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Laparoscopic total colectomy: Does the indication influence the outcome?

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World Journal of gastrointestinal Surgery 2011年第11期3卷 177-182页

作者： Eddy Cotte Faheez Mohamed Stéphane Nancey Yves Franois Olivier Glehen Bernard Flourié Jean-Christophe Saurin Gilles Poncet Department of digestive Surgery Centre Hospitalo-Universitaire Lyon Sud Hospices Civils de Lyon EA 3738 Université Claude Bernard Lyon1 Faculté de Médecine Lyon Sud Colorectal Research Unit Basingstoke and North Hampshire Foundation Trust Department of gastro-enterology Centre Hospitalo-Universitaire Lyon-Sud Hospices Civils de Lyon digestive Federation Centre Hospitalo-Universitaire Edouard Herriot Hospices Civils de Lyon

AIM: To assess and compare outcomes of laparoscopic total colectomy performed for a variety of indications. METHODS: Sixty six patients underwent laparoscopic total colectomy for inflammatory bowel disease (IBD) (13) and other diseases (53). Data on demographics, pre and post-operative outcomes were collected ***: Mean operative time was 4.5 h. Conversion rate was 13.6%. Total colectomy performed for IBD was associated with a signifi cantly higher anastomotic leak rate (23.1% vs 1.9%, P < 0.05). On univariate analysis, hand sewn anastomosis and treatment with more than 20 mg of prednisolone for at least 3 mo was associated with a higher anastomotic leak rate (P < 0.05). No signifi cant difference was found in return of gut function and overall morbidity between disease groups. CONCLUSION: Laparoscopic total colectomy is feasible and outcomes are equivalent whatever the indica- tion, except for anastomotic leak rate which is higher for patients with IBD.

关键词： Colectomy Inflammatory bowel disease Laparoscopy Familial adenomatous polyposis Constipation Colonic neoplasms Hereditary nonpolyposis Diverticulosis Treatment outcomes

Interferon-γ inhibits ghrelin expression and secretion via a somatostatin-mediated mechanism

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World Journal of gastroenterology 2011年第26期17卷 3117-3125页

作者： Jesper AB Strickertsson Kristina BV DΦssing Anna JM Aabakke Hans-Olof Nilsson Thomas VO Hansen Ulrich Knigge Andreas Kjr Torkel Wadstrm Lennart Friis-Hansen Genomic Medicine Department of Clinical BiochemistryRigshospitaletUniversity of Copenhagen Department of Basic Animal and Veterinary Sciences Faculty of Life SciencesUniversity of Copenhagen Department of Microbiology University of Lund Department of gastro-Intestinal Surgery RigshospitaletUniversity of Copenhagen Department of Clinical Physiology RigshospitaletUniversity of Copenhagen

AIM- To investigate if and how the proinflammatory cytokine interferon γ （IFNγ） affects ghrelin expression in mice. METHODS： The plasma concentration of ghrelin, and gastric ghrelin and somatostatin expression, were ex- amined in wild-type mice and mice infected with Helico- bacter pylori （H. pylorO. Furthermore, ghrelin expression was examined in two achlorhydric mouse models with varying degrees of gastritis due to bacterial overgrowth. To study the effect of IFNγ, alone, mice were given a subcutaneous infusion of IFNγ, for 7 d. Finally, the influ- ence of IFNγ, and somatostatin on the ghrelin promoter was characterized. RESULTS： H. py/ori infection was associated with a 50% reduction in ghrelin expression and plasma concentration. Suppression of ghrelin expression was in- versely correlated with gastric inflammation in achlorh- dyric mouse models. Subcutaneous infusion of IFNγ, suppressed fundic ghrelin mRNA expression and plasma ghrelin concentrations. Finally, we showed that the ghrelin promoter operates under the control of soma- tostatin but not under that of IFNγ. CONCLUSION： Gastric infection and inflammation is associated with increased IFNγ, expression and reduced ghrelin expression. IFNγ, does not directly control ghre- lin expression but inhibits it indirectly via somatostatin.

