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Effects of oral tacrolimus as a rapid induction therapy in ulcerative colitis

World Journal of Gastroenterology 2015年第6期21卷 1880-1886页

作者： Ken Kawakami Takuya Inoue Mitsuyuki Murano Ken Narabayashi Sadaharu Nouda Kumi Ishida Yosuke Abe koji nogami Nobuyuki Hida Hirokazu Yamagami Kenji Watanabe Eiji Umegaki Shiro Nakamura Tetsuo Arakawa Kazuhide Higuchi Second Department of Internal Medicine Osaka Medical College Division of Lower Gastroenterology Department of Internal Medicine Hyogo College of Medicine Department of Gastroenterology Osaka City University Graduate School of Medicine

AIM:To determine the efficacy and safety of rapid induction therapy with oral tacrolimus without a meal in steroid-refractory ulcerative colitis(UC)***:This was a prospective,multicenter,observational *** May 2010 and August 2012,49 steroid-refractory UC patients(55 flare-ups)were consecutively *** patients were treated with oral tacrolimus without a meal at an initial dose of 0.1mg/kg per *** dose was adjusted to maintain trough whole-blood levels of 10-15 ng/m L for the first 2 *** of remission at 2 and 4 wk after tacrolimus treatment initiation was evaluated using Lichtiger’s clinical activity index(CAI).RESULTS:The mean CAI was 12.6±3.6 at *** the first 7 d,93.5%of patients maintained high trough levels(10-15 ng/m L).The CAI significantly decreased beginning 2 d after treatment *** 2wk,73.1%of patients experienced clinical *** tacrolimus initiation,31.4%and 75.6%of patients achieved clinical remission at 2 and 4 wk,*** was well ***:Rapid induction therapy with oral tacrolimus shortened the time to achievement of appropriate trough levels and demonstrated a high remission rate 28 d after treatment *** induction therapy with oral tacrolimus appears to be a useful therapy for the treatment of refractory UC.

关键词： Ulcerative colitis Tacrolimus Rapid induction ther

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Prospective postsurgical capsule endoscopy in patients with Crohn's disease

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World Journal of Gastrointestinal Endoscopy 2014年第3期6卷 88-98页

作者： Tomoaki Kono Nobuyuki Hida koji nogami Masaki Iimuro Yoshio Ohda Yoko Yokoyama koji Kamikozuru Katsuyuki Tozawa Mikio Kawai Tomohiro Ogawa Kazutoshi Hori Hiroki Ikeuchi Hiroto Miwa Shiro Nakamura Takayuki Matsumoto Department of Lower Gastroenterology Hyogo College of Medicine Department of Surgery Hyogo College of Medicine Department of Upper Gastroenterology Hyogo College of Medicine

AIM: To clarify the usefulness of postsurgical capsule endoscopy(CE) in the diagnosis of recurrent small bowel lesions of Crohn's disease(CD). METHODS: This prospective study included 19 patients who underwent ileocolectomy or partial ileal resection for CD. CE was performed 2-3 wk after surgery to check for the presence/absence and severity of lesions remaining in the small bowel, and for any recurrence at the anastomosed area. CE was repeated 6-8 mo after surgery and the findings were compared with those obtained shortly after surgery. The Lewis score (LS) was used to evaluate any inflammatory changes of the small bowel. RESULTS: One patient was excluded from analysis because of insufficient endoscopy data at the initial CE. The total LS shortly after surgery was 428.3 on average(median, 174; range, 8-4264), and was ≥ 135(active stage) in 78%(14 of 18) of the patients. When the remaining unresected small bowel was divided into 3 equal portions according to the transition time(proximal, middle, and distal tertiles), the mean LS was 286.6, 83.0, and 146.7, respectively, without any significant difference. Ulcerous lesions in the anastomosed area were observed in 83% of all patients. In 38% of the 13 patients who could undergo CE again after 6-8 mo, the total LS was higher by ≥ 100 than that recorded shortly after surgery, thus indicating a diagnosis of endoscopic progressive recurrence. CONCLUSION: Our pilot study suggests that CE can be used to objectively evaluate the postoperative recurrence of small bowel lesions after surgery for CD.

关键词： Crohn’s disease Postoperative recurrence Capsule endoscopy Lewis score Small bowel

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