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Diffuse gastroduodenitis and pouchitis associated with ulcerative colitis

World Journal of Gastroenterology 2006年第36期12卷 5913-5915页

作者： Hiroki Ikeuchi Kazutoshi Hori Takashi Nishigami Hiroki Nakano Motoi Uchino Mitsuhiro Nakamura Nobuaki Kaibe masafumi noda Hidenori Yanagi Takehira Yamamura Second Department of Surgery Hyogo College of Medicine Hyogo Japan Department of Gastroenterology Hyogo College of Medicine. Hyogo Japan Second Department of Pathology Hyogo College of Medicine. Hyogo Japan

We experienced a very rare case of ulcerative colitis (UC) accompanied with analogous lesions in the stomach, duodenum, and ileal J -pouch. Ileal J-pouch anal anastomosis was performed on a 29-year old woman in 1996. Six years later, she was admitted again to our hospital because of epigastralgia, nausea, watery diarrhea and low fever. Based on the results of endoscopic examination, we diagnosed it as pouchitis. Moreover, on hypotonic duodenography, expansion of the duodenal bulb and the descending portion were poor. Kerckring folds disappeared with typical lead-pipe appearance. The pathogenesis of the gastric and duodenal lesion in this patient was similar to that of the colonic lesions of UC. For the gastroduodenal lesions in this patient, symptomatic remission was obtained following administration of crushed mesalazine tablets (1500 mg/d) for 14 d with continuous administration of omeprazole. Firstly we used ciprofloxacin to treat pouchitis. On the fifth day, she got a fever because of catheter infection. In the catheter culture, methicillin-resistant Staphylococcus aureus (MRSA) was detected. Therefore we changed ciprofloxacin to vancomycin hydrochloride (Vancomycin?). Vancomycin was very effective, and the stool frequency dramatically improved in three days. Now she continues to take mesalazine, but her condition is stable and there has been no recurrence of pouchitis.

关键词： Ulcerative colitis Pouchitis Gastroduodenal lesions

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ECA39 is a novel distant metastasis-related biomarker in colorectal cancer

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World Journal of Gastroenterology 2006年第36期12卷 5884-5889页

作者： Reigetsu Yoshikawa Hidenori Yanagi Chun-Shen Shen Yoshinori Fujiwara masafumi noda Toshihiko Yagyu Makoto Gega Tsutomu Oshima Takehira Yamamura Haruki Okamura Yoshiro Nakano Tomonori Morinaga Tomoko Hashimoto-Tamaoki Second Department of Surgery Hyogo College of Medicine Nishinomiya Hyogo 663-8501 Japan Institute for Advanced Medical Sciences Hyogo College of Medicine Nishinomiya Hyogo 663-8501 Japan Department of Dermatology Hyogo College of Medicine Nishinomiya Hyogo 663-8501 Japan Department of Genetics Hyogo College of Medicine Nishinomiya Hyogo 663-8501 Japan

AIM: To investigate the possible role of polysaccharide-K (PSK) -related markers in predicting distant metastasis and in the clinical outcome of colorectal cancer (CRC).METHODS: Firstly, we used protein microarrays to analyze the in vitro expression profiles of potential PSK-related markers in the human colorectal adenocarcinoma cell line SW480, which carries a mutant p53 gene. Then, we investigated the clinical implications of these markers in the prognosis of CRC patients. RESULTS: ECA39, a direct target of c-Myc, was identi-fied as a candidate protein affected by the anti-metastat-ic effects of PSK. Immunohistochemistry revealed that ECA39 was expressed at significantly higher levels in tumor tissues with distant metastases compared to those without (P < 0.00001). Positive ECA39 expression was shown to be highly reliable for the prediction of distant metastases (sensitivity: 86.7%, specificity: 90%, posi-tive predictive value: 86.7%, negative predictive value: 90%). A significantly higher cumulative 5-yr disease free survival rate was observed in the ECA39-negative patient group (77.3%) compared with the ECA39-positive patient group (25.8%) (P < 0.05). CONCLUSION: Our results suggest that ECA39 is a dominant predictive factor for distant metastasis in pa-tients with advanced CRC and that its suppression by PSK might represent a useful application of immuno-therapy as part of a program of integrated medicine.

