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Prevention of recurrence after surgery for Crohn's disease: Efficacy of infliximab

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World Journal of Gastroenterology 2010年第43期16卷 5405-5410页

作者： Takayuki Yamamoto Inflammatory Bowel Disease Center and Department of Surgery Yokkaichi Social Insurance Hospital

After surgery for Crohn's disease (CD), early endoscopic lesions are frequently observed despite no symptomatic recurrence. The severity of lesions found at postoperative endoscopy is reported to be a strong predictive factor for future clinical recurrence. If endoscopic lesions in the early postoperative period can be reduced with medications, symptomatic recurrence will likely be delayed and decreased. Before the introduction of biologic therapies, various medications were used for the maintenance of clinical remission after surgery; however, few demonstrated consistent efficacy. Infliximab is a recombinant anti-tumor necrosis factor-α antibody. Although infliximab is one of the most effective medications in the management of CD, its efficacy for early endoscopic lesions after surgery has not yet been assessed. The author and colleagues recently conducted a prospective study in order to investigate the impact of infliximab on early endoscopic lesions after resection for CD. We found that infliximab therapy showed clear suppressive effects on clinical and endoscopic disease activity in patients with early endoscopic lesions after resection.

关键词： Crohn’s disease Postoperative recurrence Endoscopic lesion Infliximab

Treating inflammatory bowel disease by adsorptive leucocytapheresis:A desire to treat without drugs

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World Journal of Gastroenterology 2014年第29期20卷 9699-9715页

作者： Abbi R Saniabadi Tomotaka Tanaka Toshihide Ohmori Koji Sawada Takayuki Yamamoto Hiroyuki Hanai Department of Pharmacology Hamamatsu University School of Medicine Department of Gastroenterology Akitsu Prefectural Hospital Ohmori Gastrointestinal Clinic Ikoma General and Gastroenterological Clinic Inflammatory Bowel Disease Centre Yokkaichi Social Insurance Hospital Hamamatsu South hospital

Ulcerative colitis and Crohn’s disease are the major phenotypes of the idiopathic inflammatory bowel disease (IBD), which afflicts millions of individuals throughout the world with debilitating symptoms, impairing function and quality of life. Current medications are aimed at reducing the symptoms or suppressing exacerbations. However, patients require life-long medications, and this can lead to drug dependency, loss of response together with adverse side effects. Indeed, drug side effects become additional morbidity factor in many patients on long-term medications. Nonetheless, the efficacy of anti-tumour necrosis factors (TNF)-α biologics has validated the role of inflammatory cytokines notably TNF-α in the exacerbation of IBD. However, inflammatory cytokines are released by patients’ own cellular elements including myeloid lineage leucocytes, which in patients with IBD are elevated with activation behaviour and prolonged survival. Accordingly, these leucocytes appear logical targets of therapy and can be depleted by adsorptive granulocyte/monocyte apheresis (GMA) with an Adacolumn. Based on this background, recently GMA has been applied to treat patients with IBD in Japan and in the European Union countries. Efficacy rates have been impressive as well as disappointing. In fact the clinical response to GMA seems to define the patients’ disease course, response to medications, duration of active disease, and severity at entry. The best responders have been first episode cases (up to 100%) followed by steroid naïve and patients with a short duration of active disease prior to GMA. Patients with deep ulcers together with extensive loss of the mucosal tissue and cases with a long duration of IBD refractory to existing medications are not likely to benefit from GMA. It is clinically interesting that patients who respond to GMA have a good long-term disease course by avoiding drugs including corticosteroids in the early st

关键词： Inflammatory bowel disease Myeloid lineage leucocytes Adsorptive granulocytes/monocytes apheresis Corticosteroid sparing effect Complement activation fragments Treating inflammatory bowel disease without drugs

Pericarditis and chronic inflammatory demyelinating polyneuropathy during therapy with pegylated interferon alfa-2a for chronic hepatitis C

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World Journal of Hepatology 2010年第9期2卷 358-361页

作者： Kazuaki Nishio Takeshi Konndo Shunichi Okada Machiko Enchi The Third Department of Internal Medicine School of Medicine Showa University Department of Neurology Toyoko HospitalSt.Marianna University Kawasaki social insurance hospital

We report a case of pericarditis and chronic inflam- matory demyelinating polyneuropathy with biological signs of a lupus-like syndrome due to pegylated interferon alfa-2a therapy during treatment for chronic hepatitis *** patient developed moderate weakness in the lower limbs and *** was hospitalized for congestive heart *** electrocardiogram showed gradual ST-segment elevation in leads V1 through V6 without coronary artery disease.A transthoracic cardiac ultrasonographic study revealed moderate pericardial effusion with normal left ventricular ***-DNA antibody and anti-ds DNA IgM were *** ro logical examination revealed a symmetrical predomina ntly sensory polyneuropathy with impairment of light touch and pin prick in globe and stoking-like *** with prednisolone improved the pericarditis and motor nerve disturbance and the treatment with intravenous immunoglobulin improved the sensory nerve disturbance.

