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Eosinophilic enteritis requiring differentiation from chronic enteropathy associated with SLCO2A1 gene:A case report

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World Journal of Gastroenterology 2023年第11期29卷 1757-1764页

作者： Kantaro Kimura Keisuke Jimbo Nobuyasu Arai Masamichi Sato Mitsuyoshi Suzuki takahiro kudo Tomonori Yano Toshiaki Shimizu Department of Pediatrics Juntendo University Faculty of MedicineTokyo 113-8421Japan Department of Medicine Jichi Medical UniversityTochigi 329-0498Japan

BACKGROUND Eosinophilic gastrointestinal disease(EGID)is a disorder characterized by infiltration of eosinophils causing mucosal damage and dysfunction of the gastrointestinal *** endoscopic findings of eosinophilic enteritis(EoN),an EGID variant,are nonspecific and occasionally difficult to *** contrast,chronic enteropathy associated with SLCO2A1(CEAS)is a chronic persistent small intestinal disorder characterized by endoscopic findings such as multiple oblique and circular *** SUMMARY We report the case of a 10-year-old boy who had suffered abdominal pain and fatigue for the preceding 6 *** was referred to our institute for investigation of suspected gastrointestinal bleeding because of severe anemia with hypoproteinemia and positive fecal human *** upper and lower gastrointestinal endoscopic findings were normal;however,double-balloon small bowel endoscopy showed multiple oblique and circular ulcers with discrete margins and mild constriction of the intestinal lumen in the *** findings were highly consistent with CEAS,but urine prostaglandin metabolites were within normal limits,and no previously reported mutations in the SLCO2A1 gene were *** evaluation demonstrated moderate to severe eosinophilic infiltration localized to the small intestine suggesting a diagnosis of *** remission was maintained with montelukast and a partial elemental diet,but emergent surgery for bowel obstruction due to small intestinal stenosis was performed two years after the initial *** EoN should be considered in the differential diagnosis of CEAS-like small intestinal ulcerative lesions and normal urinary prostaglandin metabolite levels.

关键词： Anemia Chronic enteropathy associated with SLCO2A1 Double-balloon endoscopy Eosinophilic gastrointestinal disease Hypoproteinemia Case report

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A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of <i>Helicobacter pylori</i>Infection in Children

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Advances in Microbiology 2017年第4期7卷 253-264页

作者： Tamaki Ikuse takahiro kudo Naho Obayashi Keisuke Jimbo Yo Aoyagi Yoshikazu Ohtsuka Thomas G. Blanchard Steven J. Czinn Toshiaki Shimizu Department of Pediatric and Adolescent Medicine Juntendo University Graduate School of Medicine Tokyo Japan Department of Pediatrics University of Maryland School of Medicine Baltimore USA

Proper diagnosis in the pediatric population is required to eradicate Helicobacter pylori (H. pylori) and prevent gastric cancer. Our aim was to assess the performance of non-invasive tests to diagnose H. pylori infection in pediatric patients. A retrospective analysis was performed on 141 pediatric patients requiring endoscopic evaluation and diagnostic tests for H. pylori infection to define the cause of abdominal symptoms. Non-invasive tests included the 13C-urea breath test (UBT), a monoclonal stool antigen test using enzyme-linked immuno-sorbent assay (mSAT), and a serum immunoglobulin G antibody test using antigens derived from Japanese individuals (S-Ab). This study investigated sensitivity, specificity, likelihood ratios for a positive and a negative test (LR+ and LR-), and accuracy of non-invasive tests, in comparison with invasive tests. Eighty two of 141 patients (58%) were recognized as H. pylori positive by invasive methods. When UBT, mSAT or S-Ab were analyzed, all were found to be effective over 94% accurate. Specificity ranged between 86.7% and 95.8%, and sensitivity ranged between 93.8% and 97.1%. When subjects were stratified into three distinct age groups, the best performance was achieved for 1-6 years old with mSAT at 100% for sensitivity, specificity, and accuracy. S-Ab yielded the best results for children 7-12 years old and the UBT test performed best for 13-18 years old. These results demonstrate the utility of UBT, mSAT, and S-Ab non-invasive tests in diagnosing H. pylori but suggest that certain tests may be optimal for children of distinct ages. Three non-invasive tests, UBT, mSAT and S-Ab showed sufficient sensitivity, specificity and accuracy for the initial diagnosis of H. pylori infection among pediatric patients. Non-invasive tests may contribute to achieving minimum invasive diagnosis with combining with a histological test and a culture test in children.

关键词： Accuracy Non-Invasive Tests Urea Breath Test Stool Antigen Test Serum Antibody Test

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Antibiotic Resistance of <i>Helicobacter pylori</i>and Eradication Rate in Japanese Pediatric Patients

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Advances in Microbiology 2017年第4期7卷 241-252页

作者： Tamaki Ikuse Yo Aoyagi Naho Obayashi Keisuke Jimbo takahiro kudo Yoshikazu Ohtsuka Thomas G. Blanchard Steven J. Czinn Toshiaki Shimizu Department of Pediatric and Adolescent Medicine Juntendo University Graduate School of Medicine Tokyo Japan Department of Pediatrics University of Maryland School of Medicine Baltimore USA