关键词： ECA39 Distant metastasis Colorectal cancer Polysaccharide-K Integrated medicine

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Constipation, hard stools, fecal urgency, and incomplete evacuation, but not diarrhea is associated with diabetes and its related factors

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World Journal of Gastroenterology 2016年第11期22卷 3252-3260页

作者： Noriko Ihana-Sugiyama Naoyoshi Nagata Ritsuko Yamamoto-Honda Eiko Izawa Hiroshi Kajio Takuro Shimbo masafumi Kakei Naomi Uemura Junichi Akiyama Mitsuhiko noda Department of Diabetes Endocrinology and Metabolism National Center for Global Health and Medicine Tokyo 162-8655 Japan Division of General Medicine Jichi Medical University Graduate School of Medicine Tochigi 329-0498 Japan Department of Gastroenterology and Hepatology National Center for Global Health and Medicine Tokyo 162-8655 Japan Department of Endocrinology and Metabolism Toranomon Hospital Tokyo 105-0001 Japan Diabetes Research Diabetes Research Center National Center for Global Health and Medicine Tokyo 162-8655 Japan Center for Clinical Sciences National Center for Global Health and Medicine Tokyo 162-8655 Japan Ohta Nishinouchi Hospital Fukushima 963-8022 Japan First Department of Comprehensive Medicine Saitama Medical Center Jichi Medical University School of Medicine Saitama 330-0834 Japan Department of Gastroenterology and Hepatology Kohnodai Hospital National Center for Global Health and Medicine Chiba 272-8516 Japan Department of Endocrinology and Diabetes Saitama Medical University Saitama 350-0495 Japan

AIM: To determine the bowel symptoms associated with diabetes and diabetes-related factors after excluding gastrointestinal (GI) organic ***: Participants were 4738 (603 diabetic and 4135 non-diabetic) patients who underwent colonoscopy and completed a questionnaire. On the day of pre-colonoscopy, 9 symptoms (borborygmus, abdominal distension, increased flatus, constipation, diarrhea, loose stools, hard stools, fecal urgency, and incomplete evacuation) were prospectively evaluated on a 7-point Likert scale. The test-retest reliability of the bowel symptom scores from the baseline and second questionnaires was analyzed using kappa statistics. Associations between bowel symptom scores and diabetes or diabetes-related factors were analyzed by a rank-ordered logistic model adjusted for related confounders, and odds ratios (ORs) were ***: In multivariate analysis, constipation [adjusted odds ratio (AOR) = 1.57, CI: 1.33-1.85, P < 0.01] and hard stools (AOR = 1.56, CI: 1.33-1.84, P < 0.01) were associated with diabetes, and fecal urgency (AOR = 1.16, CI: 0.99-1.37, P = 0.07) and incomplete evacuation (AOR = 1.16, CI: 1.00-1.36, P = 0.06) were marginally associated with diabetes. These symptoms remained associated even after excluding organic GI diseases on colonoscopy. Test-retest reliability of symptom score with a mean duration of 3.2 mo was good (mean kappa, 0.69). Associations of symptoms with diabetes-related factors were found; constipation with HbA1c ≥ 8.0% (AOR = 2.11, CI: 1.19-3.73), body mass index (BMI) < 25 (AOR = 2.11, CI: 1.22-3.66), and insulin use (AOR = 1.90, CI: 1.08-3.36); hard stools with diabetes duration (AOR = 1.03, CI: 1.00-1.07); fecal urgency with BMI < 25 (AOR = 1.73, CI: 1.00-2.98); and incomplete evacuation with BMI < 25 (AOR = 2.60, CI: 1.52-4.43), serum creatinine level (AOR = 1.27, CI: 1.10-1.47), and insulin use (AOR = 1.92, CI: 1.09-3.38).CONCLUSION: Diabetes is as

关键词： Functional bowel disease Gastrointestinal symptom rating scale Decreased passage of stools Diabetic complications

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