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Factors associated with residual gastroesophageal reflux disease symptoms in patients receiving proton pump inhibitor maintenance therapy

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World Journal of Gastroenterology 2017年第11期23卷 2060-2067页

作者： Fumiaki Kawara Tsuyoshi Fujita Yoshinori Morita Atsushi Uda Atsuhiro Masuda Masaya Saito Makoto Ooi Tsukasa Ishida Yasuyuki Kondo Shiei yoshida Tatsuya Okuno Yoshihiko Yano Masaru yoshida Hiromu Kutsumi Takanobu Hayakumo Kazuhiko Yamashita Takeshi Hirano Midori Hirai Takeshi Azuma Division of Gastroenterology Department of Internal MedicineKobe University Graduate School of Medicine Department of Pharmacy Kobe University Hospital

AIM To elucidate the factors associated with residual gastroesophageal reflux disease(GERD) symptoms in patients receiving proton pump inhibitor(PPI) maintenance therapy in clinical practice.METHODS The study included 39 GERD patients receiving maintenance PPI therapy. Residual symptoms were assessed using the Frequency Scale for Symptoms of GERD(FSSG) questionnaire and the Gastrointestinal Symptom Rating Scale(GSRS). The relationships between the FSSG score and patient background factors, including the CYP2C19 genotype, were analyzed.RESULTS The FSSG scores ranged from 1 to 28 points(median score: 7.5 points), and 19 patients(48.7%) had a score of 8 points or more. The patients' GSRS scores were significantly correlated with their FSSG scores(correlation coefficient = 0.47, P < 0.005). In erosive esophagitis patients, the FSSG scores of the CYP2C19 rapid metabolizers(RMs) were significantly higher than the scores of the poor metabolizers and intermediate metabolizers(total scores: 16.7 ± 8.6 vs 7.8 ± 5.4, P < 0.05; acid reflux-related symptom scores: 12 ± 1.9 vs 2.5 ± 0.8, P < 0.005). In contrast, the FSSG scores of the CYP2C19 RMs in the non-erosive reflux disease patients were significantly lower than those of the other patients(total scores: 5.5 ± 1.0 vs 11.8 ± 6.3, P < 0.05; dysmotility symptom-related scores: 1.0 ± 0.4 vs 6.0 ± 0.8, P < 0.01). CONCLUSION Approximately half of the GERD patients receiving maintenance PPI therapy had residual symptoms associated with a lower quality of life, and the CYP2C19 genotype appeared to be associated with these residual symptoms.

关键词： Gastroesophageal reflux disease CYP2C19 FSSG Residual symptoms Proton pump inhibitor

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Transileocolic endovascular treatment by a hybrid approach for severe acute portal vein thrombosis with bowel necrosis:Two case reports

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World Journal of Clinical Cases 2022年第6期10卷 1876-1882页

作者： Sayaka Shirai Tatsuo Ueda Fumie Sugihara Daisuke Yasui Hidemasa Saito Hiroyasu Furuki shiei Kim Hiroshi yoshida Shoji Yokobori Hiromitsu Hayashi Shin-ichiro Kumita Department of Radiology Nippon Medical School HospitalBunkyo-ku 113-8603TokyoJapan Department of Radiology Nippon Medical School Musashi Kosugi HospitalKawasaki-shi 211-8533KanagawaJapan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical School Tamanagayama HospitalTama-shi 206-8512TokyoJapan Department of Emergency and Critical Care Medicine Nippon Medical School HospitalBunkyo-ku 113-8603TokyoJapan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical School HospitalBunkyo-ku 113-8603TokyoJapan

BACKGROUND Acute portal vein thrombosis(PVT)with bowel necrosis is a fatal condition with a 50%-75%mortality rate.This report describes the successful endovascular treatment(EVT)of two patients with severe PVT.CASE SUMMARY The first patient was a 22-year-old man who presented with abdominal pain lasting 3 d.The second patient was a 48-year-old man who presented with acute abdominal pain.Following contrast-enhanced computed tomography,both patients were diagnosed with massive PVT extending to the splenic and superior mesenteric veins.Hybrid treatment(simultaneous necrotic bowel resection and EVT)was performed in a hybrid operating room(OR).EVTs,including aspiration thrombectomy,catheter-directed thrombolysis(CDT),and continuous CDT,were performed via the ileocolic vein under laparotomy.The portal veins were patent 4 and 6 mo posttreatment in the 22-year-old and 48-year-old patients,respectively.CONCLUSION Hybrid necrotic bowel resection and transileocolic EVT performed in a hybrid OR is effective and safe.

关键词： Bowel necrosis Endovascular treatment Hybrid operating room Hybrid treatment Portal vein thrombosis Transileocolic approach Case report

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