关键词： Chronic hepatitis C Chronic inflammatory demyelinating polyneuropathy Peginterferon alfa-2a Pericarditis

Xanthogranulomatous cholecystitis mimicking gallbladder carcinoma with a false-positive result on fluorodeoxyglucose PET

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World Journal of Gastroenterology 2009年第29期15卷 3691-3693页

作者： Isamu Makino Takahiro Yamaguchi Nariatsu Sato Toshiaki Yasui Ichiro Kita Department of Surgery Kanazawa Social Insurance Hospital Kanazawa Ishikawa 920-8610 Japan

Recently, several reports have demonstrated that fluorine-18 fluorodeoxyglucose positron emission tomography （FDG-PET） is useful in differentiating between benign and malignant lesions in the gallbladder. However, there is a limitation in the ability of FDG-PET to differentiate between inflammatory and malignant lesions. We herein present a case of xanthogranulomatous cholecystitis misdiagnosed as gallbladder carcinoma by ultrasonography and computed tomography. FDG-PET also showed increased activity. In this case, FDG-PET findings resulted in a false-positive for the diagnosis of gallbladder carcinoma.

关键词： Fluorodeoxyglucose F18 Positron-emissiontomography Xanthogranulomatous cholecystitis Gallbladder cancer

Competences for a culture of prevention

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西安科技大学学报 2016年第5期36卷 741-749页

作者： BOLLMANN Ulrike Institute for Work and Health(IAG) of the German social Accident insurance(DGUV)

Work is changing. Traditional approaches to prevention fall short. A broader understanding of prevention and the cultural transformation associated with it mean that there are new demands on companies and their employees. People and organisations need competences for this transformation; they must be empowered to create humane living and working conditions. In order for people and organisations to be able to develop competences for the transformation,appropriate structural conditions in educational institutions and workplaces must be created. These conditions should enable people to experience a feeling of competence,to feel part of something and to perceive their actions as autonomous.

关键词：教育机构文化转型工作条件文化事业

Surgery for luminal Crohn's disease

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World Journal of Gastroenterology 2014年第1期20卷 78-90页

作者： Takayuki Yamamoto Toshiaki Watanabe Inflammatory Bowel Disease Center and Department of Surgery Yokkaichi Social Insurance HospitalMie 510-0016Japan Department of Surgical Oncology The University of TokyoHongoTokyo 113-0033Japan

Many patients with Crohn’s disease (CD) require surgery. Indications for surgery include failure of medical treatment, bowel obstruction, fistula or abscess formation. The most common surgical procedure is resection. In jejunoileal CD, strictureplasty is an accepted surgical technique that relieves the obstructive symptoms, while preserving intestinal length and avoiding the development of short bowel syndrome. However, the role of strictureplasty in duodenal and colonic diseases remains controversial. In extensive colitis, after total colectomy with ileorectal anastomosis (IRA), the recurrence rates and functional outcomes are reasonable. For patients with extensive colitis and rectal involvement, total colectomy and end-ileostomy is safe and effective; however, a few patients can have subsequent IRA, and half of the patients will require proctectomy later. Proctocolectomy is associated with a high incidence of delayed perineal wound healing, but it carries a low recurrence rate. Patients undergoing proctocolectomy with ileal pouch-anal anastomosis had poor functional outcomes and high failure rates. Laparoscopic surgery has been introduced as a minimal invasive procedure. Patients who undergo laparoscopic surgery have a more rapid recovery of bowel function and a shorter hospital stay. The morbidity also is lower, and the rate of disease recurrence is similar compared with open procedures.

关键词： Crohn’ s disease, Laparoscopic surgery, Resection, Strictureplasty, Surgery

Viral Monitoring and Prevalence of Viral Failure in HIV-1 Infected Children under First Line Antiretroviral Therapy during the First 60 Months of Treatment in Yaoundé, Cameroon: A Serial Cross Sectional Analysis

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Open Journal of Pediatrics 2016年第1期6卷 69-74页

作者： Anne Esther Njom Nlend Sidonie Lyeb Suzie Tetang Ndiang Moyo Annie Nga Motaze National social insurance Fund hospital Department of Pediatrics Cameroon