关键词： Ghrelin Interferon-γ Somatostatin Inflam-matory diseases He/icobacterpy/ori

Bone Mineral Density in Patients with Newly Diagnosed Inflammatory Bowel Disease: Frequency and Risk Factors in Tunisian Population. Results of a Prospective Study

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Open Journal of Rheumatology and Autoimmune diseases 2015年第4期5卷 126-130页

作者： Myriam Cheikh Taieb Jomni Wassila Bougassas Lamia Ben Yaghlène Mohamed Hedi Douggui Department of Hepato-gastro-Enterology Mongi Slim Hospital Tunis Tunisia Faculty of Medicine University of Tunis El Manar Tunis Tunisia Department of gastroenterology of the Internal Security Forces Hospital Tunis Tunisia

Background and Aims: Osteopenia and osteoporosis are frequently encountered with Inflammatory Bowel Disease (IBD). Our aims were to determine the prevalence of low bone mineral density (BMD) in patients with recently diagnosed IBD, and to assess predictive factors of reduced BMD. Patients and Methods: Prospective study conducted from January 2008 to December 2012 and involved patients with IBD treated in the Department of gastroenterology of the Internal Security Forces Hospital. The data collected included: age, gender, body mass index (BMI), diagnostic delay, disease activity, and disease localization. Laboratory findings included serum calcium, phosphate, albumin, hemoglobin, and C-reactive protein. BMD was assessed by dual energy X-ray absorptiometry (DEXA) of the lumber spine and femoral neck. According to WHO criteria, osteopenia was defined as a T-score between -1 and -2 SD, and osteoporosis as a T-score less than -2 SD. Results: A total of 34 patients (17 men, 17 women) were enrolled. Mean age was 37.1 ± 13.8 years (range 16 - 62). Twenty-two patients (65%) had Crohn’s disease (CD) and 12 patients (35%) had ulcerative colitis (UC). Mean BMI was 20.5 ± 4 kg/m2. Low BMD occurred in 50% of patients (12 CD, 5 UC). Thirteen patients (38.2%) exhibited osteopenia and 4 patients (10.8%) showed osteoporosis. Mean vertebral T-score was -0.933 ± 1.41 (range -4.1 to 1.7) and BMD in this site was 1.079 ± 0.17 g/cm2 (range 0.674 to 1.380). Mean femoral T-score was -0.398 ± 1.2 (range -3.1 to 2.4) and BMD in this site was 0.990 ± 0.173 g/cm2 (range 0.633 to 1.600). There was a positive correlation between T-score and albuminemia. Low BMI was found to be predictive factor of reduced BMD at the moment of IBD diagnosis. However, no correlation was found between BMD and the other studied variables (age, gender, smoking, history of fracture, disease location, duration of disease, activity, small bowel resection, serum calcium level, phosphate, C-reactive protein and hemoglobin)

关键词： Osteopenia Osteoporosis Bone Mineral Density Inflammatory Bowel Disease

Undernutrition, risk of malnutrition and obesity in gastroenterological patients: A multicenter study

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World Journal of gastrointestinal Oncology 2016年第7期8卷 563-572页

作者： Massimiliano Rizzi Silvia Mazzuoli Nunzia Regano Rosa Inguaggiato Margherita Bianco Gioacchino Leandro Elisabetta Bugianesi Donatella Noè Nicoletta Orzes Paolo Pallini Maria Letizia Petroni Gianni Testino Francesco William Guglielmi gastroenterology Unit San Nicola Pellegrino Hospital gastroenterology Unit I Saverio De Bellis IRCCS UCL Department of Liver and Digestive Health Division of gastro-Hepatogy Department of Medical Sciences University of Torino AIGOCommittee on Nutrition and Alcoholism Dietetics and Clinical Nutrition Unit S. Carlo Borromeo Hospital gastroenterology Unit S. Giovanni di Dio Hospital gastroenterology Unit Umberto I Hospital Nutritional and gastroenterological Unit IRCCS Alcoholism and Related Conditions Unit IRCCS-AOU S. Martino-IST

AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last threesix months. Values of Malnutrition Universal Screening Tool(MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment(MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases. RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition(OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients. CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment.

