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REVIEW : Pathogenesis of Inflammatory Bowel Diseases
( Masakazu Nagahori ),( Yasuhiro Nemoto ),( Mamoru Watanabe ) 대한장연구학회 2010 Intestinal Research Vol.8 No.1
Our understanding of IBD pathogenesis has been increasing rapidly. The genetically determined interplay between the commensal microbiota, intestinal epithelial cells, and the immune system has been appreciated deeply. The interplay is also considered to be modified by specific environmental factors. This review examines the recent findings from the animal and human studies on IBD pathogenesis and the implications for future effective therapies. (Intest Res 2010;8:9-17)
( Taku Kobayashi ),( Hiroaki Ito ),( Toshifumi Ashida ),( Tadashi Yokoyama ),( Masakazu Nagahori ),( Tomoki Inaba ),( Mitsuhiro Shikamura ),( Takayoshi Yamaguchi ),( Tetsuharu Hori ),( Philippe Pinton 대한장연구학회 2021 Intestinal Research Vol.19 No.4
Background/Aims: A subgroup analysis was conducted in Japanese patients with moderate to severe ulcerative colitis (UC) enrolled in the phase 3 VISIBLE 1 study, which evaluated the safety and efficacy of a new vedolizumab subcutaneous (SC) for-mulation. Methods: Eligible patients received open-label infusions of vedolizumab 300 mg intravenous (IV) at weeks 0 and 2 in the induction phase. Patients with clinical response by complete Mayo score at week 6 entered the double-blind maintenance phase and were randomized to vedolizumab 108 mg SC every 2 weeks, placebo, or vedolizumab 300 mg IV every 8 weeks. The primary endpoint was clinical remission (complete Mayo score ≤2 points; no individual subscore >1 point) at week 52. Results: Of 49 patients who entered the induction phase, 22 out of 49 patients (45%) had clinical response at week 6 and were randomized to vedolizumab 108 mg SC (n=10), placebo (n=10), or vedolizumab 300 mg IV (n=2). At week 52, 4 out of 10 pa-tients (40%) who received vedolizumab SC had clinical remission versus 2 out of 10 patients (20%) who received placebo (dif-ference: 20% [95% confidence interval, ±27.9 to 61.8]). Two patients (2/10, 20%) who received vedolizumab SC experienced an injection-site reaction versus none who received placebo. Conclusions: Our results indicate that the efficacy of vedolizumab SC in a subgroup of Japanese patients with UC are similar with those in the overall VISIBLE 1 study population, and with those established with vedolizumab IV. The safety and tolerability of vedolizumab SC were generally similar to that established for vedolizumab IV. (ClinicalTrials.gov ID NCT02611830; EudraCT 2015-000480-14) (Intest Res 2021;19:448-460)
Magnetic resonance enterography for the evaluation of the deep small intestine in Crohn`s disease
( Kazuo Ohtsuka ),( Kento Takenaka ),( Yoshio Kitazume ),( Toshimitsu Fujii ),( Katsuyoshi Matsuoka ),( Masakazu Nagahori ),( Maiko Kimura ),( Takashi Nagaishi ),( Mamoru Watanabe ) 대한장연구학회 2016 Intestinal Research Vol.14 No.2
For the control of Crohn`s disease (CD) a thorough assessment of the small intestine is essential; several modalities may be utilized, with cross-sectional imaging being important. Magnetic resonance (MR) enterography, i.e., MRE is recommended as a modality with the highest accuracy for CD lesions. MRE and MR enteroclysis are the two methods performed following distension of the small intestine. MRE has sensitivity and specificity comparable to computed tomography enterography (CTE); although images obtained using MRE are less clear compared with CTE, MRE does not expose the patient to radiation and is superior for soft-tissue contrast. Furthermore, it can assess not only static but also dynamic and functional imaging and reveals signs of CD, such as abscess, comb sign, fat edema, fistula, lymph node enhancement, less motility, mucosal lesions, stricture, and wall enhancement. Several indices of inflammatory changes and intestinal damage have been proposed for objective evaluation. Recently, diffusion-weighted imaging has been proposed, which does not need bowel preparation and contrast enhancement. Comprehension of the characteristics of MRE and other modalities is important for better management of CD. (Intest Res 2016;14:120-126)
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)
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