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- 저자 : ( Kosaku Nanki ) (검색결과 4 건)
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Kosaku Nanki,Shinta Mizuno,Katsuyoshi Matsuoka,Keiko Ono,Shinya Sugimoto,Hiroki Kiyohara,Mari Arai,Moeko Nakashima,Kozue Takeshita,Keiichiro Saigusa,Mitsutoshi Senoh,Tadashi Fukuda,Makoto Naganuma,Har 대한장연구학회 2018 Intestinal Research Vol.16 No.1
Fecal microbiota transplantation (FMT) has been reported as a safe and effective therapy in patients with refractory and recurrentClostridium difficile infection (CDI). FMT has also been reported as a promising therapy in patients with ulcerative colitis(UC). Both, CDI and UC, are believed to be caused by dysbiosis, such as altered compositions or decreased diversity of the intestinal microbiota. This report describes a patient with UC in remission with a second recurrent episode of CDI, who was treated with FMT. A single FMT performed via colonoscopy completely resolved the patient’s diarrhea and eradicated C. difficilebacteriologically without any severe complications. Molecular biological analysis of the patient’s fecal microbiota showedthat FMT could dramatically change the altered composition of intestinal microbiota and restore its diversity. Despite the restoration of the intestinal microbiota, FMT could not prevent a relapse of UC in this patient. However, it improved the intestinalsymptoms of CDI and could prevent further recurrences of CDI.
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( Shinta Mizuno ),( Kosaku Nanki ),( Katsuyoshi Matsuoka ),( Keiichiro Saigusa ),( Keiko Ono ),( Mari Arai ),( Shinya Sugimoto ),( Hiroki Kiyohara ),( Moeko Nakashima ),( Kozue Takeshita ),( Makoto Na 대한장연구학회 2017 Intestinal Research Vol.15 No.1
Background/Aims: Recent developments in analytical techniques including next-generation sequencing have clarified the correlation between intestinal microbiota and inflammatory bowel disease. Fecal microbiota transplantation (FMT) for patients with ulcerative colitis (UC) is proposed as a potential approach to resolving their dysbiosis; however, its safety and efficacy have not been confirmed. This single-arm, open-label, non-randomized study aimed to evaluate the safety and efficacy of FMT for Japanese patients with UC as the first registered clinical trial in Japan. Methods: We enrolled 10 patients with active UC despite medical therapy. The donors were the patients` relatives and were carefully screened for infectious diseases. Fecal material was administered via colonoscopy, and the primary endpoint was the presence or absence of serious adverse events related to FMT. The secondary endpoint was a change in partial Mayo score at 12 weeks post-FMT. Scores ≤2 were considered a clinical response. Fecal samples were collected to follow changes in gut microbiota, while extracted complementary DNA were analyzed by a next-generation sequencer. We obtained written informed consent from all patients and donors. This study was approved by our Institutional Review Board and is registered in the University hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN 000012814). Results: Five patients with moderate disease and five with severe disease were enrolled. No severe adverse effects were observed. One patient achieved clinical response; however, none of the patients` microbiota diversity recovered to the donor levels. Conclusions: The use of single FMT for UC was safe; however, we failed to show its clinical efficacy and potential to change the intestinal microbiota. (Intest Res 2017;15:68-74)
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( Yasuhiro Aoki ),( Hiroki Kiyohara ),( Yohei Mikami ),( Kosaku Nanki ),( Takaaki Kawaguchi ),( Yusuke Yoshimatsu ),( Shinya Sugimoto ),( Tomohisa Sujino ),( Kaoru Takabayashi ),( Naoki Hosoe ),( Haru 대한장연구학회 2023 Intestinal Research Vol.21 No.3
Background/Aims: Thromboprophylaxis is recommended for hospitalized patients with inflammatory bowel disease (IBD) in Western countries, although it is selectively administered to high-risk patients in East Asia. A central venous catheter (CVC) is commonly placed in patients with IBD. Although CVC placement is considered a risk factor for venous thromboembolism (VTE), the degree of increased risk in patients with IBD is uncertain. This study aimed to identify the risk of VTE with CVC placement in hospitalized Japanese patients with IBD without thromboprophylaxis. Methods: This retrospective cohort study included patients with ulcerative colitis or Crohn’s disease who were admitted for disease flares at Keio University Hospital between January 2016 and December 2020. Patients who already had thrombosis or were administered any antithrombotic treatment on admission were excluded. VTE development during the hospitalization was surveyed, and VTE risk associated with CVC indwelling was estimated using propensity score matching and inverse probability of treatment weighting analyses. Results: Altogether, 497 hospitalized patients with IBD (ulcerative colitis, 327; Crohn’s disease, 170) were enrolled. VTE devel oped in 9.30% (12/129) of catheterized patients and in 0.82% (3/368) of non-catheterized patients. The propensity score match ing yielded 127 matched pairs of patients. The catheterized group demonstrated higher odds for VTE than the non-catheterized group (odds ratio, 13.15; 95% confidence interval, 1.68-102.70). A similar result was obtained in the inverse probability of treat ment weighting analysis (odds ratio, 11.02; 95% confidence interval, 2.64-46.10). Conclusions: CVC placement is a major risk factor for VTE among hospitalized Japanese patients with IBD without thromboprophylaxis. (Intest Res 2023;21:318-327)
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Kaoru Takabayashi,Naoki Hosoe,Motohiko Kato,Yukie Hayashi,Ryoichi Miyanaga,Kosaku Nanki,Kayoko Fukuhara,Yohei Mikami,Shinta Mizuno,Tomohisa Sujino,Makoto Mutaguchi,Makoto Naganuma,Naohisa Yahagi,Haruh 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.5
Background/Aims: The evaluation of small bowel lesions of Crohn’s disease (CD) using balloon-assisted enteroscopy (BAE) is crucial because mucosal healing is associated with a good prognosis. However, BAE procedures are invasive, requiring sedation or analgesia to reduce the patient’s pain. This study evaluated the clinical usefulness of a novel ultrathin single-balloon enteroscopy (SBE) procedure for CD. Methods: This single-center retrospective study included 102 CD patients who underwent trans-anal SBE between January 2012 and May 2018. Of these patients, 82 underwent enteroscopy using conventional SBE, while 20 underwent ultrathin SBE. Patients were analyzed using propensity score matching, with 20 patients per group. The median duration of the examination, terminal ileum intubation rate, median cecum intubation time, median insertion depth, adverse events, and sedated dose in each group were compared. Results: Before propensity score matching, the conventional SBE group had a larger number of surgical history patients than the ultrathin SBE group (p=0.05). After matching, the two groups did not significantly differ clinically. There were no significant differences in the mean duration of the examination, cecum intubation time, or terminal ileal intubation rate between ultrathin SBE and conventional SBE. The mean insertion depth of ultrathin SBE tended to be deeper than that of conventional SBE (p=0.09). The use of ultrathin SBE also reduced the sedative dose during needed for enteroscopy compared with conventional SBE (p=0.005). Conclusions: Novel ultrathin SBE may be less painful for CD patients than conventional SBE.
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