule endoscopy in children and adolescents with inflammatory bowel disease. Methods: We retrospectively examined children and adolescents with inflammatory bowel disease who underwent capsule endoscopy by the age 18 at a Japanese tertiary care children’s hospital. Small bowel transit time predictors were analyzed using multiple regression with explanatory variables. Results: Overall, 92 patients, aged 1–17 years, with inflammatory bowel disease (63 Crohn’s disease and 29 ulcerative colitis cases) were examined for factors affecting small bowel transit time. In the simple regression analysis, diagnosis, age, height, weight, serum albumin, general anesthesia, and small intestine lesions were significantly associated with small bowel transit time. In the multiple regression analyses, serum albumin (partial regression coefficient: −58.9, p=0.008), general anesthesia (partial regression coefficient: 127, p<0.001), and small intestine lesions (partial regression coefficient: 30.1, p=0.037) showed significant associations with small bowel transit time. Conclusion: Hypoalbuminemia, the use of general anesthesia for endoscopic delivery of the capsule, and small intestine lesions appeared to be predictors of prolonged small bowel transit time in children and adolescents with inflammatory bowel disease. Expecting the finishing time may improve examination with a fasting period reduction, which benefits both patients and caregivers.
Ito, Natsuki,Takeuchi, Ichiro,Kyodo, Reiko,Hirano, Yuri,Sato, Takuro,Usami, Masaaki,Shimizu, Hirotaka,Shimizu, Toshiaki,Arai, Katsuhiro The Korean Society of Pediatric Gastroenterology 2021 Pediatric gastroenterology, hepatology & nutrition Vol.24 No.4
Purpose: A change in diagnosis from ulcerative colitis (UC) to Crohn's disease (CD) has been reported in pediatric inflammatory bowel disease; however, only a few clinical characteristics and predictors of this diagnostic change have been reported. We aimed to describe the clinical characteristics of patients with UC who underwent a change in diagnosis to CD and identify variables associated with the change. Methods: The medical records of pediatric patients with UC who were followed up at the National Center for Child Health and Development between 2006 and 2019 were retrospectively reviewed. Clinical data on disease phenotype, laboratory parameters, endoscopic findings, and treatment of patients whose diagnosis changed to CD (cCD) were compared to those of patients whose diagnosis remained UC (rUC). Results: Among the 111 patients initially diagnosed with UC, 11 (9.9%) patients were subsequently diagnosed with CD during follow-up. There was no significant difference between the cCD and rUC groups in terms of sex, age at initial diagnosis, and the extent and severity of disease at initial diagnosis. Albumin and hemoglobin levels were significantly lower in the cCD group than in the rUC group. The proportion of patients who required biologics was significantly higher in the cCD group than in the rUC group (p<0.05). Conclusion: Approximately 10% children initially diagnosed with UC were subsequently diagnosed with CD. Hypoalbuminemia and anemia at initial diagnosis and use of biologics could be predictors of this diagnostic change.
( Katsuhiro Arai ),( Reiko Kunisaki ),( Fumihiko Kakuta ),( Shin-ichiro Hagiwara ),( Takatsugu Murakoshi ),( Tadahiro Yanagi ),( Toshiaki Shimizu ),( Sawako Kato ),( Takashi Ishige ),( Tomoki Aomatsu 대한장연구학회 2020 Intestinal Research Vol.18 No.4
Background/Aims: There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children. Methods: This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data. Results: A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn’s disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturing/non-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, P<0.01) but more L4a (47.3% vs. 29.6%, P<0.01) and L3 (64.8% vs. 52.7%, P<0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, P<0.01). Conclusions: Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children. (Intest Res 2020;18:412-420)