Host–microbiota interactions in rheumatoid arthritis

Yuichi Maeda,Kiyoshi Takeda 생화학분자생물학회 2019 Experimental and molecular medicine Vol.51 No.-

The gut microbiota has been proposed to be an important environmental factor in the development of rheumatoid arthritis (RA). Here, we review a growing body of evidence from human and animal studies that supports the hypothesis that intestinal microbiota play a role in RA. Previous studies from we and others showed an altered composition of the microbiota in early RA patients. A recent study demonstrated that Prevotella species are dominant in the intestine of patients in the preclinical stages of RA. In addition, Prevotella-dominated microbiota isolated from RA patients contributes to the development of Th17 cell-dependent arthritis in SKG mice. Moreover, it was reported that periodontal bacteria correlates with the pathogenesis of RA. In this review, we discuss the link between oral bacteria and the development of arthritis. However, many questions remain to be elucidated in terms of molecular mechanisms for the involvement of intestinal and oral microbiota in RA pathogenesis.

A Novel Technique of Hand-Sewn Purse-String Suturing by Double Ligation Method (DLM) for Intracorporeal Circular Esophagojejunostomy

Yuichi Takayama,Yuji Kaneoka,Atsuyuki Maeda,Yasuyuki Fukami,Takamasa Takahashi,Masahito Uji 대한위암학회 2019 Journal of gastric cancer Vol.19 No.3

Purpose: The optimal method for intracorporeal esophagojejunostomy remains unclearbecause a purse-string suture for fixing the anvil into the esophagus is difficult to performwith a laparoscopic approach. Therefore, this study aimed to evaluate our novel technique tofix the anvil into the esophagus. Materials and Methods: This retrospective study included 202 patients who were treatedat our institution with an intracorporeal circular esophagojejunostomy in a laparoscopyassistedtotal gastrectomy with a Roux-en-Y reconstruction (166 cases) or a laparoscopyassistedproximal gastrectomy with jejunal interposition (36 cases). After incising 3/4 ofthe esophageal wall, a hand-sewn purse-string suture was placed on the esophagus. Next,the anvil head of a circular stapler was introduced into the esophagus. Finally, the circularesophagojejunostomy was performed laparoscopically. The clinical characteristics andsurgical outcomes were evaluated and compared with those of other methods. Results: The average operation time was 200.3 minutes. The average hand-sewn pursestringsuturing time was 6.4 minutes. The overall incidence of postoperative complications(Clavien–Dindo classification grade ≥II) was 26%. The number of patients with ananastomotic leakage and stenosis at the esophagojejunostomy site were 4 (2.0%) and 12(6.0%), respectively. All patients with stenosis were successfully treated by endoscopicballoon dilatation. There was no mortality. Regarding the materials and devices for anvilfixation, only 1 absorbable thread was needed. Conclusions: Our procedure for hand-sewn purse-string suturing with the double ligationmethod is simple and safe.

A Novel Technique of Hand-Sewn Purse-String Suturing by Double Ligation Method (DLM) for Intracorporeal Circular Esophagojejunostomy

Takayama, Yuichi,Kaneoka, Yuji,Maeda, Atsuyuki,Fukami, Yasuyuki,Takahashi, Takamasa,Uji, Masahito The Korean Gastric Cancer Association 2019 Journal of gastric cancer Vol.19 No.3

Purpose: The optimal method for intracorporeal esophagojejunostomy remains unclear because a purse-string suture for fixing the anvil into the esophagus is difficult to perform with a laparoscopic approach. Therefore, this study aimed to evaluate our novel technique to fix the anvil into the esophagus. Materials and Methods: This retrospective study included 202 patients who were treated at our institution with an intracorporeal circular esophagojejunostomy in a laparoscopy-assisted total gastrectomy with a Roux-en-Y reconstruction (166 cases) or a laparoscopy-assisted proximal gastrectomy with jejunal interposition (36 cases). After incising 3/4 of the esophageal wall, a hand-sewn purse-string suture was placed on the esophagus. Next, the anvil head of a circular stapler was introduced into the esophagus. Finally, the circular esophagojejunostomy was performed laparoscopically. The clinical characteristics and surgical outcomes were evaluated and compared with those of other methods. Results: The average operation time was 200.3 minutes. The average hand-sewn purse-string suturing time was 6.4 minutes. The overall incidence of postoperative complications (Clavien-Dindo classification grade ${\geq}II$) was 26%. The number of patients with an anastomotic leakage and stenosis at the esophagojejunostomy site were 4 (2.0%) and 12 (6.0%), respectively. All patients with stenosis were successfully treated by endoscopic balloon dilatation. There was no mortality. Regarding the materials and devices for anvil fixation, only 1 absorbable thread was needed. Conclusions: Our procedure for hand-sewn purse-string suturing with the double ligation method is simple and safe.