关键词： Obesity Malnutrition Risk of Malnutrition NRS2002 gastrointestinal disease

Monoclonal antibodies:Principles and applications of immmunodiagnosis and immunotherapy for hepatitis C virus

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World Journal of Hepatology 2015年第22期7卷 2369-2383页

作者： Ashraf Tabll Aymn T Abbas Sherif El-Kafrawy Ahmed Wahid Microbial Biotechnology Department (Biomedical Technology Group) Genetic Engineering and Biotechnology DivisionNational Research Centre Biotechnology Research Laboratories Gastro--eneterology Surgery CentreMansoura University Special Infectious Agents Unit King Fahd Medical Research CenterKing Abdulaziz University National Liver Institute Menoufia University Biochemistry Department Molecular and Cellular Biology UnitFaculty of PharmacyMinia University

Hepatitis C virus(HCV) is a major health problem worldwide. Early detection of the infection will help better management of the infected cases. The monoclonal antibodies(m Ab) of mice are predominantly used for the immunodiagnosis of several viral,bacterial,and parasitic antigens. Serological detection of HCV antigens and antibodies provide simple and rapid methods of detection but lack sensitivity specially in the window phase between the infection and antibody development. Human mA b are used in the immunotherapy of several blood malignancies,such as lymphoma and leukemia,as well as for autoimmune diseases. In this review article,we will discuss methods of mouse and human monoclonal antibody production. We will demonstrate the role of mouse mA b in the detection of HCV antigens as rapid and sensitive immunodiagnostic assays for the detection of HCV,which is a major health problem throughout the world,particularly in Egypt. We will discuss the value of HCV-neutralizing antibodies and their roles in the immunotherapy of HCV infections and in HCV vaccine development. We will also discuss the different mechanisms by which the virus escape the effect of neutralizing mA b. Finally,we will discuss available and new trends to produce antibodies,such as egg yolk-based antibodies(Ig Y),production in transgenic plants,and the synthetic antibody mimics approach.

关键词： Hepatitis C virus Monoclonal antibodies Immunodiag

Cirrhosis: Therapeutic Aspects and Outcome for Hospitalized Patients in Burkina Faso

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Open Journal of Epidemiology 2021年第2期11卷 152-162页

作者： Eric Nagaonlé Somé Félicité W. Nana Isabelle Télarpoa Lompo Drabo Maxime Roger Sombié Institut de Recherche en Sciences de la Santé (IRSS) Biomedical and Public Health Department Ouagadougou Burkina Faso Université Joseph Ki-Zerbo UFR des Sciences de la Santé Gastro-Enterology Department Ouagadougou Bukina Faso

Introduction: Cirrhosis represents 27.63% of the hepatobiliary diseases in Burkina Faso. We aimed at studying the therapeutic and evolutionary features of the cirrhosis. Patients and methods: We implemented a cross-sectional and descriptive study, collecting retrospectively the data from 1st January 2012 to 31st March 2014. The diagnosis of cirrhosis was based on 1) clinical criteria (an edema-ascitic syndrome with a heterogeneous hepatomegaly with a sharp inferior border or atrophic liver and a portal hypertension);2) biological criteria (a hepatocellular insufficiency syndrome);and 3) ultrasound imaging suggesting cirrhosis. Qualitative variables were presented as frequencies and percentages while quantitative ones were presented as means. Results: The data of 273 patients representing 33.9% of all hospitalizations were analyzed. The hepatobiliary diseases represented 74.7% of all diagnosis. The participants’ mean age was 46.9 years and the sex ratio, 2.7. The HBs antigen and anti-HCV antibodies were positive in 76.5% and 14.6% of the cases, respectively. Ascites was treated with puncture in 40.2% of patients, a salt-free diet (38.8%) and diuretics (54.2%). Hepatic encephalopathy was treated with lactulose in 73.6% of patients and two patients (1.3%) underwent esophageal varices ligation to treat their gastrointestinal bleeding. Lamivudine, tenofovir, and lamivudine-tenofovir combination were administered to 57.4%, 32.8%, and 10% of HBs Antigen positive patients, respectively. Conclusion: Cirrhosis still mostly affects the young and active male population at the gastro-enterology department of the university teaching hospital Yalgado Ouédraogo. Patients show up at a very advanced stage of the disease in poorly prepared health centres. In this context, prevention by the anti-hepatitis B immunization and early systematic screening