Helicobacter pylori (H. pylori) eradication rates achieved with a proton pump inhibitor (PPI), amoxicillin and clarithromycin have recently decreased to about 75% because of the increase in clarithromycin resistance in Japan. In the present study, H. pylori resistance rates against clarithromycin, amoxicillin and metronidazole were investigated in pediatric patients and eradication rates were evaluated when tailored antibiotics regimens based on antibiotic sensitivity data were used. We isolated H. pylori endoscopically from 77 pediatric patients suffering from abdominal symptoms. The susceptibility tests of H. pylori strains to clarithromycin, amoxicillin and metronidazole were examined and eradication therapy was tailored using the appropriate antibiotics. Seventy-seven patients were treated with a mean age of 12.16 ± 3.34 years (range, 4.92-19.75) consisting of 40 males and 37 females. The average resistance rates between 1998 and 2016 to clarithromycin, amoxicillin and metronidazole were 54.5% (42 of 77), 6.5% (5 of 77) and 5.2% (4 of 77) respectively. The prevalence of clarithromycin resistance increased significantly over time to reach 88.9% by 2013-2016. Successful eradication rates using tailored antibiotic treatment was 93.8% (61 of 65). Clarithromycin-based eradication therapy rate reached 92.6% against clarithromycin-sensitive strains. Metronidazole-based initial eradication therapy also had a high successful rate (97.0%) to clarithromycin-resistant strains. Although high rates of clarithromycin resistant H. pylori reaching about 90% were observed in Japanese children, tailored eradication therapy using the appropriate antibiotic agents were highly successful. H. pylori sensitivity testing and eradication therapy with appropriate antibacterial agents may contribute to accomplishment of high initial eradication rates and consequently reducing the incidence of developing gastric cancer.

关键词： Resistance Eradication Rate Susceptibility Test Clarithromycin Metronidazole

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Influence of pulsed electric field on enzymes, bacteria and volatile flavor compounds of unpasteurized sake

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Plasma Science and Technology 2018年第4期20卷 51-56页

作者： Takamasa OKUMURA Taro YAEGASHI takahiro FUJIWARA Katsuyuki TAKAHASHI Koichi TAKAKI Tomo kudo Institute of Fluid Science Tohoku University Department of Systems Innovation Engineering Iwate University Washinoo Co. Ltd

A pulsed electric field(PEF) was applied to unpasteurized sake at constant temperatures, at which α-amylase was not inactivated. We adjusted the input energy to be identical for the temperatures by changing the number of PEF application, because the current significantly increased with the temperature, even the amplitude of the applied voltage was identical. As a result, the α-amylase was seemed to be inactivated by PEF application, not due to thermal *** glucoamylase was significantly inactivated by PEF. Moreover, the acid carboxypeptidase was inactivated by PEF at 4 °C but significantly activated at 25 °C. These results show that the sensitivity of enzyme to PEF application differs depending on the types of enzyme and treatment temperature. On the other hand, the colony number of bacteria was remarkably decreased, but the amount of the volatile flavor compounds was not decreased by PEF application.

关键词： pulsed electric field enzyme activity bacteria inactivation vulnerable molecules unpasteurized sake electroporation

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Maintenance treatment with infliximab for ulcerative ileitis after intestinal transplantation: A case report

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World Journal of Clinical Cases 2021年第19期9卷 5270-5279页

作者： Takumi Fujimura Yohei Yamada Tomoshige Umeyama Yumi kudo Hiroki Kanamori Teizaburo Mori takahiro Shimizu Mototoshi Kato Miho Kawaida Naoki Hosoe Yasushi Hasegawa Kentaro Matsubara Naoki Shimojima Masahiro Shinoda Hideaki Obara Makoto Naganuma Yuko Kitagawa Ken Hoshino Tatsuo Kuroda Department of Pediatric Surgery National Saitama HospitalWako ShiSaitama 351-0102Japan Department of Pediatric Surgery Keio University School of MedicineTokyo 160-8582Japan Department of Pathology Keio University School of MedicineTokyo 160-8582Japan Center for Diagnostic and Therapeutic Endoscopy Keio University School ofMedicineTokyo 160-8582Japan Department of Surgery Keio University School of MedicineTokyo 160-8582Japan Digestive Diseases Center International University of Health and WelfareMita HospitalTokyo 108-8329Japan Department of Gastroenterology and Hepatology Keio University School of MedicineTokyo 160-8582Japan

BACKGROUND Evidence has been published on the successful applications of the anti-tumor necrosis factor alpha antibody infliximab,such as induction therapy,salvage treatment for acute cellular rejection,and treatment for chronic ulcerative inflammation,in intestinal transplant ***,the optimal protocol for the effective use of infliximab remains largely undetermined due to scarcity of available clinical *** report a continuative application of infliximab as maintenance therapy for recurrent chronic ulcerative ileitis in a recipient of isolated intestinal transplantation(ITx).CASE SUMMARY The patient was a 11-year-old boy with intestinal motility disorder classified as a hypogenic type of intestinal *** patient underwent living-donor related intestinal *** immunosuppression regimen consisted of daclizumab,tacrolimus,and *** he did not show rejection while on tacrolimus monotherapy,routine screening endoscopy showed several ulcerative lesions in the distal end of the graft 2 years after the intestinal *** work up to evaluate the progression of anemia revealed stenosis with ulcerative inflammatory changes and multiple longitudinal ulcers in the *** the endoscopic findings suggested ulcerative lesions in Crohn’s disease,infliximab treatment was *** with infliximab and a small dose of oral prednisolone afforded successful withdrawal of total parenteral nutrition and maintenance of a well-functioning graft without infectious complications for 5 years since the administration of the first dose of *** Infliximab is effective as maintenance therapy for recurrent chronic ulcerative ileitis in an isolated ITx patient.

关键词： Intestinal transplantation Chronic ulcer Infliximab Crohn’s disease Tumor necrosis factor alpha Case report

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