Objective: The objective was to measure the prevalence of viral failure (VF) in HIV-1-infected children on first-line antiretroviral therapy (ART) in routine practice. Methods: Serial cross sectional analysis of viral load (VL) in HIV-1 infected children on first-line ART for ≥24 weeks was done. VL was measured by Real-Time-Polymerase chain reaction (biocentrics). Samples were collected at 6, 12, 24, 36, 48, 60 months of treatment. Main measurement: Virological failure (VF) defined by a one-off VL > 1000 copies/ml. Results: 375 children aged ≤16 years on first-line-ART were included. Median age at ART start was 4.2 years and ≥50% have started ART ≤3rd birthday. A total of 717 measurements of VL were collected. VF was rated between 18% and 26% from 6 - 60 months (mean 20.2%), 95% IC [13.1 - 27.3] at the threshold of 1000 copies/ml, not too different at the threshold of 400 copies/ml, 21% - 30% (mean 23.9%), 95% IC [16.3 - 31.5], p = 0.9. Conclusion: In Yaounde, almost 20% of children on first-line of adherent-ART can experiment VF while improving immune status urging improvement of adherence.

关键词： HIV Viral Failure Antiretroviral Therapy Children

Effect of G-CSF and TPO on HIBD in neonatal rats

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Asian Pacific Journal of Tropical Medicine 2015年第2期8卷 132-136页

作者： Xue-Mei Liu Yi Feng Ai-Min Li Department of Pediatrics Affiliated Yantai Yuhuangding Hospital of Qingdao University Medical College Medical insurance Office of Yantai Zhifu hospital

Objective:To observe effect of granulocyte colony-stimulating factor(G-CSF) and restructure human thrombopoietin on hypoxic-ischemic brain damage(HIBD) in new born ***:A total of 60 neonatal SD rats were selected and divided into 4 groups,with 15 in each *** A served as control *** of Groups B-D were prepared for HIBD model by ligation of left common carotid artery combined with hypoxia *** of Group A were only completed with free left common carotid artery without ligation and hypoxia *** HIBD model preparation,Group B was administrated with subcutaneous injection of normal saline for placebo treatment;Group C was administrated with cervical subcutaneous injection of 0.5 μg/10 g granulocyte colony stimulating factor(G-CSF) for 5 d(Once a day);Group D was administrated with intraperitoneal injection of 15 U/10 g recombinant human thromobopoietin(rhTPO) for *** modeling for 7,14 and 21 d,5 rate were sacrificed in each group,*** quality damage(%) conditions of experimental animals in each group were compared in different time points,and cerebral histopathological changes of each group were *** of nestin in rats of each group was detected by immunohistochemical ***:After modeling for 7,14 and 21 d,brain quality damages(%) of Groups B,C and D were significant higher than that of in Group A(P<0.05),while brain quality damage(%) degree of Group B was the highest in different time points,followed by Groups D and C,*** was significant different compared among groups(P<0.05).The histopathological observation showed that degrees of brain damages in Groups C and D were significant lower than that of in Group *** modeling for 7,14 and 21 d,nestin positive cell populations in Groups B,C,and D were significant higher than Group A(P<0.05).Nestin cell populations of Group C in different time points were significant higher than Groups B and D(P<0.05).There was no signifi

关键词： G-CSF TPO BHID Neonatal rats Nestin

Impaction of a lithotripsy basket during endoscopic lithotomy of a common bile duct stone

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World Journal of Gastroenterology 2010年第22期16卷 2832-2834页

作者： Nobutada Fukino Takatsugu Oida Atsushi Kawasaki Kenji Mimatsu Youichi Kuboi Hisao Kano Sadao Amano Department of Surgery Social Insurance Yokohama Central Hospital Department of Surgery Nihon University School of Medicine

The treatments for common bile duct (CBD) stones are being continually developed. Impaction of the lithotripsy basket during endoscopic removal of CBD stones was seen in 5.9% patients. We report the case of a 66-yearold woman who underwent surgery for the removal of an impacted biliary basket. She was admitted to our hospital with a complaint of right upper abdominal pain. Magnetic resonance cholangiopancreatography revealed a CBD stone (20 mm × 15 mm). We diagnosed her with choledocholithiasis and performed endoscopic retrograde cholangiopancreatography to remove the stone. However, unfortunately, the retrievable basket around the stone became impacted. An endotriptor along with forceps could not be used owing to the entrapment of the basket, and thus we performed urgent surgery. The basket containing the stone was removed through a longitudinal choledochotomy. The wires leading to the basket were cut, and the basket containing the stone was removed via the incision. A T-tube was inserted,and the choledochotomy was closed. The postoperative course was uneventful. In conclusion, if the diameter of a CBD stone is more than 20 mm, then the risk of basket impaction increases, and surgery may be necessary as the initial treatment of the CBD stone.

关键词： Common bile duct gallstones Impacted biliary basket Lithotripsy