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      • KCI등재

        Colonic dysmotility and morphological abnormality frequently detected in Japanese patients with irritable bowel syndrome

        ( Takeshi Mizukami ),( Shinya Sugimoto ),( Tatsuhiro Masaoka ),( Hidekazu Suzuki ),( Takanori Kanai ) 대한장연구학회 2017 Intestinal Research Vol.15 No.2

        Background/Aims: Colonoscopy and computed tomography (CT) are used primarily to exclude organic diseases in patients with irritable bowel syndrome (IBS), rather than to assess the pathophysiology of IBS. We aimed to evaluate colonic dysmotility and morphology in Japanese patients with IBS. Methods: One hundred eighty-four patients with IBS and 49 asymptomatic controls who underwent colonoscopy in combination with CT colonography or barium enema were retrospectively reviewed between 2008 and 2012. Water-aided colonoscopy was performed without sedation by a single endoscopist. The duration and pattern of colonic movement and cecal intubation time were recorded. To assess colonic morphology, barium enema or CT colonography were performed immediately after colonoscopy. Results: Colonic dysmotility was more frequent in the IBS group (28.8% vs. 2.0% in controls, P <0.001), especially in cases of IBS with diarrhea (IBS-D) (IBS with constipation [IBS-C] 28.8% vs. IBS-D 60.0% vs. mixed IBS [IBS-M] 5.1%, P <0.001). Colonic morphological abnormality was more frequent in the IBS group than in the control group (77.7% vs. 24.5%, P <0.001), especially in IBS-M and IBS-C groups (IBS-C 77.5% vs. IBS-D 48.9% vs. IBS-M 100%, P <0.001). Most patients with IBS with colonic dysmotility had experienced stress related to their symptoms. Cecal intubation time was significantly longer in the IBS group than in the control group (12.1±6.9 minutes vs. 4.6±1.9 minutes, P <0.001). Conclusions: Unsedated colonoscopy, combined with radiographic findings, can detect colonic dysmotility and morphological abnormality. Technical difficulties observed during cecal intubation may partially explain the pathophysiology of IBS. (Intest Res 2017;15:236-243)

      • KCI등재

        Impact of Rotation Correction after Brace Treatment on Prognosis in Adolescent Idiopathic Scoliosis

        Kentaro Yamane,Tomoyuki Takigawa,Masato Tanaka,Yoshihisa Sugimoto,Shinya Arataki,Toshifumi Ozaki 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.5

        Study Design: Level 4 retrospective review. Purpose: Brace treatment is the standard nonoperative treatment for adolescent idiopathic scoliosis (AIS). Rotation correction is also important, because AIS involves a rotation deformity. The purpose of this study was to evaluate the impact of rotation correction after Osaka Medical College (OMC) brace treatment on clinical outcomes in AIS. Overview of Literature: Brace treatment has a significant effect on the progression of AIS. However, few reports have examined rotation correction after brace treatment. Methods: A total of 46 patients who wore the OMC brace were retrospectively reviewed. The curve magnitude was determined according to the Cobb method, and the rotation angle of the apical vertebrae was measured by the modified Nash-Moe method. Based on the difference in the rotation angle before and after the initial brace treatment, patients were divided into two groups. Group A (n=33) was defined as no change or improvement of the rotation angle; group B (n=13) was defined as deterioration of the rotation angle. If the patients had curve or rotation progression of 5° or more at skeletal maturity, or had undergone surgery, the treatment was considered a failure. Results: Differences of rotation angle between before and after the initial brace treatment were 2°±2° in group A and –3°±2° in group B (p <0.001). The rates of treatment failure were 42% in group A and 77% in group B (p <0.05). This study included 25 patients with Lenke type 1 (54%). Group A (24%) with Lenke type 1 also had a significantly better success rate of brace treatment than group B (75%) (p <0.05). Conclusions: Insufficient rotation correction increased brace treatment failure. Better rotation correction resulted in a higher success rate of brace treatment in patients with Lenke type 1.

      • KCI등재

        Fecal microbiota transplantation for recurrent Clostridium difficile infection in a patient with ulcerative colitis

        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.

      • KCI등재

        Single fecal microbiota transplantation failed to change intestinal microbiota and had limited effectiveness against ulcerative colitis in Japanese patients

        ( 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)

      • SCOPUSKCI등재

        Risk of venous thromboembolism with a central venous catheter in hospitalized Japanese patients with inflammatory bowel disease: a propensity score-matched cohort study

        ( 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 developed in 9.30% (12/129) of catheterized patients and in 0.82% (3/368) of non-catheterized patients. The propensity score matching 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 treatment 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)

      • KCI등재

        Effectiveness of Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid as a Non-Surgical Treatment for Internal Hemorrhoids

        Yuichi Tomiki,Jun Aoki,Shunsuke Motegi,Rina Takahashi,Toshiaki Hagiwara,Yu Okazawa,Kosuke Mizukoshi,Masaya Kawai,Shinya Munakata,Shun Ishiyama,Kiichi Sugimoto,Kazuhiro Sakamoto 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.6

        Background/Aims: Sclerotherapy with aluminum potassium sulfate and tannic acid (ALTA) has a potent effect on internalhemorrhoids. In this retrospective study, we compared the effects of endoscopic ALTA therapy and standard ALTA therapy. Methods: We investigated patients who underwent treatment for internal hemorrhoids at our institution between 2014 and 2016. Theywere divided into a standard ALTA group (n=33, treated using proctoscopy) and an endoscopic ALTA group (n=48). We compared theclinical findings between the 2 groups. Results: There were no intergroup differences in background factors. The mean ALTA dose was 21.9±7.2 mL and 17.8±3.4 mL inthe standard and endoscopic ALTA groups, respectively (p<0.01). Adverse events occurred in 4 patients (12.1%) from the standardALTA group and 6 patients (12.5%) from the endoscopic ALTA group. In both groups, the patients reported good satisfaction withthe therapeutic effect at 1 month after the procedure. Hemorrhoids recurred in 2 patients (6.3%) from the standard ALTA group and 4patients (8.3%) from the endoscopic ALTA group. Conclusions: Endoscopic ALTA sclerotherapy is equivalent to standard ALTA therapy in terms of efficacy, adverse events, andrecurrence. Therefore, it is a useful non-surgical option for patients with internal hemorrhoids who prefer a less invasive treatment.

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