关键词： Cirrhosis Hepatitis B Virus Treatment Prognosis Sub-Saharan Africa

Periodontal treatment and microbiome-targeted therapy in management of periodontitis-related nonalcoholic fatty liver disease with oral and gut dysbiosis

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World Journal of gastroenterology 2023年第6期29卷 967-996页

作者： Ryutaro Kuraji Takahiko Shiba Tien S Dong Yukihiro Numabe Yvonne L Kapila Department of Periodontology The Nippon Dental University School of Life Dentistry at TokyoTokyo 102-0071Japan Department of Orofacial Sciences University of California San FranciscoSan FranciscoCA 94143United States Department of Oral Medicine Infectionand ImmunityHarvard School of Dental MedicineBostonMA 02115United States Department of Periodontology Tokyo Medical and Dental UniversityTokyo 113-8549Japan The Vatche and Tamar Manoukian Division of digestive diseases University of California Los AngelesDepartment of MedicineUniversity of California David Geffen School of MedicineLos AngelesCA 90095United States Department of Periodontology The Nippon Dental University School of Life Dentistry at TokyoTokyo 102-8159Japan Sections of Biosystems and Function and Periodontics Professor and Associate Dean of ResearchFelix and Mildred Yip Endowed Chair in DentistryUniversity of California Los AngelesLos AngelesCA 90095United States

A growing body of evidence from multiple areas proposes that periodontal disease,accompanied by oral inflammation and pathological changes in the microbiome,induces gut dysbiosis and is involved in the pathogenesis of nonalcoholic fatty liver disease(NAFLD).A subgroup of NAFLD patients have a severely progressive form,namely nonalcoholic steatohepatitis(NASH),which is characterized by histological findings that include inflammatory cell infiltration and *** has a high risk of further progression to cirrhosis and hepatocellular *** oral microbiota may serve as an endogenous reservoir for gut microbiota,and transport of oral bacteria through the gastro-intestinal tract can set up a gut microbiome *** dysbiosis increases the production of potential hepatotoxins,including lipopolysaccharide,ethanol,and other volatile organic compounds such as acetone,phenol and ***,gut dysbiosis increases intestinal permeability by disrupting tight junctions in the intestinal wall,leading to enhanced translocation of these hepatotoxins and enteric bacteria into the liver through the portal *** particular,many animal studies support that oral administration of Porphyromonas gingivalis,a typical periodontopathic bacterium,induces disturbances in glycolipid metabolism and inflammation in the liver with gut ***,also known as the hepatic phenotype of metabolic syndrome,is strongly associated with metabolic complications,such as obesity and *** disease also has a bidirectional relationship with metabolic syndrome,and both diseases may induce oral and gut microbiome dysbiosis with insulin resistance and systemic chronic inflammation *** this review,we will describe the link between periodontal disease and NAFLD with a focus on basic,epidemiological,and clinical studies,and discuss potential mechanisms linking the two diseases and possible therapeutic approaches focused on the *** conc

关键词： Periodontal disease Nonalcoholic fatty liver disease Microbiota Dysbiosis Metabolic syndrome Probiotics

Immunogenicity and mechanisms impairing the response to vaccines in inflammatory bowel disease