Effectiveness and Sustainability of Education about Incident Reporting at a University Hospital in Japan

Noriko Nakamura,Yuichi Yamashita,Shinichi Tanihara,Chiemi Maeda 대한의료정보학회 2014 Healthcare Informatics Research Vol.20 No.3

Objectives: The aim of this study was to evaluate the effectiveness and sustainability of educational interventions to encourage incident reporting. Methods: This was a quasi-experimental design. The study involved nurses working in two gastroenterology surgical wards at Fukuoka University Hospital, Japan. The number of participants on each ward was 26 nurses at baseline. For the intervention group, we provided 15 minutes of education about patient safety and the importance of incident reporting once per month for six months. After the completion of the intervention, we compared incident reporting in the subsequent 12 months for both groups. Questionnaires about reasons/motives for reporting were administered three times, before the intervention, after the intervention, and six months after the intervention for both the intervention group and the control group. Results: For the intervention group, incident reporting during the 6 months after the intervention period increased significantly compared with the baseline. During the same period, the reasons and motives for reporting changed significantly in the intervention group. The increase in reported incidents during the 6- to 12-month period following the intervention was not significant. In the control group, there was no significant difference during follow-up compared with the baseline. Conclusions: A brief intervention about patient safety changed the motives for reporting incidents and the frequency of incidents reported by nurses working in surgical wards in a university hospital in Japan. However, the effect of the education decreased after six months following the education. Regular and long-term effort is required to maintain the effect of education.

[Hernia] Feasibility and Safety of Open Tissue Repair for Incarcerated Groin Hernia with Bowel Resection

Katsuya Sakashita,Atsuyuki Maeda,Yuichi Takayama,Takamasa Takahashi,Hiroki Aoyama,Takahiro Hosoi,Kazuaki Seita,Yuji Kaneoka 대한외과학회 2022 대한외과학회 학술대회 초록집 Vol.2022 No.11

Intrathoracic anastomosis using handsewn purse-string suturing by the double-ligation method in laparo-thoracoscopic esophagectomy

Takamasa Takahashi,Yuji Kaneoka,Atsuyuki Maeda,Yuichi Takayama,Hiroki Aoyama,Takahiro Hosoi,Kazuaki Seita 대한내시경로봇외과학회 2023 Journal of Minimally Invasive Surgery Vol.26 No.2

Purpose: In minimally invasive esophagectomy (MIE), it is important to reduce the rate of anastomotic leakage to ensure its safety. At our institute, the double-ligation method (DLM) has been introduced to insert and fix the anvil of the circular stapler for intracorporeal circular esophagojejunostomy in gastric surgery. We adopted this method for intrathoracic anastomosis (IA) in MIE. The aim of this study was to investigate the safety of IA with DLM in MIE. Methods: In this study, 48 patients diagnosed with primary middle or lower third segment thoracic esophageal carcinoma with clinical stage I, II, III or IV disease were retrospectively evaluated. Postoperative outcomes were assessed. Results: Among the 48 patients, 42 patients underwent laparo-thoracoscopic esophagectomy and IA using a circular stapler with the DLM. The average total operation time and thoracoscopic operation time were 433 and 229 minutes, respectively. The average pursestring suturing time was 4.7 minutes. The rates of anastomotic leakage and stenosis were 2.4% and 14.3%, respectively. The overall incidence of postoperative complications (Clavien- Dindo grade of ≥III) was 16.7%. The average postoperative stay was 16 days. Conclusion: The procedure of IA using a circular stapler with the DLM in MIE was safe and provided a low rate of anastomotic leakage.

Clinical Efficacy of Endocytoscopy for Gastrointestinal Endoscopy

Masashi Misawa,Shin-ei Kudo,Yuki Takashina,Yoshika Akimoto,Yasuharu Maeda,Yuichi Mori,Toyoki Kudo,Kunihiko Wakamura,Hideyuki Miyachi,Fumio Ishida,Haruhiro Inoue 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4

Endocytoscopy (EC) is a contact-type optical endoscope that allows in vivo cellular observation during gastrointestinal endoscopyand is now commercially available not only in Japan but also in Asian, European Union, and Middle Eastern countries. EC helpsconduct a highly accurate pathological prediction without biopsy. Initially, EC was reported to be effective for esophageal diseases. Subsequently, its efficacy for stomach and colorectal diseases has been reported. In this narrative review, we searched for clinicalstudies that investigated the efficacy of EC. EC seems to accurately diagnose gastrointestinal diseases without biopsy. Most of thestudies aimed to clarify the relationship between endocytoscopic findings of gastrointestinal neoplasia and pathological diagnosis. Some studies have investigated non-epithelial lesions or diseases, such as inflammatory bowel disease or infectious diseases. However, there are few high-level pieces of evidence, such as randomized trials; thus, further studies are needed.