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World Journal of gastroenterology 2015年第40期21卷 11273-11281页

作者： Alicia C Marín Javier P Gisbert María Chaparro gastro- enterology Unit Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria PrincesaCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas28021 MadridSpain

Inflammatory bowel disease(IBD) is an immunological disorder that is usually treated with immunosuppressive therapy,potentially leading to increases in vulnerability to infections. Although many infections can be pre-vented by vaccination,vaccination coverage in these patients in clinical practice is insufficient. Therefore,the seroprotection condition should be verified,even for routine vaccines,such as hepatitis B or pneu-mococcus. Response to vaccines in IBD patients is thought to be impaired due to the immunological alterations generated by the disease and to the immunomodulatory treatments. The immunogenicity of hepatitis B,influenza,and pneumococcal vaccines is impaired in IBD patients,whereas the response to papillomavirus vaccine seems similar to that observed in the healthy population. On the other hand,data on the immunogenicity of tetanus vaccine in IBD patients are conflicting. Studies assessing the response to measles-mumps-rubella,varicella,and herpes zoster vaccines in IBD patients are scarce. The cellular and molecular mechanisms responsible for the impairment of the response to vaccination in IBD patients are poorly understood. Studies aiming to assess the response to vaccines in IBD patients and to identify the mechanisms involved in their immunogenicity are warranted. A better understanding of the immune response,specifically to vaccines,in patients with immune-mediated diseases(such as IBD),is crucial when developing vaccines that trigger more potent immunologic responses.

关键词： Crohn’s disease Inflammatory bowel disease Tumor n

Endoscopic techniques for diagnosis and treatment of gastroentero-pancreatic neuroendocrine neoplasms:Where we are

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World Journal of gastroenterology 2022年第26期28卷 3258-3273页

作者： Roberta Elisa Rossi Alessandra Elvevi Camilla Gallo Andrea Palermo Pietro Invernizzi Sara Massironi HPB Surgery Hepatology and Liver TransplantationENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale Tumori(INTNational Cancer Institute)Milan 20133Italy Division of gastroenterology and Center for Autoimmune Liver diseases Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy

BACKGROUND The correct localization of the primary tumor site and a complete histological diagnosis represent the milestones for the proper management of gastro-enteropancreatic neuroendocrine neoplasms(GEP-NENs).AIM To analyze current evidence on the role of endoscopy in the diagnosis/treatment of *** An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature(retrospective and prospective studies,systematic reviews,case series)published in the last 15 years,using both medical subject heading(MeSH)terms and free-language keywords:gastro-enteropancreatic neuroendocrine neoplasms;endoscopy;ultrasound endoscopy;capsule endoscopy;double-balloon enteroscopy;diagnosis;therapy;*** In the diagnostic setting,endoscopic ultrasonography(EUS)represents the diagnostic gold standard for pancreatic NENs and the technique of choice for the locoregional staging of gastric,duodenal and rectal *** diagnosis of small bowel NENs(sbNENs)has been improved with the advent of video capsule endoscopy and double-balloon enteroscopy,which allow for direct visualization of the entire small bowel;however,data regarding the efficacy/safety of these techniques in the detection of sbNENs are scanty and often *** a therapeutic point of view,endoscopic removal is the treatment of choice for the majority of gastric NENs(type 1/2),for well-differentiated localized nonmetastatic duodenal NENs<1 cm,confined to the submucosa layer and for<10 mm,stage T1–T2,rectal ***-guided pancreatic locoregional ablative treatments have been proposed in recent studies with promising results in order to control symptoms or reduce tumor burden in selected *** Standard axial endoscopy and EUS still play a pivotal role in several *** techniques for increasing the rate of R0 resection should be reserved for high-volume referral centers.

关键词： gastro-entero-pancreatic neuroendocrine neoplasms Endoscopy Ultrasound endoscopy Capsule endoscopy Double-balloon enteroscopy Diagnosis Therapy Staging